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The concept of ''equity'' in health-promotion articles by Nordic authors - a matter of some confusion and misconception.

https://arctichealth.org/en/permalink/ahliterature136208
Source
Scand J Public Health. 2011 Mar;39(6 Suppl):50-6
Publication Type
Article
Date
Mar-2011
Author
Lene Povlsen
Ina K Borup
Elisabeth Fosse
Author Affiliation
The Nordic School of Public Health, Göteborg, Sweden. Lpovlsen@image.dk
Source
Scand J Public Health. 2011 Mar;39(6 Suppl):50-6
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Concept Formation
Health Policy
Health promotion
Health Services Accessibility
Health status
Humans
Periodicals as Topic
Public Health
Scandinavia
Social Justice
Abstract
This paper focuses on equity in health, one of the key principles of the Ottawa Charter. It aims at analysing and discussing how the concept was defined, applied, and integrated in health-promotion articles by authors with a Nordic affiliation.
Abstracts were first identified by the search word ''health promotion'' as a key word. The search was limited to 1986-2008 and abstracts written in English by authors with a Nordic affiliation. Abstracts/articles for the present study were subsequently selected from these abstracts using the search word ''equity'' and analysed by quantitative and qualitative content analysis.
A majority of the 18 articles in the study did not include any proper definition of the term ''equity in health''. Most articles dealt with health in general or ''Health for All'' aspects and did not focus on specific strategies for vulnerable individuals or groups. The theoretical papers had a clear focus on equity aspects even though the concept of equity was sometimes included in an implicit way. In contrast, most papers reporting empirical studies did not specifically target equity aspects. Instead, the analysis gave the impression that many authors used the term ''equity'' synonymously with ''equality in health''.
The findings may indicate that the concept of ''equity in health'' has been attenuated or even forgotten by Nordic health-promotion researchers and needs to be re-established as a strong concern within health promotion.
PubMed ID
21382848 View in PubMed
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Exploring which context matters in the study of health inequities and their mitigation.

https://arctichealth.org/en/permalink/ahliterature136209
Source
Scand J Public Health. 2011 Mar;39(6 Suppl):43-9
Publication Type
Article
Date
Mar-2011
Author
Nancy Edwards
Erica Di Ruggiero
Author Affiliation
Faculty of Health Sciences, School of Nursing, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada. nedwards@uottawa.ca
Source
Scand J Public Health. 2011 Mar;39(6 Suppl):43-9
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Canada
Health Policy
Health promotion
Health Status Disparities
Humans
Public Health
Research
Social Justice
Socioeconomic Factors
Abstract
This commentary argues that contextual influences on health inequities need to be more thoroughly interrogated in future studies of population health interventions.
Case examples were chosen to illustrate several aspects of context: its historical, global, and dynamic nature; its multidimensional character; and its macro- and micro-level influences. These criteria were selected based on findings from an extensive literature review undertaken for the Public Health Agency of Canada and from two invitational symposia on multiple intervention programmes, one with a focus on equity, the other with a focus on context.
Contextual influences are pervasive yet specific, and diffuse yet structurally embedded. Historical contexts that have produced inequities have contemporary influences. The global forces of context cross jurisdictional boundaries. A complex set of social actors intersect with socio-political structures to dynamically co-create contextual influences.
These contextual influences raise critical challenges for the field of population health intervention research. These challenges must be addressed if we are going to succeed in the calls for action to reduce health inequities. Implications for future public health research and research-funding agencies must be carefully considered.
PubMed ID
21382847 View in PubMed
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Tools for thoughtful action: the role of ecosystem approaches to health in enhancing public health.

