bluuebunny/crossref_metadata_2025_split huggingface dataset:
Race, gender, and language concordance in the primary care setting
Authors: Martin Brian C. , Shi Leiyu , Ward Ryan D. 
Published: June 2009

PurposeThe purpose of this paper is to examine race, gender and language concordance in terms of importance to primary care.Design/methodology/approachThe 2003 Medical Expenditure Panel Survey Household Component (MEPS) was used. Four distinguishing primary care attributes and selected measures were operationalized primarily from a sample subset that identified a usual source of care (USC): accessibility to USC; interface between primary care and specialist services; treatment decisions; and preventive services received from the USC. Bivariate and multivariate results are reported.FindingsAdjusting for covariates, the following items remained statistically significant: race – choosing primary care physician as USC, USC having office hours, and going to USC for new health problems; gender – choosing primary care physician as USC and USC having office hours; and language – lack of difficulty contacting the USC after hours. However, these items appear to be isolated cases rather than indicators that concordance plays a key role in determining primary care quality. Language barriers/communication issues are the only areas where improvement appears warranted.Research limitations/implicationsWhile the study has strong accessibility and interpersonal relationship measures, service coordination and comprehensiveness indicators are limited. The analyses' cross‐sectional nature also poses a problem in drawing causal relationships and conclusive findings. Finally, sample size limitations preclude stratified analyses across racial/ethnic groups, an important consideration as the relationships between concordance and quality may vary across groups.Practical implicationsThis study indicates that more research is needed in this area to determine future resource allocation and policy direction.Originality/valueThe unique contribution of the study is to suggest that race and gender concordance may not accurately predict primary health care quality.
Working together?
Authors: Gross Revital , Tabenkin Hava , Porath Avi , Heymann Anthony , Porter Boaz 
Published: June 2009

PurposeThis article aims to analyze existing and preferred labor divisions between physicians and nurses treating patients with hypertension and diabetes in managed care organizations.Design/methodology/approachA mail survey was conducted in 2002/2003 among a representative sample of 743 physicians employed by Israel's largest managed care health plans (78 percent response rate). A telephone survey among a representative sample of 1,369 hypertensive or diabetic patients (77 percent response rate) was also used.FindingsFindings reveal a conspicuous gap between actual labor division and what physicians perceive to be ideal. Possible reasons for this gap are discussed and strategies for facilitating collaboration, which would improve service quality as well as work life quality for both physicians and nurses.Originality/valueThis study provides empirical data on the extent of nurse involvement in managed care organization chronic patient care, as well as comparing them to physicians' preferences regarding nurse involvement.
Factors affecting patient satisfaction and healthcare quality
Authors: Naidu Aditi 
Published: June 2009

PurposeThe aim of this paper is to build a comprehensive conceptual model to understand and measure variables affecting patient satisfaction‐based healthcare quality.Design/methodology/approachA total of 24 articles from international journals were systematically reviewed for factors determining patient satisfaction and healthcare quality.FindingsPatient satisfaction is a multi‐dimensional healthcare construct affected by many variables. Healthcare quality affects patient satisfaction, which in turn influences positive patient behaviours such as loyalty. Patient satisfaction and healthcare service quality, though difficult to measure, can be operationalized using a multi‐disciplinary approach that combines patient inputs as well as expert judgement.Research limitations/implicationsThe paper develops a conceptual model that needs to be confirmed empirically. Also, most research pertains to developed countries. Findings are presented that may not be generalized to developing nations, which may be quite different culturally.Practical implicationsThe paper has direct implications for health service providers. They are encouraged to regularly monitor healthcare quality and accordingly initiate service delivery improvements to maintain high levels of patient satisfaction.Originality/valueThe paper collates and examines recent healthcare quality study findings. It presents a comprehensive, conceptual model encompassing research work and a holistic view of various aspects affecting patient satisfaction and healthcare quality. Although a large amount of healthcare quality research has been done, each studying a particular service, this paper comprehensively brings together various research findings.
Reforming the Bangladesh healthcare system
Authors: Al Mahdy Husayn 
Published: June 2009

PurposeBangladesh has an outdated healthcare system that has not changed since its independence in 1971. The aim of this paper is to look into how the Bangladesh healthcare system can be reformed.Design/methodology/approachThis paper is literature‐based and a personal reflection on one country's health system.FindingsWidespread dissatisfaction exists in the population and amongst doctors about healthcare delivery.Practical implicationsMajor issues causing healthcare user dissatisfaction are discussed and recommendations for reform are suggested.Originality/valueThe paper provides an independent account of one country's healthcare policy and practice.
Frank Gilbreth and health care delivery method study driven learning
Authors: Towill Denis R. 
Published: June 2009

