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Alcohol ignition interlocks in all new vehicles: a broader perspective.

https://arctichealth.org/en/permalink/ahliterature105146
Source
Traffic Inj Prev. 2014;15(4):335-42
Publication Type
Article
Date
2014
Author
Igor Radun
Jussi Ohisalo
Sirpa Rajalin
Jenni E Radun
Mattias Wahde
Timo Lajunen
Author Affiliation
a Human Factors and Safety Behavior Group, Institute of Behavioral Sciences , University of Helsinki , Helsinki , Finland.
Source
Traffic Inj Prev. 2014;15(4):335-42
Date
2014
Language
English
Publication Type
Article
Keywords
Accidents, Traffic - mortality - prevention & control
Alcoholic Intoxication
Automobile Driving - legislation & jurisprudence
Automobiles - standards
Breath Tests - instrumentation
Cost-Benefit Analysis
Databases, Factual
Equipment Design
Finland
Humans
Protective Devices - economics - utilization
Public Opinion
Abstract
To discuss the implications of widespread implementation of alcohol ignition interlocks.
We base our discussion on data from Finland including crash statistics and surveys collected from criminal justice professionals and general driving population.
Alcohol ignition interlocks are an effective preventive measure against drunk driving when installed in the vehicles of convicted drunk drivers. However, once they are removed from the vehicles, drivers typically return to their habit of drinking and driving. Furthermore, for a number of reasons, the proportion of convicted drunk drivers that install an interlock in their vehicles is quite small. Therefore, many stakeholders believe that the solution to the drunk driving problem will come when interlocks become standard equipment in all new vehicles. However, drunk driving is a complex sociopsychological problem, and technology can rarely offer a solution to such complex problems. Consequently, many aspects of such interventions might be difficult to identify and include in cost-benefit analysis.
We express caution about requiring an interlock as standard equipment in all new vehicles.
PubMed ID
24471356 View in PubMed
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All well at work? Evaluation of workplace-based early rehabilitation in the Finnish State administration.

https://arctichealth.org/en/permalink/ahliterature193244
Source
Int J Rehabil Res. 2001 Sep;24(3):171-80
Publication Type
Article
Date
Sep-2001
Author
I. Väänänen-Tomppo
E. Janatuinen
R. Törnqvist
Author Affiliation
State Treasury, Helsinki, Finland. irma.vaananen-tomppo@valtiokont-tori.fi
Source
Int J Rehabil Res. 2001 Sep;24(3):171-80
Date
Sep-2001
Language
English
Publication Type
Article
Keywords
Cost-Benefit Analysis
Female
Finland
Follow-Up Studies
Humans
Male
Occupational Diseases - mortality - rehabilitation
Outcome and Process Assessment (Health Care)
Questionnaires
Retirement - psychology
Time Factors
Abstract
A comprehensive system for the early rehabilitation of personnel has been developed and practised within the Finnish State administration since 1989. The rehabilitation process can be initiated as soon as the working capacity of a person or work community is threatened but is not yet seriously impaired. Rehabilitation is principally carried out on an outpatient basis alongside ordinary work. The aim of the study was to evaluate the outcomes and processes of early rehabilitation. The research data comprised several thousands of cases and consisted of a cross-sectional and a follow-up survey and a register-based follow-up. The surveys showed that during the rehabilitation period the average performance of the participants began to match that of the better-off non-participants, especially with respect to their general working capacity, mental well-being and occurrence of musculoskeletal problems. The sense of coherence rose in both groups, which can be partly attributed to positive changes in the workplace. In the group process, there also proved to be many factors contributing to achievement of the participants' rehabilitation objectives. The register-based follow-up showed that rehabilitation had a positive effect on average longer-term morbidity. In the cases of early retirement, the average retirement age of early rehabilitation participants was considerably higher than the average for the State sector as a whole. A system of outpatient early rehabilitation, where the rehabilitation programme and the development of working circumstances progress side by side, proved to give encouraging results at very moderate cost.
PubMed ID
11560232 View in PubMed
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An economic evaluation of intermittent cyclosporin A therapy versus UVAB phototherapy in the treatment of patients with severe atopic dermatitis.

