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  1. Organizational structure of the Croatian family practice: a longitudinal study based on routinely collected data.


    Keglević, Mladenka Vrcić; Balint, Ines; Cvetković, Ivica; Gaćina, Ana


    This study was undertaken with the main aim of determining the trends in the number of family doctors' (FD), gender and educational structure, working status and the number of patients per FD between 1995 and 2013. As the main source of data collection served the Croatian Health Service Yearbooks and Croatian Health Insurance Fund (CHIF) databases on practices and FDs contracting in 2013. Obtained results indicated that the number of contracted FDs increased until 2007, then decreased, and again increased until 2350 in 2013. Average number of patients on FDs list was 1987 in 2012. Less than 50% FDs were specialist in family medicine, 70.3% of them were self-employed with the CHIF contract, and 81% were women. 123 practices planned by the Network did not have contracting FD in 2013. The lack of FDs, the huge number of patients over the standard number, and the location of the missing practices within the rural communities, together make Croatian FM practices less accessible.

  2. Primary Care Practice Development: A Relationship-Centered Approach

    PubMed Central

    Miller, William L.; Crabtree, Benjamin F.; Nutting, Paul A.; Stange, Kurt C.; Jaén, Carlos Roberto


    PURPOSE Numerous primary care practice development efforts, many related to the patient-centered medical home (PCMH), are emerging across the United States with few guides available to inform them. This article presents a relationship-centered practice development approach to understand practice and to aid in fostering practice development to advance key attributes of primary care that include access to first-contact care, comprehensive care, coordination of care, and a personal relationship over time. METHODS Informed by complexity theory and relational theories of organizational learning, we built on discoveries from the American Academy of Family Physicians’ National Demonstration Project (NDP) and 15 years of research to understand and improve primary care practice. RESULTS Primary care practices can fruitfully be understood as complex adaptive systems consisting of a core (a practice’s key resources, organizational structure, and functional processes), adaptive reserve (practice features that enhance resilience, such as relationships), and attentiveness to the local environment. The effectiveness of these attributes represents the practice’s internal capability. With adequate motivation, healthy, thriving practices advance along a pathway of slow, continuous developmental change with occasional rapid periods of transformation as they evolve better fits with their environment. Practice development is enhanced through systematically using strategies that involve setting direction and boundaries, implementing sensing systems, focusing on creative tensions, and fostering learning conversations. CONCLUSIONS Successful practice development begins with changes that strengthen practices’ core, build adaptive reserve, and expand attentiveness to the local environment. Development progresses toward transformation through enhancing primary care attributes. PMID:20530396

  3. Design of exploration and minerals-data-collection programs in developing areas

    USGS Publications Warehouse

    Attanasi, E.D.


    This paper considers the practical problem of applying economic analysis to designing minerals exploration and data collection strategies for developing countries. Formal decision rules for the design of government exploration and minerals-data-collection programs are derived by using a minerals-industry planning model that has been extended to include an exploration function. Rules derived are applicable to centrally planned minerals industries as well as market-oriented minerals sectors. They pertain to the spatial allocation of exploration effort and to the allocation of activities between government and private concerns for market-oriented economies. Programs characterized by uniform expenditures, uniform information coverage across regions, or uniform-density grid drilling progrmas are shown to be inferior to the strategy derived. Moreover, for market-oriented economies, the economically optimal mix in exploration activities between private and government data collection would require that only private firms assess local sites and that government agencies carry out regional surveys. ?? 1981.

  4. Developing an Internet Presence for Your Practice

    PubMed Central

    Maley, Catherine; Baum, Neil


    Yesterday, it was the Yellow Pages that informed the public where and how to reach their physicians. Today, it is the Internet. With the Internet, patients have 24/7 access to your practice that will do far more than any Yellow Pages or advertising could possibly do. This article discusses the importance of the Internet for the contemporary physician and how to create a useful and interactive Web site. PMID:21603434

  5. Developing an internet presence for your practice.


    Maley, Catherine; Baum, Neil


    Yesterday, it was the Yellow Pages that informed the public where and how to reach their physicians. Today, it is the Internet. With the Internet, patients have 24/7 access to your practice that will do far more than any Yellow Pages or advertising could possibly do. This article discusses the importance of the Internet for the contemporary physician and how to create a useful and interactive Web site.

