Health care professionals’ perceptions of seriously ill women

Physicians, psychologists, and nurses read one of four vignettes describing a woman who had received one of four diagnoses—breast cancer, lung cancer, heart attack, or severe burn—and indicated on the Profile of Mood States (McNair, Lorr, & Droppelman, 1971) how they perceived the woman had been feeling during the past week. They then answered 10 questions about the woman's recovery and about their own anticipated behaviors while interacting with her. A number of differences emerged between professional groups in terms of their expectations for patients regardless of diagnosis. In addition, respondents held different emotional expectations for the patient, based solely on her diagnosis. These results support the need for training health care professionals to recognize psychological distress in, and appropriately refer, seriously ill women.     

Health care professionals’ perspectives on physical activity within the Ugandan mental health care system

BackgroundMental health care systems in Africa are faced with a high burden of mental disorders. There is need to explore evidence-based, scalable interventions to compliment the “traditional” health care system. Physical activity (PA) can augment the effectiveness of existing programs. However, little is known about the perspectives of health care professionals on PA. Understanding this is key to implementation.MethodsThis was a qualitative exploratory study based on 13 key informant interviews among experienced health care professionals working at Butabika National Referral and Teaching Hospital, Uganda. Data was analyzed through content thematic analysis.ResultsParticipants reported PA benefits were: improved individual competences and engagement, social reintegration and reduced family and community burden. Self-stigma, lack of community support, lack of infrastructure and equipment, lack of monitoring capacity, human resource challenges and a focus solely on pharmacotherapy were among the most reported barriers to application of PA in management of mental health problems.ConclusionDespite the high level of understanding of PA among health care professionals, PA promotion largely depends on implementation of strategies to deal with community and health systems barriers. Although patients need to be empowered to deal with their individual barriers, greater support and action is needed by policy makers. Public health programs should support PA through community engagement and social re-integration programs. The government should promote a holistic mental health care perspective and provide adequate infrastructural and human resources to support PA in the existing primary and mental health care systems.     

Effectiveness of preventive oral health care in Hispanic children living near US–Mexico border

Objective  

The effect of preventive oral healthcare on dental caries in Hispanic children in a school district near the US–Mexico border in Texas was studied.     

Do slums matter? Location and early childhood preventive care choices among urban residents of Bangladesh

Upward trends in the relative proportions of slum residents in developing countries have led to widespread concern regarding the impact of slum residency on health behaviors. Measurement of these impacts requires recognizing that unobservable household characteristics that affect the location decision may also affect health care choices and outcomes. To address the potential for bias, this paper models the location decision and the household's demand for maternal and child health services simultaneously using a flexible, semi-parametric approach. It uses a unique urban data set from Bangladesh that incorporates sophisticated geographical mapping techniques to carefully delineate between slum and non-slum areas at a particular point in time. The results suggest that accounting for the endogenous location decision of a family substantially reduces bias in estimated marginal effects of slum residence on preventive care demand. While community infrastructure variables appear correlated with preventive care demand, the causal effect of the availability of primary health care facilities is indistinguishable from zero when unobserved heterogeneity is taken into account. The findings suggest that improvements in community infrastructure in urban areas of developing countries are a more favorable health policy solution at the margin than the construction of additional health care facilities.     

Greek pre-service kindergarten teachers’ beliefs about and practices of developmentally appropriate practices in early childhood education

The continuum of beliefs reported by Greek pre-service kindergarten teachers and how those beliefs relate to classroom practices are explored in this article. Considering the potentially important influence of teachers’ beliefs on their practices, the level of early childhood teachers’ beliefs about developmentally appropriate practices (DAPs) and the relationship between their beliefs and practices are regarded as important topics of study in early childhood education. This study was designed in order to investigate Greek pre-service kindergarten teachers’ self-reported beliefs and practices related to the National Association for the Education of Young Children’s policy statement for DAP. Research results indicated that participants favour DAP both as far as their beliefs and the instructional activities they implement are concerned. Even though the analysis indicated correlations among DAP and developmentally inappropriate practice (DIP) beliefs and practices, beliefs have not been found to predict practices.     

