Assessment of newspaper reporting of public health and the medical model: a methodological case study

A case study over a 4-week period reviewed health items reportedin the Australian newspaper, The [Brisbane] Courier Mail, underthe two broad categories of public health and the medical model.Content analysis was utilized to assess 19 criteria which measuredprominence, content, stakeholders, orientation of reportingand tone of items. The findings suggest that public health,including health promotion, is presented less often, less prominentlyand less positively than medical model issues (Westwood, 1995).No comparable review of press reporting of these two modelswas identified in extensive international literature searchesand this study is considered to break new ground. The potentialinfluence of the print media in the education of the populationon public health issues is presented. It is proposed that agreater understanding of the dynamics of health reporting andparticularly the relationship between public health and themedical model may lead to more constructive and informativereporting.     

The productive performance of public hospital clinics in Greece: a case study.

One of the most important and crucial issues for political and social reasons in Greece is the reorganization of the public sector health system--more precisely, the improvement of public hospital operations, both in terms of the resources they use and the quality and quantity of the services they provide. This study focuses on investigating the productivity performance of 10 clinics in a public hospital located in Thessaloniki. The methodology applied is the data envelopment analysis (DEA) to measure the Malmquist productivity index. The results indicated that the efficiency of the hospital clinics has improved. However, clinics' efficiency varies a lot from month to month. In a competitive environment, these differences need to be addressed, investigated and reduced in order to improve total efficiency.     

Planning and change: a Cambodian public health case study

This paper questions the appropriateness of highly structured strategic planning approaches in situations of complexity and change, using the Cambodian German Health Project as a case study. Based on participant observation and organisational analysis in the Cambodian public health sector, the paper examines the rhetoric of values, objectives and strategies outlined in the original project documents and their assumptions and implications, and the responses to the changing political situation. It demonstrates the limitations of these planning processes in complex situations of high uncertainty, with little reliable information and a rapidly changing environment. Having highlighted the limitations of the strategic planning process in these circumstances, the paper recommends changes that shift the focus away from planning towards informed strategic management, that monitors the changing environment and is given freedom to respond to emerging risks and opportunities. The Cambodian German Health Project was initiated in October 1995 as a bilateral health aid project between the German government and the government of the Kingdom of Cambodia, but was disrupted by the "events of 5-6 July, 1997", as the military action is officially described. Project planning had included an intensive goal oriented planning process (ZOPP) undertaken in collaboration with counterparts from the Ministry of Health, Provincial Health Departments and other bilateral, international and non-government stakeholders. Following the military action, the project was initially suspended, then substantially re-drafted within a new framework of assistance, and eventually re-established after an interval of eight months. The paper will examine these planning processes and responses in the light of Mintzberg's (1994 The rise and fall of strategic planning. New York: Prentice-Hall) argument that strategic planning fails because of three conceptual fallacies implicit in the process: (1) The fallacy of predeterminism allows planners to assume that goals, results, appropriate activities and required inputs can confidently be predicted based on past and current experience, when the reality is that both the internal and external environments are subject to change that may not be predictable. (2) The fallacy of detachment suggests that the functions of planning and implementation are discrete management functions, and that objective, rational decisions in determining activities and inputs are sufficient to successfully achieve project goals and results. (3) The fallacy of formalisation provides an expectation that the processes of planning will "capture" the creative insight required for successful strategic development, and reach a binding consensus despite the complex interactions and relationships that characterise bilateral aid projects.     

Experimental pretesting of public health campaigns: a case study

The aim of the present study is to demonstrate the merits of evaluating new public health campaign materials in the developmental phase using an experimental design. This is referred to as experimental pretesting. In practice, most new materials are tested only after they have been distributed using nonexperimental or quasiexperimental designs. In cases where materials are pretested prior to distribution, pretesting is usually done using qualitative research methods such as focus groups. Although these methods are useful, they cannot reliably predict the effectiveness of new campaign materials in a developmental phase. Therefore, we suggest when pretesting new materials, not only qualitative research methods but also experimental research methods must be used. The present study discusses an experimental pretest study of new campaign materials intended for distribution in a national sexually transmitted infection (STI) AIDS prevention campaign in the Netherlands. The campaign material tested was the storyline of a planned television commercial on safe sex. A storyboard that consisted of drawings and text was presented to members of the target population, namely, students between the ages of 14 and 16 enrolled in vocational schools. Results showed positive effects on targeted determinants of safe sexual behavior. The advantages, practical implications, and limitations of experimental pretesting are discussed.     

