1
|
Pajula S, Vuoristo M, Koljonen V. Improving access and evaluation for body contouring surgery in massive weight loss patients with unified, public guidelines. J Plast Reconstr Aesthet Surg 2023; 87:200-202. [PMID: 37890337 DOI: 10.1016/j.bjps.2023.10.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Affiliation(s)
- Susanna Pajula
- Department of Plastic and General Surgery, University Hospital of Turku, Finland.
| | - Mikko Vuoristo
- Department of Plastic Surgery, University Hospital of Helsinki, Finland
| | - Virve Koljonen
- Department of Plastic Surgery, University Hospital of Helsinki, Finland
| |
Collapse
|
2
|
Law TJ, Stephens D, Wright JG. Surgical wait times and socioeconomic status in a public healthcare system: a retrospective analysis. BMC Health Serv Res 2022; 22:579. [PMID: 35488331 PMCID: PMC9051767 DOI: 10.1186/s12913-022-07976-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/18/2022] [Indexed: 11/27/2022] Open
Abstract
Background One aim of publicly-funded health care systems is to provide equitable access to care irrespective of ability to pay. At the same time, differences in socioeconomic status (SES) are associated with health outcomes and access to care, including waiting times for surgery. In public systems where both high- and low-SES patients use the same resources, low-SES patients may be adversely impacted in surgical waiting times. The purpose of this study was to determine whether a publicly-funded health system can provide equitable access to surgical care across socioeconomic status. Methods Patient-level records were obtained from a comprehensive provincially-administered surgical wait time database, encompassing years 2006–2015 and 98% of Ontario hospitals. Patient SES was determined by linking postal code with the Material and Social Deprivation Index. Surgical waiting times (time in days between decision to treat and surgery) accounted for patient-initiated delays in treatment, and regression analysis considered age, SES, rurality, sex, priority level for surgical urgency (assigned by surgeons), surgical subspecialty, number of visits, and procedure year. Results For the 4,253,305 surgical episodes, the mean wait time was 62.3 (SD 75.4) days. Repeated measures least squares regression analysis showed the least deprived SES quintile waited 3 days longer than the most deprived quintile. Wait times dropped in the initial study period but then increased. The proportion of procedures exceeding wait time access targets remained low at 11–13%. Conclusions The least deprived SES quintile waited the longest, although the absolute difference was small. This study demonstrates that publicly-funded healthcare systems can provide equitable access to surgical care across SES.
Collapse
Affiliation(s)
- Tyler J Law
- Center for Health Equity in Surgery and Anesthesia, University of California, San Francisco, USA. .,Department of Anesthesia & Periopative Care, University of California, San Francisco, USA. .,Zuckerberg San Francisco General Hospital, San Francisco, USA.
| | - Derek Stephens
- Department of Biostatistics, University of Toronto, Toronto, Canada.,The Hospital for Sick Children, Toronto, Canada
| | - James G Wright
- Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK.,Ontario Medical Association, Toronto, Canada
| |
Collapse
|
3
|
An X, Xiao L, Yang X, Tang X, Lai F, Liang XH. Economic burden of public health care and hospitalisation associated with COVID-19 in China. Public Health 2022; 203:65-74. [PMID: 35032917 PMCID: PMC8754688 DOI: 10.1016/j.puhe.2021.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/10/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study aimed to evaluate the socio-economic burden imposed on the Chinese healthcare system during the coronavirus disease 2019 (COVID-19) pandemic. STUDY DESIGN A cross-sectional study was used to investigate how COVID-19 impacted health and medical costs in China. Data were derived from a subdivision of the Centers for Disease control and Prevention of China. METHODS We prospectively collected information from the Centers for Disease Control and Prevention and the designated hospitals to determine the cost of public health care and hospitalisation due to COVID-19. We estimated the resource use and direct medical costs associated with public health. RESULTS The average costs, per case, for specimen collection and nucleic acid testing (NAT [specifically, polymerase chain reaction {PCR}]) in low-risk populations were $29.49 and $53.44, respectively; however, the average cost of NAT in high-risk populations was $297.94 per capita. The average costs per 1000 population for epidemiological surveys, disinfectant, health education and centralised isolation were $49.54, $247.01, $90.22 and $543.72, respectively. A single hospitalisation for COVID-19 in China cost a median of $2158.06 ($1961.13-$2325.65) in direct medical costs incurred only during hospitalisation, whereas the total costs associated with hospitalisation of patients with COVID-19 were estimated to have reached nearly $373.20 million in China as of 20, May, 2020. The cost of public health care associated with COVID-19 as of 20, May, 2020 ($6.83 billion) was 18.31 times that of hospitalisation. CONCLUSIONS This study highlights the magnitude of resources needed to treat patients with COVID-19 and control the COVID-19 pandemic. Public health measures implemented by the Chinese government have been valuable in reducing the infection rate and may be cost-effective ways to control emerging infectious diseases.
