Diabetes self-care: knowledge,beliefs motivation,and action

A growing concern among health-care providers is the problem of adherence. This paper describes the complexities of adhering to the diabetic treatment regimen and emphasizes that care of diabetes should be viewed as a set of problems extending over time. A problemsolving approach is proposed as a way of increasing adherence to diabetes self-care.     

Alcohol, education and action: shifting emphases

Over the past 20 years there has not only been a substantialincrease in indicators of alcoholrelated harm, but also an increasein professional and public awareness of alcohol problems andthe need to prevent them. Sadly, however, much of this awarenessof the need for prevention has resulted in little more thanrather desultory calls for more education. From my ‘pointof view’ it is time to shift further some of the emphasesin the debate aboust alcohol, education and action.     

Defending diversity: affirmative action and medical education.

Affirmative action programs of all types are under attack legally and politically. Although medical schools have not been specifically targeted, their affirmative action programs, like others in higher education, are potentially in danger. This article examines the current legal status of affirmative action in medical education and concludes that a refurbished defense of such programs is essential if they are to survive impending judicial and political scrutiny. An analysis of existing case law and available evidence suggests that a carefully reinvigorated diversity argument is the tactic most likely to pass constitutional muster, as well as the justification most likely to blunt growing public and political opposition to admissions policies that take race and ethnicity into consideration.     

Continuing education, motivation for cost control, a Swiss experiment

The article reviews the prospective, controlled experience of the introduction of a physician network service (health maintenance organisation 5000 insured persons). There was a reduction of cost (26%-33%) compared with the control group, without loss of quality. This reduction still holds good after four years. Risk selection explains only a small part of the reduction in cost. The only interventions consisted of gatekeeping plus continuing medical education (CME). Diagnosis and financial data were not available and profiling was not used to control the experience. CME was provided by a quality circle once a week. In these meetings, the subjective and objective features particular to outpatient medicine were addressed.     

Schools for health, education and development: a call for action

In 2007, the World Health Organization, together with UnitedNations and international organization as well as experts, metto draw upon existing evidence and practical experience fromregions, countries and individual schools in promoting healththrough schools. The goal of the meeting was to identify currentand emerging global factors affecting schools, and to help themrespond more effectively to health, education and developmentopportunities. At the meeting, a Statement was developed describingeffective approaches and strategies that can be adopted by schoolsto promote health, education and development. Five key challengeswere identified. These described the need to continue buildingevidence and capturing practical experience in school health;the importance of improving implementation processes to ensureoptimal transfer of evidence into practice; the need to alleviatingsocial and economic disadvantage in access to and successfulcompletion of school education; the opportunity to harness mediainfluences for positive benefit, and the continuing challengeto improve partnerships among different sectors and organizations.The participants also identified a range of actions needed torespond to these challenges, highlighting the need for actionby local school communities, governments and international organizationsto invest in quality education, and to increase participationof children and young people in school education. This paperdescribes the rationale for and process of the meeting and thedevelopment of the Statement and outlines some of the most immediateefforts made to implement the actions identified in the Statement.It also suggests further joint actions required for the implementationof the Statement.     

The future of medical education: a call for action

The challenge of building new medical schools or expanding the class size of current ones is a lengthy and costly enterprise. That reality argues for the creation of a national vision about how to proceed and what to prioritize, a vision that could serve as a map for public and private officials considering further investment in medical education. A national commission funded by one or several health philanthropies is suggested as an expeditious vehicle to focus this discussion and move the debate forward. Instructive educational innovations in osteopathic and nursing education are suggested as germane to the deliberations of a national commission, as are creative means of student funding.     

Communicative action,education, and knowledge: an approximation to the Habermas thinking

This paper has the objective of presenting a synthesis of Habermas thought on communicative action, relating this with formal education, and more specifically with nursing education. Initially, different concepts of truth and knowledge, as well as the characteristics of modern age education, are pointed out. Secondly, the language concept, which serves as the base to Habermas communicative action theory, is presented. Finally, the study presents the contributions of this author to the materialization of a dialog-based form of teaching learning.     

Adopting and maintaining physical activity behaviours in people with severe mental illness: The importance of autonomous motivation

ObjectivePhysical activity can improve the health of people with serious mental illness (SMI) but many are inactive. Adopting theoretically-based research considering the motivational processes linked to the adoption and maintenance of an active lifestyle between different diagnostic groups of people with SMI can assist in understanding physical activity in this group. Within the Self-Determination Theory (SDT) and the Trans-Theoretical Model (TTM) (stages of change) frameworks, we investigated differences in motives for physical activity between different diagnostic groups.MethodsAll participants completed the Behavioral Regulation in Exercise Questionnaire 2 (BREQ-2), the International Physical Activity Questionnaire (IPAQ) and the Patient-centered Assessment and Counseling for Exercise (PACE) questionnaire.ResultsOverall 294 persons with SMI (190♀) (43.6 ± 13.6 years) agreed to participate. People with affective disorders had higher levels of introjected regulations than people with schizophrenia. No significant differences were found for other motivational regulations. Moreover, no significant differences were found according to gender, setting and educational level. Multivariate analyses showed significantly higher levels of amotivation and external regulations and lower levels of identified and intrinsic regulations in the earlier stages of change. Strongest correlations with the IPAQ were found for motivational regulations towards walking.ConclusionsOur results suggest that in all people with SMI the level of identified and intrinsic motivation may play an important role in the adoption and maintenance of health promoting behaviours. The study provides a platform for future research to investigate the relationships between autonomy support, motivational regulations and physical and mental health variables within lifestyle interventions for this population.     

Successful people selection in action

As a people-intensive industry, the health care service should invest both time and resource in attracting, selecting and retaining its staff. Highlights the fact that the traditional interview is a poor selection tool. Outlines a systematic approach to hiring people and describes the structured behaviour interview tool. Explains the tool using a recent recruitment exercise in the health-care setting. Concludes that line management should play an active role in staff selection and organizations should look for better approach and tools to improve their hiring effectiveness.