https://arctichealth.org/en/permalink/ahliterature136548
Source
Can J Public Health. 2010 Nov-Dec;101(6):439-41
Publication Type
Article
Author
Jena C Webb
Donna Mergler
Margot W Parkes
Johanne Saint-Charles
Jerry Spiegel
David Waltner-Toews
Annalee Yassi
Robert F Woollard
Author Affiliation
CoPEH-Canada, Montreal, QC. jennifer.webb@mail.mcgill.ca
Source
Can J Public Health. 2010 Nov-Dec;101(6):439-41
Language
English
Publication Type
Article
Keywords
Canada
Ecosystem
Health status
Humans
Public Health - methods
Social Environment
Social Justice
Socioeconomic Factors
Sociology, Medical
Abstract
The intimate interdependence of human health and the ecosystems in which we are embedded is now a commonplace observation. For much of the history of public health, this was not so obvious. After over a century of focus on diseases, their biologic causes and the correction of exposures (clean water and air) and facilitation of responses (immunizations and nutrition), public health discourse shifted to embrace the concept of determinants of health as extending to social, economic and environmental realms. This moved the discourse and science of public health into an unprecedented level of complexity just as public concern about the environment heightened. To address multifactorial, dynamic impacts on health, a new paradigm was needed which would overcome the separation of humans and ecosystems. Ecosystem approaches to health arose in the 1990s from a rich background of intellectual ferment as Canada wrestled with diverse problems ranging from Great Lakes contamination to zoonotic diseases. Canada's International Development Research Centre (IDRC) played a lead role in supporting an international community of scientists and scholars who advanced ecosystem approaches to health. These collective efforts have enabled a shift to a research paradigm that embraces transdisciplinarity, social justice, gender equity, multi-stakeholder participation and sustainability.
PubMed ID
21370776 View in PubMed
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'Forensic' labelling: an empirical assessment of its effects on self-stigma for people with severe mental illness.

https://arctichealth.org/en/permalink/ahliterature136897
Source
Psychiatry Res. 2011 Jun 30;188(1):115-22
Publication Type
Article
Date
Jun-30-2011
Author
James D Livingston
Katherine R Rossiter
Simon N Verdun-Jones
Author Affiliation
BC Mental Health & Addiction Services, Provincial Health Services Authority, British Columbia, Canada. jlivingston@forensic.bc.ca
Source
Psychiatry Res. 2011 Jun 30;188(1):115-22
Date
Jun-30-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Canada
Female
Forensic Psychiatry
Humans
Male
Mental Disorders - epidemiology - psychology
Middle Aged
Psychiatric Status Rating Scales
Quality of Life
Self Concept
Social Stigma
Young Adult
Abstract
Increasingly, specialized 'forensic' mental health services are being developed to address the criminogenic and clinical needs of people with mental illness who are involved in the criminal justice system. Theoretically, the construction of such specialized services can produce simultaneous positive benefits and negative consequences. This mixed methods study examined and compared the level of self-stigma that was experienced by people who receive compulsory community-based treatment services in the forensic (n=52) and civil (n=39) mental health systems of British Columbia, Canada. The quantitative findings indicate that 'forensic' labelling was not associated with elevated levels of self-stigma. Quantitative level of self-stigma was significantly associated with psychiatric symptom severity, history of incarceration, and history of homelessness. The qualitative findings suggest that access to high-quality, well-resourced forensic mental health services may, for some service users, come at the risk of increased exposure to social and structural stigma. Together, these findings reveal some of the strengths and weaknesses that are associated with organizing forensic mental health services using a specialized service delivery model.
PubMed ID
21333361 View in PubMed
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Source
Can J Public Health. 2009 Sep-Oct;100(5):397
Publication Type
Article

Ethics, economics and the regulation and adoption of new medical devices: case studies in pelvic floor surgery.

https://arctichealth.org/en/permalink/ahliterature141261
Source
BMC Med Ethics. 2010;11:14
Publication Type
Article
Date
2010
Author
Sue Ross
Charles Weijer
Amiram Gafni
Ariel Ducey
Carmen Thompson
Rene Lafreniere
Author Affiliation
Department of Obstetrics and Gynaecology, University of Calgary, Calgary, Canada. sue.ross@albertahealthservices.ca
Source
BMC Med Ethics. 2010;11:14
Date
2010
Language
English
Publication Type
Article
Keywords
Beneficence
Canada
Conflict of Interest
Decision Making - ethics
Device Approval - legislation & jurisprudence - standards
Economics, Hospital
Equipment and Supplies - economics - ethics
Female
Gynecologic Surgical Procedures - instrumentation
Humans
Legislation, Medical - trends
Pelvic Floor - surgery
Personal Autonomy
Principle-Based Ethics
Social Justice
Surgical Instruments - economics - ethics - standards
Urologic Surgical Procedures - instrumentation
Abstract
Concern has been growing in the academic literature and popular media about the licensing, introduction and adoption of surgical devices before full effectiveness and safety evidence is available to inform clinical practice. Our research will seek empirical survey evidence about the roles, responsibilities, and information and policy needs of the key stakeholders in the introduction into clinical practice of new surgical devices for pelvic floor surgery, in terms of the underlying ethical principals involved in the economic decision-making process, using the example of pelvic floor procedures.
Our study involves three linked case studies using, as examples, selected pelvic floor surgery devices representing Health Canada device safety risk classes: low, medium and high risk. Data collection will focus on stakeholder roles and responsibilities, information and policy needs, and perceptions of those of other key stakeholders, in seeking and using evidence about new surgical devices when licensing and adopting them into practice. For each class of device, interviews will be used to seek the opinions of stakeholders. The following stakeholders and ethical and economic principles provide the theoretical framework for the study: Stakeholders--federal regulatory body, device manufacturers, clinicians, patients, health care institutions, provincial health departments, and professional societies. Clinical settings in two centres (in different provinces) will be included. Ethics--beneficence, non-maleficence, autonomy, justice. Economics--scarcity of resources, choices, opportunity costs.For each class of device, responses will be analysed to compare and contrast between stakeholders. Applied ethics and economic theory, analysis and critical interpretation will be used to further illuminate the case study material.
The significance of our research in this new area of ethics will lie in providing recommendations for regulatory bodies, device manufacturers, clinicians, health care institutions, policy makers and professional societies, to ensure surgical patients receive sufficient information before providing consent for pelvic floor surgery. In addition, we shall provide a wealth of information for future study in other areas of surgery and clinical management, and provide suggestions for changes to health policy.
Notes
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PubMed ID
20738887 View in PubMed
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Job attitudes and well-being among public vs. private physicians: organizational justice and job control as mediators.

