Transforming the Orientation of a Health Organization through Community Involvement

Health organizations have been oriented to meeting needs and fulfilling demands which are perceived and defined by physician providers (Freidson, 1970 Stevens, 1971). Organizational goals, services, structures, and processes of operation were formulated in accordance with the interests, values, and concerns of provider-members. Latent to this provider orientation was the assumption that professional members were the ones most qualified to determine what was best for the organization and for its consumers (Freidson 1971). In recent times, however, numerous social changes have occurred on a societal level and within the institution of medicine (Hepner, 1972; Somers, 1971; Rosengren and Lefton, 1969). These changes have encouraged consumers to challenge the provider orientation of health organizations and to ask whether providers or consumers should determine the actions of the organization (Berki and Heston, 1972; Zola and McKinlay, 1974; Corey et al, 1972). It is within this context that the Penn Urban Health Services Center at the Graduate Hospital of the University of Pennsylvania sought to develop a consumer orientation through the mechanism of community involvement. To move toward attaining this goal, Penn-Urb established a Community Involvement Committee (CIC) which had two charges: to develop a mechanism by which information could be exchanged between the health organizations and the community. to develop a mechanism for effectively involving the community in the process of planning and developing Penn-Urb. It was hoped that through the fulfillment of these two charges, Penn-Urb and its community could increase their awareness and understanding of each other and become more responsive to respective needs and demands

New Mexico pecan production

Presented at Urbanization of irrigated land and water transfers: a USCID water management conference on May 28-31, 2008 in Scottsdale, Arizona.Includes bibliographical references.Pecans are a major agricultural crop in New Mexico. Currently there are approximately 11,000 hectares of pecans in the Elephant Butte Irrigation District, consuming more than one third of the annual diversion. The research presented here provides previously unavailable broad-scale estimates of pecan ET and pecan yield response to water. The data at the foundation of this paper were generated using the Regional ET Estimation Model (REEM) developed at New Mexico State University for agricultural and riparian vegetation (Samani et al. 2005, 2006, 2007). REEM uses remotely sensed satellite data to calculate ET as a residual of the energy balance. This research extends the results of REEM to an analysis of yield response to water in irrigated pecan production in the EBID. The study region is rapidly urbanizing and experiencing growing competition for scarce surface and groundwater supplies. The results of this research provide new insight into pecan water use and yields. This research illustrates the linkages that can be made between remote sensing technology, farm-level water management, and yield outcomes. This research sheds new light on the long-standing practice of deficit irrigation in pecans, the yield and conservation impacts of this practice, as well as water conservation policy implications