Telah menjadi kebiasaan bagi rakyat Malaysia setiap

31 Ogos kita akan merayakan sambutan kemerdekaan. Bangga

sungguh kita menjadi rakyat Malaysia yang mana negaranya

aman, makmur dan sejahtera. Orang luar pun suka datang dan tinggal di sini dan mereka juga mengiyakan bahawa Malaysia sungguh aman dan sejahtera. Apa yang penting, di sini tidak ada bom yang jatuh di sana dan jatuh di sini. Sebab itulah hari kemerdekaan dapat disambut dengan penuh meriah. Harus diingat sambutan kemerdekaan bukan sahaja cukup dengan meraikannya, memperingati perjuangan orang-orang terdahulu, pengisian ceramah, pertandingan esei sempena kemerdekaan, dan mengibarkan bendera. Asas untuk seseorang itu menghargai kemerdekaan dan keamanan yang dikecapi selama ini adalah dengan mempelajari dan menghayati perjalanan sejarah negara

Colquitt, Gavin

Emter, Morgan

Peden, John

Walker, Ashley

Frontiers in Public Health

The purpose of this study was to examine predictors of coordinated and comprehensive care within a medical home among children with special health care needs (CSHCN). The latest version of the National Survey of Children with Special Health Care Needs (NS-CSHCN) employed a national random-digit-dial sample whereby US households were screened, resulting in 40,242 eligible respondents. Logistic regression analyses were performed modeling the probability of coordinated, comprehensive care in a medical home based on shared decision-making and other factors. A total of 29,845 cases were selected for inclusion in the model. Of these, 17,390 cases (58.3%) met the criteria for coordinated, comprehensive care in a medical home. Access to a community-based service systems had the greatest positive impact on coordinated, comprehensive care in a medical home. Adequate insurance coverage and being White/Caucasian were also positively associated with the dependent variable. Shared decision-making was reported by 72% of respondents and had a negative, but relatively negligible impact on coordinated, comprehensive care in a medical home. Increasing age, non-traditional family structures, urban residence, and public insurance were more influential, and negatively impacted the dependent variable. Providers and their respective organizations should seek to expand and improve health and support services at the community level

Ashley Walker

John G. Peden

Morgan Emter

Gavin Colquitt

Directory of Open Access Journals

Predictors of Coordinated and Comprehensive Care Within a Medical Home for Children With Special Healthcare (CHSCN) Needs