Collapse
Affiliation(s)
- X An
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - L Xiao
- Disease Control and Prevention Center of Jiulongpo District, Chongqing, China
| | - X Yang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - X Tang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - F Lai
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiao-Hua Liang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
| |
Collapse
|
4
|
Sævareid TJL, Pedersen R, Magelssen M. Positive attitudes to advance care planning - a Norwegian general population survey. BMC Health Serv Res 2021; 21:762. [PMID: 34334131 PMCID: PMC8327435 DOI: 10.1186/s12913-021-06773-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 07/19/2021] [Indexed: 12/02/2022] Open
Abstract
Background Authorities recommend advance care planning and public acceptance of it is a prerequisite for widespread implementation. Therefore, we did the first study of the Norwegian public with an aim of getting knowledge on their attitudes to issues related to advance care planning. Methods An electronic survey to a nationally representative web panel of Norwegian adults. Results From 1035 complete responses (response rate 40.7%), we found that more than nine out of ten of the general public wanted to participate in advance care planning, believed it to be useful for many, and wanted to make important healthcare decisions themselves. Almost nine out of ten wanted to be accompanied by next of kin during advance care planning. Most (69%) wanted health care personnel to initiate advance care planning and preferred it to be timed to serious illness with limited lifetime (68%). Only about 9% stated that health care personnel should have the final say in healthcare decisions in serious illness. Conclusions Developing and implementing advance care planning as a public health initiative seems warranted based on the results of this study. Patient perspectives should be promoted in decision-making processes. Nevertheless, training of health care personnel should emphasise voluntariness and an individual approach to initiating, timing and conducting advance care planning because of individual variations.
Collapse
Affiliation(s)
| | - Reidar Pedersen
- Centre for Medical Ethics, University of Oslo, Kirkeveien 166, Frederik Holsts hus, 0450, Oslo, Norway
| | - Morten Magelssen
- Centre for Medical Ethics, University of Oslo, Kirkeveien 166, Frederik Holsts hus, 0450, Oslo, Norway
| |
Collapse
|
5
|
Farrés A, Albarracín A, Serra B, Prats P. Cesarean rate in selected hospital network of private sector: A retrospective study. J Healthc Qual Res 2021; 36:317-323. [PMID: 34353772 DOI: 10.1016/j.jhqr.2021.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/08/2021] [Accepted: 06/23/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION In Spain over the last two decades, cesarean section (CS) rates have increased from 15 to 25% in the Public Health Sector and from 28 to 38% in the private sector. There are multiples causes for this rise, which are often unclear. The aim of our study is to collect and analyze all the CS rates data from a hospital network of the 42 Quirónsalud Hospitals (private sector) and to assess its distribution regarding the different types of hospitals and patient characteristics. MATERIAL AND METHODS An observational retrospective study between 2017 and 2018 was performed. Hospitals are classified into three groups: large hospitals (11), medium hospitals (17) and small hospitals (14). The cesarean section rate was measured by patient categorization into three groups: total deliveries, low risk cesarean sections and low risk cesarean sections without previous cesarean delivery. RESULTS We analyzed 62,685 deliveries: 42,987 were vaginal deliveries (68.6%) and 19,698 CS (31.4%). The mean age for the total number of deliveries was 34.18 years old, whilst the mean age for the low-risk group was 34.12. Of the 19,698 CS, 18.36% (3618) were in high-risk population and 81.63% (16,080) in low risk population. 69.54% (11,183) of the low-risk CS were in patients without a previous CS. CONCLUSIONS The overall rate of CS in the Quirónsalud group is slightly higher than the one from the Public Healthcare. The older maternal age as well as the hospital resources involved in the delivery attendance can explain this difference.
