An integrated residency in internal and preventive medicine

The importance of preventive and population-based principles in clinical practice is widely acknowledged. The challenge of imparting these principles in either undergraduate or postgraduate medical education has, however, not been fully met. The necessary skills are provided comprehensively by preventive medicine residency programs, but at the expense of clinical training. Sequential residencies in primary care and preventive medicine, the currently available means of obtaining thorough preparation in both clinical and population-based principles, represent an inefficient, generally unappealing, and non-integrated approach. In response to these concerns, and in an effort to make preventive medicine training appeal to a wider audience, the authors developed and implemented a residency program fully integrating internal and preventive medicine. The program meets, and generally exceeds, the requirements of both specialty boards over a four-year period. The program provides extensive training in clinical, preventive, and public health skills, along with case management and cost-effective care, conferring the MPH degree and leading to dual board eligibility. The model is ideally wed to the demands of the modern health care environment in the United States, is extremely attractive to applicants, and may warrant replication both to train academic and administrative leaders and to raise the standards of preventive and public health practice in primary care

A national study of state tax appropriations for capital needs in public higher education

This study investigated the relationship of key issues related to capital and operating budget practices of state tax appropriations and policies at the state level, including new facilities construction, renovation, replacement and renewal which may exist between and among states by governance structure. Recognized "good practices" in capital planning and allocation processes and funding mechanisms recommended by experts were also examined. The data collection methodology employed by Derrick A. Manns for his FY1997 and FY2003 studies were used to allow for comparisons to FY2008 data collected by the researcher. The statewide governance typology developed by Aims McGuinness that distinguishes between governing and coordinating boards was used to see if tighter state control in the form of consolidated governing boards might equate to higher levels of good practices with regards to facilities in public higher education. Key findings include: (1) only half (18 out of 39) of responding states have a long range state master plan for facilities; (2) the majority of states do not conduct recommended periodic facilities audits; and (3) the total deferred maintenance has more than doubled from FY1997 to FY2008. Key conclusions include: (1) A major facilities information gap exists, with missing data at the federal and state levels; and (2) From FY1997 to FY2008, while the total US population grew by 36 million or 13.6%, and headcount enrollment in public higher education grew by 22.8%, state tax appropriations for public higher education operating budgets grew by only 21% and in the 18 states that provided data, state tax appropriations for capital budgets increased by 80%. However, this increase is tempered by the low initial amounts of capital appropriations, and the fact that no major federal investments in higher education facilities to spur matching state action to build up public higher education's physical infrastructure occurred, as did in the Baby Boom era (1965-73). While headcount enrollment increased by 2.5 million or 22.8%, no significant federal investments and only limited state investments in public higher education's physical infrastructure occurred. All-time record enrollment increases occurred simultaneously to an escalation of deferred maintenance. While state governance structures are stable over time, the practices and policies of capital budgeting are highly varied, and tighter state control in the form of consolidated governing boards does not necessarily equate to higher levels of good practices with regards to facilities in public higher education. (Published By University of Alabama Libraries

The dark side of LMX: variances among out-group members in growth need and work outcomes

Given my interest in LMX relationships and impression management (IM) behaviors, this dissertation was focused on the out-group in LMX, regarding member job performance and attitudes (Study I), and the impact of IM on performance ratings (Study II). With the suspicion that there may be individual differences that separate those who do not belong in the out-group from those who may belong there, Study I was designed to address the question concerning how the differences among out-group members impact their job performance and attitudes. Specifically, this study investigated the effect of growth-need strength (GNS) on out-group member job performance and job related attitudes. By adopting theories of person-job fit, some of the causes of undesirable work outcomes among out-group members, such as low commitment, low satisfaction, and high turnover intentions, were examined. Results from Study I suggest that for out-group members with a high growth-need, a better relationship with the supervisors may bring higher growth satisfaction and decreased turnover intent, but also more stress. With evidence found in Study I that not all out-group members believed that they belonged in the out-group, Study II investigated whether these out-group members would try to change their out-group status by means of IM. Cognitive Dissonance Theory was used as the theoretical foundation for this study. Data for both studies were collected from a state-owned hospital in main land China. Findings from Study II indicate that out-group members with a higher growth-need would use impression management more frequently, and that impression management attempts can be effective in improving performance ratings, even for out-group members. (Published By University of Alabama Libraries

Clinical prevention and population health: curriculum framework for health professions

The Clinical Prevention and Population Health Curriculum Framework is the initial product of the Healthy People Curriculum Task Force convened by the Association of Teachers of Preventive Medicine and the Association of Academic Health Centers. The Task Force includes representatives of allopathic and osteopathic medicine, nursing and nurse practitioners, dentistry, pharmacy, and physician assistants. The Task Force aims to accomplish the Healthy People 2010 goal of increasing the prevention content of clinical health professional education. The Curriculum Framework provides a structure for organizing curriculum, monitoring curriculum, and communicating within and among professions. The Framework contains four components: evidence base for practice, clinical preventive services-health promotion, health systems and health policy, and community aspects of practice. The full Framework includes 19 domains. The title Clinical Prevention and Population Health has been carefully chosen to include both individual- and population-oriented prevention efforts. It is recommended that all participating clinical health professions use this title when referring to this area of curriculum. The Task Force recommends that each profession systematically determine whether appropriate items in the Curriculum Framework are included in its standardized examinations for licensure and certification and for program accreditation