Physiotherapists in occupational health — the Australian experience

Abstract

Occupational health physiotherapy (OHP) as a distinct discipline has been practised in Australia since the 1970s. In 1984, a national special interest group was formed within the Australian Physiotherapy Association (APA) to provide professional support and education for the growing numbers of physiotherapists in the field. In its latest form the group has nearly 300 members with chapters in each of the six states and in one of two territories. Since 1999, the APA has facilitated the development of a structured tiered career pathway for its members in all the special interest groups. To date, a number of OHP members have successfully completed the recognition process for advanced standing in the field of OHP and become either Titled or Specialist. It is planned to increase the numbers of physiotherapists working at advanced practitioner levels in workplace health and safety and continue to have OHP representatives on peak national health and safety groups and key bodies in the workers' rehabilitation and compensation field. The way forward for the special interest group lies in furthering educational opportunities for group members, and improving knowledge of other stakeholders including the physiotherapy profession about the skills group members have. Opportunities for networking and sharing resources via an international subgroup may be a reality in the near future.     

The value of specialization--is there an outcome difference in the management of fistulas complicating diverticulitis

PURPOSE: The value of specialization has frequently been challenged by many health care institutions and providers. This review was conducted to determine whether there were any outcome differences in the management of fistulas complicating diverticulitis. METHODS: We conducted an historical cohort study using hospital charts of all cases of fistulas complicating diverticulitis that were operated on in four university-affiliated hospitals between 1975 and 1995. There were 122 patients, with 37 under the care of fully trained colorectal surgeons and 85 under the care of general surgeons. RESULTS: There were no significant differences in patient demographics, preoperative comorbidities, or the number of preoperative diagnostic investigations between the two groups. The colorectal surgeons performed more intraoperative ureteral stenting (Colorectal Surgery 55.5 percentvs. General Surgery 24.4 percent,P=0.001). The general surgeons performed more initial diverting Hartmann's and colostomy procedures (Colorectal Surgery 5.4 percentvs. General Surgery 27 percent,P=0.013). The patients in the General Surgery group had longer preoperative lengths of stay (median Colorectal Surgery 3 (range, 1–28) daysvs. General Surgery 8 (range, 0–29) days;P<0.001), longer postoperative lengths of stay (median Colorectal Surgery 11 (range, 5–40) daysvs. General Surgery 14 (range, 2–80) days;P=0.001), and longer total lengths of stay (median Colorectal Surgery 14 (range, 6–62) daysvs. General Surgery 24 (range, 6–100) days;P<0.001). The patients in the General Surgery group experienced a higher rate of wound infections (Colorectal Surgery 5.4 percentvs. General Surgery 12.9 percent), and a larger proportion of them experienced complications (Colorectal Surgery 27 percentvs. General Surgery 41.2 percent). CONCLUSIONS: We conclude that specialization in colon and rectal surgery contributed to an improved outcome, with a lower rate of diverting procedures, a shorter hospital stay, and a lower rate of complications.Presented at the meeting of The American Society of Colon and Rectal Surgeons, Boston, Massachusetts, June 24 to 29, 2000.     

Medicina interna en el Uruguay. Enseñanza de la especialidad

Internal medicine in Uruguay has undergone a change in recent years related to labor and economic aspects at our society level. This is rethought to the formation of the speciality trying to achieve a doctor more competent and updates with a profile in line with the progress of medicine worldwide. This is a review of the teaching of the speciality in internal medicine in Uruguay with the most innovative aspects in term of training.     

上海地区二三级医院管理现状及发展趋势的研究

医院管理机制和管理者素质已成为医疗机构核心竞争力的重要组成部分。本研究采用问卷调查法,分析了上海二、三级医院544名管理者对目前医院管理现状、管理者培养机制、继续教育和职业化发展等四方面的认识,探讨了我国医院管理者职业化发展的途径。     

药品监管公务员专业化的含义及其能力要求初探

建设高素质、专业化的药品监管公务员队伍是药品监督管理基础性、战略性的任务。我国药品监管公务员队伍组建的时间不长,队伍的专业分布、学历层次与知识结构都与药品监管职能的要求存在着一定差距。针对这一问题,在大量调研的基础上,对药品监管公务员专业化的概念、含义以及其能力要求进行深入探讨。     

高校科技期刊影响力分析及发展策略探讨

【目的】 以提升非知名高校科技期刊影响力为侧重目标,探讨新形势下高校科技期刊的发展策略。【方法】 采用文献法、数据分析法、访谈法等研究方法,对高校科技期刊的总体情况、学科分布特点和影响力等现状进行分析,并重点分析影响因子变化情况。 【结果】 超过80%的高校仅主办1种科技期刊;有52.92%的期刊属于占学科总数7.69%的几大类综合学科;除少数知名高校综合性学报外,数量较多的几大类综合学科期刊的影响力优势不足;在30种变更刊名并强化专业特色的高校科技期刊中,复合影响因子和综合影响因子增加的期刊数量分别占86.67%和96.67%。 【结论】 专业化办刊对影响力的提升是积极有效的,高校科技期刊应乘势而上、克服困难谋发展,转变理念、走高质量发展之路,拓宽渠道、走多元化服务之路,尝试新的体制机制、走专业领域内的集团化发展道路,以提升期刊的影响力。     

Specialization and competition in healthcare delivery networks

Hospital networks, which offer multiple services at multiple locations, are investigating strategies to fight the growing competition from specialty hospitals. Specialty hospitals focus on a selective range of profitable services, have better control over costs, and deliver higher (perceived) quality. A hospital network too can create specialized facilities; however, this may lead to the loss of sales from services that it no longer offers. Using a spatial model, we study when it is profitable for the network to specialize, and how to determine which facilities provide the greatest value through specialization. We find that a hospital network, when facing specialized competitors, can often improve its overall profitability by specializing some of its facilities; and that among its different facilities, the network’s best choice for specialization is the facility that is closest to the competitor, and thus most directly affected. Interestingly, we find that the value of specialization is contingent upon the competitive pressure that the specialized competitor exerts on the network. Specializing one facility yields the greatest benefits for the network when the competitor is located at the fringe of the market, thus presenting a reduced threat to the hospital network. On the other hand, if the specialized competitor is located at the core of the network’s customer base, we find that the attractiveness of specializing one facility is much smaller and that the hospital network might fare better with a strategy based on diversification, i.e., offering a full-menu of services at every facility.