The thesis draws on historical and social policy perspectives to examine the factors influencing development and change in alcohol treatment policy between 1950 and 1990. The study uses data from primary and secondary documentation and from taped interviews. Three themes are highlighted as particularly relevant to an examination of policy trends. The first of these is the emergence and evolution of a `policy community'. Spearheaded by psychiatrists in the 1960s, the `policy community' broadened to include other professional groups and the voluntary sector by the 1990s. The second theme concerns the role of research in influencing the nature and direction of treatment policy. The study indicates increasing use of research as the rationale for policy and illustrates the move towards a `contractor' relationship between research workers and policy makers. The final theme deals with the influence on policy of ideological frames and changing conceptualisations of the alcohol problem. Two major shifts were important for treatment, the re-discovery of the disease concept of alcoholism in the 1950s and the emergence of a new public health model of alcohol problems in the 1970s. Within these broad themes, the study includes an examination of tensions - between different professional perspectives, between government departments with differing responsibilities, between different ideologies - and of moves to secure consensus in the formulation and implementation of treatment policy. The final chapter addresses shifts in thinking from the re-emergence of a `disease' model of alcoholism in the 1950s, to a `consumptionist' (population-based) model in the 1970s, towards a `harm reduction' approach to alcohol problems management in the 1990s. The thesis concludes that over the past forty years competing paradigms of the alcohol problem have emerged and gained policy salience within particular historical-social contexts in the search for policy consensus to manage the problematic aspects of alcohol consumption.

The purpose of this study was to explore specific activities school psychologists performed related to both testing and placing within a medical model and prevention within a public health model. Spurred by landmark legal mandates, school districts are moving toward preventative practice within a framework consistent with tenets of a public health model or Response to Intervention (RtI) framework. These activities are counter to traditional test-and-place activities performed by school psychologists associated with a medical model of service delivery. School psychologists assigned to 41 elementary schools in the northwest corner of Oregon completed a survey that included activities associated with testing-and-placing students typified by a medical model and those activities akin to a public health model. All schools participating in this study implemented Positive Behavioral Interventions and Supports (PBIS). PBIS is a widely implemented evidence-based practice in education that emphasizes prevention, and is a reflection of RtI or the public health model. Although PBIS was a common denominator across all schools, there were differences in overall implementation effectiveness as measured by the School-wide Evaluation Tool (SET). This study investigated the degree to which activities performed by school psychologists impacted PBIS implementation in their buildings. School psychologists estimated the frequency devoted to these activities. Frequency served as a proxy for priority and also defined the service models that guided their practices. In addition to this descriptive statistical analysis, inferential statistics were used to measure the correlation between the School Psychologist Survey, the SET-General Index scores, and the SET-Behavior Expectations Index scores. A multiple-regression analysis was also conducted to determine which variable (i.e., SET-General Index or SET-Behavior Expectations Index) was the best predictor of outcome data from the School Psychologist Survey. These data were also entered into scatterplots to provide interpretations of meaningful statistical significance for an in-depth analysis of the School Psychologist Survey, SET-General Index, and SET-Behavior Index scores. This study is important because it potentially provides school psychologists with specific preventative activities they can perform within a public health model of service delivery to make contributions for improving the overall school environment for students.

No description available.

The Primary Care Behavioral Health (PCBH) model of service delivery is being used increasingly as an effective way to integrate behavioral health services into primary care. Despite its growing popularity, scientifically robust research on the model is lacking. In this article, we provide a qualitative review of published PCBH model research on patient and implementation outcomes. We review common barriers and potential solutions for improving the quantity and quality of PCBH model research, the vital data that need to be collected over the next 10 years, and how to collect those data.

Thesis advisor: Judith A. Vessey / This undergraduate thesis explores the underlying problem of interprofessional conflict and the resulting poor communication between physicians and nurses. It establishes the importance of understanding and addressing this subject within the health care community on a basis of reported negative outcomes, including compromised patient safety and quality of care. It also proposes a preventive health model as the most effective approach to describing the problem. An exploration of the antecedents to this interprofessional conflict identifies gender identity as having a significant role in setting the stage for the kind of relationships between nurses and physicians that harbor tension. Gender roles are discussed in the context of the developing professional identities of both physicians and nurses. The discussion further identifies how these social and professional distinctions result in the imposition of hierarchical arrangements that give way to oppressive relationships. The analysis proposes a need for dialogue –a form of primary prevention- regarding the oppressive internalized sexism that appears to have resulted from this hierarchical evolution. / Thesis (BS) — Boston College, 2010. / Submitted to: Boston College. Connell School of Nursing. / Discipline: College Honors Program.

