Inter-organizational networks on the Dutch home health care market

The demand for home care in the Netherlands is growing and changing. A decreasing rate of institutionalization, combined with an increasing number of elderly people with special age-related, often complex health problems, has led to new groups of patients, to be cared for in their home settings. This requires a strong coordination of services between suppliers from the primary and secondary health care sectors. In order to promote coordinated care, Dutch health care providers are building inter-organizational networks. The development of such arrangements was the target of 12 demonstration projects, selected by the Ministry of Health for the National Home Care Programme. This article presents some of the results of an evaluation study of the Programme, with special attention given to the question of the extent to which such inter-organizational networks contribute to the balance between quality and cost.     

An overview of hospital accreditation in Taiwan, Republic of China

This paper examines the hospital accreditation system in Taiwan, Republic of China. The paper describes the historical evolution of accreditation; preliminary teaching hospital accreditation; hospital and teaching hospital accreditation; issues and problems; and perspectives and challenges.     

Establishing a new university department of rural health: the first 2 years of the South Australian Centre for Rural and Remote Health

ABSTRACT: This study aimed to describe the establishment of a new University Department of Rural Health (UDRH) in South Australia and to report early achievements. In May 1997, the UDRH was established, key staff were recruited, infrastructure was developed and in April 1998 a Joint University Committee on Rural and Remote Health was formed. By mid-1999, 14 full-time equivalent staff were employed in Whyalla and Adelaide. Early achievements include: review of undergraduate rural placements; increased rural clinical placements by 1000 student-weeks; partnership with the Dental School resulting in training opportunities and falling public dental waiting lists; multidisciplinary teaching practices in four rural sites; priority public health projects established; competitive research grants won; and a capital grant to strengthen Aboriginal health services infrastructure secured. These early achievements demonstrate UDRH potential to have a real impact on health worker education, service delivery, and public health status in rural and remote areas. This strong foundation must now be built on.     

Quality of health care for ethnic/racial minority populations

This article reviews the composition and characteristics of the health professions, the demographics of the national population, and factors that influence access to health care and satisfaction with care for ethnic/racial minority populations in the United States. In addition, an overview of publicly funded US health insurance programs for the poor is provided along with a discussion of the impact that managed care is having on the American health care system. Finally, the paper summarizes conference discussions regarding the problems, strategies, and approaches that the UK and the US have experienced with respect to providing quality health care for ethnic/racial minority populations.     

Morbus sacer in Africa: some religious aspects of epilepsy in traditional cultures

Epilepsy when manifested as grand mal seizure provokes strong and ambivalent feelings in those witnessing it. Terms such as morbus sacer, denoting both a sacred and demoniac condition, or folk names indicating divine punishment, have expressed these feelings in European societies from antiquity to the Middle Ages and beyond. An atmosphere of fear, shame and mysticism surrounds epilepsy even in our days in many non-Western and also in Western cultures. In the course of work and studies in Tanzania, where I organized the Mahenge Clinic for Epilepsy in 1960, and in other parts of Africa, I found that epilepsy is conceived of as an "African' affliction, a manifestation of supernatural forces that makes it difficult to reach epilepsy sufferers with modern medical treatment. Epilepsy is traditionally looked on as caused by ancestral spirits or attributed to possession by evil spirits. It is also thought to be due to witchcraft, and "poisoning," and often taken to be contagious. Epilepsy may, under Christian missionary teaching, have come to be considered as due to demoniac possession or divine punishment for sins, in accordance with biblical examples. In many parts of Africa, syncretic amalgamation of indigenous traditions with Judeo-Christian doctrines influenced popular attitudes toward epilepsy. We demonstrated that persistent efforts at health education in the context of organized treatment of epilepsy can result in a change of popular notions about epilepsy and consequently lead to significant improvement in the quality of life of epilepsy sufferers.     

我国南方武警官兵卫生服务需求分析

目的：探讨武警部队基层官兵卫生服务需求状况及疾病构成。方法：采用国际通用的两周健康询问调查法对淮河以南地区的7个省、自治区总队的1457名武警基层官兵的卫生服务需求进行了问卷调查。数据采用WinSAS6．11统计软件包分析。结呆;两周患病率在武警部队三类支队,干部与战士之间无差异（P＞0．05）;慢性病患病率随军龄延长而升高,存在非常显著差异（P＜0．01）。武警部队官兵两周患病以呼吸系统、传染病和寄生虫病为主;慢性病以骨骼肌肉系统、消化系统疾病为主。结论;南方武警官方的卫生服务需求高于我国城市与农村居民;传染病与社会、心理、行为因素所致的某些非传染性疾病共同成为官兵健康的主要威胁,提示武警部队可能存在潜在的职业性危害因素。     

贯彻实施《母婴保健法》 促进山区妇幼卫生工作的发展

《中华人民共和国母婴保健法》（下称《母婴保健法》）的颁布实施,标志着我国妇幼卫生工作纳入了法制化管理的轨道。我县依法开展了各项妇幼卫生工作,进一步推动了山区县妇幼卫生工作的发展。１　加强领导　广泛宣传自１９９６年６月１日实施《母婴保健法》以来,我县在县政府和县卫生局领导下,通过多种形式和多种渠道广泛宣传,使《母婴保健法》家喻户晓,深入人心,提高了全社会贯彻实施《母婴保健法》的积极性和自觉性,为依法开展妇幼卫生工作打下了良好的思想基础。２　强化妇幼保健服务功能２１　根据《母婴保健法》关于婚前医学…     

Radiation exposure: a new risk factor for idiopathic perifoveal telangiectasis

Objective

To examine the association between previous radiation exposure and idiopathic perifoveal telangiectasis (IPT).

Siblings in foster care: Success and failure

This article reports on a retrospective study of 59 joint placements of siblings in foster homes, involving a total of 137 children. An overall picture is presented of the agencies' considerations in making these placements. The number of prematurely terminated placements in this group amounted to 14 (23.7%). Several factors that appear related to premature termination are discussed.Frits Boer is a university lecturer in the Department of Child and Youth Psychiatry at the University of Leiden in the Netherlands and works as a child psychiatrist at the Academic Center for Child and Adolescent Psychiatry Curium in Oegstgeest. Stella Spiering is developmental psychologist in Rijswijk, the Netherlands.