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Communication of bed allocation decisions in a critical care unit and accountability for reasonableness.

https://arctichealth.org/en/permalink/ahliterature172222
Source
BMC Health Serv Res. 2005;5:67
Publication Type
Article
Date
2005
Author
Andrew B Cooper
Amit S Joglekar
Jennifer Gibson
Alissa H Swota
Douglas K Martin
Author Affiliation
Department of Critical Care Medicine, Sunnybrook and Women's College Health Science Centre, University of Toronto, Toronto, Canada. ab.cooper@sw.ca
Source
BMC Health Serv Res. 2005;5:67
Date
2005
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Decision Making, Organizational
Hospital Administrators - psychology
Hospitals, University - ethics
Humans
Intensive Care Units - ethics - utilization
Interdisciplinary Communication
Interviews as Topic
Medical Staff, Hospital - psychology
Nursing Staff, Hospital - psychology
Ontario
Organizational Policy
Patient Admission - standards
Patient Discharge
Qualitative Research
Questionnaires
Resource Allocation - ethics
Social Responsibility
Abstract
Communication may affect perceptions of fair process for intensive care unit bed allocation decisions through its impact on the publicity condition of accountability for reasonableness.
We performed a qualitative case study to describe participant perceptions of the communication of bed allocation decisions in an 18-bed university affiliated, medical-surgical critical care unit at Sunnybrook and Women's College Health Sciences Centre. Interviewed participants were 3 critical care physicians, 4 clinical fellows in critical care, 4 resource nurses, 4 "end-users" (physicians who commonly referred patients to the unit), and 3 members of the administrative staff. Median bed occupancy during the study period (Jan-April 2003) was 18/18; daily admissions and discharges (median) were 3. We evaluated our description using the ethical framework "accountability for reasonableness" (A4R) to identify opportunities for improvement.
The critical care physician, resource nurse, critical care fellow and end-users (trauma team leader, surgeons, neurosurgeons, anesthesiologists) functioned independently in unofficial "parallel tracks" of bed allocation decision-making; this conflicted with the official designation of the critical care physician as the sole authority. Communication between key decision-makers was indirect and could exclude those affected by the decisions; notably, family members. Participants perceived a lack of publicity for bed allocation rationales.
The publicity condition should be improved for critical care bed allocation decisions. Decision-making in the "parallel tracks" we describe might be unavoidable within usual constraints of time, urgency and demand. Formal guidelines for direct communication between key participants in such circumstances would help to improve the fairness of these decisions.
Notes
Cites: Am J Respir Crit Care Med. 2003 Mar 1;167(5):708-1512598213
Cites: Crit Care Med. 2001 Oct;29(10):1893-711588447
Cites: J Neurol Neurosurg Psychiatry. 2003 Sep;74(9):1299-30312933940
Cites: Comput Inform Nurs. 2003 Sep-Oct;21(5):249-5814504601
Cites: Crit Care. 2003 Dec;7(6):405-614624673
Cites: Crit Care Med. 2003 Dec;31(12):2764-814668612
Cites: Crit Care Med. 2003 Dec;31(12):2809-1114668623
Cites: Am J Respir Crit Care Med. 2004 Feb 15;169(4):512-714656750
Cites: Nurs Clin North Am. 1989 Dec;24(4):1009-152685769
Cites: Nurs Outlook. 1993 May-Jun;41(3):108-128346049
Cites: JAMA. 1994 Apr 20;271(15):1200-37818629
Cites: Am J Respir Crit Care Med. 1997 Oct;156(4 Pt 1):1282-3019351636
Cites: Crit Care Med. 2000 Aug;28(8):3044-910966293
Cites: Nurs Res. 2001 May-Jun;50(3):188-9211393642
Cites: J Health Adm Educ. 2001 Spring;19(2):173-9311586656
Cites: Crit Care Med. 2003 Mar;31(3):956-912627011
PubMed ID
16259634 View in PubMed
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Levels and trends of contaminants in humans of the Arctic.

https://arctichealth.org/en/permalink/ahliterature277951
Source
Int J Circumpolar Health. 2016;75:33804
Publication Type
Article
Date
2016
Author
Jennifer Gibson
Bryan Adlard
Kristin Olafsdottir
Torkjel Manning Sandanger
Jon Øyvind Odland
Source
Int J Circumpolar Health. 2016;75:33804
Date
2016
Language
English
Publication Type
Article
Abstract
The Arctic Monitoring and Assessment Programme (AMAP) is one of the six working groups established under the Arctic Council. AMAP is tasked with monitoring the levels of contaminants present in the Arctic environment and people as well as assessing their effects on a continuous basis, and reporting these results regularly. Most of the presented data have been collected over the last 20 years and are from all eight Arctic countries. Levels of contaminants appear to be declining in some of the monitored Arctic populations, but it is not consistent across the Arctic. Most Arctic populations continue to experience elevated levels of these contaminants compared to other populations monitored globally. There are certain contaminants, such as perfluorinated compounds and polybrominated diphenyl ethers, which are still increasing in Arctic populations. These contaminants require more investigation to find out the predominant and important sources of exposure, and whether they are being transported to the Arctic through long-range transport in the environment.
PubMed ID
27974136 View in PubMed
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Levels and trends of contaminants in humans of the Arctic.

