Seeking to Understand Telephone Support for Dementia Caregivers

Caregivers of persons with dementia encounter particular challenges in their roles and often experience unmet needs for information and emotional support. This article describes a qualitative descriptive study designed to explore the intervention of telephone support for such caregivers. Data were collected from both caregivers and telephone support providers. Results revealed that telephone support met four specific needs of dementia caregivers: the need for (a) information and education, (b) referral and/or assistance required to navigate through the system, (c) emotional support, and (d) caregiver support that is convenient and hassle free. Caregivers’ main experience with the intervention was the sense of companionship, whereas service providers experienced mixed feelings of helplessness and an opportunity to empower caregivers.

Disaster Intervention: Long-term Psychosocial Benefits in Armenia

This paper describes a unique situation in which disaster intervention following a massive earthquake led to significant, uninterrupted, psychosocial benefits to the entire country, and an intervention program that continues to evolve. The mental health program initially provided service to the victims, and then, training to local professionals during which personnel simultaneously conducted clinical research. Members of the mental health team made a life-long commitment to the country, and continue their activities to expand its impact on public health policy. The difficult history and life circumstances of the Armenian people provided the opportunity for disaster interventions to have extensive psychosocial benefits.

[Annual "Door Knock" Fundraising Campaign Jubilee--for the patients and against the disease]

Marking the annual "Door Knock" Fundraising Campaign Jubilee, this article provides an overview of the Israel Cancer Association (ICA) activity for patients and against the disease, that comply with the principles of the World Cancer Declaration (WCD) of the UICC (Union for International Cancer Control). To elucidate, as a voluntary organization, all of ICA's resources are derived exclusively from public contributions--with no funding from the government budget. This independence enables ICA to operate according to strictly professional criteria, while maintaining a global and national point of view and vision. ICA activity will be presented with respect to the international treaty, from monitoring the disease at the national level, to activity to promote research, prevention methods, early detection, enhancing treatment modalities and rehabilitation, and maintaining quality of life for patients and survivors. This presentation will also provide an overview of how ICA's initiative, in close collaboration with the Ministry of Health, and the HMO's, white relying on the volunteer activity of members of the ICA professional committees, and that of many other volunteers, leads Israel to significant accomplishments in each one of the treaty sections. These activities have resulted in concrete achievements at the national level, positioning Israel high on the global scale.

Regional patterns and correlates of HIV voluntary counselling and testing among youths in Nigeria

Prevalence of Voluntary Counselling and Testing (VCT) for HIV among young people in Nigeria is low with implications on the epidemic control. Using the 2003 Nigerian National Demographic and Health Survey, we examined the regional prevalence, pattern and correlates of VCT for HIV among youths aged 15 to 24 in Nigeria. Analysis was based on 3573 (out of 11,050) observations using logistic regression model to estimate the effects of identified predictors of volunteering for HIV testing. Results show that national prevalence of VCT is low (2.6%) with regional variations. Generally, the critical factors associated with VCT uptake are age, sex, education, wealth index and risk perception with North (sex, education, religion, occupation and risk perception) and South (age and education) variance. It is recommended that Nigerian HIV programmers should introduce evidence based youth programmes to increase the uptake of VCT with differing approaches across the regions.

Improving effective surgical delivery in humanitarian disasters: lessons from Haiti

Kathryn Chu and colleagues describe the experiences of Médecins sans Frontières after the 2010 Haiti earthquake, and discuss how to improve delivery of surgery in humanitarian disasters.

[The role of the ASL of Brescia in the health and safety of immigrant workers]

According to available studies, migrant workers represent a vulnerable workers' category. For this reason, the Italian law on safety and health at work (art. 11, D.Lgs 81/08) points out the need for Public Administration initiatives devoted to migrant workers' health and safety at work. Local Public Health Department of Brescia for years now had a significant commitment in migrants' health. Thanks to the collaboration of occupational physicians and expert physicians on migration health, it was developed a multidimensional method to assess working risks taking into account also the fragile conditions of migrant workers, considering both personal and social characteristics and professional experience, in order to support companies in the planning of necessary actions to improve health and safety at work. The method was shared by both local industrial association and trade unions and then tested in some manufactures.

