[Continuing education in cattle practice - results of a survey]. / Fortbildung für die Rinderpraxis - Ergebnisse einer Umfrage.

OBJECTIVE: Continuing education is mandatory for veterinarians in Germany and Austria. The objective of this study was to analyse interests and preferences of veterinarians in cattle practice as well as to elucidate framework requirements for continuing education, including e-learning. Results should help to improve and to optimise continuing education programs. MATERIAL AND METHODS: A survey was conducted as a questionnaire via internet and shared at two local meetings as well as by email to members of the Farm Animal Health Service Styria (Tiergesundheitsdienst Steiermark). All responses were analysed anonymously. RESULTS: A total of 259 questionnaires were returned and 195 were included in the final analyses. The majority of participants (59.0%) were in farm animal practice for more than 10 years. Of the participants, 50.8% declared to have attended up to five continuing education events per year, 27.7% more than five. The majority (71.5%) had no experience with e-learning at that time. With regard to framework requirements for attending continuing education events, the majority (62.8%) of participants preferred events of 2 days over weekends. Total expenses, including costs for travelling and lodging, should not exceed 500 € per event (62.8% of participants). The favourite topics were animal reproduction (87.2%), metabolic disorders (85.6%) and mastitis (79.4%). Participants with less than 5 years of professional experience chose significantly more often the topics feed analyses, acupuncture, pregnancy diagnosis and homoeopathy/phytotherapy than participants with longer professional experience. CONCLUSION: The results of this study provide important information about the interests and framework requirements for continuing education for cattle practitioners that should help to improve the offers in continuing education programs.

The health law partnership: adding a lawyer to the health care team reduces system costs and improves provider satisfaction.

Addressing the legal issues of patients of low socioeconomic status can be useful in increasing organizational reimbursements, reducing costs and improving access to care. Medical-legal partnership is an addition to the health care armamentarium that directly addresses this goal. A medical-legal partnership is an interdisciplinary collaboration between a medical entity such as a hospital or clinic and a legal entity such as a law school or legal aid society that addresses barriers to access to care and limitations to well-being experienced by patients of low socioeconomic status. The Health Law Partnership is one such medical legal partnership that provides a holistic, interdisciplinary approach to health care. An evaluation of the legal and educational services provided by Health Law Partnership showed that Health Law Partnership secured otherwise unreimbursed Medicaid payments for services over a 4-year period from 2006 to 2010, increased physician satisfaction, and saved hospital employers approximately $10 000 in continuing education costs annually.

Curriculum resource use and relationships with educational outcomes in an online curriculum.

PURPOSE: Web-based continuing education (CE) offerings have increased dramatically, yet educators know little about factors influencing resource use within online curricula or relationships between resource use and educational outcomes. METHOD: The authors conducted a study of online curriculum delivery to health care professionals in 2004 and 2005. The authors assessed knowledge and confidence regarding content (herbs and dietary supplements) at baseline and completion. They assessed hours spent and use of three resources (modules read, links accessed, and listserv participation) and how these effected change of knowledge and confidence. RESULTS: Median time spent on the curriculum was 7 to 10 hours. Three quarters of participants read 36 to 40 modules; half accessed <30 of 335 Internet links. Listserv participation varied; 149 participants (19%) read or=41 postings. Those receiving modules incrementally across several weeks reported more hours spent, more modules read, and more links accessed, but less listserv participation than those receiving all modules at once (all P

Financial support for research training and career development in complementary and alternative medicine from the National Institutes of Health.

Research careers are a relatively new reality for complementary and alternative medicine (CAM) practitioners (eg, chiropractors, naturopaths, doctors of oriental medicine, etc). Before the establishment in 1998 of the National Center for Complementary and Alternative Medicine (NCCAM) as part of the National Institutes of Health (NIH), there were few funding resources available for those interested in a CAM research career and fewer still feasible paths. Now, however, NCCAM provides a broad array of research training and career development awards for those seeking a long-term career in CAM research. These awards include predoctoral and postdoctoral fellowships, individual career development awards, and institutional training awards. The goal of this article is to provide information about current research training funding opportunities from NCCAM and NIH as a whole that are available to CAM practitioners in the context of the historical challenges of transitioning from a clinical career in CAM practice to a CAM research career.

A policy for allocating off-site continuing education funds.

Providing support for travel to conferences, workshops and other off-site continuing education activities is an expensive component of a professional development program. The authors describe a policy addressing this issue which was implemented within the multidisciplinary environment of a comprehensive cancer centre. The policy is open, easily adapted to changes in overall funding and can be used to reflect the organization's expectations regarding employee performance in service, academic, management and leadership roles.

The Gambia: cost and effectiveness of a mobile maternal health care service, West Kiang.

A relatively small body of knowledge has been generated in the past to identify the cost-effectiveness of mobile versus static clinics, or combinations thereof. The changes introduced by the new mobile maternal health care service offered an opportunity to address the issue of cost-effectiveness of changes introduced to a specific geographical area. Considerably higher total costs were incurred, particularly as a result of increased training and staffing. However, evidence (Foord, 1993) has shown that several key measures of process eg. number of haemoglobin tests taken and haemoglobin levels increased significantly. Therefore the extra expenditure created clear service improvements. Linking such changes to reductions in mortality was more difficult as the population size and rarity of maternal deaths made it difficult to show statistically significant differences. The results should only provide part of the information required by decision makers, for a number of reasons. First, this cost-effectiveness analysis provided no information regarding any form of equity. Secondly, many factors affect cost-effectiveness ratios and further investigation of the organisation and management of the mobile service may highlight further room for improvement within the service itself, thus improving the efficiency. In this case there were grounds for re-assessing costs in relation to training, undertaking an assessment of staffing needs and increasing accountability in the use of resources. This study gives detailed information on the structure of costs for a mobile unit. It is unusual in its consideration of how a mobile team fits into the structure of existing health services and implications of provision on other levels of service.(ABSTRACT TRUNCATED AT 250 WORDS)

PIP: This paper reports findings from an evaluation of the cost-effectiveness of introducing a mobile unit to provide maternal health services in a rural district of the Gambia. The costs and effectiveness of the new service were evaluated using a quasi-experimental design comparing the new service in West Kiang, run from Karantaba health center, with the usual practices of providing maternal care. Upper Baddibu was selected as the comparison area, where health services were provided from a health post at Ngayen Sanjal village. This study is unusual in its consideration of how a mobile team fits into the structure of existing health services and the implications of provision upon other levels of service. The evaluation found that considerably higher total costs were incurred, particularly as a result of increased training and staffing. Several key measures of process, however, such as the number of hemoglobin tests taken and hemoglobin levels, increased significantly. The extra expenditures therefore clearly resulted in improved services. Linking such changes to reductions in mortality, however, is more difficult since population size and the rarity of maternal deaths make it hard to demonstrate statistically significant differences. Furthermore, providing no information on any form of equity and given that many factors affect cost-effectiveness ratios, the results of this cost-effectiveness analysis should provide only part of the information required by decision makers. More research is needed to determine the effect of improvements in staff utilization at static units before adding mobile units.