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Access to health care and geographic mobility of HIV/AIDS patients.

https://arctichealth.org/en/permalink/ahliterature213684
Source
AIDS Patient Care. 1995 Dec;9(6):297-302
Publication Type
Article
Date
Dec-1995
Author
R S Hogg
M T Schechter
A. Schilder
R. Le
S A Strathdee
I L Goldstone
M V O'Shaughnessy
Author Affiliation
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital/University of British Columbia, Vancouver, Canada.
Source
AIDS Patient Care. 1995 Dec;9(6):297-302
Date
Dec-1995
Language
English
Publication Type
Article
Keywords
Adult
British Columbia
Catchment Area (Health) - statistics & numerical data
Cross-Sectional Studies
Data Collection
Delivery of Health Care - standards - trends
Female
HIV Infections - diagnosis - therapy
Health Services Accessibility - standards - statistics & numerical data - trends
Humans
Logistic Models
Male
Middle Aged
Questionnaires
Socioeconomic Factors
Abstract
To determine the patterns and determinants of mobility in persons with HIV infection or AIDS on a population basis.
Descriptive cross-sectional population health study.
650 full members (i.e., HIV-positive) of the Vancouver Persons with AIDS Society who were residents of British Columbia and who allow the society to include unsolicited material with their monthly newsletter.
Migration history, access to HIV-related care at diagnosis, current and pre-HIV sociodemographic characteristics, and current health status.
Two hundred and fifty-two persons living with HIV/AIDS participated in the study. At the time of the survey, the majority of subjects were male (94 percent), aged between 30 and 54 years (87 percent), and able to carry out daily activities without assistance (84 percent). The median time since the known date of HIV infection was 6 years. Access to care at diagnosis was associated in this population with being diagnosed in the largest metropolitan area in the province (OR = 2.14; 95 percent CI: 1.18, 3.87), a pre-HIV income of $30,000 or more per annum (OR = 0.49; 95 percent CI: 0.27, 0.89), a known date of diagnosis prior to 1990 (78 percent versus 64 percent; p = 0.019), and living in the same residence from the date of known HIV diagnosis to the date of the survey (63 percent versus 51 percent; p = 0.024).
Although no definitive causal association can be provided by this cross-sectional analysis, our results clearly highlight several ways in which the need for treatment and care potentially affect where persons with HIV/AIDS choose to live.
PubMed ID
11361439 View in PubMed
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"A challenge" - healthcare professionals' experiences when meeting women with symptoms that might indicate endometriosis.

https://arctichealth.org/en/permalink/ahliterature277305
Source
Sex Reprod Healthc. 2016 Mar;7:65-9
Publication Type
Article
Date
Mar-2016
Author
Hanna Grundström
Preben Kjølhede
Carina Berterö
Siw Alehagen
Source
Sex Reprod Healthc. 2016 Mar;7:65-9
Date
Mar-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Delivery of Health Care - standards
Dysmenorrhea - diagnosis - etiology
Dyspareunia - diagnosis - etiology
Endometriosis - complications - diagnosis
Female
Gynecology
Humans
Male
Menstruation
Middle Aged
Nurse Midwives
Ovulation
Pelvic Pain - diagnosis - etiology
Physicians
Professional Competence
Professional-Patient Relations
Sweden
Abstract
The aim of the study was to identify and describe the experiences of healthcare professionals when meeting women with symptoms that might indicate endometriosis.
Semi-structured interviews were conducted with 10 gynecologists, six general practitioners and nine midwives working at one university hospital, one central hospital, one private gynecology clinic and five healthcare centers in south-east Sweden. The interviews were recorded and transcribed verbatim and analyzed using qualitative conventional content analysis.
Three clusters were identified: the corroborating encounter, the normal variation of menstruation cycles, and the suspicion of endometriosis. The healthcare professionals tried to make a corroborating encounter by acknowledging the woman, taking time to listen, and giving an explanation for the problems. Healthcare professionals had different ways to determine what was normal as regards menstrual pain, ovulation pain and dyspareunia. They also needed to have the competence to act and react when the symptoms indicated endometriosis.
Meeting women with symptoms that might indicate endometriosis is challenging and demands a certain level of competence from healthcare professionals. Sometimes the symptoms are camouflaged as "normal" menstruation pain, making it hard to satisfy the needs of this patient group.
PubMed ID
26826048 View in PubMed
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Across-province standardization and comparative analysis of time-to-care intervals for cancer.

