Purpose This study aims to take a discursive view on positive leadership (PL). A positive approach has gained momentum in recent years as appropriate leadership practices are implemented in organizations. Despite the turn toward discursive approaches in organization studies, there is insufficient evidence supporting PL as a socially constructed experience. Design/methodology/approach The present study addresses an integrative discourse perspective for capturing the PL concept as a social process within the public health-care context. Findings Four meanings of PL are highlighted: role-taking, servicing, balancing and deciphering. Research limitations/implications The meanings shift the emphasis of certain PL definitions to a contextual interpretation. For scholars, the perspective demonstrates a multidimensional process approach in the desired organizational context as a counterbalance to one unanimously agreed-upon PL definition. Practical implications For leaders, an integrative discourse perspective offers tools for comprehending PL as a process: how to identify, negotiate and reconcile various PL meanings. Originality/value An integrative discourse perspective provides a novel perspective capturing the PL concept within the public health-care field.
Type 2 diabetes mellitus (T2DM) is a common disorder that is estimated to affect approximately 100 million people worldwide. Forecasts have suggested a substantial increase in incidence, mainly in Asia, Africa and North America. Thus, an increasing number of people with diabetes-related complications will have to be cared for in the future. This development will be a major health problem for the people affected, as well as a major health economic challenge for many countries. Thiazolidinediones represent a new class of drugs with a novel mechanism of action that addresses the root cause of T2DM. Their mode of action targets the core defect of T2DM, namely, insulin resistance. One of these drugs, pioglitazone, was recently approved by the Swedish authorities. To evaluate the cost effectiveness of this new drug, a published mathematical simulation model was used. This model was adapted to Swedish conditions, and local Swedish unit costs were put into the model. Modelling is necessary when performing economic evaluations in diabetes because of the complexity of the disease and its long time horizon. The cost-effectiveness analyses showed that the cost per life-year gained with pioglitazone combination therapy compared with current treatment ranged from 37,000 Swedish kronor (SEK) to SEK149,000. Although there is no threshold value for cost effectiveness in Sweden, the values presented would normally be regarded as cost effective in the Swedish healthcare system. Modelling studies are a good starting point, but long-term naturalistic studies are needed to establish the cost effectiveness of these new drugs.
INTRODUCTION: Disease in the musculoskeletal system accounts for the largest proportion of chronic disease in Denmark, and the associated costs amount to billions of kroner every year. Prevention and treatment have focussed on exercise and training. Training in fitness centres is one of the most popular forms of exercise in Denmark and the number of users is increasing rapidly. We suspect that musculoskeletal problems are common among members of fitness centres, and that good communication between the centres and the health care sector would optimize treatment. The purpose of the present study is to describe the extent of musculoskeletal problems among members of fitness centres and the degree of communication between the centres and the health care sector. MATERIALS AND METHODS: Information regarding age, sex, musculoskeletal complaints, possible treatment, and whether there had been any communication between health care providers and the fitness centres before or during the period of training was collected among members of five fitness centres in Denmark. RESULTS: 485 (94%) out of a total of 516 members participated in the study. 56% reported that they had one or more musculoskeletal problem when joining the centre. Out of these, 77% stated that musculoskeletal problems were the main or a contributing reason for joining the centre. More than half the participants with musculoskeletal complaints had received some kind of treatment within the previous year. However, communication between health care providers and fitness centres was uncommon. CONCLUSION: The fitness sector is growing rapidly and more than 50% of members suffer from musculoskeletal problems. Most of these also receive treatment for their problems but there is very little and almost no formal communication between the health care sector and the fitness centres.
The healthcare sector is a significant contributor to global carbon emissions, in part due to extensive travelling by patients and health workers.
To evaluate the potential of telemedicine services based on videoconferencing technology to reduce travelling and thus carbon emissions in the healthcare sector.
A life cycle inventory was performed to evaluate the carbon reduction potential of telemedicine activities beyond a reduction in travel related emissions. The study included two rehabilitation units at Umeå University Hospital in Sweden. Carbon emissions generated during telemedicine appointments were compared with care-as-usual scenarios. Upper and lower bound emissions scenarios were created based on different teleconferencing solutions and thresholds for when telemedicine becomes favorable were estimated. Sensitivity analyses were performed to pinpoint the most important contributors to emissions for different set-ups and use cases.
Replacing physical visits with telemedicine appointments resulted in a significant 40-70 times decrease in carbon emissions. Factors such as meeting duration, bandwidth and use rates influence emissions to various extents. According to the lower bound scenario, telemedicine becomes a greener choice at a distance of a few kilometers when the alternative is transport by car.
Telemedicine is a potent carbon reduction strategy in the health sector. But to contribute significantly to climate change mitigation, a paradigm shift might be required where telemedicine is regarded as an essential component of ordinary health care activities and not only considered to be a service to the few who lack access to care due to geography, isolation or other constraints.