https://arctichealth.org/en/permalink/ahliterature179565
Source
Acta Derm Venereol. 2004;84(2):138-41
Publication Type
Article
Date
2004
Author
Heini Salo
Markku Pekurinen
Håkan Granlund
Marja Nuutinen
Pekka Erkko
Sakari Reitamo
Author Affiliation
National Public Health Institute, Department of Vaccines, Helsinki, Finland. heini.salo@ktl.fi
Source
Acta Derm Venereol. 2004;84(2):138-41
Date
2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Confidence Intervals
Cost Savings
Cost of Illness
Cost-Benefit Analysis
Cyclosporine - economics - therapeutic use
Delivery of Health Care - economics - utilization
Dermatitis, Atopic - diagnosis - drug therapy - economics - radiotherapy
Female
Finland
Health Care Costs
Humans
Male
Middle Aged
Probability
Risk assessment
Severity of Illness Index
Treatment Outcome
Ultraviolet Therapy - economics - methods
United States
Abstract
We performed a cost-effective evaluation of cyclosporin A versus UVAB phototherapy in the treatment of severe atopic dermatitis. The analysis was based on a one-year open prospective clinical trial conducted in Finland and showed that patients who received intermittent cyclosporin A therapy had on average 191 remission days per year, i.e. where disease activity was reduced by 50% or more. Patients receiving UVAB phototherapy had on average 123 remission days per year. All costs were estimated for the one-year period. Health service utilization of the 2 treatment groups was estimated based on the data gathered during the clinical study. Total costs were USD 5,438 in the cyclosporin A group and USD 5,635 in the UVAB group. Direct health-care costs were USD 4,935 in the cyclosporin A group and USD 3,124 in the UVAB group. The cost of a remission day was USD 28 in the cyclosporin A group and USD 46 in the UVAB group. In terms of direct health-care costs, the cost of a remission day was USD 26 in the cyclosporin A group and USD 25 in the UVAB group. Our results demonstrate that cyclosporin A therapy is similarly cost-effective as UVAB phototherapy in terms of total cost in the treatment of atopic dermatitis unresponsive to topical treatment. In terms of direct health-care costs, i.e. treatment and health services utilization costs, however, UVAB is significantly less costly, but side effects are frequent.
PubMed ID
15206694 View in PubMed
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An occupational health intervention programme for workers at high risk for sickness absence. Cost effectiveness analysis based on a randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature160853
Source
Occup Environ Med. 2008 Apr;65(4):242-8
Publication Type
Article
Date
Apr-2008
Author
S. Taimela
S. Justén
P. Aronen
H. Sintonen
E. Läärä
A. Malmivaara
J. Tiekso
T. Aro
Author Affiliation
Evalua International, PO Box 35, FIN-01531 Vantaa, Finland. simo.taimela@evalua.fi
Source
Occup Environ Med. 2008 Apr;65(4):242-8
Date
Apr-2008
Language
English
Publication Type
Article
Keywords
Absenteeism
Adolescent
Adult
Cost-Benefit Analysis
Female
Finland
Health Care Costs - statistics & numerical data
Health Resources - utilization
Humans
Male
Middle Aged
Occupational Health - statistics & numerical data
Occupational Health Services - economics - methods
Outcome and Process Assessment (Health Care) - methods
Risk assessment
Sick Leave - economics - statistics & numerical data
Abstract
To determine whether, from a healthcare perspective, a specific occupational health intervention is cost effective in reducing sickness absence when compared with usual care in occupational health in workers with high risk of sickness absence.
Economic evaluation alongside a randomised controlled trial. 418 workers with high risk of sickness absence from one corporation were randomised to intervention (n = 209) or to usual care (n = 209). The subjects in the intervention group were invited to occupational health service for a consultation. The intervention included, if appropriate, a referral to specialist treatment. Register data of sickness absence were available for 384 subjects and questionnaire data on healthcare costs from 272 subjects. Missing direct total cost data were imputed using a two-part regression model. Primary outcome measures were sickness absence days and direct healthcare costs up to 12 months after randomisation. Cost effectiveness (CE) was expressed as an incremental CE ratio, CE plane and CE acceptability curve with both available direct total cost data and missing total cost data imputed.
After one year, the mean of sickness absence was 30 days in the usual care group (n = 192) and 11 days less (95% CI 1 to 20 days) in the intervention group (n = 192). Among the employees with available cost data, the mean days of sickness absence were 22 and 24, and the mean total cost euro974 and euro1049 in the intervention group (n = 134) and in the usual care group (n = 138), respectively. The intervention turned out to be dominant-both cost saving and more effective than usual occupational health care. The saving was euro43 per sickness absence day avoided with available direct total cost data, and euro17 with missing total cost data imputed.
One year follow-up data show that occupational health intervention for workers with high risk of sickness absence is a cost effective use of healthcare resources.
Notes
Cites: Stat Med. 2003 Sep 15;22(17):2799-81512939787
Cites: J Occup Environ Med. 2003 May;45(5):499-50612762074
Cites: Annu Rev Public Health. 2002;23:151-6911910059
Cites: Occup Environ Med. 2004 Nov;61(11):924-915477286
Cites: Occup Environ Med. 2007 Nov;64(11):739-4617303674
Cites: Eur Spine J. 2007 Jul;16(7):919-2417186282
Cites: J Occup Rehabil. 2006 Dec;16(4):557-7817086503
Cites: Occup Environ Med. 2006 Oct;63(10):676-8216644897
Cites: Spine (Phila Pa 1976). 2006 May 1;31(10):1075-8216648740
Cites: Med Care. 2006 Apr;44(4):352-816565636
Cites: J Occup Rehabil. 2005 Dec;15(4):569-8016254756
Cites: Occup Environ Med. 2005 Feb;62(2):74-915657187
Comment In: Occup Environ Med. 2008 Apr;65(4):219-2018349154
PubMed ID
17933885 View in PubMed
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[Antidotes and other treatment of poisoning--what,where,when].