PurposeThe purpose of this article is to look at method study, as devised by the Gilbreths at the beginning of the twentieth century, which found early application in hospital quality assurance and surgical “best practice”. It has since become a core activity in all modern methods, as applied to healthcare delivery improvement programmes.Design/methodology/approachThe article traces the origin of what is now currently and variously called “business process re‐engineering”, “business process improvement” and “lean healthcare” etc., by different management gurus back to the century‐old pioneering work of Frank Gilbreth. The outcome is a consistent framework involving “width”, “length” and “depth” dimensions within which healthcare delivery systems can be analysed, designed and successfully implemented to achieve better and more consistent performance.FindingsHealthcare method (saving time plus saving motion) study is best practised as co‐joint action learning activity “owned” by all “players” involved in the re‐engineering process. However, although process mapping is a key step forward, in itself it is no guarantee of effective re‐engineering. It is not even the beginning of the end of the change challenge, although it should be the end of the beginning. What is needed is innovative exploitation of method study within a healthcare organisational learning culture accelerated via the Gilbreth Knowledge Flywheel.Research limitations/implicationsIt is shown that effective healthcare delivery pipeline improvement is anchored into a team approach involving all “players” in the system especially physicians. A comprehensive process study, constructive dialogue, proper and highly professional re‐engineering plus managed implementation are essential components. Experience suggests “learning” is thereby achieved via “natural groups” actively involved in healthcare processes.Originality/valueThe article provides a proven method for exploiting Gilbreths' outputs and their many successors in enabling more productive evidence‐based healthcare delivery as summarised in the “learn‐do‐learn‐do” feedback loop in the Gilbreth Knowledge Flywheel.
Four years beyond tsunami
Authors: Sahai Achuthan Nisha 
Published: June 2009

PurposeThe purpose of this paper in respect of tsunami‐affected villages in Tamil Nadu undertaken in a field trip in June 2005, and updated through online research is to first provide an overview of discrete, ongoing initiatives by different stakeholders – NGOs; Government and UNDP; Government's announcement to have a tsunami early warning system for the Indian Ocean in place by mid‐2007, paralleled by a partnership of different stakeholders to launch a pan‐India village‐info‐kiosk movement in July 2005.Design/methodology/approachThe first step was to identify existing reports/programmes on disaster preparedess and mitigation, and then track the progress of the implementation of initiatives by different stakeholders. While highlighting the need for coordinated action, the author also proposed initiating a pilot project in two‐three pre‐selected village‐sites, which in turn could be upgraded to make them “Multi hazard‐ready”.FindingsWhile the initiatives by different stakeholders were aimed at covering the targeted villages, as per their respective plans – there was as yet little visible attempt to privilege the tsunami‐affected villages, as was being done with their recovery efforts. Significantly, there was no mention of the proposed post tsunami Central Recovery Resource Center (CRRC) at Chennai “to meet the need for a coordinated action by all stakeholders” in the course of the discussions of early June, nor a reference to the potential for such a forum to deliberate on a coordinated Multi hazard, early warning action plan along the lines highlighted through vertical and horizontal linkages.Practical implicationsWhile the above activities were not part of a grand design – conceptualized, implemented and overseen by an over arching coordinating agency, nevertheless, together they add up to a broad based comprehensive DM resource base/infrastructure upon which hopefully an agency like the INCOIS in coordination with different stakeholders – possibly under the aegis of the Chennai CRRC – could build up its mandated tsunami – multi hazard – early warning system and its dissemination to the village‐level in TN.Originality/valueThe paper serves as a “one window resource guide” to provide at least the contours of a road map pointing to one of the few possible ways on how to go about a risk management plan in a coordinated and focused mode.
Managing crisis response communication in construction projects – from a complexity perspective
Authors: Zhong Ying , Pheng Low Sui 
Published: June 2009