https://arctichealth.org/en/permalink/ahliterature160988
Source
BMC Cancer. 2007;7:186
Publication Type
Article
Date
2007
Author
Marcy Winget
Donna Turner
Jon Tonita
Charlotte King
Zoann Nugent
Riaz Alvi
Richard Barss
Author Affiliation
Medical Affairs and Community Oncology, Alberta Cancer Board, 10123-99 Street, Edmonton, Alberta, T5J 3H1, Canada. marcywin@cancerboard.ab.ca
Source
BMC Cancer. 2007;7:186
Date
2007
Language
English
Publication Type
Article
Keywords
Alberta - epidemiology
Colorectal Neoplasms - diagnosis - epidemiology - therapy
Delivery of Health Care - standards - statistics & numerical data
Humans
Lung Neoplasms - diagnosis - epidemiology - therapy
Manitoba - epidemiology
National Health Programs - standards - utilization
Neoplasms - diagnosis - epidemiology - therapy
Saskatchewan - epidemiology
Time Factors
Waiting Lists
Abstract
A set of consistent, standardized definitions of intervals and populations on which to report across provinces is needed to inform the Provincial/Territorial Deputy Ministries of Health on progress of the Ten-Year Plan to Strengthen Health Care. The objectives of this project were to: 1) identify a set of criteria and variables needed to create comparable measures of important time-to-cancer-care intervals that could be applied across provinces and 2) use the measures to compare time-to-care across participating provinces for lung and colorectal cancer patients diagnosed in 2004.
A broad-based group of stakeholders from each of the three participating cancer agencies was assembled to identify criteria for time-to-care intervals to standardize, evaluate possible intervals and their corresponding start and end time points, and finalize the selection of intervals to pursue. Inclusion/exclusion criteria were identified for the patient population and the selected time points to reduce potential selection bias. The provincial 2004 colorectal and lung cancer data were used to illustrate across-province comparisons for the selected time-to-care intervals.
Criteria identified as critical for time-to-care intervals and corresponding start and end points were: 1) relevant to patients, 2) relevant to clinical care, 3) unequivocally defined, and 4) currently captured consistently across cancer agencies. Time from diagnosis to first radiation or chemotherapy treatment and the smaller components, time from diagnosis to first consult with an oncologist and time from first consult to first radiation or chemotherapy treatment, were the only intervals that met all four criteria. Timeliness of care for the intervals evaluated was similar between the provinces for lung cancer patients but significant differences were found for colorectal cancer patients.
We identified criteria important for selecting time-to-care intervals and appropriate inclusion criteria that were robust across the agencies that did not result in an overly selective sample of patients to be compared. Comparisons of data across three provinces of the selected time-to-care intervals identified several important differences related to treatment and access that require further attention. Expanding this collaboration across Canada would facilitate improvement of and equitable access to quality cancer care at a national level.
Notes
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Cites: CMAJ. 1995 Feb 1;152(3):398-97828105
PubMed ID
17916257 View in PubMed
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[Acute confusion. Publication of our May/June edition on creating a very interesting exchange. Here it is].

https://arctichealth.org/en/permalink/ahliterature145708
Source
Perspect Infirm. 2009 Sep-Oct;6(5):15
Publication Type
Article
Author
Louise Bélanger
Renée Coulombe
Linda Wanis
Geneviève Roch
Author Affiliation
Université de Montréal.
Source
Perspect Infirm. 2009 Sep-Oct;6(5):15
Language
French
Publication Type
Article
Keywords
Confusion
Delivery of Health Care - standards
Humans
Nursing Care - standards
Quebec
PubMed ID
20120302 View in PubMed
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AGREEing on Canadian cardiovascular clinical practice guidelines.