https://arctichealth.org/en/permalink/ahliterature279904
Source
Int J Circumpolar Health. 2016 Jan;75(1):33804
Publication Type
Article
Date
Jan-2016
Author
Jennifer Gibson
Bryan Adlard
Kristin Olafsdottir
Torkjel Manning Sandanger
Jon Øyvind Odland
Source
Int J Circumpolar Health. 2016 Jan;75(1):33804
Date
Jan-2016
Language
English
Publication Type
Article
Abstract
The Arctic Monitoring and Assessment Programme (AMAP) is one of the six working groups established under the Arctic Council. AMAP is tasked with monitoring the levels of contaminants present in the Arctic environment and people as well as assessing their effects on a continuous basis, and reporting these results regularly. Most of the presented data have been collected over the last 20 years and are from all eight Arctic countries. Levels of contaminants appear to be declining in some of the monitored Arctic populations, but it is not consistent across the Arctic. Most Arctic populations continue to experience elevated levels of these contaminants compared to other populations monitored globally. There are certain contaminants, such as perfluorinated compounds and polybrominated diphenyl ethers, which are still increasing in Arctic populations. These contaminants require more investigation to find out the predominant and important sources of exposure, and whether they are being transported to the Arctic through long-range transport in the environment.
PubMed ID
28156389 View in PubMed
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Levels and trends of contaminants in humans of the Arctic.

https://arctichealth.org/en/permalink/ahliterature289273
Source
Int J Circumpolar Health. 2016; 75:33804
Publication Type
Journal Article
Date
2016
Author
Jennifer Gibson
Bryan Adlard
Kristin Olafsdottir
Torkjel Manning Sandanger
Jon Øyvind Odland
Author Affiliation
Health Canada, Ottawa, ON, Canada; jennifer.gibson@hc-sc.gc.ca.
Source
Int J Circumpolar Health. 2016; 75:33804
Date
2016
Language
English
Publication Type
Journal Article
Keywords
Arctic Regions
Environmental Exposure - statistics & numerical data
Environmental Monitoring - statistics & numerical data
Environmental Pollutants - analysis
Environmental Pollution - analysis - statistics & numerical data
Fluorocarbons - analysis
Halogenated Diphenyl Ethers
Humans
Hydrocarbons, Brominated - analysis
Risk assessment
Abstract
The Arctic Monitoring and Assessment Programme (AMAP) is one of the six working groups established under the Arctic Council. AMAP is tasked with monitoring the levels of contaminants present in the Arctic environment and people as well as assessing their effects on a continuous basis, and reporting these results regularly. Most of the presented data have been collected over the last 20 years and are from all eight Arctic countries. Levels of contaminants appear to be declining in some of the monitored Arctic populations, but it is not consistent across the Arctic. Most Arctic populations continue to experience elevated levels of these contaminants compared to other populations monitored globally. There are certain contaminants, such as perfluorinated compounds and polybrominated diphenyl ethers, which are still increasing in Arctic populations. These contaminants require more investigation to find out the predominant and important sources of exposure, and whether they are being transported to the Arctic through long-range transport in the environment.
Notes
Cites: Int J Circumpolar Health. 2012 Mar 19;71:17998 PMID 22456049
Cites: Environ Sci Technol. 2012 Aug 21;46(16):9071-9 PMID 22770559
Cites: Sci Total Environ. 2010 Oct 15;408(22):5165-234 PMID 20728918
Cites: Int J Circumpolar Health. 2012 Jul 10;71:18594 PMID 22789518
Cites: Environ Int. 2013 Sep;59:33-40 PMID 23770579
Cites: J Environ Monit. 2010 Nov;12(11):2128-37 PMID 20877852
Cites: Arch Environ Health. 1992 May-Jun;47(3):185-95 PMID 1596101
Cites: Sci Total Environ. 2015 Oct 1;529:198-212 PMID 26011616
Cites: Am J Clin Nutr. 2014 Jan;99(1):5-13 PMID 24153349
Cites: Environ Int. 2014 Aug;69:58-66 PMID 24815340
Cites: Sci Total Environ. 2013 Jun 1;454-455:283-8 PMID 23562682
Cites: Mol Hum Reprod. 2010 Jan;16(1):14-22 PMID 19812089
Cites: Environ Res. 2015 Jan;136:57-66 PMID 25460621
Cites: Environ Sci Technol. 2010 Jan 1;44(1):316-22 PMID 19957995
Cites: Can J Public Health. 2013 Mar 07;104(3):e246-51 PMID 23823890
Cites: JAMA. 2012 Jan 25;307(4):391-7 PMID 22274686
Cites: J Environ Monit. 2011 Aug;13(8):2143-52 PMID 21738945
Cites: Environ Sci Technol. 2012 Mar 20;46(6):3127-34 PMID 22332897
Cites: J Pediatr. 2000 May;136(5):599-605 PMID 10802490
Cites: Chemosphere. 1997 Jun;34(12 ):2571-83 PMID 9204541
Cites: Environ Int. 2014 Oct;71:63-73 PMID 24973640
Cites: Environ Health Perspect. 2011 May;119(5):641-6 PMID 21156396
Cites: Int J Circumpolar Health. 2012;71:null PMID 23166895
Cites: Chemosphere. 1999 Jan;38(2):311-23 PMID 10901657
Cites: Environ Res. 2013 Apr;122:65-73 PMID 23375553
Cites: Environ Health Perspect. 2010 Oct;118(10):1434-8 PMID 20562056
Cites: Environ Health Perspect. 2007 Feb;115(2):226-30 PMID 17384769
Cites: Sci Total Environ. 2015 Mar 15;509-510:248-59 PMID 25135671
Cites: Asian J Androl. 2014 Jan-Feb;16(1):81-8 PMID 24369136
Cites: Environ Sci Technol. 2011 Feb 1;45(3):1121-6 PMID 21166449
Cites: J Toxicol Sci. 2012 Feb;37(1):123-30 PMID 22293416
Cites: Environ Sci Technol. 2013;47(21):12064-72 PMID 24073820
PubMed ID
27974136 View in PubMed
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Nutrition and exercise environment available to outpatients, visitors, and staff in Children's hospitals in Canada and the United States.