  6. A practical guideline for identifying research intent with projects that collect private, identifiable health information.


    Amdur, Robert J; Speers, Marjorie A


    Radiation oncologists frequently engage in activities that involve the collection and analysis of data from medical records. Access to health information is an ethical issue because, if not done according to appropriate guidelines, it constitutes an invasion of privacy or breach in confidentiality. To protect patients for the social harm that may result from medical record review, our society has established laws and regulations that apply to projects that require medical record review. A major branch point in the guidelines for such projects is whether private information will be collected for research or nonresearch purposes. However, a problem with discussing privacy protection in terms of a research versus nonresearch model is that it is difficult to make this distinction for many kinds of projects. The purpose of this paper is to establish a practical guideline that can be used to decide if a project that involves analysis of private, identifiable medical information should be considered research from the regulatory standpoint.

  7. The Practice of Manpower Forecasting: A Collection of Case Studies. Studies on Education; Vol. 1.

    ERIC Educational Resources Information Center

    Ahamad, Bashir; And Others

    In the 1960's academics, politicians, administrators and industrialists became convinced of the importance of education for economic development. The forecasting of qualified manpower needs was able to turn this new idea into practice. During the decade hundreds of manpower forecasts were made, and innumerable international conferenceses were held…

  8. The Practice of Manpower Forecasting: A Collection of Case Studies. Studies on Education; Vol. 1.

    ERIC Educational Resources Information Center

    Ahamad, Bashir; And Others

    In the 1960's academics, politicians, administrators and industrialists became convinced of the importance of education for economic development. The forecasting of qualified manpower needs was able to turn this new idea into practice. During the decade hundreds of manpower forecasts were made, and innumerable international conferenceses were held…

  9. Crystallography of Powdered Samples at High Pressure: Practical Aspects of Diffraction Data Collection and Analysis.

    NASA Astrophysics Data System (ADS)

    Crichton, W. A.


    In this presentation we will give an overview of some typical techniques used to collect, and to analyse, angle- dispersive x-ray diffraction data from powdered samples under high-pressure (and temperature) conditions. The presentation will have a practical basis, using data collected from samples at high-pressure and temperature conditions using large-volume presses and diamond-anvil cells that have been either resistively or laser-heated. We will show how these experiments have been optimised to obtain a variety of different experimental results (phase identification and phase diagram mapping, EoS measurement, structure solution, etc). We will demonstrate different analysis procedures, explain their methodology and, as often as possible, present these analyses with software that is freely available. Demonstration of the techniques will take the audience though basic elements of diffraction data collection and methods of phase identification to indexing and unit-cell refinement, though some common structure solution methods and Rietveld refinement strategies. We will also discuss methods for collecting better data and maximising the information that can be gleaned from powdered samples (of minerals, ceramics, element, glasses, liquids and other materials) at high pressure.

  10. Developing Collective Training for Small Unmanned Aerial Systems Employment

    NASA Technical Reports Server (NTRS)

    Durlach, Paula J.; Priest, Heather; Martin, Glenn A.; Saffold, Jay


    The projected use of small unmanned aerial systems (SUAS) in military operations will produce training requirements which go beyond current capabilities. The paper describes the development of prototype training procedures and accompanying research simulations to address this need. We initially constructed a testbed to develop simulation-based training for an SUAS operator equipped with a simulated vertical-lift and land SUAS. However, the required training will go beyond merely training an operator how to pilot an SUAS. In addition to tactics, techniques, and procedures for employment of SUASs, collective training methods must be trained. Moreover, the leader of a unit equipped with SUAS will need to learn how to plan missions which incorporate the SUAS, and take into account air space and frequency management considerations. The demands of the task require the leader to allocate personnel to the SUAS mission, communicate and coordinate with those personnel during the mission, and make use of the information provided. To help address these training issues, we expanded our research testbed to include a command and control node (C2 node), to enable communications between a leader and the SUAS operator. In addition, we added a virtual environment in which dismounted infantry missions can be conducted. This virtual environment provides the opportunity for interactions among human-controlled avatars and non-player characters (NPCs), plus authoring tools to construct scenarios. Using these NPCs, a collective exercise involving friendly, enemy, and civilian personnel can be conducted without the need for a human role-player for every entity. We will describe the results of our first experiment, which examined the ability of players to negotiate use of the C2 node and the virtual environment at the same time, in order to see if this is a feasible combination of tools for training development.