https://arctichealth.org/en/permalink/ahliterature154833
Source
Can J Cardiol. 2008 Oct;24(10):753-7
Publication Type
Article
Date
Oct-2008
Author
James A Stone
Leslie Austford
John H Parker
Norm Gledhill
Guy Tremblay
Heather M Arthur
Author Affiliation
University of Calgary, Calgary, Canada. jastone@shaw.ca
Source
Can J Cardiol. 2008 Oct;24(10):753-7
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
Canada
Cardiovascular Diseases - therapy
Delivery of Health Care - standards
Guideline Adherence
Health Promotion - standards
Humans
Practice Guidelines as Topic
Abstract
The use of clinical practice guidelines (CPGs), particularly the routine implementation of evidence-based cardiovascular health maintenance and disease management recommendations, affords both expert and nonexpert practitioners the opportunity to achieve better, and at least theoretically similar, patient outcomes. However, health care practitioners are often stymied in their efforts to follow even well-researched and well-written CPGs as a consequence of contradictory information. The purposeful integration and harmonization of Canadian cardiovascular CPGs, regardless of their specific risk factor or clinical management focus, is critical to their widespread acceptance and implementation. This level of cooperation and coordination among CPG groups and organizations would help to ensure that their clinical practice roadmaps (ie, best practice recommendations) contain clear, concise and complementary, rather than contradictory, patient care information. Similarly, the application of specific tools intended to improve the quality of CPGs, such as the Appraisal of Guidelines for Research and Evaluation (AGREE) assessment tool, may also lead to improvements in CPG quality and potentially enhance their acceptance and implementation.
Notes
Cites: Health Technol Assess. 2004 Feb;8(6):iii-iv, 1-7214960256
Cites: Circulation. 2004 Jun 29;109(25):3112-2115226228
Cites: Can J Cardiol. 2004 Oct;20(12):1195-815494770
Cites: BMJ. 1996 Jan 13;312(7023):71-28555924
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Cites: J Am Coll Cardiol. 2005 Oct 4;46(7):1242-816198838
Cites: Can J Cardiol. 2005 Oct;21 Suppl D:3D-19D16292364
Cites: CMAJ. 2005 Nov 22;173(11):1297, 129916301688
Cites: Eur J Cardiovasc Prev Rehabil. 2005 Dec;12(6):521-916319540
Cites: JAMA. 1999 Oct 20;282(15):1458-6510535437
Cites: BMJ. 1999 Dec 18-25;319(7225):161810600968
Cites: Jt Comm J Qual Improv. 2000 Sep;26(9):525-3710983293
Cites: Med Law. 2000;19(2):181-810994208
Cites: Fam Pract. 2000 Dec;17(6):557-6311120731
Cites: Med Care. 2001 Aug;39(8 Suppl 2):II85-9211583124
Cites: Qual Saf Health Care. 2003 Feb;12(1):18-2312571340
Cites: J Eval Clin Pract. 2003 May;9(2):195-20212787183
Cites: Clin Med. 2003 May-Jun;3(3):279-8412848267
Cites: Circulation. 2006 Feb 14;113(6):814-2216461821
Cites: Can J Cardiol. 2006 May 15;22(7):556-816755309
Cites: Can J Cardiol. 2006 May 15;22(7):583-9316755313
Cites: Am J Med. 2006 Aug;119(8):676-8316887414
Cites: Can J Cardiol. 2006 Sep;22(11):913-2716971976
Cites: CMAJ. 2006 Oct 24;175(9):1033, 103517060643
Cites: Can J Cardiol. 2007 Jan;23(1):21-4517245481
PubMed ID
18841253 View in PubMed
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[Agreement between the Federation of family physicians of Quebec and the minister of Health and Social Services: impact on mental health].

https://arctichealth.org/en/permalink/ahliterature150724
Source
Sante Ment Que. 2009;34(1):179-85
Publication Type
Article
Date
2009
Author
Jacques Ricard
Author Affiliation
Direction de l'organisation des services de première ligne intégrée, ministère de la Santé et des Services sociaux du Québec.
Source
Sante Ment Que. 2009;34(1):179-85
Date
2009
Language
French
Publication Type
Article
Keywords
Delivery of Health Care - standards
Humans
Interinstitutional Relations
Mental health
Physicians, Family
Quebec
Social Work, Psychiatric - organization & administration
PubMed ID
19475201 View in PubMed
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Allocation of home care services by municipalities in Norway: a document analysis.

