A comparison of different types of prospective memory reminders in schizophrenia.

People with schizophrenia often experience difficulties with prospective memory (PM), but few empirical studies have directly compared the effectiveness of different types of reminders in remediating these difficulties. In the present study, two distinct types of reminders were compared to a standard (no reminder) condition in outpatients with schizophrenia (n = 30) and controls (n = 30). Using an adapted version of the well-validated laboratory PM measure, Virtual Week, participants were asked to complete three different conditions (counterbalanced), in which they were (i) provided with access to self-initiated reminders, (ii) provided with experimenter-initiated reminders, and (iii) completed a standard (no-reminder) condition. Both groups benefited from the provision of reminders, but self-initiated reminders were the most beneficial, particularly for time-based tasks. These data align with a broader literature that shows PM can be enhanced by the use of reminders. However, it extends this literature in an important way by showing that these benefits are equivalent for people with schizophrenia, and may be greatest where access to reminders is self-initiated. The implications of these data for the development of rehabilitative interventions are discussed.

The management of new primary care organizations: an international perspective.

Management practice arising from parallel policies for modernizing health systems is examined across a purposive sample of 16 countries. In each, novel organizational developments in primary care are a defining feature of the proposed future direction. Semistructured interviews with national leaders in primary care policy development and local service implementation indicate that management strategies, which effectively address the organized resistance of medical professions to modernizing policies, have these four consistent characteristics: extended community and patient participation models; national frameworks for interprofessional education and representation; mechanisms for multiple funding and accountabilities; and the diversification of non-governmental organizations and their roles. The research, based on a two-year fieldwork programme, indicates that at the meso-level of management planning and practice, there is a considerable potential for exchange and transferable learning between previously unconnected countries. The effectiveness of management strategies abroad, for example, in contexts where for the first time alternative but comparable new primary care organizations are exercising responsibilities for local resource utilization, may be understood through the application of stakeholder analyses, such as those employed to promote parity of relationships in NHS primary care trusts.

Desarrollo y validación de una encuesta para evaluar la satisfacción de los pacientes con la consulta médica en consultorios de atención primaria / Development and validation of a survey to assess patients satisfaction with medical consultation in primary health care

Te aim of this work was to devise and assess the reliability of an instrument to measure satisfaction with medical consultation of primary care urban patients at public outpatients clinics. A model was elaborated, based on data collected from the literature and from focal groups of patients and physicians and an enquiry was developed and applied at four outpatient clinics. Fifty enquires were obtained and analyzed to discard questions of difficult understanding. Next, a second self administered questionnaire and with fewer questions was devised. Its reliability was assessed in 53 enquires, obtaining a Cronbach's of 0.904. Questions that decreased consistency were discared, finally obtaining a self administered instrument with analysis with varimax rotation, which separated three factors that explain 64 percent of the variance. It is concluded that a valid and reliable instrument was obtained