The Union and Médecins Sans Frontières approach to operational research

Operational research (OR) has become a hot topic at national meetings, international conferences and donor fora. The International Union Against Tuberculosis and Lung Disease (The Union) and Médecins Sans Frontières (MSF) Operational Centre Brussels strongly promote and implement OR with colleagues in low- and middle-income countries. Here we describe how the two organisations define OR, and explain the guiding principles and methodology that underpin the strategy for developing and expanding OR in those countries. We articulate The Union's and MSF's approach to supporting OR, highlighting the main synergies and differences. Then, using the Malawi National Tuberculosis Control Programme as an example, we show how OR can be embedded within tuberculosis control activities, leading to changes in policy and practice at the national level. We discuss the difficult, yet vitally important, issue of capacity building, and share our vision of a new paradigm of product-related training and performance-based OR fellowships as two ways of developing the necessary skills at country level to ensure research is actually performed. Finally, we highlight the need to consider and incorporate into practice the ethical components of OR. This is a key moment to be involved in OR. We are confident that in partnership with interested stakeholders, including the World Health Organization, we can stimulate the implementation of quality, relevant OR as an integral part of health service delivery that in turn will lead to better health for people, particularly for those living in the poorer parts of the world.

Working in partnership with the voluntary sector: early explorer clinics

The first three years of life have been identified as key to promoting children's later wellbeing, and partnership working across the statutory and voluntary sectors has been proposed as one of the best ways to meet the needs of families. Child health clinics are attended by parents seeking reassurance or help and advice from a health professional regarding child health and development. They have been used in Oxford to develop Early Explorer clinics, in which the statutory health visiting service and voluntary sector Peers Early Education Programme work together with the aim of improving outcomes for children and families. These Early Explorer clinics provide the opportunity to engage parents in supporting their child's development through interaction and non-directed exploratory play. They also offer opportunities to identify vulnerable families, who are provided with additional support. This paper examines a model of partnership working between statutory and voluntary sectors aimed at maximising opportunities to promote the health and wellbeing of infants and their families.

[Lessons learned from Magen David Adom's activities during the 2nd Lebanon War]

The activities of Magen David Adom (MDA) during the 2nd Lebanese War led to a series of conclusions (some established during the fighting) regarding the operational concept of the organization, the response to the needs of the team members, and the resource requirements. The fighting led to an update in the operational concept, moving to the smaller based operational unit--the station, creating a flexible concept, enabling response to various simultaneous scenes, quickly generating a common situational awareness, and relocation of resources to the more relevant events. TechnoLogy must support the operational concept. The response to stress-related victims should be part of the operational concept during conflict. Debriefing and learning processes are part of the response and enable adaptation to the changing reality. A comprehensive response to the needs of the team members is required, by relocation of family members, meeting the daily needs and preventing stress-related reactions among them. A rotation of leave of absence, central management of human resources and the management of volunteers--spontaneous and those who return to active work, are other components of this issue. The required resources--personal protective equipment, collective protection, command control and communications equipment, the supplies level and the different vehicles required for the operation, are important issues in the operational program of the organization. Collecting blood, maintaining a strategic stockpile and protecting the units, are all part of MDA missions.

Reducing admissions with social enterprises

This article refers to the results of an audit to illustrate how social enterprise rapid response teams can prevent unnecessary hospital admissions during the winter by helping patients to manage their conditions at home.

A conflict of responsibility: no patient left behind

In its program END THE WAIT, the National Kidney Foundation (NKF) outlined four comprehensive strategies to achieve the goal that within 10 years, every individual on the US waiting list will receive a transplant within 1 year of listing. Lifetime immunosuppressive coverage is a critical piece of the foundation of this program. Events in 2009 that were dedicated toward achieving a lifetime immunosuppressive benefit were complicated by legislative challenges and a dynamic that placed oral medications in the ESRD bundling proposal in direct conflict with the potential for the lifetime immunosuppressive benefit. In line with its mission, the NKF could not sacrifice one kidney patient constituency for another. Successful patient-centered organizations stay consistent with their mission. The NKF had to weigh the risk of postponing a long-sought goal and its relationships with other organizations with standards of patient safety and equitable and efficient patient care. In a perfect world, we never have to make such choices. In the real world, we can use such choices to forge new ways and dialogue to achieve better health care for all patients affected by kidney disease.

Workforce retention issues in voluntary child welfare

Unlike many studies focused on retention and turnover in public child welfare, this study examined issues of job satisfaction and retention in voluntary child welfare. Although three-fourths of the 1,624 workers surveyed intended to remain in child welfare, 57.3% had thought about leaving their agencies during the past year. All respondents were dissatisfied with their level of pay, but those thinking of leaving were significantly less satisfied with the contingent rewards they received.