https://arctichealth.org/en/permalink/ahliterature141542
Source
Eur J Public Health. 2011 Aug;21(4):520-5
Publication Type
Article
Date
Aug-2011
Author
Tarja Heponiemi
Hannamaria Kuusio
Timo Sinervo
Marko Elovainio
Author Affiliation
National Institute for Health and Welfare, Helsinki, Finland. tarja.heponiemi@thl.fi
Source
Eur J Public Health. 2011 Aug;21(4):520-5
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cross-Sectional Studies
Female
Finland
Humans
Job Satisfaction
Male
Middle Aged
Physicians - psychology
Private Sector
Public Sector
Questionnaires
Sleep Initiation and Maintenance Disorders
Social Justice
Stress, Psychological
Abstract
The present study examined whether there are differences in job-related attitudes and well-being among physicians working in private sector and public sector. In addition, we examined whether psychosocial factors (organizational justice and job control) could mediate these possible differences in different sectors.
Cross-sectional survey data from the Finnish Health Professional Study was used. A random sample of Finnish physicians included 1522 women and 1047 men aged 25-65 years. Outcome variables were job satisfaction, organizational commitment, psychological distress, work ability and sleeping problems. Job control and organizational justice were measured using established questionnaires. Series of regression analyses were performed and the mediational effects were tested following the procedures outlined by Baron and Kenny.
Physicians working in private sector had higher levels of job satisfaction and organizational commitment and lower levels of psychological distress and sleeping problems when compared with physicians working in public sector. Private physicians also had higher levels of organizational justice, which acted as a mediator behind more positive attitudes and better well-being in private sector. Private physicians had higher levels of job control but it did not act as a mediator.
Private physicians feel better than public physicians and this is partly due to higher organizational justice in private sector. Public health care organizations should invest effort to increase the fairness in their organizations and management and pay more attention in improving the well-being of their employees, which could possibly increase the attractiveness of public sector as a career option.
PubMed ID
20709783 View in PubMed
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Constructing the symbolic complainant: police subculture and the nonenforcement of protection orders for battered women.

https://arctichealth.org/en/permalink/ahliterature216148
Source
Violence Vict. 1995;10(3):227-47
Publication Type
Article
Date
1995
Author
G S Rigakos
Author Affiliation
York University, North York Ontario, Canada.
Source
Violence Vict. 1995;10(3):227-47
Date
1995
Language
English
Publication Type
Article
Keywords
British Columbia
Fantasy
Female
Gender Identity
Humans
Imagination
Male
Organizational Culture
Social Control, Formal
Social Responsibility
Spouse Abuse - legislation & jurisprudence - prevention & control - psychology
Stereotyping
Symbolism
Women's Rights
Abstract
This exploratory study examines the effects of patriarchy on police and individual attitudes toward the enforcement of protective court orders for battered women. Police officers (N = 13) and justice officials (N = 8) in the Municipality of Delta were interviewed for their opinions on the efficacy of both Criminal Code peace bonds and Family Relations Act (R.S.B.C., amended 1986) civil restraining orders. Interview data suggest that both protective orders are rarely treated seriously by the police or the courts. It is argued that the occupational culture of the police leads to exaggerated patriarchal notions of women, marriage, and family that are conservative; blame the victim; point finger at other institutions; foster images of women as manipulative; and produce a fictitious narrative of battered women.
PubMed ID
8777189 View in PubMed
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[Prioritization of health care: is there room for selection or risk?].