A partir do Séc.XX, os modelos de organização do Sistema de Saúde no Brasil obedeceram à lógica do paradigma unicausal da medicina moderna, direcionando suas atividades em consonância com as expectativas das classes dominantes, em diferentes conjunturas políticas. Os modelos tecnoassistenciais unicausais organizaram as práticas de saúde antepondo barreiras entre o agente e o hospedeiro como no Modelo Campanhista e Modelo Médico Sanitarista ou tratando o indivíduo doente onde sua maior expressão se deu na oferta de consultas médicas sob a gerência do Instituto Nacional de Previdência Social (Modelo Médico Privatista) . O Movimento da Reforma Sanitária Brasileira, inscreveu na Constituição do Brasil de 1988 o direito à saúde, o Sistema Único de Saúde e os princípios que devem nortear a formulação de um novo modelo de saúde, entre eles: democracia, descentralização, hierarquização, resolutividade, admitindo a causalidade complexa do adoecer que necessita de ações intersetoriais para construção da saúde com mudança das práticas de saúde. Em 1993 o Governo Brasileiro estabeleceu o Programa de Saúde da Família (PSF) como estratégia para a construção do novo modelo e a cidade de Vitória seguindo as orientações do governo federal tem investido recursos técnicos e financeiros para ampliação de cobertura do Programa. Adotando-se a referência teórica de modelo tecnoassistencial adotado MEHRY, CECÍLIO e NOGUEIRA em 1991, este estudo tem por objetivo identificar nas atividades dos médicos, elementos que sinalizem a operacionalização de conceitos fundamentais para a mudança do modelo. Esta pesquisa é um estudo de caso de uma Região de Saúde da cidade de Vitória que utilizando a abordagem qualitativa na coleta e análise dos relatos de 7 médicos entrevistados evidenciou que a prática dos médicos do PSF reproduzem o Modelo Médico Sanitarista e Médico Privatista, na dependência do sujeito que opera as práticas, sua formação, sua subjetividade e também na dependência do contexto em que o PSF se desenvolve. / Since the XX century, the models of organization of the Health System in Brazil obey to the logic of the unique cause paradigm of the modern medicine, directing his activities in consonance with the expectations of the dominant classes, on different politic contexts. The technique and assistencial model and the unique cause organized the health parctices putting barriers between the agent and the host as in the Campaing Model and the Medic Sanitarist Model or treating the sick one. It,s biggest expression was with the offering of medical appointments with the management of the National Social Welfare Institute. The Brazilian Sanitary Reformation Movement booked in Brazilian Constitution of 1988 the right of health, The Unique Health System and the principles that should lead the formulation of a new health system, between then: democracy, decentralization, hierarchy, resolution, admitting the complex causality of sicken that requires actions betwueen different sectors to build the health with changes on health practices. On 1994, the Brazilian government established the Program of Family Health (PFH) as an strategy to form the new model and the city of Vitória, following the orientations of the federal government, has invested financial riches to enlarge the program. Using the theoretical reference of the construction of the technique and assistencial model used by MEHRY, CECILIO and NOGUEIRA on 1991, this study has as an objective identify the elements on the medical practices that sign and characterize the practice of fundamental concepts in the model change. This is a Case Study Research of an area of Vitória that using a quality approach in the collect of the reports, showed that the medical practices of the PFH reproduce the Medical Sanitary Model and the Medical Privativist, depending on as much the subject that does the practice, his formation, his subjective and also depending on the context that PFH develops itself.

