Physicians in health care management: 1. Physicians as managers: roles and future challenges.

Physicians are increasingly expected to assume responsibility for the management of human and financial resources in health care, particularly in hospitals. Juggling their new management responsibilities with clinical care, teaching and research can lead to conflicting roles. However, their presence in management is crucial to shaping the future health care system. They bring to management positions important skills and values such as observation, problem-solving, analysis and ethical judgement. To improve their management skills physicians can benefit from management education programs such as those offered by the Physician-Manager Institute and several Canadian universities. To manage in the future environment they must increase their knowledge and skills in policy and political processes, financial strategies and management, human resources management, systems and program quality improvement and organizational design.     

Child undernutrition in war-torn society: the Ethiopian experience.

Using data from a cross-sectional nutrition survey conducted in rural Ethiopia between March and April 1992, roughly a year after the end of one of the longest civil wars in modern human history, this study attempts to document the magnitude and correlates of childhood undernutrition in Ethiopia. Findings from the study reveal that, at the time of the survey, 59% of children in the country were exposed to long-term or chronic undernutrition (stunted); about 4% were suffering from acute problems (wasted); and about the same proportion were both stunted and wasted. Less than a third of the country's children had normal growth. The logistic-binomial regression results demonstrated the existence of significant clustering of risks of undernutrition within areas of residence and notable differentials by age of child, duration of breast-feeding, age at introduction of supplementary foods and number of under-five siblings. Significant variations were also noted by age of household head, per capita land holding, religious affiliation and prevalence of endemic diseases in an area.     

Physicians should keep an open mind on complementary health care,Congress says.

Three hundred physicians from Canada and abroad attended the 3rd World Congress of Medical Acupuncture and Natural Medicine held in Edmonton last summer. Speakers emphasized that physicians should view complementary health care services with an open mind and consider therapeutic options that may be used in addition to conventional medical therapy.     

Improved system for floor cleaning in health care facilities.

A new system has been developed for sanitizing floors in hospitals; this system replaces the traditional procedure of daily dusting and wet mopping with a disinfectant-detergent solution and periodic buffing . This new system relies on a sequence of procedures consisting of dust mopping using a chemically treated dust mop, machine buffing of a sprayed-on polymer treatment, and a second dust mopping . The effectiveness of the procedures was evaluated by means of surface sampling for bacterial contamination and air sampling for airborne bacteria and dust. The level of bacterial contamination on the floors was reduced by 93.6% by using the new system, compared with 79.8% by using the conventional process of dust mopping and wet mopping with a disinfectant solution. The levels of airborne bacteria during and after the individual procedures did not vary significantly from the initial level (123.6 CFU/per m3 of air). A survey of representative colonies from air samples revealed staphylococci, gram-positive bacilli, gram-positive diplococci, yeast cells, and infrequent gram-negative rods. The distribution at the conclusion of the sanitizing process was similar to that at the outset. Similarly, the levels of airborne dust measured during and after the individual procedures did not vary significantly from the initial level. When compared with the traditional method of cleaning by wet mopping , the new method was significantly more effective in removal of microbial contamination and required less labor.     

Oral health and dental care facilities in Maltese residential homes

Objectives: To establish oral health care practices, including the use of dental services, in the residential homes of Malta and Gozo by assessing the knowledge of home managers and assistance of care staff regarding residents’ oral health and hygiene; and evaluating the residents’ demand for dental treatment and residential home managers response to this demand. Subjects: A total population sample of licensed residential homes (38) in Malta and Gozo was used comprising all home managers in government (seven), church (20), and privately run (11) residential homes. Method: A 19‐question questionnaire was designed, piloted and sent to the home managers requesting them to report on the dental care provision for their elderly residents. The questionnaire was distributed by post, along with a reply‐paid envelope and an explanatory letter. A response deadline of 1 month was included. Results: An 87% response rate was achieved. Whilst the majority of home managers (64%) were aware of domiciliary dental services, there was no code of care practice for oral health. Routine dental check‐ups were not organised for residents of most homes. Although home staffs were generally given information about residents’ oral health and hygiene, the majority did not assist residents with oral hygiene. Home managers identified the following barriers to the use of dental services by residents: cost, communication problems with dental staff, journey to place of treatment, waiting time at the dental clinic, access to premises/clinic, lack of information on oral health and dental service availability, no one to accompany the person to the clinic, and health problems such as mobility, poor eyesight, hearing impairment and mental health status. Conclusion: Although most home managers appreciate the importance of oral health care for their residents, the residents still face many barriers to maintaining adequate oral health care and accessing dental services.     

Gender difference in health status and health care facilities in some social groups and subgroups of southern West Bengal, India

In recent years, social scientists are concerned with individual well-being and also in identifying the high-risk groups. In South Asia, gender is an important determinant of variation in resource allocation. Three contrasting social groups of southern West Bengal, India have been studied to find out whether there is any gender discrimination in allocation of health facilities and also to assess the health status of these groups. In general, a tendency towards favouring the males appears to exist in respect of allocation of health facilities. Also, females are more affected with the ailments associated with hard work.