What Does It Take? California County Funding Requests for Recovery-Oriented Full Service Partnerships Under the Mental Health Services Act

The need to move mental health systems toward more recovery-oriented treatment modes is well established. Progress has been made to define needed changes but evidence is lacking about the resources required to implement them. The Mental Health Services Act (MHSA) in California was designed to implement more recovery-oriented treatment modes. We use data from county funding requests and annual updates to examine how counties budgeted for recovery-oriented programs targeted to different age groups under MHSA. Findings indicate that initial per-client budgeting for Full Services Partnerships under MHSA was maintained in future cycles and counties budgeted less per client for children. With this analysis, we begin to benchmark resource allocation for programs that are intended to be recovery-oriented, which should be evaluated against appropriate outcome measures in the future to determine the degree of recovery-orientation

The undervalued role of over-regulation in autism: chaos theory as a metaphor and beyond

TOPIC: A triad of impairment that consists of impaired communication, impaired social skills and over-regulated behavior characterizes autism. Causality of autism is yet to be identified. Therapy has been devised to apply to the work with children and adolescents with a diagnosis of autism in the domains of impaired communication and impaired social skills. Little attention has been paid to the importance of the over-regulated behavior that forms part of the triad of impairment. PURPOSE: This paper considers this point of over-regulation in the triad of impairment in autism through the lens of Chaos theory. SOURCES: Contemporary literature on autism and Chaos theory. CONCLUSIONS: Implications for nursing practice and research are raised

Nursing knowledge: practice and practical knowing

What is nursing knowledge? Is it scientific knowing or practical thinking? This chapter discusses what we know of thinking in the western philosophical tradition and how this can be brought to bear on this complex question. The thinking adventure situates mindfulness and praxis as essential elements of nurse practice

A modified hermeneutic phenomenological approach toward individuals who have autism

Individuals with autism have a unique cognitive processing style characterized by impaired abstraction, impaired theory of mind, and visual as opposed to linguistic processing of information. A consequence of this unique cognitive processing style is that traditional ways of hermeneutical phenomenological examination may be inadequate to achieve the kind of understanding of experience toward which this method is directed. In order to stay true to Heidegger\u27s hermeneutic phenomenology, we needed to develop modifications to this research methodology, which include the use of visual aids to promote participant engagement and access the eidetic memory of a participant with autism, so as to elicit concrete descriptors of an experience

Health financing in Ghana

This study reviews Ghana's health financing system with a special emphasis on its National Health Insurance Scheme (NHIS). It suggests a number of options to reform the structural and operational features of Ghana’s NHIS to ensure its smooth transition to universal coverage and financial sustainability. Health financing reform options are developed in the context of Ghana’s health system configuration as well as its demographic, epidemiological, socioeconomic, labor-market, industrial-structure, political, and geographic realities. Findings show that for the NHIS to expand enrollment and become sustainable, more public resources will be needed

Breast Cancer Knowledge And Attitudes Toward Mammography As Predictors Of Breast Cancer Preventive Behavior In Kazakh, Korean, And Russian Women In Kazakhstan

Objectives: To explore differences in breast cancer knowledge and attitudes toward mammography for women representing three ethnic groups (Kazakh, Korean, and Russian) and to determine how these factors affect breast cancer preventive practices in Almaty City, Kazakhstan. Methods: A cross-sectional, descriptive study design was utilized. Face-to-face interviews were conducted with 500 women in Almaty City. A combination of descriptive (ANOVA) and multivariate analyses (structural equation modeling) was used to estimate differences in respondents\u27 breast cancer knowledge, attitudes, and practices (KAP). Results: Findings indicate that women may be influenced by their clinicians\u27 advice to engage in breast cancer preventive practices. Multivariate models suggest that breast cancer knowledge and attitudes toward the effectiveness of mammography are significant determinants of breast cancer preventive practices among study participants. Conclusions: Clinicians should encourage women to engage in breast cancer preventive practices. Clinical and public health interventions should be aimed at both women and healthcare providers to use mammography as a tool for early detection of breast cancer in Almaty City, Kazakhstan. © Birkhäuser 2008

SPARC the Change: What the Strategic Purchasing Africa Resource Center Has Learned about Improving Strategic Health Purchasing in Africa

ABSTRACTEmbodied in the goals of universal health coverage (UHC) are societal norms about ethics, equity, solidarity, and social justice. As African countries work toward UHC, it is important for their governments to use all available resources, knowledge, and networks to continue to bring this goal closer to reality for their populations. The Strategic Purchasing Africa Resource Center (SPARC) was established in 2018 as a “go-to” source of Africa-based expertise in strategic health purchasing, which is a critical policy tool for making more effective use of limited funds for UHC. SPARC facilitates collaboration among governments and research partners across Africa to fill gaps in knowledge on how to make progress on strategic purchasing. The cornerstone of this work has been the development and use of the Strategic Health Purchasing Progress Tracking Framework to garner insights from each country’s efforts to make health purchasing more strategic. Application of the framework and subsequent dialogue within and between countries generated lessons on effective purchasing approaches that other countries can apply as they chart their own course to use strategic purchasing more effectively. These lessons include the need to clarify the roles of purchasing agencies, define explicit benefit packages as a precondition for other strategic purchasing functions, use contracting to set expectations, start simple with provider payment and avoid open-ended payment mechanisms, and use collaborative rather than punitive provider performance monitoring. SPARC has also facilitated learning on the “how-to” and practical steps countries can take to make progress on strategic purchasing to advance UHC