https://arctichealth.org/en/permalink/ahliterature216199
Source
Duodecim. 1995;111(1):45-50
Publication Type
Article
Date
1995
Author
I. Niiniluoto
Author Affiliation
Filosofian laitos, Helsingin yliopisto.
Source
Duodecim. 1995;111(1):45-50
Date
1995
Language
Finnish
Publication Type
Article
Keywords
Attitude to Health
Finland
Health Priorities
Health services needs and demand
Humans
Social Justice
Social Values
PubMed ID
8654255 View in PubMed
Less detail
Source
Camb Q Healthc Ethics. 2013 Apr;22(2):159-69
Publication Type
Article
Date
Apr-2013

Appeals to individual responsibility for health--reconsidering the luck egalitarian perspective.

https://arctichealth.org/en/permalink/ahliterature115446
Source
Camb Q Healthc Ethics. 2013 Apr;22(2):146-58
Publication Type
Article
Date
Apr-2013

Work-unit measures of organisational justice and risk of depression--a 2-year cohort study.

https://arctichealth.org/en/permalink/ahliterature115698
Source
Occup Environ Med. 2013 Jun;70(6):380-5
Publication Type
Article
Date
Jun-2013
Author
Matias Brødsgaard Grynderup
Ole Mors
Åse Marie Hansen
Johan Hviid Andersen
Jens Peter Bonde
Anette Kærgaard
Linda Kærlev
Sigurd Mikkelsen
Reiner Rugulies
Jane Frølund Thomsen
Henrik Albert Kolstad
Author Affiliation
Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark. matigryn@rm.dk
Source
Occup Environ Med. 2013 Jun;70(6):380-5
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Adult
Burnout, Professional - complications
Denmark
Depression - etiology
Depressive Disorder - etiology
Female
Humans
Interviews as Topic
Logistic Models
Male
Middle Aged
Multivariate Analysis
Occupational Diseases - etiology - psychology
Occupational Exposure - adverse effects
Odds Ratio
Risk factors
Social Justice
Stress, Psychological - complications
Work
Workplace - psychology
Abstract
The aim of this study is to analyse if low justice at work, analysed as aggregated workplace means, increases the risk of depression.
A total of 4237 non-depressed Danish public employees within 378 different work units were enrolled in 2007. Mean levels of procedural and relational justice were computed for each work unit to obtain exposure measures that were robust to reporting bias related to depression. Two years later in 2009, 3047 (72%) participated at follow-up. Those reporting high levels of depressive, burn-out or stress symptoms were assigned to a psychiatric diagnostic interview. In the interview 58 cases of new onset depression were identified. Depression ORs by work unit level of procedural and relational justice were estimated by multivariable logistic regression accounting for established risk factors for depression.
Working in a work unit with low procedural justice (adjusted ORs of 2.50, 95% CI 1.06 to 5.88) and low relational justice (3.14, 95% CI 1.37 to 7.19) predicted onset of depression.
Our results indicate that a work environment characterised by low levels of justice is a risk factor for depression.
PubMed ID
23476045 View in PubMed
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Job demands and musculoskeletal symptoms among female geriatric nurses: the moderating role of psychosocial resources.

https://arctichealth.org/en/permalink/ahliterature115851
Source
J Occup Health Psychol. 2013 Apr;18(2):211-9
Publication Type
Article
Date
Apr-2013
Author
Laura Pekkarinen
Marko Elovainio
Timo Sinervo
Tarja Heponiemi
Anna-Mari Aalto
Anja Noro
Harriet Finne-Soveri
Author Affiliation
Service System Department, National Institute for Health and Welfare, Helsinki, Finland. laura.pekkarinen@thl.fi
Source
J Occup Health Psychol. 2013 Apr;18(2):211-9
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Assisted Living Facilities
Confidence Intervals
Female
Finland - epidemiology
Geriatric Nursing
Health Surveys
Humans
Logistic Models
Middle Aged
Musculoskeletal Diseases - epidemiology - physiopathology - prevention & control
Occupational Injuries - prevention & control
Odds Ratio
Social Support
Stress, Psychological - epidemiology - prevention & control
Workload
Workplace
Young Adult
Abstract
The present study examined whether job resources (job control, social support, and distributive justice) moderate the associations of high job demands induced by physical and mental workload with musculoskeletal symptoms among geriatric nurses. The data were drawn in Finland from 975 female nurses working in 152 geriatric units who responded to a survey questionnaire. Information on the objective workload in terms of resident characteristics and structural factors was also collected at the unit level. After adjusting for the objective workload, multilevel logistic regression analyses showed that self-reported physical workload was associated with higher risk of musculoskeletal symptoms (OR = 1.93, 95 % CI [1.38, 2.72]) among nurses with low social support. In addition, mental workload was associated with higher risk of musculoskeletal symptoms (OR = 1.72, 95% CI [1.12, 2.62]) for those with low distributive justice. The results suggest that social support and fair reward systems may help to buffer against the detrimental effects of heavy job demands on nurses' musculoskeletal symptoms.
PubMed ID
23458058 View in PubMed
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Can organizational justice help the retention of general practitioners?