Frontiers - Publisher Connector

Hasnah, Hussiin

UMP Institutional Repository

68 CREATETelah menjadi kebiasaan bagi rakyat Malaysia setiap 31 Ogos kita akan merayakan sambutan kemerdekaan. Bangga sungguh kita menjadi rakyat Malaysia yang mana negaranya aman, makmur dan sejahtera. Orang luar pun suka datang dan tinggal di sini dan mereka juga mengiyakan bahawa Malaysia sungguh aman dan sejahtera. Apa yang penting, di sini tidak ada bom yang jatuh di sana dan jatuh di sini. Sebab itulah hari kemerdekaan dapat disambut dengan penuh meriah. Harus diingat sambutan kemerdekaan bukan sahaja cukup dengan meraikannya, memperingati perjuangan orang-orang terdahulu, pengisian ceramah, pertandingan esei sempena kemerdekaan, dan mengibarkan bendera. Asas untuk seseorang itu menghargai kemerdekaan dan keamanan yang dikecapi selama ini adalah dengan mempelajari dan menghayati perjalanan sejarah negara.Sebenarnya masyarakat di negara ini tidak menyedari akan kepentingan sejarah dalam pembangunan dan kemajuan sesuatu bangsa. Malahan kita juga sering dihantui dengan pentingnya bahasa Inggeris jika dibandingkan dengan pengetahuan atau pendidikan sejarah di sekolah, kita juga dihantui pentingnya anak-anak kita diberi pendidikan teknikal, kejuruteraan, sains, matematik dan secara tidak disedari pendidikan sejarah dipinggirkan. Tidakkah kita takut suatu hari nanti, ramai di antara golongan profesional yang kita didik hari ini meninggalkan negara ini, dan mencari hujan emas di negara orang? Perkara ini bukanlah perkara baharu yang berlaku dalam dunia pekerjaan pada hari ini. Jumlah anak Malaysia yang bekerja di negara orang pada hari ini sudah tidak boleh dikira dengan jari lagi. Jumlahnya sudah cukup besar dari hari ke hari. Kalau kita lihat di negara yang maju seperti di negara Barat dan juga di beberapa buah negara Asia yang tidak kurang majunya dan setanding dengan negara Barat seperti Jepun, Korea, dan Taiwan mereka sangat mementingkan pendidikan sejarah atau juga dikenali sebagai pendidikan patriotisme dalam membangunkan generasinya. Oleh itu, kita dapat lihat di negara Jepun misalnya, walaupun mereka maju dalam teknologi dan boleh mengatasi negara Barat, mereka tetap bangga menggunakan bahasa ibunda mereka, dan mengekalkan nilai-nilai tradisi Jepun. Malahan di negara itu, pelajaran Sejarah adalah sangat penting sehingga mengatasi subjek lain yang diajar. Ini sangat berlainan dengan di negara kita pendidikan Sejarah terkebawah, pendidikan sains dan teknologi yang teratas. Begitu juga pendidikan moral dan pendidikan agama mengalami nasib yang sama. Justeru, kita dapat lihat pada hari ini, generasi Malaysia begitu rapuh imannya dan begitu nipis kejiwaannya terhadap isu-isu kenegaraan. Sesuatu perlu dilakukan untuk menyedarkan generasi Malaysia khususnya masyarakat Melayu pada hari ini. Tidak perlu kita menuding jari orang itu bersalah atau orang ini bersalah. Sesuatu perlu dikaji semula dalam sistem pendidikan kita pada hari ini. Mengapa kemajuan dan pembangunan negara bangsa dikaitkan dengan sejarah? Apa kaitannya? Secara mata kasar, kita dapat lihat pendidikan kejuruteraan, sains, teknologi berjaya memperlihatkan tumbuhnya bangunan-bangunan pencakar langit, ilmu kedoktoran melahirkan para doktor, ilmu sains melahirkan ahli sains dan penyelidik, ilmu psikologi dan falsafah