https://arctichealth.org/en/permalink/ahliterature180761
Source
Duodecim. 2004;120(4):485-93
Publication Type
Article
Date
2004

Are Urban Stream Restoration Plans Worth Implementing?

https://arctichealth.org/en/permalink/ahliterature285719
Source
Environ Manage. 2017 Jan;59(1):10-20
Publication Type
Article
Date
Jan-2017
Author
Auri Sarvilinna
Virpi Lehtoranta
Turo Hjerppe
Source
Environ Manage. 2017 Jan;59(1):10-20
Date
Jan-2017
Language
English
Publication Type
Article
Keywords
City Planning - economics
Conservation of Natural Resources - economics - methods
Cost-Benefit Analysis
Ecosystem
Environmental Policy - economics
Finland
Humans
Rivers
Uncertainty
Urbanization - trends
Abstract
To manage and conserve ecosystems in a more sustainable way, it is important to identify the importance of the ecosystem services they provide and understand the connection between natural and socio-economic systems. Historically, streams have been an underrated part of the urban environment. Many of them have been straightened and often channelized under pressure of urbanization. However, little knowledge exists concerning the economic value of stream restoration or the value of the improved ecosystem services. We used the contingent valuation method to assess the social acceptability of a policy-level water management plan in the city of Helsinki, Finland, and the values placed on improvements in a set of ecosystem services, accounting for preference uncertainty. According to our study, the action plan would provide high returns on restoration investments, since the benefit-cost ratio was 15-37. Moreover, seventy-two percent of the respondents willing to pay for stream restoration chose "I want to conserve streams as a part of urban nature for future generations" as the most motivating reason. Our study indicates that the water management plan for urban streams in Helsinki has strong public support. If better marketed to the population within the watershed, the future projects could be partly funded by the local residents, making the projects easier to accomplish. The results of this study can be used in planning, management and decision making related to small urban watercourses.
Notes
Cites: J Environ Manage. 2006 Jun;79(4):399-40816303238
Cites: Proc Natl Acad Sci U S A. 2015 Jun 16;112(24):7348-5526082539
Cites: Science. 2005 Apr 29;308(5722):636-715860611
Cites: Ecol Appl. 2011 Sep;21(6):1932-4921939035
Cites: Science. 2004 May 28;304(5675):1251-215166349
Cites: Nature. 2010 Sep 30;467(7315):555-6120882010
Cites: Ecol Appl. 2011 Sep;21(6):1989-200621939039
Cites: Water Sci Technol. 2003;48(7):149-5614653645
Cites: Science. 2008 Feb 8;319(5864):756-6018258902
Cites: J Environ Manage. 2013 Dec 15;131:256-6924184528
Cites: Int J Environ Res Public Health. 2012 Oct 26;9(11):3866-8223202821
Cites: J Environ Manage. 2012 Nov 30;111:18-2322813855
Cites: Conserv Biol. 2013 Dec;27(6):1286-9324112105
PubMed ID
27812794 View in PubMed
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Atraumatic dental treatment among Finnish elderly persons.

