Work performance and health of junior hospital doctors a review of the literature

Concern has been expressed for a number of years about the long working hours and consequent sleep loss often experienced by junior hospital doctors. In recent months there has been renewed pressure for the demanding work schedules, common in many hospitals, to be changed. Concern centres on two related areas, namely the potential effects on the doctors work performance and the effects on their health. This paper reviews the literature relating to both areas and assesses how far the expressed need for change is supported by existing evidence. In addition attention is drawn to aspects of sleep loss and work performance requiring further investigation.     

Community dissatisfaction and depressed mood in Suburbia

Because of contradicting theoretical statements and empirical data, there is a need to specify the exact part that neighborhood and individual characteristics represent in determining mental health related behavior and the livabiiity of residential neighborhoods. This article adds to the understanding of the general problem by exploring the contributions that economic and social status of neighborhoods and individuals make towards depressed mood and community dissatisfaction. The study was limited to men residing in “classic suburbia” in the early 1960s. Seven hypotheses were proposed — the expectancy congruence, the additive, the big reward, and big failure, the atypical person, the reward visibility, and the economic status maintenance hypotheses. Support for the big reward and pan of the additive hypothesis was observed. The relationships presented in the paper clearly demonstrate that to gain an understanding of community dissatisfaction and depressed mood we must examine an individual's social and economic status and that of his neighborhood.     

福建省建瓯市生殖健康/计划生育项目情景分析调查(上)

本文采用情景分析定性研究方法, 对联合国人口基金援华项目点福建省建瓯市的生殖健康／ 计划生育基础情况进行了全面的考察和深入的讨论, 并为进一步开展项目活动提出了相应的建议本文采用情景分析定性研究方法, 对联合国人口基金援华项目点福建省建瓯市的生殖健康／ 计划生育基础情况进行了全面的考察和深入的讨论, 并为进一步开展项目活动提出了相应的建议     

Accessibility of health and human services for the HIV-infected

Most research on services for the HIV/AIDS population has focused on primary medical care or on service brokering by advocacy groups. Little research data exist on the extent to which services of programs that do not specialize in HIV/AIDS clients are available to these individuals who often have multiple and multi-dimensional problems. The reported research examines selected data from a sample of 236 medical, behavioral health and social service programs in Miami-Dade County, Florida. A constructed measure of involvement in services for HIV/AIDS clients, pertinent provider program and client characteristics are examined in the context of geo-distributed data on reported AIDS cases and census data. In logistic regression analyses, two aspects of race/– the population in the zip code area served by the program, and the clients or patients seen in the program – were significant in predicting program under-response, defined as level of response relative to cumulative reported AIDS cases from the program's zip code area. The analysis is briefly discussed regarding its relevance and methodological generalizability for HIV/AIDS and related public health policy and applied purposes.     

A multi-dimensional client satisfaction instrument

Development of a client satisfaction measure through successive factor analyses is described. Five factors, each defined by five items and accounting for at least 11% of the total variance, were identified and replicated. A single second order factor also emerged in both studies. Reliability of the second order factor, and of three of the first order factors is sufficient for most purposes. The second order factor, which is a linear combination of the first order factors, was not significantly correlated with sex, age, race, or number of attempts made before receiving a client response. The distribution of scores was highly skewed, with most respondents scoring near the upper (satisfied) end.     

Evaluating sociodemographic data: implications for program planning and development

Sociodemographic data can have broad implications for program planning and development. Yet, such data are often obtained and analyzed in a non-rigorous methodological fashion. Four of these methodological issues are discussed in this paper. Their relevance for program planning and development are clarified, using examples from the utilization, needs assessment, illness behavior, and social functioning literature.     

A case study in defining developmental costs for quality assurance in mental health center programs

Issues related to the state-of-the-art of ambulatory mental health care review as well as to the resources necessary for planning and operating a quality assurance program may be hampering development of such programs in community mental health centers nationwide. Faced with the problem of responsible and prudent program management, it has become increasingly difficult for CMHC directors to implement innovative, but unproven, and often unpriced programs which have the potential to draw scarce professional resources away from direct service delivery. Pressure to implement CMHC program requirements that are not ordinarily considered revenue-producing in nature, for example, consultation and education services and quality assurance activities, may further create anxiety for mental health program directors, especially during periods when they are ostensibly confronted with the need to maximize CMHC revenues. Before mental health professionals and administrators of mental health programs can be expected to introduce quality assurance programs, they need to have some idea how much the system costs. The figures reported from three North Carolina mental health centers may offer some indication of what other mental health centers might expect to spend in developing a quality assurance program. Salary expenses for multidisciplinary staff participation in quality assurance activities are presented.     

Evaluating physician competency: What difference does it make?

There are a number of skills that professional experts believe physicians in training should learn in order to be labeled competent practitioners. The beliefs of the experts should be subjected to the rigors of scientific investigation. This paper presents a system for evaluating clinical competency which is designed to test the beliefs of the experts as well as the skills of the practitioner. Four measures of clinical competency are included: data collection completeness, problem identification accuracy, interview skills, patient and physician assessment. Preliminary results suggest a more careful re-examination of beliefs about the skills considered necessary and sufficient in determining clinical competency.     

妇幼保健课教学浅谈

妇幼保健是计划生育干部的必修课程之一,本文结合笔者的教学实践,就如何激发学生的学习积极性,提高课堂教学效果进行了初步探讨