Collapse
Affiliation(s)
- A Farrés
- Obstetrics Service, Department of Obstetrics, Gynecology and Reproductive Medicine, Institut Universitari Quiron Dexeus, Barcelona, Spain.
| | - A Albarracín
- Planning and Healthcare Evaluation Department, Quirónsalud Grupo Hospitalario, Madrid, Spain
| | - B Serra
- Obstetrics Service, Department of Obstetrics, Gynecology and Reproductive Medicine, Institut Universitari Quiron Dexeus, Barcelona, Spain
| | - P Prats
- Obstetrics Service, Department of Obstetrics, Gynecology and Reproductive Medicine, Institut Universitari Quiron Dexeus, Barcelona, Spain
| |
Collapse
|
6
|
Sato N, Fujita K, Kushida K, Chen TF. Exploring the factors influencing the quality of "Health Support Pharmacy" services in Japan: Perspectives of community pharmacists. Res Social Adm Pharm 2020; 16:1686-1693. [PMID: 32147461 DOI: 10.1016/j.sapharm.2020.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 02/05/2020] [Accepted: 02/19/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Internationally, community pharmacists play a key role in public health services. In Japan, a new system called Health Support Pharmacy (HSP) was introduced in 2016, to promote responsible self-medication with non-prescription medicines and increase awareness of public health activities provided through community pharmacies. The number of HSP services provided has been increasing; however, the service quality varies depending on pharmacies and/or pharmacists. Thus, it is important to identify factors that influence HSP service quality. OBJECTIVE To identify factors that can impact on the quality of HSP services provided by community pharmacists in Japan. METHODS In-depth semi-structured online interviews were conducted with twenty-four community pharmacists from across Japan. Interviews were audio-recorded, transcribed verbatim, and thematically analysed. All themes identified were deductively categorised into 3 domains using Donabedian's framework of structure, process and outcome. RESULTS Participants identified 8 key themes and 23 sub-themes pertaining to the quality of pharmacy public health services. For the structure domain these were: adequate resources, professional expertise, and policy and procedures. For the process domain these were: provision of individual services, provision of community health education and other events, and collaboration with other professionals. For the outcome domain these were: impact on individuals and the general public, and impact on other professionals. CONCLUSIONS This study identified factors which can impact HSP service quality by community pharmacists in Japan. Whilst the major themes identified align with those reported in other studies pertaining to expanded roles for community pharmacists, this study also identified findings which appear to be unique to the Japanese context. These findings, based on Donabedian's framework, may be used to better understand the scope and quality of HSP services delivered in Japan.
Collapse
Affiliation(s)
- Noriko Sato
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Camperdown, New South Wales, 2006, Australia.
| | - Kenji Fujita
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Camperdown, New South Wales, 2006, Australia.
| | - Kazuki Kushida
- Showa Pharmaceutical University, Faculty of Pharmacy, Tokyo, 194-8543, Japan.
| | - Timothy F Chen
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Camperdown, New South Wales, 2006, Australia.