https://arctichealth.org/en/permalink/ahliterature190062
Source
J Oral Rehabil. 2002 May;29(5):435-40
Publication Type
Article
Date
May-2002
Author
S. Honkala
E. Honkala
Author Affiliation
Faculty of Dentistry, Health Science Centre, Kuwait University, Kuwait, Finland. sisko.honkala@hs.kuniv.edu.kw
Source
J Oral Rehabil. 2002 May;29(5):435-40
Date
May-2002
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Chi-Square Distribution
Community Health Services
Cost-Benefit Analysis
DMF Index
Dental Care for Aged - economics
Dental Marginal Adaptation
Dental Restoration Failure
Dental Restoration, Permanent - methods
Dental Scaling
Feasibility Studies
Finland
Follow-Up Studies
Health Education, Dental
Home Care Services - economics
Humans
Oral Hygiene
Patient satisfaction
Statistics as Topic
Surface Properties
Abstract
There is an increase in elderly dentate adults who will retain more of their natural teeth, and thus the demand for restorative dental services among them will be high. In Finland, systematic dental care for old people has not been organized. Health centres have mainly targeted the development of dental care for children, adolescents and young adults. With this background, atraumatic restorative treatment (ART) was seen as a complementary procedure in oral health services for the elderly. It was tested in 1997-1999 in Helsinki among 119 old people (mean age 72.5 years) living in their homes and receiving community-based support services. Patients were satisfied with having dental examination and oral health education at home. The ART fillings (n=33) were provided for 21 persons and depuration for 56. After 1 year, 25 fillings (58%) could be evaluated: 68% of the fillings were assessed as being good, 11% as having a slight marginal detect and 16% as having unacceptable marginal defect, and one filling was totally lost. In conclusion, ART is an appropriate approach in dental care for the elderly. However, more testing should be completed to find out how the screening could be organized to make the dental home visits more cost-effective and less time consuming.
PubMed ID
12028490 View in PubMed
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Benchmarking in nursing care by the RAFAELA patient classification system - a possibility for nurse managers.

https://arctichealth.org/en/permalink/ahliterature161098
Source
J Nurs Manag. 2007 Oct;15(7):683-92
Publication Type
Article
Date
Oct-2007
Author
Lisbeth Fagerström
Auvo Rauhala
Author Affiliation
Vasa Central Hospital, Vasa, Finland. lisbeth.fagerstrom@syh.fi
Source
J Nurs Manag. 2007 Oct;15(7):683-92
Date
Oct-2007
Language
English
Publication Type
Article
Keywords
Benchmarking - organization & administration
Cost-Benefit Analysis
Data Interpretation, Statistical
Decision Making, Organizational
Diagnosis-Related Groups
Finland
Hospital Costs - statistics & numerical data
Hospitals, Community
Hospitals, University
Humans
Inpatients - classification - statistics & numerical data
Length of Stay - statistics & numerical data
Needs Assessment - organization & administration
Nurse Administrators - organization & administration
Nurse's Role
Nursing Administration Research
Nursing Service, Hospital - organization & administration
Nursing Staff, Hospital - organization & administration
Nursing, Supervisory - organization & administration
Personnel Staffing and Scheduling - organization & administration
Quality Indicators, Health Care
Resource Allocation - organization & administration
Workload - classification - statistics & numerical data
Abstract
The aim of the study was to explore the possibilities of benchmarking with the RAFAELA system. In this study, comparisons are made between: (1) costs for one nursing care intensity point; (2) the nursing care intensity per nurse; (3) the relationship between nursing care intensity per nurse and (4) the optimal nursing care intensity.
During the period from 1994 to 2000 a new system for patient classification, the RAFAELA system, was developed in Finland.
86 wards from 14 different hospitals in Finland took part in the study.
The costs for one nursing care intensity point on the adults' wards were on average 7.80euro. The average workload was 25.2 nursing care intensity points per nurse. The optimal nursing care intensity was exceeded during 49.5% of the days and under during 20% of the days.
The study shows that benchmarking with the RAFAELA system provides many opportunities for the nurse managers' resource allocation and their personnel administration.
PubMed ID
17897144 View in PubMed
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Benefit-risk assessment of the levonorgestrel intrauterine system in contraception.

