Development of a Guide To Recommended Audiovisual Materials on Diabetes, 1983

The task of reviewing and critiquing the hundreds of audiovisual programs available for diabetes education is an exceedingly time consuming and tedious activity. To assist the many users of educational audiovisual materials the Outreach Core of the Michigan Diabetes Research and Training Center undertook the review and critique of these programs. Based on specified selection and review cri teria, 35 programs have been chosen for inclusion in a booklet entitled "Recommended Audiovisual Re sources for Diabetes Education. " This booklet is available to any diabetes educator upon request.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68617/2/10.1177_014572178400900408.pd

The Biggest Problem in Diabetes

An assessment of the big gest problem in diabetes care from the viewpoint of 115 health care profes sionals and 428 diabetic patients was obtained. There was substantial agreement by health pro fessionals and patients alike that diet and diet- related issues constituted the most difficult problem faced by persons with diabetes and by health professionals caring for those persons. These find ings may be important in organizing diabetes patient education and in the selection of research efforts within the overall field of diabetes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68782/2/10.1177_014572178601200107.pd

Individual unmet needs for care: are they sensitive as outcome criterion for the effectiveness of mental health services interventions?

BACKGROUND: Mental health interventions should demonstrate an effect on patients' functioning as well as his/her needs, in particular on unmet needs whose assessment depends on the perspective of either the patient or the clinician. However, individual met and unmet needs appear to change over time, qualitatively and quantitatively, raising questions about their sensitivity to change and about the association between level of needs and treatment. METHODS: Data on baseline and follow-up need assessment in community mental health services in four European countries in the context of a cluster randomised trial on a novel mental health service intervention were used, which involved 102 clinicians with key worker roles and 320 patients with schizophrenia or related psychotic disorders. Need assessment was performed with the Camberwell assessment of needs short appraisal schedule (CANSAS) among patients as well as clinicians. Focus is the sensitivity to change in unmet needs over time as well as the concordance between patient and clinician ratings and their relationship with treatment condition. RESULTS: At follow-up 294 patients (92%) had a full need assessment, while clinician rated needs were available for 302 patients (94%). Generally, the total number of met needs remained quite stable, but unmet needs decreased significantly over time, according to patients as well as to clinicians. Sensitivity to change of unmet needs is quite high: about two third of all unmet needs made a transition to no or met need, and more than half of all unmet needs at follow-up were new. Agreement between patient and clinician on unmet needs at baseline as well as follow-up was rather low, without any indication of a specific treatment effect. CONCLUSIONS: Individual unmet needs appear to be quite sensitive to change over time but as yet less suitable as outcome criterion of treatment or specific interventions

A journey towards shared governance: status and prospects for collaborative management in the protected areas of Bangladesh

Establishment of Protected Areas (PAs), in the face of rapid deforestation, forest degradation and climate change has been one of the key efforts in conservation of biodiversity worldwide in recent times. While Bangladesh has gained a degree of prominence in the world for its successful social forestry programs, the concept of collaborative protected area management is rather new in the country, initiated in 2004 by the Bangladesh Forest Department in five PAs with financial assistance from USAID. Based on empirical evidence from three of the pilot PAs, we examined the achievements and associated challenges and prospects for co-management. Our fieldwork revealed a number of challenges faced by co-management institutions: (1) institutions were dominated by the elite group, overshadowing the voice of the community people; (2) mutual trust and collective performance are key to good governance but had not taken root in the PAs; (3) encroachment onto forest land and subsequent conversion to agriculture remained a serious problem that discouraged forest-dependent people from participating actively in co-management initiatives; (4) legal provisions (including acts, rules and policies) were not clearly and adequately disseminated and understood at the community level; (5) there remained a degree of ambiguity regarding the roles and responsibilities of forest department (FD) and co-management committees (CMC) in field operations, and this was not enhancing transparency and accountability of the overall initiative; (6) the long-term sustainability of co-management institutions was another major concern, as the local intuitional structure was still in a nascent stage, and provisioning of resources (either internally or externally) remained somewhat uncertain. We offer recommendations for improvement