PurposeThe number of crisis incidents and their severity is rising along with the growing complexity of technology and society. There are enumerable incidents that can interrupt progress in construction projects. The crisis response phase puts the project organization's established normal communication systems and processes under enormous and additional pressure. The aim of this paper is to make a contribution to link and extend the knowledge of complexity theory on communication management in the context of the crisis response. This paper aims to propose and refine a conceptual framework for understanding the underlying pattern of communication behavior and decisions of human systems in response to a crisis and to investigate how to enhance the organization's adaptability and resilience in the event of a crisis.Design/methodology/approachThe paper reviews, proposes and refines a conceptual complexity‐informed framework for effective crisis response communication management.FindingsConventional crisis response communication models and management are grounded on the linear, command‐and‐control principles of “scientific management”, that they are rather limited in describing flexible reactions to the changing circumstances and explaining the dynamic and complex crisis response situations. The paper breaks out of this mould to propose an alternative model for crisis response communication based on complexity theory.Practical implicationsThe conceptual model proposed in the paper suggests that while the behavior of these complex systems cannot be predicted all the parts nevertheless self‐organize, learn and adapt to their dynamically changing environment.Originality/valueIn terms of this proposed conceptual framework, a flexible and adaptive management approach for the construction project manager to communicate and respond quickly and effectively in the midst of a crisis is suggested.
Causes of slope instability in the Himalayas
Authors: Singh Ashish Kumar 
Published: June 2009

PurposeThe purpose of this paper is to attempt to generate a better, systematic and scientific understanding of the basic reasons behind slope instability to help in developing the basic principles of landslide hazard zonation, monitoring and forecasting of landslide hazards for better and more effective landslide hazard mitigation and management.Design/methodology/approachThe study is based on extensive field observations and intensive reviews of literature from secondary sources.FindingsMass movements especially landslides as they are known to common man are a recurring natural phenomenon and are an integral part of any geological/geomorphological circle of landform development through sequential development of slopes in any elevated region and especially in young fold mountain chains.Practical implicationsThe paper presents a valuable insight into the basic reasons behind a landslide to spread awareness, to educate and sensitize people towards better and effective landslide hazard mitigation and thereby ensure people's participation in disaster management. It also aims to initiate and encourage research in the field of landslide management.Originality/valueLandslides occur frequently and without any appreciable warning as such causing havoc and often insurmountable damage to life and property but despite their uncertainty, their causative factors and indicators of slope instability are very well known to an extent that the magnitude of these events, susceptible areas, the timing of such events and their potential impact can be studied, analyzed and evaluated on the basis of past occurrences and existing knowledge to mitigate their impact. The real value of the present study is to minimize losses due to landslides through better knowledge and enhanced levels of understanding of the phenomenon and its management by simply avoiding those particular reasons that could lead to slope instability problems.
Earthquake safety elements in traditional Koti Banal architecture of Uttarakhand, India
Authors: Rautela Piyoosh , Chandra Joshi Girish 
Published: June 2009

PurposeDespite being located in earthquake sensitive region and often experiencing seismic tremors the State of Uttarakhand in the Indian Himalayas exhibits an elaborate tradition of constructing multistoreyed houses. Both the local dialects of the State (Kumaoni and Garhwali) have unique words for identifying four different floors of a building. This is suggestive of a common occurrence of multistoreyed structures in the region. This paper attempts to establish that the people inhabiting this rugged earthquake prone terrain have evolved the art of constructing earthquake safe structures well before the evolution of the structural engineering principles governing such a construction.Design/methodology/approachDetailed investigations were undertaken in the area to establish the antiquity of the traditional structures, as were also earthquake safety provisions incorporated traditionally in these. Radiocarbon dating of the wood used in the structures was used to establish the time of the construction of these structures.FindingsInvestigations suggest that the region has evolved a distinct, elaborate and magnificent earthquake‐safe construction style. This construction style, designated Koti Banal architecture, attained its zenith around 880 years ago. This architectural style exhibits the existence of elaborate procedures for site selection, preparing the platform for raising the multistoreyed structure, also for the detail of the entire structure that was constructed on principles somewhat akin to that of framed structures of modern times.Research limitations/implicationsThe representative structures of this architecture are observed to be deteriorating fast due to lack of patronage, resources and awareness. This article brings forth awareness regarding the heritage value of these structures, enabling organized efforts for the conservation and upkeep of these structures.Originality/valueThis article is the result of original research undertaken by the authors and paves the way for the conservation of the age old traditional structures.
The accident of passenger‐car vessel Samina Express (2000), when 80 persons died
Authors: Goulielmos Alexandros M. , Goulielmos Markos A. , Gatzoli Androniki 
Published: June 2009