| |
Collapse
|
7
|
Nishijima M, Sarti FM, Vodenska I, Zhang G. Effects of decentralization of primary health care on diabetes mellitus in Brazil. Public Health 2018; 166:108-120. [PMID: 30476779 DOI: 10.1016/j.puhe.2018.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/07/2018] [Accepted: 10/03/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the effects of primary healthcare decentralization on type 2 diabetes mellitus mortality and morbidity in different municipalities of a developing country. STUDY DESIGN This was a retrospective study based on a panel of annual data from 5560 Brazilian municipalities from 2000 to 2011. METHODS The investigation used the staggered municipal adoption of a federal health information program as a quasi-experiment to identify the treatment effects of health decentralization on diabetes indicators. Using Difference-in-Differences models and instrumental variables, we analyzed the effects of primary healthcare decentralization on diabetes rates (i.e. diabetes deaths and hospitalizations by the number of people with a diabetes diagnosis and by population). RESULTS Evidence suggests improvements in universal access to primary health care and progress in the average health outcomes related to diabetes mortality (reduction of 30%) and hospitalization (reduction of 2.3%) due to decentralization. Effects are further pronounced in developed regions with higher incomes, while the poorest and less developed regions showed virtually no effect. CONCLUSIONS These results demonstrate that there are particular preconditions for successful primary health decentralization, especially related to returns of scale (big health facilities are associated with low cost per treatment), lack of human and physical capital, and government coordination problems.
Collapse
Affiliation(s)
| | | | - I Vodenska
- Metropolitan College, Boston University, USA
| | - G Zhang
- Metropolitan College, Boston University, USA
| |
Collapse
|
8
|
Llobera J, Sansó N, Ruiz A, Llagostera M, Serratusell E, Serrano C, Roselló MLM, Benito E, Castaño EJ, Leiva A. Strengthening primary health care teams with palliative care leaders: protocol for a cluster randomized clinical trial. BMC Palliat Care 2017; 17:4. [PMID: 28693520 PMCID: PMC5504625 DOI: 10.1186/s12904-017-0217-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 06/23/2017] [Indexed: 12/12/2022] Open
Abstract
Background The objective of the Balearic Islands Palliative Care (PC) Program is to improve the quality of PC through a shared model consisting of primary health care professionals, home-based PC teams, and PC units in hospitals. According to the World Health Organization (WHO), patients with advanced cancer and other terminal diseases benefit from early identification and proactive PC. We will evaluate the effectiveness of an intervention in which a PC leader is established in the primary health care center, and assess the effect of this intervention on the early identification of patients in need of PC, the efficient use of health care services, and direct health care costs. Methods Design: A two-arm cluster randomized clinical trial of 30 Primary Health Care Centers (PHCC) in Mallorca (Spain), in which each center was randomized to an intervention arm or a usual care arm. We expect that the number of patients identified as suitable for PC (including non-oncological PC) is at least 5% greater in the intervention arm. Sample size: A total of 4640 deceased patients. Outcomes will be assessed by a blinded external review of the electronic records. Interventions: General practitioners (GPs) and nurse leaders in PC for each PHCC will be appointed. These leaders will help promote PC training of colleagues, improve symptom management and psychological support of patients, and evaluate the complexity of individual cases so that these cases receive assistance from PC home-based teams. Measurements: Early identification (>90 days before death), evaluation of case complexity, level of case complexity (with referral to a home-based PC team), use and cost of hospital and primary care services, and quality of life during the last month of life (≥2 emergency room visits, ≥2 hospital admissions, ≥14 days of hospitalization). Discusion PC leaders in primary care teams will improve the early identification of patients eligible for PC. This initiative could improve the quality of end-of-life care and utilization of hospital resources. Trial registration ISRCTN Registry identifier: ISRCTN92479122. Retrospectively registered on 28 February 2017.
