Search results

This paper aims to assess the psychological impact of home confinement in Tunisian medical students and analyze the relationship between psychopathology and cognitive emotion regulation strategies.

In total, 251 medical students who have been in home confinement accepted to participate in an online questionnaire survey. They completed depression, anxiety and stress scale, beck hopelessness scale and cognitive emotion regulation questionnaire.

Moderate to extremely severe levels of depression, anxiety and stress were reported by 57.4%, 51.0% and 31.4% of medical students, respectively. Based on the cut-off value of nine, 31.1% of the participants showed high levels of hopelessness. Hierarchical regression analysis identified four cognitive emotion regulation strategies as significant independent contributors to psychopathology above and beyond home confinement related variables. Self-blame positively predicted stress. Catastrophizing positively predicted anxiety and hopelessness. Refocusing on planning negatively predicted anxiety. Positive reappraisal negatively predicted hopelessness.

Cognitive emotion regulation strategies may constitute a valuable target of preventive and interventional measures to improve medical students’ mental health.

A unique feature of this study is the demonstration of the important role played by cognitive emotion regulation strategies in predicting anxiety, stress and hopelessness in medical students. In the context of mandatory home confinement, these cognitive strategies were significant predictors of psychopathology above and beyond home confinement related variables.

A nurse home care scheduling system is described. The objective is to provide medical care at patients’ homes using the fewest number of nurses possible to deliver the required care. The heuristic scheduling system is easy to implement as a computerized adaptive system. As such, it is easy to use on a daily basis and easy to update as new data related to completed treatment and new requests are obtained. A case study illustrates the advantages of implementing such a system.

This paper aims to examine the marketing strategies designed by three innovative early 1900s food companies. It traces the coordination of these businesses’ research funding, advertising, direct mail and promotional tactics to show how they intersected and impacted consumers and health professionals in the period when scientists were first able to quantify the relationship between good health and food. The paper analyzes internal company documents, advertisements and marketing materials from Knox Gelatine, Borden and Sunkist.

Research for this paper benefited from the author’s unlimited access to the private documents of the Knox Gelatine Company and its executives. These documents were analyzed chronologically and thematically. They chronicled the company’s attempts to influence the medical world and the ways it cultivated home economists. The paper also used publicly available digitized documents from Sunkist and Borden. The paper would benefit from further detailed analysis of these documents to parse Knox’s targeting by race and ethnicity.

In the 1920s, Knox, Borden and Sunkist developed a marketing strategy which leveraged a new class of experts – the hundreds of thousands of medical professionals, home economists, teachers and government agents who advised American women. By distributing specific laboratory research on the nutritional benefits of their products to this emerging class of health professionals and the consumers who trusted them, these companies developed relationships with opinion leaders designed specifically to influence product sales.

This research benefited from access to the private documents of Knox Gelatine Company which divulge the company’s attempts to influence the medical world and cultivate home economists. The paper would benefit from further analysis of these documents to parse the company’s targeting by race and ethnicity as well as a deeper comparison to companies that tried to work with health professionals unsuccessfully and companies that adopted this tactic in the household products or tobacco area. Opportunities also exist to do a fuller analysis of variations in food marketing by rural versus urban as well as race.

By reconstructing the sequencing and content of these three companies’ 1920s marketing strategies, this research uncovers a form of early 20th century food marketing directed at health and science professionals which has been neglected in advertising histories.

The belief that children have mental health needs different than those of adults is a relatively recent phenomenon. Systematic field studies of mental illness began in the early 19th century (Anthony, Eaton, & Henderson, 1995), although awareness of these illnesses and the recognition of the need for treatment were well established by the 1600s (Grob, 1994). Field studies and census data from mental hospitals in the 1800s reveal few cases of mental illness identified among children under the age of 16. In the late 19th and early 20th centuries, the recognition that children have specific mental health needs arose as the result of the confluence of several factors. The Progressive Movement promoted child labor and mandatory public education laws that created legal separations between the role of children and adults (Abbott, 1908; Sutton, 1983). Hall (1905) helped popularize the idea that childhood and adolescence constituted distinct periods of development. Perhaps most pressing, however, was a perceived rise in juvenile delinquency and sexual promiscuity. To address these problems, separate courts were established for juvenile offenders to keep children out of institutions and to provide treatment and rehabilitation (Alper, 1941). Based on the work of Healy and Bronner (1916), researchers and policy makers began to think of juvenile crime as arising from “mental conflicts” in children. Institutions such as the Chicago Juvenile Psychopathic Institute and the Boston Psychopathic Hospital were established to care for these children (Horn, 1989).

The purpose of this paper is to examine the information search behaviors of mature consumers (age 55 and older) for new service purchases across several contexts.

Almost 200 mature consumers in the Midwestern USA were surveyed regarding new home, medical, or financial service purchases made within the past 12 months. Questions regarding information search, importance of different information sources, satisfaction with the service decision, and demographics were collected.

Mature consumers consulted few information sources for service decisions, irrespective of context. Service context did affect the number of service providers considered; significantly fewer providers were considered for medical and financial services than for home services. Information search was negatively related to age, but unrelated to service outcome satisfaction and responsibility for the decision.

No comparison was made between the search behavior of older and younger consumers. Although the breadth of information search was examined, the depth of search within each type of information source was not. As a descriptive study, it was not possible to address why such little external search was conducted. A convenience sample was used.

Mature consumers conducted more external search for less‐involved service contexts (e.g. home services) than for those more‐involved (e.g. medical and financial services). Companies are beginning to realize the value of maintaining relationships with mature consumers; the results may suggest ways to improve those relationships with mature consumers by detailing the service decision process. Additionally, public policy interventions or education programs based on the work might help mature consumers to learn better service decision strategies.