https://arctichealth.org/en/permalink/ahliterature177035
Source
Drug Saf. 2004;27(15):1185-204
Publication Type
Article
Date
2004
Author
Tiina Backman
Author Affiliation
Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland. tiina.backman@fimnet.fi
Source
Drug Saf. 2004;27(15):1185-204
Date
2004
Language
English
Publication Type
Article
Keywords
Administration, Intravaginal
Contraception - economics - methods
Contraceptive Agents, Female - adverse effects - pharmacokinetics - pharmacology
Cost-Benefit Analysis - methods
Female
Finland
Humans
Intrauterine Devices, Medicated - adverse effects - standards
Levonorgestrel - adverse effects - pharmacokinetics - pharmacology
Multicenter Studies as Topic
Randomized Controlled Trials as Topic
Risk Assessment - methods
Time Factors
Abstract
The levonorgestrel-releasing intrauterine system (IUS) is a long-acting, fully reversible method of contraception. It is one of the most effective forms of contraception available, and combines the advantages of both hormonal and intrauterine contraception. The levonorgestrel-releasing IUS also gives the users many non-contraceptive benefits: the amount of menstrual bleeding and the number of days of menstrual bleeding are reduced, which makes it suitable for the treatment of menorrhagia (heavy menstrual blood loss). Dysmenorrhoea (painful menstruation) and premenstrual symptoms are also relieved. In addition, the levonorgestrel-releasing IUS provides protection for the endometrium during hormone replacement therapy. The local release of levonorgestrel into the uterine cavity results in a strong uniform suppression of the endometrial epithelium as the epithelium becomes insensitive to estradiol released from the ovaries. This accounts for the reduction in menstrual blood loss. All possible patterns of bleeding are seen among users of the levonorgestrel-releasing IUS; however, most of the women who experience total amenorrhoea continue to ovulate. The first months of use are often characterised by irregular, scanty bleeding, which in most cases resolves spontaneously. The menstrual pattern and fertility return to normal soon after the levonorgestrel-releasing IUS is removed. The contraceptive efficacy is high with 5-year failure rates of 0.5-1.1 per 100 users. The absolute number of ectopic pregnancies is low, as is the rate per 1000 users. The levonorgestrel-releasing IUS is equally effective in all age groups and the bodyweight of the user is not associated with failure of the method. In Western cultures continuance rates among users of the levonorgestrel-releasing IUS are comparable with those of other long-term methods of contraception. Premature removal of the device is most often associated with heavy menstrual bleeding and pain, as with other long-term methods of contraception, and is most common in the youngest age group. When adequately counselled about the benign nature of oligo- or amenorrhoea, most women are very willing to accept life without menstruation. The risk of premature removal can be markedly diminished with good pre-insertion counselling, which also markedly increases user satisfaction. User satisfaction is strongly associated with the information given at the time of the levonorgestrel-releasing IUS insertion. Thus, the benefits of the levonorgestrel-releasing IUS make it a very suitable method of contraception for most women.
PubMed ID
15588115 View in PubMed
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Benefits, challenges and impact of teleconsultation - a literature review.

https://arctichealth.org/en/permalink/ahliterature261966
Source
Stud Health Technol Inform. 2013;192:1157
Publication Type
Article
Date
2013
Author
Samuel Frade
Hugo Rodrigues
Source
Stud Health Technol Inform. 2013;192:1157
Date
2013
Language
English
Publication Type
Article
Keywords
Cost-Benefit Analysis - methods
Efficiency, Organizational - economics
Finland
Health Care Costs - statistics & numerical data
Models, Economic
Portugal
Remote Consultation - economics - utilization
Workload - statistics & numerical data
Abstract
Teleconsultation involves the use of technology so that the medical professionals and patients can interact with each other bringing health to where ever it is needed. Although it has been demonstrated to be feasible and effective its sustainability remains an important question. This paper presents the results of a literature review on teleconsultation, based on the Portuguese context. Although Portugal has some successful projects, a national or international conjoint effort would be more fruitful. Technologically it gets lets costly to provide teleconsultation, as pervasive computing grows. The gap of benefits between teleconsultation and regular consultation will diminish as patients grow fonder into technology.The economic value of this type of consultation remains a difficult subject, so a small budget economic analysis, based on a break-even method, is suggested. This analysis conducted on Finland shows that teleconsultation can be cost-effective.
PubMed ID
23920931 View in PubMed
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179 records – page 1 of 18.