Cites: Int J Med Inform. 2006 Aug;75(8):565-7616298545
The health and social care sector (HCS) is currently facing multiple challenges across Europe: against the background of ageing societies, more people are in need of care. Simultaneously, several countries report a lack of skilled personnel. Due to its structural characteristics, including a high share of part-time workers, an ageing workforce, and challenging working conditions, the HCS requires measures and strategies to deal with these challenges.
This qualitative study analyses if and how organisations in three countries (Germany, Finland, and the UK) report similar challenges and how they support longer working careers in the HCS. Therefore, we conducted multiple case studies in care organisations. Altogether 54 semi-structured interviews with employees and representatives of management were carried out and analysed thematically.
Analysis of the interviews revealed that there are similar challenges reported across the countries. Multiple organisational measures and strategies to improve the work ability and working life participation of (ageing) workers were identified. We identified similar challenges across our cases but different strategies in responding to them. With respect to the organisational measures, our results showed that the studied organisations did not implement any age-specific management strategies but realised different reactive and proactive human relation measures aiming at maintaining and improving employees' work ability (i.e., health, competence and motivation) and longer working careers.
Organisations within the HCS tend to focus on the recruitment of younger workers and/or migrant workers to address the current lack of skilled personnel. The idea of explicitly focusing on ageing workers and the concept of age management as a possible solution seems to lack awareness and/or popularity among organisations in the sector. The concept of age management offers a broad range of measures, which could be beneficial for both, employees and employers/organisations. Employees could benefit from a better occupational well-being and more meaningful careers, while employers could benefit from more committed employees with enhanced productivity, work ability and possibly a longer career.
The high rate of violence in the healthcare sector supports the need for greater surveillance efforts.
The purpose of this study was to use a province-wide workplace incident reporting system to calculate rates and identify risk factors for violence in the British Columbia healthcare industry by occupational groups, including nursing.
Data were extracted for a 1-year period (2004-2005) from the Workplace Health Indicator Tracking and Evaluation database for all employee reports of violence incidents for four of the six British Columbia health authorities. Risk factors for violence were identified through comparisons of incident rates (number of incidents/100,000 worked hours) by work characteristics, including nursing occupations and work units, and by regression models adjusted for demographic factors.
Across health authorities, three groups at particularly high risk for violence were identified: very small healthcare facilities [rate ratios (RR) = 6.58, 95% CI =3.49, 12.41], the care aide occupation (RR = 10.05, 95% CI = 6.72, 15.05), and paediatric departments in acute care hospitals (RR = 2.22, 95% CI = 1.05, 4.67).
The three high-risk groups warrant targeted prevention or intervention efforts be implemented. The identification of high-risk groups supports the importance of a province-wide surveillance system for public health planning.
The session began with three presenters - LouAnn Benson, Walter Porter, and Lisa Dolchok - all of whom are or have been affiliated with the Circle of Healing Program at Southcentral Foundation in Anchorage, Alaska. The Southcentral Foundation is a Native Health Corporation that administers what used to be the Indian Health Service Hospital and Medical Center. In the Circle of Healing Program, the Southcentral Foundation has designed and implemented an approach to health care that allows its patients simultaneously to access Western medicine, traditional Native healing, and other alternative approaches to health care, such as acupuncture. An important figure in this effort is Dr. Robert Morgan, a psychologist who has worked with the program for several years, and who helped suggest presenters for this part of the program. Originally, Bob planned to be present in Quebec City, but family priorities meant a change in plans. Bob's absence had a silver lining, however, because in his stead he sent LouAnn Benson, one of his able colleagues, who talked about the program from the perspective of an insider.
Laboratory testing services are presently undergoing dynamic changes in response to a wide range of external factors. Government regulations, reimbursement, and managed care are only a few of the influences affecting the availability of testing services and on-site testing capabilities in hospital, independent, and physician office laboratories. Medical practice changes, marketplace influences, test technologies, and costs also play a role in determining where testing is being performed. To better understand the factors influencing clinical laboratory test volumes and menus and to identify on-site testing deemed essential in physician office laboratories, we gathered information from a network of clinical laboratories in the Pacific Northwest. Questionnaires were sent to 257 Laboratory Medicine Sentinel Monitoring Network participants in March 1996. In the past 2 years, changes in on-site test volumes and test menus have been primarily due to medical practice changes and marketplace influences. When laboratories had a decrease in test volumes or test menu choices, the size of the patient workload and the volumes of test orders have had the greatest impact. Laboratory regulations and managed care contracts have played a role in shifting on-site testing to outside sources; however, these factors did not appear to be primary influences. Only 5% of physician office laboratories identified tests that they believed were essential for optimal patient care but did not perform on-site.