Do health workers practice what they preach? A study of knowledge, opinions and practices of health care professionals, with respect to their own health, in Madagascar

In this study, a questionnaire was used to study the individual behavior of a sample of fifty health workers, doctors and nurses from Tamatave (Madagascar) with respect to a number of current health issues. We used the results to assess the impact and efficacy of previous training and to obtain information about the extent to which health staff actually follow the recommendations and standards that they are given and expected to teach, as far as their own health is concerned. It was clear that the standard management procedures and instructions concerning basic health-preserving behavior were far from being universally accepted and followed by health workers themselves. This was the case even for common diseases and health issues for which specific training had been given, such as malaria, diarrhea, AIDS and STDs, tobacco use, HBP management and the use of antibiotics. More attention should be paid to involving health workers in their training programs so that they are really convinced by the recommendations given. So long as most health workers are not themselves committed to the recommendations and have inadequate behavior regarding their own health, they are unlikely to be effective at promoting good health practice.     

Investigating early childhood teachers’ views on science teaching practices: the integration of science with visual art in early childhood settings

This study investigates early childhood teachers’ views about science teaching practices in an early childhood settings. It was conducted in a preschool located in Ankara, Turkey. The data of the study were collected through multiple sources of information such as interviews with early childhood teachers and observations of their practices in the classroom. The findings of this study indicated that early childhood teachers believed in the importance of science activities in their practices and they claimed that they provided child-centred activities for children to enrich their science experiences. Moreover, the findings showed that they used different learning experiences that were naturalistic, informal, and structured. The findings also revealed that an integrated curriculum improved children’s developmental progress. More specifically, participant teachers used art as an assessment tool in science activities because they considered that they were able to evaluate children’s understanding on the basis of their art work such as their drawings.     

Overruling uncertainty about preventative medications: the social organisation of healthcare professionals’ knowledge and practices

In this article, we draw on an institutional ethnographic (IE) study of cardiovascular disease prevention in general practice, exploring the work of healthcare professionals who introduce a discussion of risk and preventative medications into consultations with patients. Our aim is to explicate, using IE's theoretical ontology and analytical tools, how troubling patient experiences in this clinical context are coordinated institutionally. We focus our attention on the social organisation of healthcare professionals’ knowledge and front-line practices, highlighting the textual processes through which they overrule patients’ concerns and uncertainties about taking preventative medication, such that some patients feel unable to openly discuss their health needs in preventative consultations. We show how healthcare professionals activate knowledge of ‘evidence-based risk reduction’ to frame patients’ queries as ‘barriers’ to be overcome. Our analysis points not to deficiencies of healthcare professionals who lack the expertise or inclination to adequately ‘share decisions’ with patients, but to the ways in which their work is institutionally orientated towards performance measures which will demonstrate to local and national policymakers that they are tackling the ‘burden of (cardiovascular) disease’.     

Regulators’ views of quality in early childhood care and education settings in Ireland

There is a substantial literature on the importance of good-quality early childhood care and education services. There is also, however, some agreement that service quality is a nebulous concept which is difficult to define and therefore difficult to assess. While there is growing literature in the area, the views of one stakeholder group—that of regulators—is relatively scarce in the academic literature. This article presents the views of this stakeholder group using the findings from a systematic analysis of reports of pre-school inspections carried out in the Republic of Ireland. A total of 3007 individual inspection reports comprising 81,189 regulation references were analysed in this study. The findings indicate that regulators are of the view that the majority of services are compliant across most of the 27 regulations inspected, with three-quarters (73%) of all services inspected reported to be non-compliant on five or fewer regulations. The three areas reported to have the highest levels of non-compliance were “management and staffing“ (46.2%), “safety“ (43%) and “records“ (35%). Variation in the findings was identified according to the type of inspection (follow-up inspections had the highest levels of non-compliance), type of service (drop-in services had the highest levels of non-compliance), geography (Dublin North East had the highest level of non-compliance) and extent of the commentary (children's health, welfare and development generated extensive commentary, far in excess of other regulation areas). While international comparisons are not possible due to different approaches and foci for assessment, variation has also been a feature of studies conducted in other jurisdictions including Scotland and the United States. The findings from this study provide an understanding of the views of regulators across the breadth of regulations that legally underpin the service and can act as a benchmark for a variety of stakeholders.     

What factors hinder women of color from obtaining preventive health care?

This commentary examines how women of color fare on the use of preventive care. Logistic regression models of women's use of preventive care were computed with data from the 1994 Commonwealth Fund Minority Health Survey. It was found that having a regular doctor was the most consistent predictor of the use of preventive care, irrespective of the women's racial/ethnic background, socioeconomic circumstances, or place of residence. These findings reinforce the importance of physicians in the delivery of preventive care. Suggestions for improving the use of preventive services by women of color are provided.     