A partir do Séc.XX, os modelos de organização do Sistema de Saúde no Brasil obedeceram à lógica do paradigma unicausal da medicina moderna, direcionando suas atividades em consonância com as expectativas das classes dominantes, em diferentes conjunturas políticas. Os modelos tecnoassistenciais unicausais organizaram as práticas de saúde antepondo barreiras entre o agente e o hospedeiro como no Modelo Campanhista e Modelo Médico Sanitarista ou tratando o indivíduo doente onde sua maior expressão se deu na oferta de consultas médicas sob a gerência do Instituto Nacional de Previdência Social (Modelo Médico Privatista) . O Movimento da Reforma Sanitária Brasileira, inscreveu na Constituição do Brasil de 1988 o direito à saúde, o Sistema Único de Saúde e os princípios que devem nortear a formulação de um novo modelo de saúde, entre eles: democracia, descentralização, hierarquização, resolutividade, admitindo a causalidade complexa do adoecer que necessita de ações intersetoriais para construção da saúde com mudança das práticas de saúde. Em 1993 o Governo Brasileiro estabeleceu o Programa de Saúde da Família (PSF) como estratégia para a construção do novo modelo e a cidade de Vitória seguindo as orientações do governo federal tem investido recursos técnicos e financeiros para ampliação de cobertura do Programa. Adotando-se a referência teórica de modelo tecnoassistencial adotado MEHRY, CECÍLIO e NOGUEIRA em 1991, este estudo tem por objetivo identificar nas atividades dos médicos, elementos que sinalizem a operacionalização de conceitos fundamentais para a mudança do modelo. Esta pesquisa é um estudo de caso de uma Região de Saúde da cidade de Vitória que utilizando a abordagem qualitativa na coleta e análise dos relatos de 7 médicos entrevistados evidenciou que a prática dos médicos do PSF reproduzem o Modelo Médico Sanitarista e Médico Privatista, na dependência do sujeito que opera as práticas, sua formação, sua subjetividade e também na dependência do contexto em que o PSF se desenvolve. / Since the XX century, the models of organization of the Health System in Brazil obey to the logic of the unique cause paradigm of the modern medicine, directing his activities in consonance with the expectations of the dominant classes, on different politic contexts. The technique and assistencial model and the unique cause organized the health parctices putting barriers between the agent and the host as in the Campaing Model and the Medic Sanitarist Model or treating the sick one. It,s biggest expression was with the offering of medical appointments with the management of the National Social Welfare Institute. The Brazilian Sanitary Reformation Movement booked in Brazilian Constitution of 1988 the right of health, The Unique Health System and the principles that should lead the formulation of a new health system, between then: democracy, decentralization, hierarchy, resolution, admitting the complex causality of sicken that requires actions betwueen different sectors to build the health with changes on health practices. On 1994, the Brazilian government established the Program of Family Health (PFH) as an strategy to form the new model and the city of Vitória, following the orientations of the federal government, has invested financial riches to enlarge the program. Using the theoretical reference of the construction of the technique and assistencial model used by MEHRY, CECILIO and NOGUEIRA on 1991, this study has as an objective identify the elements on the medical practices that sign and characterize the practice of fundamental concepts in the model change. This is a Case Study Research of an area of Vitória that using a quality approach in the collect of the reports, showed that the medical practices of the PFH reproduce the Medical Sanitary Model and the Medical Privativist, depending on as much the subject that does the practice, his formation, his subjective and also depending on the context that PFH develops itself.

Due to the subjective nature of pain and the profound debilitating effects of pain for a growing number of people, there are many challenges to approaching and fully addressing its problems. The traditional biomedical model of health limits its treatment focus to the physical components of pain. Biomedicine provides useful and effective short-term relief of bodily symptoms, but usually cannot cure pain that persists in both mind and body over time. Because chronic pain is often accompanied with discomfort, depression, and other significant life impairments, health researchers have recently conceptualized more comprehensive models to address pain. In the bio-psycho-social-spiritual health model, chronic pain is assessed and treated in the context of a person’s overall quality of life, considering biological, psychological, social, and spiritual health conditions. This movement towards adopting integrative health care models can also provide patient guidance needed for developing inner resources to adapt to pain, as well as recover from and prevent disease. Self-compassion comes from a fertile field of inquiry emerging out of a wider conception of health that includes spirituality. The construct is based on three related components that can assist a person living with pain: (a) being kind to oneself while in pain or suffering, (b) perceiving difficult times as shared human experiences, and (c) holding painful thoughts and feelings with mindfulness, instead of over-identification. Measured using the Self-Compassion Scale, it demonstrates positive associations with a variety of health indicators. However, a direct relationship with chronic pain has not yet been examined. In applying recent research in quality of life (QoL) and self-compassion to a chronic pain patient population, the purpose of this study is twofold: (a) to produce a comprehensive assessment of bio-psycho-social-spiritual QoL conditions (b) to examine differences in QoL with the presence of self-compassion and determine its potential moderating effect on life impairments due to pain. From this project, the QoL conditions that are affected by chronic pain and the moderation effect of self-compassion will be understood better so that more effective treatment and prevention procedures can be developed for people living with pain from long-term disease conditions. / text