https://arctichealth.org/en/permalink/ahliterature115920
Source
Health Policy. 2013 Apr;110(1):22-8
Publication Type
Article
Date
Apr-2013
Author
Tarja Heponiemi
Kristiina Manderbacka
Jukka Vänskä
Marko Elovainio
Author Affiliation
National Institute for Health and Welfare, Helsinki, Finland. tarja.heponiemi@thl.fi
Source
Health Policy. 2013 Apr;110(1):22-8
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Attitude of Health Personnel
Female
Finland
General Practitioners - organization & administration - psychology - supply & distribution
Humans
Job Satisfaction
Male
Middle Aged
Personnel Turnover
Primary Health Care - manpower - organization & administration
Social Justice
Young Adult
Abstract
In many countries, public sector has major difficulties in recruiting and retaining physicians to work as general practitioners (GPs). We examined the effects of taking up a public sector GP position and leaving public sector GP work on the changes of job satisfaction, job involvement and turnover intentions. In addition, we examined whether organizational justice in the new position would moderate these associations. This was a four-year prospective questionnaire study including two measurements among 1581 (948 women, 60%) Finnish physicians. A change to work as a public GP was associated with a substantial decrease in job satisfaction and job involvement when new GPs experienced that their primary care organization was unfair. However, high organizational justice was able to buffer against these negative effects. Those who changed to work as public GPs had 2.8 times and those who stayed as public GPs had 1.6 times higher likelihood of having turnover intentions compared to those who worked in other positions. Organizational justice was not able to buffer against this effect. Primary care organizations should pay more attention to their GPs - especially to newcomers - and to the fairness how management behaves towards employees, how processes are determined, and how rewards are distributed.
PubMed ID
23453045 View in PubMed
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AIDER: a model for social accountability in medical education and practice.

https://arctichealth.org/en/permalink/ahliterature115994
Source
Med Teach. 2013 Aug;35(8):e1403-8
Publication Type
Article
Date
Aug-2013
Author
Gurjit Sandhu
Ivneet Garcha
Jessica Sleeth
Karen Yeates
G Ross Walker
Author Affiliation
Postgraduate Medical Education, Faculty of Health Sciences, 70 Barrie Street, Queen’s University, Kingston,ON K7L 3N6, Canada. sandhug@queensu.ca
Source
Med Teach. 2013 Aug;35(8):e1403-8
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Age Factors
Canada
Disabled Persons
Education, Medical - organization & administration
Healthcare Disparities
Humans
Physicians
Schools, Medical - organization & administration
Sex
Sexism
Social Justice
Socioeconomic Factors
Total Quality Management
Vulnerable Populations
Abstract
Social accountability in healthcare requires physicians and medical institutions to direct their research, services and education activities to adequately address health inequities. The need for greater social accountability has been addressed in numerous national and international healthcare reviews of health disparities and medical education.
The aim of this work is to better understand how to identify underserved populations and address their specific needs and also to provide physicians and medical institutions with a means by which to cultivate social accountability.
The authors reviewed existing literature and prominent models focusing on social accountability, as well as medical education frameworks, and identified the need to engage underserved stakeholders and incorporate education that includes knowledge translation and reciprocity. The AIDER model was developed to satisfy the need in medical education and practice that is not explicitly addressed in previous models.
The AIDER model (Assess, Inquire, Deliver, Educate, Respond) is a continuous monitoring process that explicitly incorporates reciprocal education and continuous collaboration with underserved stakeholders.
This model is an incremental step forward in helping physicians and medical institutions foster a culture of social accountability both in individual practice and throughout the continuum of medical education.
PubMed ID
23444886 View in PubMed
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829 records – page 1 of 42.