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Age, period, and cohort analysis of regular dental care behavior and edentulism: a marginal approach.

https://arctichealth.org/en/permalink/ahliterature136132
Source
BMC Oral Health. 2011;11:9
Publication Type
Article
Date
2011
Author
Kar-Yan Li
May Chun Mei Wong
Kwok-Fai Lam
Eli Schwarz
Author Affiliation
Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China.
Source
BMC Oral Health. 2011;11:9
Date
2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Cohort Studies
Cross-Sectional Studies
Denmark
Dental Care - psychology - utilization
Dental Health Surveys
Female
Health Behavior
Health Policy
Humans
Linear Models
Logistic Models
Male
Middle Aged
Mouth, Edentulous - epidemiology
Prevalence
School Dentistry
Sex Factors
Social Class
Space-Time Clustering
Young Adult
Abstract
To analyze the regular dental care behavior and prevalence of edentulism in adult Danes, reported in sequential cross-sectional oral health surveys by the application of a marginal approach to consider the possible clustering effect of birth cohorts.
Data from four sequential cross-sectional surveys of non-institutionalized Danes conducted from 1975-2005 comprising 4330 respondents aged 15+ years in 9 birth cohorts were analyzed. The key study variables were seeking dental care on an annual basis (ADC) and edentulism. For the analysis of ADC, survey year, age, gender, socio-economic status (SES) group, denture-wearing, and school dental care (SDC) during childhood were considered. For the analysis of edentulism, only respondents aged 35+ years were included. Survey year, age, gender, SES group, ADC, and SDC during childhood were considered as the independent factors. To take into account the clustering effect of birth cohorts, marginal logistic regressions with an independent correlation structure in generalized estimating equations (GEE) were carried out, with PROC GENMOD in SAS software.
The overall proportion of people seeking ADC increased from 58.8% in 1975 to 86.7% in 2005, while for respondents aged 35 years or older, the overall prevalence of edentulism (35+ years) decreased from 36.4% in 1975 to 5.0% in 2005. Females, respondents in the higher SES group, in more recent survey years, with no denture, and receiving SDC in all grades during childhood were associated with higher probability of seeking ADC regularly (P
Notes
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PubMed ID
21410991 View in PubMed
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Aging, social capital, and health care utilization in Canada.

https://arctichealth.org/en/permalink/ahliterature155173
Source
Health Econ Policy Law. 2008 Oct;3(Pt 4):393-411
Publication Type
Article
Date
Oct-2008
Author
Audrey Laporte
Eric Nauenberg
Leilei Shen
Author Affiliation
Department ofHealth Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. audrey.laporte@utoronto.ca
Source
Health Econ Policy Law. 2008 Oct;3(Pt 4):393-411
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
Adult
Aging
Canada
Cross-Sectional Studies
Female
Health Policy
Health Services - utilization
Humans
Male
Middle Aged
National Health Programs
Social Support
Abstract
This paper examines relationships between aging, social capital, and healthcare utilization. Cross-sectional data from the 2001 Canadian Community Health Survey and the Canadian Census are used to estimate a two-part model for both GP physicians (visits) and hospitalization (annual nights) focusing on the impact of community- (CSC) and individual-level social capital (ISC). Quantile regressions were also performed for GP visits. CSC is measured using the Petris Social Capital Index (PSCI) based on employment levels in religious and community-based organizations [NAICS 813XX] and ISC is based on self-reported connectedness to community. A higher CSC/lower ISC is associated with a lower propensity for GP visits/higher propensity for hospital utilization among seniors. The part-two (intensity model) results indicated that a one standard deviation increase (0.13%) in the PSCI index leads to an overall 5% decrease in GP visits and an annual offset in Canada of approximately $225 M. The ISC impact was smaller; however, neither measure was significant in the hospital intensity models. ISC mainly impacted the lower quantiles in which there was a positive association with GP utilization, while the impact of CSC was strongest in the middle quantiles. Each form of social capital likely operates through a different mechanism: ISC perhaps serves an enabling role by improving access (e.g. transportation services), while CSC serves to obviate some physician visits that may involve counseling/caring services most important to seniors. Policy implications of these results are discussed herein.
PubMed ID
18793479 View in PubMed
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Source
Alcohol Alcohol. 1999 Nov-Dec;34(6):824-9
Publication Type
Article
Author
M. McKee
Author Affiliation
London School of Hygiene and Tropical Medicine, UK.
Source
Alcohol Alcohol. 1999 Nov-Dec;34(6):824-9
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alcoholism - mortality - prevention & control
Cause of Death
Cross-Sectional Studies
Female
Health Policy - legislation & jurisprudence
Humans
Longitudinal Studies
Male
Middle Aged
Russia - epidemiology
Abstract
The contribution that alcohol has made to the large fluctuations in mortality in Russia in recent years is now widely recognized. An association between heavy drinking and Russia is part of popular culture. But what is the reality? This paper reviews the evidence on historical patterns of consumption in Russia, highlighting the difficulties of obtaining valid statistics during the Soviet period (1917-1991). It notes how the state, at various times, encouraged alcohol sales. By the early 1980s, the social cost of heavy drinking was becoming apparent. This led, in 1985, to the imposition of the wide-ranging and initially highly effective anti-alcohol campaign by Mikhail Gorbachev. The features of this campaign and of its subsequent collapse are described. In the 1990s, consumption of alcohol increased rapidly. There has, however, been a recent reduction in alcohol-related deaths. It is concluded that heavy drinking is not an inevitable feature of Russian life and that, as the state has done much to create the present problem, it also has a role to play in resolving it.
PubMed ID
10659717 View in PubMed
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An exploration of the theoretical concepts policy windows and policy entrepreneurs at the Swedish public health arena.