Decision-making styles of a medical center's management group: a case study

It has been said that those in a position to hire select people like themselves. Is this true? The following article--a study of the decision-making styles of a medical center's management group--makes a compelling argument in favor of this idea.     

Development of an interest in a career in public health during medical school

OBJECTIVES: In The Netherlands, approximately 12% of medical graduates spend their professional life in public health, but it is the authors' belief that few of them become interested in such a career during medical school. The aim of this study was to investigate students' development of interest in a career in a public health specialty during medical school. METHODS: A written questionnaire was completed by students of all years at a Dutch medical school in 2002 (n=1371) and 2003 (n=1293). Students indicated their interest in a career in 37 Dutch medical specialties. Three public health specialties were distinguished and compared with the least popular specialty, the most popular specialty and with the average interest over all specialties. RESULTS: Interest in a career in occupational health and social insurance health was low throughout medical school. However, almost 15% of students indicated a high level of interest in youth health care in the first year of medical school, which is over twice as many as for the average specialty. This percentage decreased dramatically during medical school. At graduation, all three public health specialties had interest figures well below the average. CONCLUSIONS: Students have little interest in careers in public health. However, given that approximately 12% of medical graduates spend their professional life in public health, the factors that influence career preferences should be investigated. Targeted measures may yield more primary career preference in this direction. Reasons for the loss of interest in youth health care need to be investigated.     

International public health research involving interpreters: a case study from Bangladesh

Background  

Cross-cultural and international research are important components of public health research, but the challenges of language barriers and working with interpreters are often overlooked, particularly in the case of qualitative research.     

Local health districts and the public health workforce: a case study of Wyoming and Idaho.

This study of personnel in local health departments (LHDs) focused on two predominantly rural states: Idaho and Wyoming. Although in the same region of the country, the structure of local public health is different in each state. Idaho's regionalized LHDs are relatively autonomous, whereas Wyoming's are county based, with many public health functions retained at the state level. The majority of professionals are nurses followed by environmental health workers and sanitarians, similar to data reported nationally. With increased emphasis on core public health functions of policy, assurance, and assessment, rural LHDs will be challenged to redirect the functions of their workforce.     

Structured peer group supervision of school consultation:A case study

Structured peer group supervision (SPGS) supports applied skill growth for novice mental health professionals. Whereas previous SPGS research has focused on counseling, consultation is a core competency for school psychologists, with unique features meriting consideration during SPGS. This case study describes the influence of SPGS on applied communication and problem-solving skills of nine graduate students taking a school consultation course. Structured interviews measured participants’ perceptions, including information about how SPGS influenced consultation skills. Thematic coding revealed positive impacts of SPGS on communication skill development, and as logistical and conceptual support. Implications for school consultation training and practice are discussed.     

Preparing for and responding to public health emergencies in China: a focus group study

To gather information that would assist China's central government and local governments in public health emergency management, we conducted focus groups to identify current problems. In three provinces, selected to reflect differing economic and social status, we met with two groups each, composed of public health officials and practitioners. Sampling to achieve a mix and for convenience, we followed a guide to cover five topics. Eleven common problems emerged. China's central government and local governments should take immediate action to solve these remaining problems in public health emergency management.     

Disease eradication as a public health strategy: a case study of poliomyelitis eradication

Disease eradication as a public health strategy was discussed at international meetings in 1997 and 1998. In this article, the ongoing poliomyelitis eradication initiative is examined using the criteria for evaluating candidate diseases for eradication proposed at these meetings, which covered costs and benefits, biological determinants of eradicability (technical feasibility) and societal and political considerations (operational feasibility). The benefits of poliomyelitis eradication are shown to include a substantial investment in health services delivery, the elimination of a major cause of disability, and far-reaching intangible effects, such as establishment of a "culture of prevention". The costs are found to be financial and finite, despite some disturbances to the delivery of other health services. The "technical" feasibility of poliomyelitis eradication is seen in the absence of a non-human reservoir and the presence of both an effective intervention and delivery strategy (oral poliovirus vaccine and national immunization days) and a sensitive and specific diagnostic tool (viral culture of specimens from acute flaccid paralysis cases). The certification of poliomyelitis eradication in the Americas in 1994 and interruption of endemic transmission in the Western Pacific since March 1997 confirm the operational feasibility of this goal. When the humanitarian, economic and consequent benefits of this initiative are measured against the costs, a strong argument is made for eradication as a valuable disease control strategy.