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Nurse Practitioner and Physician Assistant Satellite Health Centers: The Pending Demise of an Organizational Form?
No full textA national cohort of 44 rural satellite health centers originally staffed by nurse practitioners (NPs) and physician assistants (PAs) was studied in 1975 and resurveyed in 1979 and in 1984 to examine the viability of this type of health-care delivery organization during a period of significant growth in the nation\u27s physician supply. Twelve of these practices had ceased to function, although eight have been replaced by physician practices. Of the remaining 32, 14 have physicians on their staffs and 18 remain staffed only by NPs and PAs. Those centers staffed by physicians experience greater patient utilization, charge more for office visits, have larger budgets, and generate more of their budgets from fees for services and therefore appear to be more organizationally stable than centers staffed only by NPs and PAs. Although broader studies are needed for substantiation, these findings suggest that the period when NP/PA-staffed satellite health centers were important organizations for delivering care to previously underserved rural communities may be ending
Psychosocial Nursing Care of the Emergency Patient
No full texthttps://digitalcommons.tacoma.uw.edu/nursing_books/1001/thumbnail.jp
Coordinating County Based Services for the Frail Elderly
No full textThe aging network is fraught with fragmentation. Services to the elderly are administered out of multiple agencies and departments at all levels of government. This article discusses the approach taken by one county to diminish the level of fragmentation to frail elders by a cooperative agreement between key county departments providing services to the aged
Program innovations and character in Cub Scouts: Findings from Year 1 of a mixed-methods, longitudinal study
No full textYouth development programs seek to promote positive development through mentoring and engaging youth in opportunities for individual growth and community connectedness. We present findings from the initial phase of a mixed-method, longitudinal study aimed at assessing the impact of one such program, Cub Scouts, on character development. We assessed if Scouting, and a recent innovation focused on program quality, are associated with the development of character and other positive outcomes. Participants were 1,083 Scouts and non-Scouts, aged 5-12 years. At the start of the study, there was no difference in indicators of character between Scouts and non-Scouts, once matched through propensity score analyses. Through content analyses of interviews and short-answer questionnaires administered to leaders, we found that leaders’ views of character and of their roles corresponded to those envisioned by Cub Scouts. Implications for character development, and for the role of program components in character development, are discussed
Methodological challenges in participatory action research with undocumented Central American migrants
No full textAn interdisciplinary participatory action research (PAR) project was designed in collaboration with local immigrant organizations to document the impact of deportation policy on Central American immigrant families living in the northeastern U.S. This paper reports on selected methodological challenges of university - based co - researchers in this community - university PAR process which is currently concluding its fourth year. The paper discusses the iterative action - reflection processes focusing on: (1) an ove rview of the PAR project and its multiple phases within the U.S. and in Guatemala; (2) select challenges and contributions of the PAR approach for participating immigrant families “living in the shadows” and, (3) methodological concerns from the three co - a uthors, who include a graduate student who joined the early stages of partnership - building; an assistant professor in the early stages of her career; and a senior scholar with many years of experience in activist scholarship. We conclude with thoughts on w hy, despite these challenges, PAR is “worth the trouble”