  11. Development of a spiritual self-care practice scale.


    White, Mary L; Schim, Stephanie Myers


    Development of a valid, reliable instrument to measure spiritual self-care practices of patients with heart failure. African American patients (N = 142) with heart failure participated in the study. Spiritual advisors from several religious groups reviewed the Spiritual Self-Care Practices Scale (SSCPS) for content validity. Construct validity was determined using a principal components factor analysis. Reliability was established using Cronbach's alpha coefficients. Religious advisors provided suggestions to improve content validity. Four factors consistent with spiritual practices (personal spiritual practices, spiritual practices, physical spiritual practices, and interpersonal spiritual practices) emerged from the factor analysis. The alpha coefficient was moderate at 0.64. Results indicated the SSCPS was reliable and valid for measuring spiritual self-care practices among African Americans with heart failure. Additional testing is needed to confirm results in other patient groups with chronic illnesses.

  12. Teachers' Knowledge Development and Change: Untangling Beliefs and Practices

    ERIC Educational Resources Information Center

    Theriot, Shirley; Tice, Kathleen C.


    Through a case-study approach, the authors focus on understanding the complexity of teachers' knowledge development, particularly as it pertains to teachers' beliefs about literacy development and their teaching practices in literacy. Participants of the study are middle-school teachers who shared their beliefs and practices through (1) a…

  13. Grounding Continuous Professional Development (CPD) in Teaching Practice

    ERIC Educational Resources Information Center

    Harwood, Tracy; Clarke, Jane


    This article argues that developing a team-based approach to teaching and learning provides the basis for building commitment and continuous professional development in teaching practice among staff in higher education. A team approach that is grounded in practice leads to open communication and opportunities for formal and informal professional…

  14. Strategies for Career Development: Promise, Practice and Pretence. Report 305.

    ERIC Educational Resources Information Center

    Hirsh, Wendy; And Others

    Case studies of 15 leading employers in the United Kingdom were conducted to examine their career development practices. Employees, line managers, executives, and human resources professionals in the finance, energy, high technology, manufacturing, service, and public service sectors were interviewed regarding the career development practices and…

  15. Continous quality improvement of perfusion practice: the role of electronic data collection and statistical control charts.


    Baker, R A; Newland, R F


    In-hospital data collection may be used to improve the selection, operative techniques, and process of care for cardiac surgical patients. The aim of this report is to demonstrate the influence of the automated generation of quality indicators (QI) for cardiopulmonary bypass (CPB) and the implementation of a continuous quality improvement (CQI) programme on the CPB process of care. Adult patients undergoing CPB were divided into three consecutive groups: Group 1 (n = 363); no QI data feedback, Group 2 (n = 253); automated QI data feedback alone, and Group 3 (n = 363) data feedback and implementation of CQI. There were no significant differences in demographic, procedural or clinical outcomes for each group. Significant improvement, as determined by adherence to practice protocols and reduction in practice variation, was observed for cardiac index < 1.6 L/min/m2 (min), mean arterial pressure < 40 mmHg (min), venous saturation < 60% (min), arterial blood temperature of > 37.5 degrees C (min), minimum pCO2 (mmHg), maximum pCO2 (mmHg), and minimum pO2 (mmHg). There was no change in the minimum haemoglobin (g/dl) on bypass. Automated generation of QI resulted in improved adherence to process of care guidelines, highlighting the potential of electronic data collection. This technique is optimised in a CQI programme, utilising statistical control charts for data interpretation.