Magister Public Health - MPH / Introduction: Health Sector Reform was initiated as a component of the Structural Adjustment Policies that were imposed on the developing countries by the international monetary organizations such as the International Monetary Fund and the World Bank during the 1980s and the 1990s. It included three main components, that is, financing reforms, decentralization and introducing competition to the health sector. Changes to the Egyptian health system were introduced in the 1980s through the cost recovery projects, while the Health Sector Reform Program was announced in 1997. This culminated in a change from a Primary Health Care model to a Family Health Model as regards the Primary Health Care sector of the Egyptian health system. Changes in the health systems have profound effects on people, so that it is essential to study the ongoing transformation of the Egyptian health system and its implications. Aim: The aim of the current study was to determine the acceptability of the Family Health Model, which replaces Primary Health Care, as currently implemented in Wardan Village, Giza, Egypt. Methodology: The study was a cross sectional survey utilizing a structured questionnaire that was used to determine the awareness and perception/satisfaction of the community members in an Egyptian rural area (Wardan village, Giza Governorate) towards the transformation from primary health care to family health model. 357 subjects participated in this study. Results: Awareness of the study participants towards the transformation process was 15.6%. The overall satisfaction with the family health unit by the participants was 80.5% compared with 35.7% for the old PHC one. Higher satisfaction was associated with older age (p=0.02), less education (p<0.001), being married in the past or present (p=0.02), working status (p=0.007), and more years of using the unit (p<0.001). Acceptability of the family health model among the participants of the current study was high at 88.3%. Higher score of acceptability were associated with less education (p<0.001), being or have been married (p=0.048), and with working status (p=0.005). 93.8% of the participants think that family health unit services are accessible and 79.9% of the participants think that the family health unit provides quality services. Conclusion: The Family Health Model has achieved successes when implemented but encountered some difficulties that have limited the gains and interfered with some of its aspects. The current study has shown that the Family Health Unit has gained a high score of satisfaction and acceptability by the study participants, although the awareness of the study participants about the transformation of the Primary Health Care Model to a Family Health Model was low.

Hälsa är ett begrepp som har avsaknad av en bestämd definition. Det finns flertalet erkända definitioner såsom WHO:s men det finns även de definitioner som skapats av den enskilda individen. De flesta definitioner som finns kring och om hälsa har sitt ursprung i den fysiska aktivitetens värld, än dock menar flera personer att om hälsa enbart skall ses som god utifrån den fysiska aktiviteten så blir begreppet hälsa inte särskilt innehållsrikt. Syftet med studien var att undersöka hur lärarna ser på begreppet hälsa. Enligt bakgrund och tidigare forskning så är hälsa ett personligt och svårdefinierat begrepp, vilket de sex lärare som intervjuades i denna kvalitativa studie bekräftade. Lärarnas kunskap om hälsa har inhämtats från tidigare idrottsliga erfarenheter och utbildning. Resultatet i denna studie visar att hälsoundervisningen stundtals blir personlig då lärarna utgår från sina tidigare idrottsliga erfarenheter när de talar och undervisar om hälsa. Resultatet har analyserats utifrån två hälsomodeller, kontinuummodellen samt den kliniska modellen. Resultatet som framkommer är att hälsa många gånger ses ur ett kontinuumperspektiv och sällan ur ett dikotomt perspektiv. Sammanfattat så handlar denna studie om hur lärarna ser på begreppet hälsa och hur de önskade att hälsoundervisningen skulle kunna se ut. / Health defines a person’s general condition, both mind and body. Being healthy or have “good health” is something that people, on a daily basis, can read about in the newspaper or on the internet, but what is health or being healthy? Health is often taken for granted and is also often associated with training, but many claim that health is not only about being fit or train hard. There are different definitions of health; world health organization (WHO) has one that has been acknowledged for many years: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. This definition has been controversy because it says that a person only can have good health if the person is free from illness, injury or pain which can seems quite possible to achieve. WHO:s definition about health, is not the only one, there are  many more definitions that has been created by dissimilar people. The aim with this study was to see how teachers look at health (and health studies) and where they got their knowledge about health. If you look at previous studies it says that health is a personal thing, each individual has their own opinion what health is, something that the teacher in this study agreed about. This is a qualitative study and sex teachers were interviewed. The result has been analyzed by two health models, the continuum model and the clinic model. The result showed that the teachers look at health from a continuum perspective and the teachers also said that their athletic background were the main reason for there value of health and how they look at health overall.