Theoretical frameworks for project goal-setting: A qualitative case study of an organisational practice in Nigeria.

INTRODUCTION: Goal-setting in any practice context is vague unless the process is based on a framework that produces good goals. Popular goal-setting frameworks construct Specific, Measurable, Attainable, Realistic, and Time-bound (SMART) goal statements. Yet, research of how healthcare goals that are foundational to health plans are formulated is scanty. This case study explored the goal-setting practice of an organisation in Nigeria to discover the theoretical frameworks for setting the goals of their leprosy projects. METHODS: The study triangulated individual semi-structured interviews of 10 leprosy managers with a review of their project plans and a participant observation of the organisation's annual planning event. A five-stage thematic analysis was used to serially identify, code, and integrate goal-setting themes from the data collected. FINDINGS: This produced three final emergent themes: stakeholders, strategy, and goal statements, with 11 associated conceptual frameworks. All were further theoretically integrated into one general framework that illustrates the organisational goal-setting practice at the time of study. This revealed a practice with a four-staged linear centre-driven process that led to a top-down, problem-based goal formulation, and produced assigned project plans based on hierarchical non-SMART goal statements. CONCLUSION: Collaborative goal-setting process is proposed for Specific, Measurable, Attainable, Realistic, Timed, and Agreeable statements of project objectives and aims written with Change, Beneficiaries, Indicator, Target, Timeframe and Change, Beneficiaries, Location, and Timeframe models respectively.

Temporal Variation in Ankle Fractures and Orthopedic Resident Program Planning in an Urban Level 1 Trauma Center.

Previous studies have described the mechanism of ankle fractures, their seasonal variation, and fracture patterns but never in conjunction. In addition, the cohorts previously studied were either not from trauma centers or were often dominated by low-energy mechanisms. The present study aimed to describe the epidemiology of ankle fractures presenting to an urban level 1 trauma center. The records from an urban level 1 trauma center located in the Midwestern United States were retrospectively reviewed, and the injury mechanism and energy, time of injury, day of week, month, and patient characteristics (age, gender, comorbidities, smoking status) were collected. The fractures were classified using the AO (Arbeitsgemeinschaft für Osteosynthesefragen), Lauge-Hansen, and Danis-Weber systems. Of these systems, the Lauge-Hansen classification system resulted in the greatest number of "unclassifiable" cases. Most ankle fractures were due to high-energy mechanisms, with motor vehicle collisions the most common high-energy mechanism. The review found that most ankle fractures were malleolar fractures, regardless of the mechanism of injury. The ankle fracture patients had greater rates of obesity, diabetes, and smoking than present in the region where the hospital is located. The fractures were most likely to occur in the afternoon, with more fractures presenting on the weekend than earlier in the week and more fractures in the fall and winter than in the spring and summer. The temporal variation of these fractures should be considered for health services planning, in particular, in regard to resident physician staffing at urban level 1 trauma centers.

Especialização Estratégia Saúde da Família [2014]

O Curso de Especialização Estratégia Saúde da Família é oferecido pela Universidade Federal de Minas Gerais por meio do Núcleo de Educação em Saúde Coletiva (Nescon ­ Programa Ágora). Confere ao formando o título de Especialista Estratégia Saúde da Família. Abrange uma carga horária de 360 horas, 180 horas em disciplinas obrigatórias e mínimo de 180 horas em disciplinas optativas. Sua temática desenvolve-se por meio de 3 unidades didáticas : Unidade didática I - (disciplinas obrigatórias): Iniciação à metodologia: textos científicos (30h); Modelo de Atenção à Saúde (30h); Processo de trabalho em saúde(30h); Planejamento e avaliação em saúde (60h); Práticas educativas e tecnologias em saúde(30h). Unidade didática II- (disciplinas optativas): Família como foco da atenção à saúde(30h); Atenção à saúde bucal do adulto (60h); Atenção à saúde bucal do idoso (30h); Atenção à saúde da criança: aspectos básicos(60h); Atenção à saúde da criança: agravos nutricionais (30h); Atenção à saúde da criança: doenças respiratórias (30h); Atenção à saúde do adolescente(30h); Projeto social: saúde e cidadania; Protocolo de cuidados à saúde(30h); Rede de atenção: saúde da mulher(60h); Rede de atenção: saúde do adulto(60h); Rede de atenção: saúde do idoso(60h); Rede de atenção: saúde mental (60h); Rede de atenção: urgências (60h); Vigilância à saúde ambiental (30h); Vigilância à saúde do trabalhador (30h); Vigilância à saúde: endemias e epidemias: tuberculose e hanseníase (30h); Vigilância à saúde: epidemias: dengue, leishmaniose, influenza e febre maculosa (30h). Unidade Didática III - Trabalho de Conclusão do Curso (TCC),

Community based rehabilitation programmes: monitoring and evaluation in order to measure results.