https://arctichealth.org/en/permalink/ahliterature291433
Source
BMC Health Serv Res. 2017 Sep 22; 17(1):673
Publication Type
Journal Article
Multicenter Study
Date
Sep-22-2017
Author
Solrun G Holm
Terje A Mathisen
Torill M Sæterstrand
Berit S Brinchmann
Author Affiliation
Faculty of Nursing and Health Sciences, Nord University, Storgt 105, 8370, Leknes, Norway. solrun.holm@nord.no.
Source
BMC Health Serv Res. 2017 Sep 22; 17(1):673
Date
Sep-22-2017
Language
English
Publication Type
Journal Article
Multicenter Study
Keywords
Aged, 80 and over
Cities - statistics & numerical data
Delivery of Health Care - standards
Female
Health Care Rationing - organization & administration
Health Services for the Aged - supply & distribution
Home Care Services - supply & distribution
House Calls - statistics & numerical data
Humans
Length of Stay - statistics & numerical data
Male
Norway
Residence Characteristics - statistics & numerical data
Retrospective Studies
Social Support
Abstract
In Norway, elder care is primarily a municipal responsibility. Municipal health services strive to offer the 'lowest level of effective care,' and home healthcare services are defined as the lowest level of care in Norway. Municipalities determine the type(s) of service and the amount of care applicants require. The services granted are outlined in an individual decision letter, which serves as a contract between the municipality and the home healthcare recipient. The purpose of this study was to gain insight into the scope and duration of home healthcare services allocated by municipalities and to determine where home care recipients live in relation to home healthcare service offices.
A document analysis was performed on data derived from 833 letters to individuals allocated home care services in two municipalities in Northern Norway (Municipality A = 500 recipients, Municipality B = 333 recipients).
In Municipality A, 74% of service hours were allotted to home health nursing, 12% to practical assistance, and 14% to support contact; in Municipality B, the distribution was 73%, 19%, and 8%, respectively. Both municipalities allocated home health services with no service end date (41% and 85% of the total services, respectively). Among recipients of "expired" services, 25% in Municipality A and 7% in Municipality B continued to receive assistance.
Our findings reveal that the municipalities adhered to the goal for home care recipients to remain at home as long as possible before moving into a nursing home. The findings also indicate that the system for allocating home healthcare services may not be fair, as the municipalities lacked procedures for revising individual decisions. Our findings indicate that local authorities should closely examine how they design individual decisions and increase their awareness of how long a service should be provided.
Notes
Cites: BMC Health Serv Res. 2014 Sep 26;14:439 PMID 25258004
Cites: Br J Community Nurs. 2010 Oct;15(10):497-502 PMID 20966846
Cites: Scand J Caring Sci. 2015 Jun;29(2):317-24 PMID 25308748
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Cites: J Clin Nurs. 2010 Jan;19(1-2):100-8 PMID 20500248
Cites: Policy Polit Nurs Pract. 2009 Nov;10(4):276-84 PMID 20164066
Cites: Health Econ Rev. 2016 Dec;6(1):8 PMID 26914355
Cites: Health Soc Care Community. 2016 Jul;24(4):399-410 PMID 25728063
Cites: Soc Sci Med. 2013 Aug;91:194-201 PMID 22944147
Cites: J Aging Soc Policy. 2016 Oct-Dec;28(4):277-91 PMID 26959294
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Cites: Br J Community Nurs. 2011 Jul;16(7):342-6 PMID 21727793
Cites: Comput Inform Nurs. 2012 Jun;30(6):300-11 PMID 22411417
PubMed ID
28938892 View in PubMed
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[An improvement of step-by-step medical care for patients with ischemic stroke in Orel region].

https://arctichealth.org/en/permalink/ahliterature172738
Source
Zh Nevrol Psikhiatr Im S S Korsakova. 2005;(Suppl 14):8-17
Publication Type
Article
Date
2005
Author
M A Evzel'man
Source
Zh Nevrol Psikhiatr Im S S Korsakova. 2005;(Suppl 14):8-17
Date
2005
Language
Russian
Publication Type
Article
Keywords
Brain Ischemia - epidemiology - therapy
Delivery of Health Care - standards - trends
Humans
Incidence
Russia - epidemiology
Survival Rate
Urban Population
Abstract
In Orel region, standardized mortality rates of cerebrovascular disorders (CVD) are one of the lowest in Russian Federation (RF)--200.1 per 100,000 population as compared to 316 per 100,000 in the country. According to the brain stroke register, CVD mortality in Orel city was evaluated as 79 per 100,000 population. The causes of such decrease are as follows: (1) people are well informed about the first signs of stroke and 60% of patients referred to medical services after the first signs; (2) Municipal Health Care department issued an instruction on the immediate hospitalization, with a small number of contra-indications, of all patients with acute lesions of brain blood circulation (ABBC)--as a result, 70% of patients were admitted within the first 6 hours from stroke development; (3) an efficient system of the first pre-hospital care performed by an emergency team, with delivering stroke patients to hospitals by the team that first diagnosed ABBC; (4) sufficient hospital facilities (100 beds for vascular neurological patients with 12 beds for intensive therapy per 331,300 population); (5) hospitalization of all patients with acute stroke to vascular neurological departments with intensive therapy wards and neurologists trained all the methods of critical care and intensive therapy; (6) a sufficient supply of all medications necessary for treatment of the acute stage of stroke. The scheme of therapeutic and diagnostic care for patients with ischemic stroke is proposed that could be recommended for organization of medical care to patients with ABBC in RF cities and towns.
PubMed ID
16184848 View in PubMed
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261 records – page 1 of 27.