  16. Characteristics of Medical Practices in Three Developed Managed Care Markets

    PubMed Central

    Landon, Bruce E; Normand, Sharon-Lise T; Frank, Richard; McNeil, Barbara J


    Objective To describe physician practices, ranging from solo and two-physician practices to large medical groups, in three geographically diverse parts of the country with strong managed care presences. Data Sources/Study Design Surveys of medical practices in three managed care markets conducted in 2000–2001. Study Design We administered questionnaires to all medical practices affiliated with two large health plans in Boston, MA, and Portland, OR, and to all practices providing primary care for cardiovascular disease patients admitted to five large hospitals in Minneapolis, MN. We offer data on how physician practices are structured under managed care in these geographically diverse regions of the country with a focus on the structural characteristics, financial arrangements, and care management strategies adopted by practices. Data Collection A two-staged survey consisting of an initial telephone survey that was undertaken using CATI (computerized assisted telephone interviewing) techniques followed by written modules triggered by specific responses to the telephone survey. Principal Findings We interviewed 468 practices encompassing 668 distinct sites of care (overall response rate 72 percent). Practices had an average of 13.9 member physicians (range: 1–125). Most (80.1 percent) medium- (four to nine physicians) and large-size (10 or more physicians) groups regularly scheduled meetings to discuss resource utilization and referrals. Almost 90 percent of the practices reported that these meetings occurred at least once per month. The predominant method for paying practices was via fee-for-service payments. Most other payments were in the form of capitation. Overall, 75 percent of physician practices compensated physicians based on productivity, but there was substantial variation related to practice size. Nonetheless, of the practices that did not use straight productivity methods (45 percent of medium-sized practices and 54 percent of large practices), most

  17. Practical MRI atlas of neonatal brain development

    SciTech Connect

    Barkovich, A.J.; Truwit, C.L.


    This book is an anatomical reference for cranial magnetic resonance imaging (MRI) studies in neonates and infants. It contains 122 clear, sharp MRI scans and drawings showing changes in the normal appearance of the brain and skull during development. Sections of the atlas depict the major processes of maturation: brain myelination, development of the corpus callosum, development of the cranial bone marrow, and iron deposition in the brain. High-quality scans illustrate how these changes appear on magnetic resonance images during various stages of development.

  18. Social Justice Competencies and Career Development Practices

    ERIC Educational Resources Information Center

    Arthur, Nancy; Collins, Sandra; Marshall, Catherine; McMahon, Mary


    The recent focus on social justice issues in career development is primarily conceptual in nature and few resources account for the challenges or successes experienced by career development practitioners. The purpose of this article is to report the results of a research study of career practitioners in Canada regarding the competencies they use…

  19. Nutrition capacity development: a practice framework.


    Shrimpton, Roger; Hughes, Roger; Recine, Elisabetta; Mason, John B; Sanders, David; Marks, Geoffrey C; Margetts, Barrie


    To outline a framework and a process for assessing the needs for capacity development to achieve nutrition objectives, particularly those targeting maternal and child undernutrition. Commentary and conceptual framework. Low- and middle-income countries. Result A global movement to invest in a package of essential nutrition interventions to reduce maternal and child undernutrition in low- and middle-income countries is building momentum. Capacity to act in nutrition is known to be minimal in most low- and middle-income countries, and there is a need for conceptual clarity about capacity development as a strategic construct and the processes required to realise the ability to achieve population nutrition and health objectives. The framework for nutrition capacity development proposed recognises capacity to be determined by a range of factors across at least four levels, including system, organisational, workforce and community levels. This framework provides a scaffolding to guide systematic assessment of capacity development needs which serves to inform strategic planning for capacity development. Capacity development is a critical prerequisite for achieving nutrition and health objectives, but is currently constrained by ambiguous and superficial conceptualisations of what capacity development involves and how it can be realised. The current paper provides a framework to assist this conceptualisation, encourage debate and ongoing refinement, and progress capacity development efforts.

  20. Developing a Coaching Portfolio: Enhancing Reflective Practice

    ERIC Educational Resources Information Center

    Hubball, Harry; Robertson, Scott


    A portfolio is a well-organized document containing critical analyses and evidence related to a coach's background, context(s) of coaching, approach to coaching, coaching accomplishments, and goals for further development. Here, the authors describe different types of coaching portfolios as well as strategies for developing a coaching portfolio.…

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