Although Community Based Rehabilitation has now formally existed for almost 30 years, few papers have been written about the results of this approach. The authors hope to contribute with this paper towards methodologies that will help to measure results of Community Based Rehabilitation programmes. The importance of establishing--prior to the development of Community Based Rehabilitation--an extensive baseline has not been extensively covered as the importance of it is almost self-evident; yet the lack of baseline data often severely hampers the possibility of being able to measure the effects of Community Based Rehabilitation. The article places considerable importance on management information systems and monitoring, since it is believed that evaluation will greatly benefit from both the existence of baseline data as well as a well-developed and well-implemented information system. The present article emphasises the need for participatory processes in the development of baseline data and information systems. Four key areas for measuring CBR are highlighted: people, power, public society and partnerships. Finally, a tool is presented in order to evaluate (or monitoring and evaluation) systematically. What gets measured gets done; If you don't measure results, you can't tell success from failure; If you can't see success, you can't reward it; If you can't reward success, you're probably rewarding failure; If you can't see success, you can't learn from it; If you can't recognize failure, you can't correct it; If you can demonstrate results, you can win public support.

Reforma sanitária brasileira: contribuição para a compreensão e crítica / Sanitary reform brazilian: contribuiton to the comprehension and critical

Passados 20 anos da 8ª. Conferência Nacional de Saúde e três décadas da fundação do Centro Brasileiro de Estudos de Saúde, justifica-se uma análise sobre o projeto, processo e perspectivas da Reforma Sanitária Brasileira. Desse modo, o objetivo da presente investigação é analisar a emergência e o desenvolvimento de uma Reforma Sanitária numa formação social capitalista, seus fundamentos e características, discutindo os desafios da práxis. Partindo de quatro tipos de práxis e de mudanças em sociedades - reforma parcial, reforma geral, movimentos políticos revolucionários e revolução social total - defende-se a tese segundo a qual a Reforma Sanitária Brasileira, como fenômeno social e histórico, constitui uma reforma social. O estudo tem como hipótese que a Reforma Sanitária Brasileira, embora proposta como práxis de reforma geral e teorizada para alcançar a revolução do modo de vida, apresentaria como desfecho uma reforma parcial - setorial e institucional. Realizou-se um estudo de caso, a partir de pesquisa documental, em duas conjunturas, tendo como componente descritivo o ciclo idéia-proposta-projeto-movimento-processo e, como componente explanatório, a análise do desenvolvimento da sociedade brasileira, recorrendo ao referencial "gramsciano", particularmente as categorias de revolução passiva e transformismo. Os resultados apontam para uma reforma parcial cuja práxis tenderia à manipulação político-ideológica na medida em que aponta para mudanças, mas mantém o status quo...

NLEP--current situation and strategy during the 11th plan period (2007-2012).

National Leprosy Control Programme was established in 1955 based on dapsone domiciliary treatment. The multidrug therapy came into wide use from 1982. Based on the recommendations of the high power committee established by the Government of India, the NLEP was launched in 1983 with the objective to arrest the disease activity in all the known cases of leprosy. In order to strengthen the process of elimination of the disease in this country, the first World Bank supported project was introduced in 1993. The 2nd phase of the elimination project was started in 2001-02 and ended in December 2004. The prevalence rate of leprosy was found to be 0.95/10,000 population by December 2005, a success in the elimination of leprosy. On 30th September 2006 the rate on record is 0.89/10,000 population, a further decline. During 2005-06 the annual new case detection rate was 14.27 per 100,000 population which was 23.4 during 2004-05, a reduction of 39.0%. During the 11th plan period (April 2007 to March 2012) the government proposes to carry on the leprosy programme with the same intensity further to achieve annual new case detection rate less than 10 cases per 100,000 population.

How can the private practitioners support leprosy elimination in India.

The private providers especially private practitioners are the first contact points for any types of ailments both in the urban and rural situations. From 2001 onwards, the services for National Leprosy Eradication changed to integrated system involving general healthcare system. Special emphasis is laid on correct diagnosis of leprosy cases before declaring and putting them under multidrug therapy. The government doctors were provided repeated training for this capacity building to diagnose and manage all diagnosed cases. Government of India also arranged practice of giving orientation programme to the private practitioners through IMA in the year 2004-05. The private practitioners can support the programme through case diagnosis, continuation of treatment and spreading awareness.

Experience of involvement of IMA members in leprosy elimination after CME conducted during 2004-2005.

Leprosy can affect all age groups. In 1991 the World Health Assembly took major initiative towards global elimination of the disease. It was possible to achieve 90% reduction in leprosy cases all over the world. India is not lagging behind to eliminate leprosy as Government of India, various NGOs and IMA have joined hands to fight the menace aggressively. During the year 2004-05 the IMA organised training workshops on leprosy for private practitioners, who are mostly members of IMA. After the completion of workshops a wrap-up workshop was organised in each state. It was a treat opportunity for the IMA to mobilise its resources to contribute to the national cause.

Improving physical health care in a mental health trust.

It is a challenge both to general medicine and psychiatry to develop systems that are better equipped to meet the physical health needs of mental health patients and reduce mortality rates (Hansen et al, 1997). Central and North West London Mental Health NHS Trust is establishing a department of physical health care staffed by nurses with general nursing backgrounds to tackle this problem. This nurse-led department is designed to train nurses and doctors in key aspects of physical health assessment and treatment interventions.