melahirkan golongan pemikir dan ahli falsafah, jadi kalau sejarah apa sumbangannya? Pendidikan sejarah akan melahirkan warganegara atau generasi yang sentiasa berlumba-lumba untuk membangunkan negaranya. Dalam hal ini, generasi yang dididik tadi akan menggunakan masa lampau sebagai idolanya untuk membawa negara ke mercu kejayaan dan terkenal di arena antarabangsa. Mereka akan berusaha untuk menaikkan nama negara kerana mereka percaya negara ini mampu melakukannya kerana negara ini adalah sebuah negara yang sangat dikenali suatu masa dahulu. Justeru, tidak mustahil dengan kemajuan dan pembangunan yang dikecapi kini akan membuka mata negara luar akan keupayaan negara ini dalam pelbagai aspek politik, ekonomi dan sosial.Pendidikan sejarah juga berperanan bagi memupuk semangat patriotisme atau semangat kebangsaan yang kuat dalam diri seseorang individu. Semangat kebangsaan ini perlu ada dalam diri setiap individu yang mengaku dirinya sebagai warganegara Malaysia. Perlu disedari tanpa semangat sayangkan negara yang kuat, negara ini akan runtuh bila-bila masa. Tetapi apa yang berlaku sekarang ini ialah kurangnya penghayatan masyarakat terhadap program-program yang berunsurkan patriotisme. Contoh yang paling mudah sekali ialah semasa sambutan bulan kemerdekaan. Ada di antara mereka pada hari ini yang merasakan sambutan terhadap bulan tersebut tidak memberi apa-apa erti dan tidak ada kaitan dengan mereka yang hidup dalam dunia yang sudah ada segalanya. Bagi mereka perjuangan menentang penjajah sudah tamat, Komunis sudah lari, negara dah maju, nak buat apa lagi?  Pemikiran sebegini perlu dibuang dalam diri setiap generasi baharu pada hari ini kerana setiap individu itu ada tanggungjawab atau amanah yang perlu dipikul. Kalau orang Melayu dulu berjuang mempertahankan tanah air daripada penjajah, Melayu baharu pula harus berjuang bagi memastikan mereka tidak mudah dijajah dari segi ekonomi, budaya dan pemikiran. Cabaran yang paling besar yang dimainkan oleh pendidikan sejarah adalah untuk melahirkan mahasiswa yang mempunyai jati diri dan semangat kenegaraan yang kuat. Pembangunan pesat teknologi maklumat serta penyebaran budaya Barat telah menjadi penyumbang utama kepada pembentukan “the new society” (masyarakat baharu yang tiada identiti). Dalam hal ini, universiti atau Institut Pengajian Tinggi (IPT) memainkan peranan penting dalam mendidik mahasiswa agar mempunyai jati diri sebagai warganegara Malaysia dan pada waktu yang sama mampu mempertahankan kedaulatan tanah air, maruah agama dan identiti bangsa. Penghakisan jati diri begitu senang berlaku dalam masyarakat pada hari ini khususnya para remaja yang mudah terikut-ikut dengan budaya asing. Masalah sosial yang berlaku dalam masyarakat pada hari ini juga menggambarkan betapa unsur-unsur sayangkan bangsa dan negara sudah terhakis. Begitu juga dengan nilai-nilai murni yang menjadi identiti bangsa Melayu sebelum ini juga semakin pudar ditelan zaman. Contoh terdekat dapat dilihat pada gejala-gejala sosial yang begitu berleluasa di kalangan remaja Malaysia pada hari ini seperti penagihan serta penyalahgunaan dadah, fenomena bohsia dan bohjan, pelacuran, rempit, berpeleseran, “black metal”, jenayah rogol, ragut dan banyak lagi. Bangsa yang maju adalah bangsa yang celik sejarahOleh: HASNAH HUSSIINArtikel/Rencana Pilihan

