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Biomedical subjects

J A McFadyen

Publications and source records attributed to J A McFadyen.

6 recordsLinked to original sources
PubMed1998

Mental health services--maintaining strategic direction.

UNLABELLED: AIM AND KEY ISSUES: This article reviews the theoretical basis of strategic management in an attempt to provide managers with a better understanding of the underpinning concepts and consequent actions they need to take to avoid loss of control and ultimate failure. BACKGROUND: The authors argue that community care for the severely mentally ill is failing and that in part the reason for this perceived failure is a closer allegiance to primary care that has shifted the focus away from mental illness. Such a shift, coupled with poor management and a desire by Community Mental Health Nurses (CMHNs) to retain a broad focus and maintain the 'autonomy' they gain when not held in the gravitational grasp of Consultant Psychiatrists, has resulted in strategic drift. The authors suggest 10 possible reasons to explain why CMHNs currently fail to meet the needs of the severely mentally ill. Among these are a lack of explicit strategic implementation plans, professional ambivalence and self-interest, poor management of resources and conflicting demands from key interest groups. CONCLUSION: It seems that mental health services in this country have reached the point where resistance to change should be crumbling in the face of perceived failure to deliver the required services. Whilst it could be argued that a major and potent source of internal change is performance gaps, few things force change more than sudden and unexpected information about poor organizational performance.

Community Health Nursing↗
PubMed1996

Provision of free and discounted dental services to selected populations: a survey of attitudes and practices of dentists attending the 1996 Dallas Midwinter Meeting.

An attitudes and practices survey of dentists attending the Dallas Midwinter Meeting in January 1996 in Dallas was conducted as a collaborative effort between the Dallas County Dental Society and the Baylor College of Dentistry. The survey was developed to help determine participating dentists' attitudes and practices in the area of provision of dental services on a discounted or free basis to disadvantaged patient groups. A total of 225 dentists responded to the survey. Of these surveyed dentists, 213 (94.6%) were in private practice and 199 (88.4%) described themselves as general dentists. A considerable amount of charitable dental services, discounted and free, was reported to be provided by the group of respondent dentists. A total of 152 (67.6%) of the dentists surveyed reported providing discounted or free care to elderly patients with low income, 125 (55.6%) provided such care to low-income patients without age restriction, and 137 (60.9%) cared for patients of record with temporary financial hardship. In other patient categories, 79 (35.1%) of the dentists provided free/discounted services to handicapped persons and 47 (20.9%) provided care to homebound patients. These findings concerning charitable practices by dentists were similar to those found in a comparable survey conducted by the American Dental Association in 1994. Dentists were fairly evenly split as to their preference where to volunteer services. Of the total respondents, 84 (40.6%) preferred providing services in their own office and 91 (44.0%) preferred to do so at a community health clinic that hosted volunteers.

Attitude of Health Personnel↗
PubMedDate not supplied

The failure of community care for the severely mentally ill.

For the past 10 years or more there has been an ongoing debate about community mental health (CMH) nursing. It is clearly important in any discourse about CMH nursing to begin by examining where this branch of nursing is at present, i.e. what route it has taken, as well as considering where it is destined to travel. The views expressed in this article are supported by a literature review undertaken as part of a research study into CMH nursing. The first and quantitative stage, which was completed in late 1995, and the second qualitative part of the study has now reached the data analysis stage. The preliminary findings from this study are discussed in this article.

Community Health Nursing↗
PubMedDate not supplied

Safe, sound and supportive: forensic mental health services.

Certain independent inquiries, the failure to implement the care programme approach, the new mental health strategy, the recent National Service Framework for Mental Health (Department of Health (DoH), 1999), and the Fallon Inquiry into the Personality Disorder Unit at Ashworth Special Hospital have all raised many questions about psychiatric care which remain unanswered. The issue of organizing and developing forensic services can be regarded as a key element if safer services are to be a reality. This article offers a model for forensic mental health services which is derived from policy statements, the published strategy, research, and discussion papers.

Forensic Psychiatry↗
PubMedDate not supplied

Orofacial injuries in youth soccer.

PURPOSE: The purpose of this study was to estimate the incidence of orofacial injuries in youth soccer in the 1995 fall and 1996 spring seasons for eight Dallas, Texas metropolitan area YMCA youth soccer leagues. METHOD: Surveys requesting orofacial injury as well as game and practice information were sent to all soccer coaches of children 3 to 12 years of age in eight cooperating YMCA leagues in the Dallas metropolitan area. RESULTS: The incidence of orofacial injury was low. In 47,772 hours of games and practice only 17 orofacial injuries were reported by the 122 coaches who responded. All reported injuries were to soft tissue and none required professional attention. CONCLUSION: The reported incidence of orofacial injury was very low suggesting that at the age and skill levels represented by these YMCA teams, soccer appears to be relatively safe to the maxillofacial complex.

Age Factors↗