Collapse
Affiliation(s)
- Joan Llobera
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, 07005, Palma, Spain.,Instituto de Investigación Sanitaria de Palma (IdISPa), 07010, Palma, Spain
| | - Noemí Sansó
- Department of Nursing and Physiotherapy, University of Balearic Islands, Valldemossa road 7,5 Km, 07122, Palma, Spain.
| | - Amador Ruiz
- Sta Catalina Health care centre, Baleares Health Services-IbSalut, Camí de son Cladera 6, 07009, Palma, Spain
| | - Merce Llagostera
- Equipo de Soporte a la Atención Domiciliaria Mallorca (ESAD-Mallorca), Baleares Health Services-IbSalut, UBS Es Molinar, c/ Guayaquil 9, Palma, Spain
| | | | - Carlos Serrano
- Equipo de Soporte a la Atención Domiciliaria Mallorca (ESAD-Mallorca), Baleares Health Services-IbSalut, UBS Es Molinar, c/ Guayaquil 9, Palma, Spain
| | | | - Enric Benito
- Balearic Islands Palliative Care Regional Program, Baleares Health Services-IbSalut, C/ Jesús 40, 07010, Palma, Spain
| | - Eusebio J Castaño
- Service of Health Planning of the Health counseling of the Government of the Balearic Islands, Plaza España 9, 07002, Palma de Mallorca, Islas Baleares, Spain
| | - Alfonso Leiva
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, 07005, Palma, Spain.,Instituto de Investigación Sanitaria de Palma (IdISPa), 07010, Palma, Spain
| |
Collapse
|
9
|
Caires ELP, Bezerra MC, Junqueira AFTDA, Fontenele SMDA, Andrade SCDA, d'Alva CB. Treatment of postmenopausal osteoporosis: a literature-based algorithm for use in the public health care system. Rev Bras Reumatol Engl Ed 2017; 57:254-263. [PMID: 28535898 DOI: 10.1016/j.rbre.2017.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 12/05/2016] [Indexed: 06/07/2023] Open
Abstract
Bisphosphonates are considered first-line agents in the treatment of postmenopausal osteoporosis based on extensive experience of use, safety, and proven efficacy in reducing vertebral, non-vertebral and femur fractures. However, post-marketing reports based on the treatment of millions of patients/year over lengthy periods of time have revealed the occurrence of initially unexpected adverse effects, such as osteonecrosis of the jaw and atypical femoral fracture, leading to the restriction of treatment duration with bisphosphonates by global regulatory agencies. However, despite the association between these effects and bisphosphonates, this risk should be analyzed in the context of osteoporosis treatment, alongside the benefit of preventing osteoporotic fractures and their clinical consequences. Therefore, we consider it plausible to discuss the restriction to the use of bisphosphonates, possible indications for prolonged treatment and alternative therapies following the suspension of this drug class for patients with persistent high risk of fracture after initial treatment, especially considering the problems of public health funding in Brazil and the shortage of drugs provided by the government. Thus, to standardize the treatment of osteoporosis in the public health care system, we aim to develop a proposal for a scientifically-based pharmacological treatment for postmenopausal osteoporosis, establishing criteria for indication and allowing the rational use of each pharmacological agent. We discuss the duration of the initial bisphosphonate treatment, the therapeutic options for refractory patients and potential indications of other classes of drugs as first-choice treatment in the sphere of public health, in which assessing risk and cost effectiveness is a priority.