Bangsa yang maju adalah bangsa yang celik sejarah

The purpose of this study was to examine predictors of coordinated and comprehensive care within a medical home among children with special health care needs (CSHCN). The latest version of the National Survey of Children with Special Health Care Needs (NS-CSHCN) employed a national random-digit-dial sample whereby US households were screened, resulting in 40,242 eligible respondents. Logistic regression analyses were performed modeling the probability of coordinated, comprehensive care in a medical home based on shared decision-making and other factors. A total of 29,845 cases were selected for inclusion in the model. Of these, 17,390 cases (58.3%) met the criteria for coordinated, comprehensive care in a medical home. Access to a community-based service systems had the greatest positive impact on coordinated, comprehensive care in a medical home. Adequate insurance coverage and being White/Caucasian were also positively associated with the dependent variable. Shared decision-making was reported by 72% of respondents and had a negative, but relatively negligible impact on coordinated, comprehensive care in a medical home. Increasing age, non-traditional family structures, urban residence, and public insurance were more influential, and negatively impacted the dependent variable. Providers and their respective organizations should seek to expand and improve health and support services at the community level.
In the late 1990s, the definition for disability was re-evaluated to expand its meaning to facilitate a shift in care options. A national agenda was set to focus efforts on providing children with special health care needs (CSHCN) and their families with a more comprehensive approach to services including a move to community-based and family-centered care (1). This continues today, and is reflected in Health People 2020 (HP2020), as a key outcome is care for CSHCN that is coordinated and focused on the family (2). However, HP2020 also states that access to adequate and affordable health care is an important factor in one\u27s quality of life (2). People with disabilities face many barriers to accessing care that is adequate, accessible, coordinated, and family centered (3). Individuals living with disabilities, compared to those without, are more negatively impacted by a lack of access to health care services (4). Previously, parents and caregivers cited access to care as one of the primary factors impeding the overall health and quality of life of their family member living with a disability (5). Access to care is mediated by many barriers. Approximately half of individuals with disabilities cannot afford health care (3). Families have noted that access to many health care services is hindered by cost (6). Many services available to families are not covered by insurance plans, which leaves the burden of cost on family members or requires families to attempt to provide some services at home (5). The American Academy of Pediatrics (7) recommends care coordination as one strategy to alleviate challenges experienced by families caring for CSHCN.
Care coordination is defined by the American Academy of Pediatrics as “a process that links CSHCN and their families with appropriate services and resources in a coordinated effort to achieve good health” (7). Care coordination is important because CSHCN receive services from a variety health care and service providers. Needs are varied and unique, which requires a multifaceted approach. Furthermore, care coordination requires knowledge of a diverse set of medical and social services, communication with professionals, and close monitoring (8). Adequate and appropriate care coordination requires a well-developed health care plan between the families and health care provider (9). Care coordination promotes functionality and decreases the likelihood a CSHCN experiences an unmet health service need (10).
Family decision-making and adequate health insurance are listed as quality indicators for a higher quality service system within a community-oriented approach (11). These indicators can increase ease of service utilization and decrease dependence on emergency-based health services (12). Additionally, reduced access is associated with poorer health status. Children with special healthcare needs are less likely to participate in community and school activities if presenting with poorer health status and experiencing more functional limitations (13). It has been recommended that health care and community providers focus on incorporating family centered, coordinated care to improve a child\u27s ability to be an active participant in community activities. When care coordination is lacking, family involvement in health care decisions is limited. The child\u27s needs and the needs of the family are often left unmet. Because of the disparities which exist among CSHCN, an ecological (community-based) approach to care is recommended (14).
Children with special healthcare needs often lack proper basic care due to inadequate insurance coverage (15). When coverage is improved, CSHCN are still faced with barriers to access services such as lack of guidance, fewer service providers, and higher costs for specialized services (16). However, increasing access to additional services in the community can improve the adequacy of insurance coverage and lessen the overall impact of caring for a CSHCN on the family (17).
The Maternal and Child Health Bureau (MCHB) has consolidated these important aspects of care for CSHCN into six core outcomes that reflect both potential barriers and components of effective care: shared decision-making, coordinated and comprehensive care in a medical home, adequate insurance, early and continuous screening, ease of use of community-based services, and transition services (18). Of these six outcomes, CSHCN receiving care in a medical home is the most important in the receipt of quality care. The American Academy of Pediatrics defines a medical home as “a course of ongoing, comprehensive, coordinated, family-centered care in the child\u27s community” (19). In the MCHB definition, coordinated and comprehensive care within a medical home has five components: usual source of care, personal doctor or nurse, care coordination, family-centered care, and getting needed referrals (18). The key difference in these definitions is the context of the community. Access to community-based services is an essential component of improving care coordination and improving the overall health care of individuals with disabilities (3).
Due to the importance of coordinated and comprehensive care within a medical home among CSHCN, the purpose of this study was to examine predictors of this outcome. We hypothesize that access to community-based services and shared decision-making among providers and families will significantly improve the likelihood that families caring for CSHCN received coordinated and comprehensive care within a medical home. However, other factors such as insurance coverage, family financial burden, hours spent caring for the child, and parental education may mediate this relationship. Therefore, we used logistic regression to examine the relationship between community-based care and care coordination while accounting for these potential covariates

Georgia Southern University: Digital Commons@Georgia Southern

Predictors of Coordinated and Comprehensive Care Within a Medical Home for Children with Special Healthcare (CHSCN) Needs

http://umpir.ump.edu.my/id/eprint/12318/1/CREATE%202011%20%28Sep-Dec%29_Part_50.pdf

Bangsa yang maju adalah bangsa yang celik sejarah

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