Community-based participatory research: implications for public health funding. (65/396)

Community-based participatory research (CBPR) increasingly is being recognized by health scholars and funders as a potent approach to collaboratively studying and acting to address health disparities. Emphasizing action as a critical part of the research process, CBPR is particularly consistent with the goals of "results oriented philanthropy" and of government funders who have become discouraged by the often modest to disappointing results of more traditional research and intervention efforts in many low income communities of color. Supporters of CBPR face challenging issues in the areas of partnership capacity and readiness, time requirements, funding flexibility, and evaluation. The authors suggest strategies for addressing such issues and make a case for increasing support of CBPR as an important tool for action-oriented and community-driven public health research.  (+info)

Developing a neonatal workforce: role evolution and retention of advanced neonatal nurse practitioners. (66/396)

BACKGROUND: Over the past decade more than 120 advanced neonatal nurse practitioners (ANNPs) have graduated from the Southampton based ANNP programme. OBJECTIVES: To determine the scope of practice and evolving role of ANNPs and to identify factors that may affect future recruitment and retention. METHOD: An open ended structured questionnaire on clinical role, working arrangements, retention and attrition, continuing education, and professional development was sent to 95 ANNPs. RESULTS: A response rate of 83% was achieved. There was an attrition rate of 14%, with most ANNPs remaining in their original seconding unit. Factors considered to be important for role satisfaction included a well defined role, working within a team of ANNPs, appropriate remuneration, and evidence of unit support for both role definition and continuing professional development. CONCLUSIONS: Although ANNPs are expensive to both train and employ, this evidence suggests that there is a good return on the investment in terms of retention to the unit and the specialty. Their role incorporates many features of advanced nursing practice as well as providing "value added" neonatal care by merging traditional medical and nursing roles and crossing professional boundaries. In 2004 the manpower challenges for neonatal units will be even more acute; these data confirm that there are effective options available but they require long term strategic planning and investment.  (+info)

Promoting safe walking and biking to school: the Marin County success story. (67/396)

Walking and biking to school can be an important part of a healthy lifestyle, yet most US children do not start their day with these activities. The Safe Routes to School Program in Marin County, California, is working to promote walking and biking to school. Using a multipronged approach, the program identifies and creates safe routes to schools and invites communitywide involvement. By its second year, the program was serving 4665 students in 15 schools. Participating public schools reported an increase in school trips made by walking (64%), biking (114%), and carpooling (91%) and a decrease in trips by private vehicles carrying only one student (39%).  (+info)

Ownership and performance of outpatient substance abuse treatment centers. (68/396)

BACKGROUND: Little is known about the organization and performance of outpatient substance abuse treatment (OSAT) centers. We examine several performance measures of OSAT units, including clients treated, services provided, revenue sources, financial performance, and access to care, in relation to ownership of the center. METHODS: Data were drawn from a national random sample of 575 OSAT centers (85.8% response rate) participating in a telephone survey conducted in 1988. Analysis of variance by ownership was conducted on each performance measure, with differences subjected to tests of statistical significance. RESULTS: Descriptive results show that major funding sources differ by ownership. Private for-profit centers generate higher profits, charge higher prices, and achieve higher levels of financial performance than public and not-for-profit centers. Public centers provide better access to care for persons who are unable to pay. CONCLUSIONS: There appear to be substantial and interrelated differences by ownership type in the financing and operation of OSAT units.  (+info)

Schistosomiasis research funding: the TDR (Special Programme for Research and Training in Tropical Diseases) contribution. (69/396)

In spite of the recent decline in financial support on the part of some major donors, the overall international support for schistosomiasis research in current US dollars has been holding steady. However, when adjusted for inflation, a clear decline-during the last decade appears and only in a few countries has this decline been balanced by increased national or bilateral funding. The prevailing level of support for schistosomiasis research is barely sufficient to maintain established laboratories and researchers, and highlights the need to attract young investigators. The important goal of bringing a new generation of scientists into the field of schistosomiasis can only be achieved by a considerable long-term increase in funding, both at the national and the international levels. A break-through in current research emphasizing improved techniques for control is needed to encourage donors and governments to improve the situation.  (+info)

Are foundations overlooking mental health? (70/396)

Over the past decade philanthropic giving for health has increased dramatically, but giving for mental health has not kept pace. Historically, foundations have been key partners in efforts to improve care for people with mental disorders, and foundation funding has influenced the evolution of U.S. mental health services and systems. Although mental health giving grew in the 1990s, the rate of growth was far below that for total foundation giving or giving for health. The authors suggest possible reasons why mental health funding lost ground and describe promising funding approaches and models for increasing both the amount and the impact of philanthropic giving for mental health.  (+info)

Current HIV/AIDS end-of-life care in sub-Saharan Africa: a survey of models, services, challenges and priorities. (71/396)

BACKGROUND: In response to increased global public health funding initiatives to HIV/AIDS care in Africa, this study aimed to describe practice models, strategies and challenges to delivering end-of-life care in sub-Saharan Africa. METHODS: A survey end-of-life care programs was conducted, addressing the domains of service aims and configuration, barriers to pain control, governmental endorsement and strategies, funding, monitoring and evaluation, and research. Both closed and qualitative responses were sought. RESULTS: Despite great structural challenges, data from 48 programs in 14 countries with a mean annual funding of US 374,884 dollars demonstrated integrated care delivery across diverse settings. Care was commonly integrated with all advanced disease care (67%) and disease stages (65% offering care from diagnosis). The majority (98%) provided home-based care for a mean of 301 patients. Ninety-four percent reported challenges in pain control (including availability, lack of trained providers, stigma and legal restrictions), and 77% addressed the effects of poverty on disease progression and management. Although 85% of programs reported Government endorsement, end-of-life and palliative care National strategies were largely absent. CONCLUSIONS: The interdependent tasks of expanding pain control, balancing quality and coverage of care, providing technical assistance in monitoring and evaluation, collaborating between donor agencies and governments, and educating policy makers and program directors of end-of-life care are all necessary if resources are to reach their goals.  (+info)

Descriptive survey of non-commercial randomised controlled trials in the United Kingdom, 1980-2002. (72/396)

OBJECTIVES: To describe the characteristics of randomised controlled trials supported by the main non-commercial sources of funding in the United Kingdom between 1980 and 2002. DESIGN: Descriptive survey. SETTING: Randomised controlled trials funded by the Medical Research Council, NHS research and development programme, Department of Health, Chief Scientist Office in Scotland, and medical research charities. PARTICIPANTS: 1464 randomised controlled trials supported by the main non-commercial sources of funding. RESULTS: Support for randomised controlled trials by the main sources of non-commercial funding in the United Kingdom has fallen in recent years, without any concomitant increase in the sample sizes of these studies. Drug trials in a limited range of health problems have dominated among the studies supported by the Medical Research Council and medical research charities. Until recently, the NHS research and development programme supported randomised controlled trials of various healthcare interventions, in a wide range of health problems, but between 1999 and 2002 many of the subprogrammes that had commissioned trials were discontinued. CONCLUSIONS: The future of non-commercial randomised controlled trials in the United Kingdom has been threatened by the discontinuation or demise of national and regional NHS research and development programmes. Support also seems to be declining from the Medical Research Council and the medical research charities. It is unclear what the future holds for randomised controlled trials that address issues of no interest to industry but are of great importance to patients and practitioners.  (+info)