Finnish and Greek early childhood teachers’ perspectives and practices in supporting children’s autonomy

Kindergarten teachers from different cultural backgrounds attribute various meanings to children’s autonomy. There seems to be cultural differences in early childhood education curricula with regard to how a child’s autonomy is described and how it is supported. This qualitative study asks: how do teachers narrate their perspective and pedagogical support of children’s autonomy, and what kinds of similarities and differences in the pedagogy and practices can be found in Finnish and Greek early childhood education (ECEC) contexts? The data of this qualitative study consist of a semi-structured questionnaire of 14 kindergarten teachers and observations of their pedagogical practices in the day care groups of 4- to 5-year-old children. The results suggest that teachers’ overall conception of autonomy was identical, but the different cultural contexts and curriculums affected the way the teachers emphasized and valued different dimensions of autonomy.     

‘Youth-friendly’ characteristics of professionals in mental health settings

Abstract

Adolescents have a unique developmental vulnerability to suicide, with youth presenting as the second most vulnerable group to suicide across the lifespan. Youth have been recognized as underserved mental health service recipients, with only one in six of those in need receiving care. Calls for innovative mental health services to better serve youth have been articulated for over a decade and the adolescent health and mental health communities have responded. However, to date there has been little empirical discussion of the caregiver characteristics that would increase the likelihood of youth feeling comfortable discussing their mental health concerns. Objectives of this study were twofold: (1) to ask a large sample of Canadian youth [n?=?11 171: 5146 males, 6001 females (n?=?24 participants did not indicate their sex )] to identify characteristics of mental health professionals they would define as ‘youth-friendly’, and (2) to test which youth-friendly characteristics are deemed important to youth based on their circumstances, including those experiencing recent suicidality. Gender differences are also tested and explored. The absence of youth-friendly mental health service provision is proposed to be a modifiable barrier to help seeking in at-risk youth.     

Should health care professionals encourage living kidney donation?

Living kidney donation provides a promising opportunity in situations where the scarcity of cadaveric kidneys is widely acknowledged. While many patients and their relatives are willing to accept its benefits, others are concerned about living kidney programs; they appear to feel pressured into accepting living kidney transplantations as the only proper option for them. As we studied the attitudes and views of patients and their relatives, we considered just how actively health care professionals should encourage living donation. We argue that active interference in peoples’ personal lives is justified – if not obligatory. First, we address the ambiguous ideals of non-directivity and value neutrality in counselling. We describe the main pitfalls implied in these concepts, and conclude that these concepts cannot account for the complex reality of living donation and transplantation. We depict what is required instead as truthful information and context-relative counselling. We then consider professional interference into personal belief systems. We argue that individual convictions are not necessarily strong, stable, or deep. They may be flawed in many ways. In order to justify interference in peoples’ personal lives, it is crucial to understand the structure of these convictions. Evidence suggests that both patients and their relatives have attitudes towards living kidney donation that are often open to change and, accordingly, can be influenced. We show how ethical theories can account for this reality and can help us to discern between justified and unjustified interference. We refer to Stephen Toulmin’s model of the structure of logical argument, the Rawlsian model of reflective equilibrium, and Thomas Nagel’s representation of the particularistic position.     

Have health care professionals adopted the marketing concept?

The marketing concept is a philosophical foundation of marketing which states that an organization's key task is to discover what target markets want and need, and to deliver the desired products and services with more satisfaction than does the competition. This study surveyed nurses, physicians and hospital administrators to determine the degree of acceptance of the marketing concept as a managerial orientation for hospitals.     

Junior Doctors of Health©: an interprofessional service-learning project addressing childhood obesity and encouraging health care career choices

While much literature describes programmatic success of clinical service-learning opportunities, this initiative integrates student learning across a comprehensive discipline set (Dental Medicine, Graduate Studies, Health Administration, Medicine, Nursing, Occupational Therapy, Pharmacy, Physical Therapy, and Physician Assistant), providing preventive health education and role modeling to low-income elementary-school children. Junior Doctors of Health? (JDOH), a health education curriculum taught by Medical University of South Carolina students, addresses childhood obesity and encourages child interest in health professional (HP) and biomedical science (BS) careers. Of the 78 surveyed HP/BS students, over 80% agreed JDOH was worthwhile for their professional development, increased their appreciation and ability as an interprofessional team member, improved their understanding and interest in underserved communities, and provided them with valuable childhood-obesity prevention information. With the increased need for childhood-obesity prevention and team building among students of various health and science professions, recommendations are offered to others interested in creating or collaborating to build similar service-learning initiatives.