https://arctichealth.org/en/permalink/ahliterature167637
Source
Arch Pediatr Adolesc Med. 2006 Sep;160(9):900-5
Publication Type
Article
Date
Sep-2006
Author
Christine M McDonald
Tara Karamlou
James G Wengle
Jennifer Gibson
Brian W McCrindle
Author Affiliation
Division of Cardiology, Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada.
Source
Arch Pediatr Adolesc Med. 2006 Sep;160(9):900-5
Date
Sep-2006
Language
English
Publication Type
Article
Keywords
Canada
Child
Environment
Exercise
Food Service, Hospital - organization & administration
Hospitals, Pediatric - organization & administration
Humans
Logistic Models
United States
Abstract
Children's hospitals should advocate for children's health by modeling optimum health environments.
To determine whether children's hospitals provide optimum health environments and to identify associated factors.
Telephone survey.
Canadian and US hospitals with accredited pediatric residency programs.
Food services directors or administrative dietitians.
Health environment grades as determined for 4 domains quantifying (1) the amount of less nutritious food sold at cafeterias (cafeteria grade), (2) the presence of fast food outlets (outlet grade), (3) the amount of nutritious food alternatives available (healthful alternative grade), and (4) the presence of patient obesity or employee exercise programs (program grade).
The overall response rate was 87%. Compared with Canadian hospitals, US hospitals had more food outlets (89% vs 50%) and more snack/beverage vending machines (median, 16 vs 12) (P = .001 for both), despite equivalent consumer numbers. External companies managed more outlets at US vs Canadian hospitals (65% vs 14%; P = .01), and, generally, US hospitals recuperated more revenue from their outlets. Worst cafeteria grade was associated with US hospital location (odds ratio [OR], 8.9; 95% confidence interval [CI], 1.6-50; P = .01) and lower healthful alternative grade (OR, 0.016; 95% CI, 0.002-0.15; P
PubMed ID
16953013 View in PubMed
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Priority setting in Ontario's LHINs: ethics and economics in action.

https://arctichealth.org/en/permalink/ahliterature129359
Source
Healthc Q. 2011;14(4):35-43
Publication Type
Article
Date
2011
Author
Jennifer Gibson
Craig Mitton
Gwen DuBois-Wing
Author Affiliation
Joint Centre for Bioethics and the Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario. jennifer.gibson@utoronto.ca
Source
Healthc Q. 2011;14(4):35-43
Date
2011
Language
English
Publication Type
Article
Keywords
Community Networks - economics - ethics - organization & administration
Health Priorities - economics - ethics - organization & administration
Humans
Models, organizational
Ontario
Policy Making
Program Development
Program Evaluation
Abstract
Healthcare organizations the world over are faced with having to set priorities and allocate resources within the constraint of a fixed envelope of funding. Drawing on economic principles of value for money and ethical principles of fair process, a priority setting framework was developed for Ontario's local health integration networks (LHINs) in late 2007 and early 2008. Subsequently, over an 18-month period, the framework was piloted in three LHINs. In this article, the framework and pilot implementations are described, results from a formal evaluation are outlined and recommendations for future use are highlighted.
Notes
Comment In: Healthc Q. 2011;14(4):1422220329
PubMed ID
22116564 View in PubMed
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6 records – page 1 of 1.