PurposeThe purpose of this paper is to inform readers comprehensively and sufficiently about the marine accident of MV Samina Express with 80+2 dead in the Aegean Sea in September 2000.Design/methodology/approachThe paper uses analysis of court and experts as well as published papers on the accident using nonlinear management techniques.FindingsWhen dialogue and communications in shipping companies fail then accidents to vessels result.Research limitations/implicationsThere was difficult access to court material and limited information on actual causes and the action of payers.Practical implicationsOpen communications can aid in finding the cause of accidents.Originality/valueThe paper reveals the causes of accident due to human errors in a clear way; it outlines the responsibility of the captain as manager of the ship; and shows where and why the dialogue and communication fails.
School as a determinant for health outcomes – a structural equation model analysis
Authors: Ravens‐Sieberer Ulrike , Freeman John , Kokonyei Gyongyi , Thomas Christiane A. , Erhart Michael 
Published: June 2009

PurposeThe purpose of this paper is to investigate whether students' perceptions of their school environment and their adjustment to school are associated with health outcomes across gender and age groups.Design/methodology/approachData from the cross‐sectional international Health Behavior in School‐aged Children Survey of the year 2002 (n=162 306) were analyzed. A structural equation model (LISREL) specified social school climate and school demands influencing, school adjustment (achievement and liking of school). The latter aspects were assumed to influence the health outcomes general health item, life satisfaction and multiple psychosomatic symptoms. Analyses were repeated across gender and age (11, 13 and 15 years).FindingsThe specified LISREL model fitted the data well on the entire sample as well as for age and gender subgroups (RMSEA=0.043‐0.054). Overall, girls' general perceived health and life satisfaction seemed to be more strongly affected by the school environment than boys'. Age affected the goodness of fit of the model and reduced the strength of the relationship between school pressure and school adjustment. In all subgroups, the relationship between better school perceptions and better subjective health and life satisfaction were supported by the analyses.Research limitations/implicationsReported findings are limited to the cross‐sectional study design which precludes causal inferences. Further research using longitudinal data is warranted to confirm the findings.Practical implicationsRelationships between school environment and school adjustment and health‐related outcomes revealed the relative importance of school social climate and demands for school adjustment and through the latter in determining subjective health and life satisfaction. School social climate is a target for promoting health and well‐being of children and adolescents.Originality/valueComplex statistical analyses employing structural equation modelling confirmed findings on the importance of school aspects for child and adolescents in a huge data set.
Strengthening “school” in school mental health promotion
Authors: Rowling Louise 
Published: June 2009

PurposeThe purpose of this paper is to highlight new and existing research on school characteristics that are essential elements in building the capacity of school communities to implement whole school approaches to mental health promotion.Design/methodology/approachThrough an overview of recent research and writing the need for a paradigmatic shift is identified so that educational research and school processes as well as mental health outcomes are utilized as the starting point for school mental health promotion.FindingsMuch of the current advocated practice for improved mental health outcomes arises from evidence from health sector interventions, evidence that may not match the breadth and complexity of conditions in schools that need to be considered to bring about change. The practice may also ignore school processes and structures and the research that delineates how these operate. The results of research in Australia identify two key educational areas, leadership and professional learning that require an increased focus in school mental health promotion. These have emerged from a decade of experience in the implementation and evaluation of MindMatters.Practical implicationsHealth and educational personnel need to target these areas for particular development to ensure strong supports are created for sustainable local school action.Originality/valueThe paper focuses on school leadership and teacher efficacy – areas that have relevance for whole school mental health and wellbeing.
MindMatters – a programme for the promotion of mental health in primary and secondary schools
Authors: Franze M. , Paulus P. 
Published: June 2009

PurposeThe purpose of this article is to present a German adaptation of the Australian programme MindMatters for school mental health promotion in secondary schools.Design/methodology/approachAs well as other methods, the external evaluation consisted of a questionnaire‐based pre‐post‐design (at one year interval of measurement; n=633 teachers and 4,019 students).FindingsTeachers felt more positive about their schools, and felt under less pressure. The concepts of students, teachers and parents about working and living in schools became more similar (including an increase of parents' and students' suggestions for improving school‐life). Students felt that the level of promotion of social competence and the clarity of behaviour codes had improved, although the reported increase was small. There was some evidence that participation in MindMatters decreased student learning and motivation.Research limitations/implicationsOn the whole, the recorded effects, however, were minimal (probably due to the lapse between the times of data collection and politically influenced, structural changes in schools that slowed down the implementation of MindMatters). Future research should focus on a long‐term evaluation of MindMatters.Practical limitationsSince the effect of the programme was influenced by the participation in school specific teacher training and the affiliation to school health promotion networks the reported results stress the importance of teacher training for “MindMatters‐schools”.Originality/valueThe article illustrates that MindMatters would appear to promote some aspects of mental health in schools under specific circumstances.