Collapse
Affiliation(s)
- Ellen Luz Pereira Caires
- Universidade Federal do Ceará (UFC), Faculdade de Medicina, Serviço de Endocrinologia e Diabetes, Fortaleza, CE, Brazil
| | - Mailze Campos Bezerra
- Universidade Federal do Ceará (UFC), Faculdade de Medicina, Serviço de Reumatologia, Fortaleza, CE, Brazil; Universidade Federal do Ceará (UFC), Faculdade de Medicina, Núcleo de Atendimento Multidisciplinar às Doenças Osteometabólicas, Fortaleza, CE, Brazil
| | - Ana Flávia Torquato de Araújo Junqueira
- Universidade Federal do Ceará (UFC), Faculdade de Medicina, Serviço de Endocrinologia e Diabetes, Fortaleza, CE, Brazil; Universidade Federal do Ceará (UFC), Faculdade de Medicina, Núcleo de Atendimento Multidisciplinar às Doenças Osteometabólicas, Fortaleza, CE, Brazil
| | - Sheila Márcia de Araújo Fontenele
- Universidade Federal do Ceará (UFC), Faculdade de Medicina, Serviço de Reumatologia, Fortaleza, CE, Brazil; Universidade Federal do Ceará (UFC), Faculdade de Medicina, Núcleo de Atendimento Multidisciplinar às Doenças Osteometabólicas, Fortaleza, CE, Brazil
| | - Silvana Cristina de Albuquerque Andrade
- Universidade Federal do Ceará (UFC), Faculdade de Medicina, Núcleo de Atendimento Multidisciplinar às Doenças Osteometabólicas, Fortaleza, CE, Brazil; Universidade Federal do Ceará (UFC), Faculdade de Medicina, Serviço de Nefrologia e Transplante Renal, Fortaleza, CE, Brazil
| | - Catarina Brasil d'Alva
- Universidade Federal do Ceará (UFC), Faculdade de Medicina, Serviço de Endocrinologia e Diabetes, Fortaleza, CE, Brazil; Universidade Federal do Ceará (UFC), Faculdade de Medicina, Núcleo de Atendimento Multidisciplinar às Doenças Osteometabólicas, Fortaleza, CE, Brazil.
| |
Collapse
|
10
|
Abstract
Purpose This study aims to take a discursive view on positive leadership (PL). A positive approach has gained momentum in recent years as appropriate leadership practices are implemented in organizations. Despite the turn toward discursive approaches in organization studies, there is insufficient evidence supporting PL as a socially constructed experience. Design/methodology/approach The present study addresses an integrative discourse perspective for capturing the PL concept as a social process within the public health-care context. Findings Four meanings of PL are highlighted: role-taking, servicing, balancing and deciphering. Research limitations/implications The meanings shift the emphasis of certain PL definitions to a contextual interpretation. For scholars, the perspective demonstrates a multidimensional process approach in the desired organizational context as a counterbalance to one unanimously agreed-upon PL definition. Practical implications For leaders, an integrative discourse perspective offers tools for comprehending PL as a process: how to identify, negotiate and reconcile various PL meanings. Originality/value An integrative discourse perspective provides a novel perspective capturing the PL concept within the public health-care field.
Collapse
Affiliation(s)
- Ville Pietiläinen
- Faculty of Social Sciences, University of Lapland , Rovaniemi, Finland
| | - Ilkka Salmi
- Faculty of Social Sciences, University of Lapland , Rovaniemi, Finland
| |
Collapse
|
11
|
Wu TT. Using smart mobile devices in social-network-based health education practice: a learning behavior analysis. Nurse Educ Today 2014; 34:958-963. [PMID: 24568697 DOI: 10.1016/j.nedt.2014.01.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 01/20/2014] [Accepted: 01/31/2014] [Indexed: 06/03/2023]
Abstract
Virtual communities provide numerous resources, immediate feedback, and information sharing, enabling people to rapidly acquire information and knowledge and supporting diverse applications that facilitate interpersonal interactions, communication, and sharing. Moreover, incorporating highly mobile and convenient devices into practice-based courses can be advantageous in learning situations. Therefore, in this study, a tablet PC and Google+ were introduced to a health education practice course to elucidate satisfaction of learning module and conditions and analyze the sequence and frequency of learning behaviors during the social-network-based learning process. According to the analytical results, social networks can improve interaction among peers and between educators and students, particularly when these networks are used to search for data, post articles, engage in discussions, and communicate. In addition, most nursing students and nursing educators expressed a positive attitude and satisfaction toward these innovative teaching methods, and looked forward to continuing the use of this learning approach.
Collapse
Affiliation(s)
- Ting-Ting Wu
- Department of Information Management, Chia-Nan University of Pharmacy and Science, No. 60, Sec. 1, Erren Rd., Rende Dist. Tainan City 71710, Taiwan.
| |
Collapse
|