Promoting older peoples' participation in activity, whose responsibility? A case study of the response of health, local government and voluntary organizations

The benefits for older people of participating in regular activity are well documented. This paper focuses on how publicly funded community-based organizations enable older people to engage in physical activity. The research questions were: (i) What activity promotion schemes/initiatives exist for older people? (ii) Who has responsibility for them, how are they funded and organized and what evidence exists of interagency working? (iii) Who are the older people that participate? (iv) What are the perceived and measurable outcomes of the initiatives identified? To establish the type and range of provision for older people in a sector of London, the strategies and information about existing activity promoting schemes of inner city health, local government and voluntary organizations were reviewed. Key informants were then interviewed to establish the rationale, achievements and different schemes. One hundred and nine activity-promoting initiatives for older people were identified. Most were provided within an environment of short-term funding and organizational upheaval and reflected eclectic theoretical and ideological approaches. The findings demonstrate: (i) the need for organizations to apply evidence about what attracts and sustains older people's participation in physical activity, and (ii) the need to develop funded programmes that build on past achievements, have explicit outcomes and exploit opportunities for cross agency working.

Barriers and facilitators to partnership working between Early Intervention Services and the voluntary and community sector

Partnership working between health and the voluntary and community sector has become an increasing political priority. This paper describes and explores the extent and patterns of partnership working between health and the voluntary and community sector in the context of Early Intervention Services for young people with a first episode of psychosis. Data were collected from 12 Early Intervention Services and through semistructured interviews with 47 voluntary and community sector leads and 42 commissioners across the West Midlands of England. Most partnerships were described as ad hoc and informal in nature although four formal partnerships between Early Intervention Services and voluntary and community sector organizations had been established. Shared agendas, the ability to refer clients onto an organization that could provide a service they could not and shared training facilitated partnership working in this context. Barriers to closer working included differences in culture such as managing risk, the time required to make and maintain relationships and recognition of the advantages of remaining a small and autonomous organization. The four more formal partnerships were also built on the organizations' experience of working together informally, in one case through a specific pilot project. The voluntary and community organizations involved were also branches of larger national organizations for whom finding sustainable funding was less of an issue. In theoretical terms, eight Early Intervention Service: voluntary and community sector partnerships were at a stage of 'pre-partnership collaboration', three at 'partnership creation and consolidation' and one at 'partnership programme delivery'. The empirical data viewed through the lens of the partnership life-cycle model could help early intervention services, and voluntary and community sector professionals better understand where they are, why they are there and the conditions needed to realise the full potential of partnership working.

[A pioneer in the fight against AIDS in Nigeria]

The Association MVS (French acronym for Mieux Vivre avec le Sida) founded by a physician in Niger in 1994 was the first entity to provide medical and psychological care to symptomatic HIV-infected patients from Niger as well as neighboring countries (Nigeria, Burkina Faso). It has often been at the forefront by offering voluntary screening, undertaking patient management as early as 1998, decentralizing in 2003, and setting up a innovative training facility. Despite these achievements and a solid reputation for excellence in Niger, the Association MVS receives practically no government funding with state subsidies accounting for only 1% of the budget in the last two years. Over the 5-year period ending in 2006, more than 10,000 voluntary screenings were performed with a growing number of requests from women and unsolicited requests. More than 124 patients receive regular follow-up including 73 undergoing ARV treatment. The Association MSV has branches in Tahoua, Zinder, and Agadez. The years 2006 and 2007 have been turning points for the Association MVS because the management facilities need renovation and the awareness unit was forced to close. The screening and patient follow-up center has been able to remain effective since it is located in a quiet area but it is far away from popular neighborhoods. Plans should be made to centralize all activities in a single community friendly location. The experience of the Association MVS underlines the increasing importance of civilian involvement in managing daily problems faced by people and, insofar as possible, in political decision-making on such issues.

Global and local networking for HIV/AIDS prevention: the case of the Saathii E-forum

The global spread of HIV/AIDS has sparked the proliferation of civil society groups working on various aspects of the disease such as prevention, treatment, support, and policy. In this article, we explore the role of the Internet in networking civil society organizations working on HIV/AIDS-related issues across local and global spaces. Specifically, we conducted a thematic analysis of an e-forum established by the nongovernmental organization (NGO) Saathii, working on HIV/AIDS issues in India to (a) identify the specific functions served by the e-forum and (b) explore how global and local actors use the e-forum to network with one another. The thematic analysis documented four key functions of the online forum: (a) to provide HIV/AIDS-related news, (b) to serve as an informational resource, (c) to promote political activism, and (d) to express emotions. The discussion elaborates on the how global and local actors network with one another and build solidarity.