A large range of ages was sampled in the study (respondents ranged from 55 to 93) and multiple responses were obtained from some participants across several service contexts, allowing for a within‐subjects design of the survey. It was then possible to explore the effect of context on the number of service providers considered and the number of external information sources consulted prior to purchase.

The purpose of this paper is to propose a general model that examines the contextual factors underlying the decision‐making process of international hospital outshopping.

Patients who chose medical treatment abroad were selected to analyze the drivers of internationalization in medical services. A total number of 27 international patients who traveled from developed countries to receive medical treatment at the largest hospital in Thailand were interviewed and their responses assessed through narrative analysis.

The narrative analysis reveals that while high costs and the deteriorating conditions of health care in developed countries are initially driving consumers to leave their local service area and choose foreign service providers, pull factors such as innovation, organizational efficiency, emotional service quality and patient‐doctor relationships in service encounters are nurturing a real preference for choosing foreign health care providers.

This exploratory study is limited to the largest hospital in South East Asia. Future research could expand upon its findings and comparisons be made with other different foreign health care providers.

In order to attract foreign customers a personal service, such as medical treatment, must be based on and sustained by continuous innovation in service quality.

The paper is the first empirical in‐depth study that examines the factors underlying the decision‐making process of international hospital outshopping.

This chapter describes the efforts of a team of health care workers to make a sub-acute health care facility (SCF) serving profoundly damaged children into a high reliability organization (HRO). To obtain this goal, the health care team implemented change in four behavioral areas: (1) risk awareness and acknowledgment; (2) defining care; (3) how to think and make decisions; and (4) information flow. The team focused on five reliability enhancement issues that emerged from previous research on banking institutions: (1) process auditing; (2) the reward system; (3) quality degradation; (4) risk awareness and acknowledgment; and (5) command and control. These HRO processes emerged from the change effort. Three additional HRO processes also emerged: high trust, and building a high reliability culture based on values and on beliefs. This case demonstrates that HRO processes can reduce costs, improve safety, and aid in developing new markets. Other experiences in implementing high reliability processes show that each organization must tailor make processes to its own situation (e.g. BP, U.S. Chemical Safety and Hazards Board, Federal Aviation Administration, U.S. Navy Aviation Program, and Kaiser Permanente Health Care System). Just as in the flexibility called for in organizing for high reliability operations, flexibility is called for in deciding which HRO processes work in specific situations.

People with severe persistent mental illness pose a significant challenge to managed care organizations and society in general. The financial costs are staggering as is the community impact including homelessness and incarceration. This population also has a high incident of chronic comorbid disorders that not only drives up healthcare costs but also significantly shortens longevity. Traditional case management approaches are not always able to provide the intense and direct interventions required to adequately address the psychiatric, medical and social needs of this unique population. This article describes a Medicare Advantage Chronic Special Needs Program that provides a Medical Home, Active Community Treatment, and Integrated Care. A comparison of utilization and patient outcome measures of this program with fee for service Medicare found significant reduction in utilization and costs, as well as increased adherence to the management of chronic medical conditions and preventative services.

The purpose of this article is to identify enabling and inhibiting factors that influence patients during their consideration of medical tourism for their healthcare requirement. The research provides marketing and practice implications that help in promoting medical tourism service. Furthermore, the paper provides evidence from medical tourism service to establish the relationship between resource integration and adoption of the service.

The article takes a two‐pronged exploratory study approach, with study one focusing on analysing prospective medical tourists' emotional impediments in their consideration of the service, while study two analyses the factors that helped medical tourists who have already availed the service, overcome the impediments.

In this article, it is identified that resource integration, particularly social resources, has a major impact on individual's decision to adopt a service. The exploratory study indicates that perceived knowledge disadvantage, lack of perceived control, and lack of social support in the destination country lead causes emotional discomfort to medical tourists. The study also indicates that the ability to integrate social resources available to them helped prospective medical tourists in their assessment of medical tourism service prior to adopting it. The article establishes that integration of social resources enables the patients to overcome the emotional discomfort and thus pursues to adopt medical tourism service.

While previous medical tourism service research has primarily focused on cognitive factors in patients' decision making such as quality and cost of healthcare services in destination countries, this article throws light on the enabling and inhibiting factors that influence adoption of medical tourism service.

Power outages which may be triggered, for example, by natural hazards and system failures are a common phenomenon, associated with large impacts on society including the healthcare sector. Minimising adverse impacts effectively requires an analysis of possible impacts and the identification of measures aiming at reducing vulnerability and increasing resilience.

To systematically identify impacts as well as preparation, mitigation and recovery (PMR) measures, a moderated workshop with participants representing different healthcare sub‐sectors in Germany was conducted and complemented by semi‐structured interviews and a thorough analysis of literature. Impacts were determined for three scenarios of power outage duration, <8, 8‐24 and >24 hours.

Whereas hospitals are in general well prepared with respect to shorter outages, due to obligatory emergency power in Germany, outpatient medical care, nursing homes (NH) and, in particular, home‐care nursing are early affected. Failure of these sub‐sectors puts additional strains on hospitals. If outages last more than one day and are associated with failure of other critical infrastructures (CIs), especially water supply, hospitals may be severely affected. Effective preparation and mitigation measures identified based on a facility‐specific impact analysis, as well as good cooperation between actors, may reduce impacts.

The largely case‐study‐based literature is complemented by a systematic and extensive analysis of direct and indirect impacts on the main healthcare sub‐sectors in Germany, followed by an identification of specific PMR measures. As a novelty outage duration is explicitly accounted for. Also, interdependencies between the healthcare sub‐sectors as well as dependencies on other CI are considered.