https://arctichealth.org/en/permalink/ahliterature148044
Source
Health Promot Int. 2009 Dec;24(4):434-44
Publication Type
Article
Date
Dec-2009
Author
Karin Guldbrandsson
Bjöörn Fossum
Author Affiliation
Division of Social Medicine, Department of Public Health Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden. karin.guldbrandsson@ki.se
Source
Health Promot Int. 2009 Dec;24(4):434-44
Date
Dec-2009
Language
English
Publication Type
Article
Keywords
Cross-Sectional Studies
Health Behavior
Health Policy
Health Promotion - organization & administration
Humans
Policy Making
Public Health Administration
Sweden
Time Factors
Abstract
In John Kingdon's Policy Streams Approach policy formation is described as the result of the flow of three 'streams', the problem stream, the policy stream and the politics stream. When these streams couple, a policy window opens which facilitate policy change. Actors who promote specific solutions are labelled policy entrepreneurs. The aim of this study was to test the applicability of the Policy Streams Approach by verifying whether the theoretical concepts 'policy windows' and 'policy entrepreneurs' could be discernable in nine specified cases. Content analyses of interviews and documents related to child health promoting measures in three Swedish municipalities were performed and nine case studies were written. The policy processes preceding the municipal measures and described in the case studies were scrutinized in order to find statements related to the concepts policy windows and policy entrepreneurs. All conditions required to open a policy window were reported to be present in eight of the nine case studies, as was the most important resource of a policy entrepreneur, sheer persistence. This study shows that empirical examples of policy windows and policy entrepreneurs could be identified in child health promoting measures in Swedish municipalities. If policy makers could learn to predict the opening of policy windows, the planning of public health measures might be more straightforward. This also applies to policy makers' ability to detect actors possessing policy entrepreneur resources.
Notes
Comment In: Health Promot Int. 2010 Mar;25(1):134-5; author reply 13620167828
PubMed ID
19819897 View in PubMed
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Are United States and Canadian cancer screening rates consistent with guideline information regarding the age of screening initiation?

https://arctichealth.org/en/permalink/ahliterature131650
Source
Int J Qual Health Care. 2011 Dec;23(6):611-20
Publication Type
Article
Date
Dec-2011
Author
Srikanth Kadiyala
Erin C Strumpf
Author Affiliation
Rand Corporation, Santa Monica, CA 90401, USA. kadiyala@rand.org
Source
Int J Qual Health Care. 2011 Dec;23(6):611-20
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Canada
Cross-Sectional Studies
Female
Guideline Adherence - statistics & numerical data
Guidelines as Topic
Health Policy
Health Surveys
Humans
Male
Mass Screening - utilization
Middle Aged
Neoplasms - diagnosis - prevention & control
United States
Abstract
To understand whether US and Canadian breast, colorectal and prostate cancer screening test utilization is consistent with US and Canadian cancer screening guideline information with respect to the age of screening initiation.
Cross-sectional, regression discontinuity.
Canada and the US.
Canadian and American women of ages 30-60 and men of ages 40-60.
None. Main Outcomes Measures Mammography, prostate-specific antigen (PSA) and colorectal cancer test use within the past 2 years.
We identify US and Canadian compliance with age screening information in a novel manner, by comparing test utilization rates of individuals who are immediately on either side of the guideline recommended initiation ages.
US mammography utilization within the last 2 years increased from 33% at age 39 to 48% at age 40 and 60% at age 41. US colorectal cancer test utilization, within the last 2 years, increased from 15% at age 49 to 18% at age 50 and 28% at age 51. US PSA utilization within the last 2 years increased from 37% at age 49 to 44% at age 50 and 54% at age 51. In Canada, mammography utilization within the last 2 years increased from 47% at age 49 to 57% at age 50 and 66% at age 51.
American and Canadian cancer screening utilization is generally consistent with each country's guideline recommendations regarding age. US and Canadian differences in screening due to guidelines can potentially explain cross-country differences in breast cancer mortality and affect interpretation of international comparisons of cancer statistics.
PubMed ID
21890706 View in PubMed
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Associations between pedagogues attitudes, praxis and policy in relation to physical activity of children in kindergarten--results from a cross sectional study of health behaviour amongst Danish pre-school children.

https://arctichealth.org/en/permalink/ahliterature131117
Source
Int J Pediatr Obes. 2011 Oct;6 Suppl 2:12-5
Publication Type
Article
Date
Oct-2011
Author
Bent Egberg Mikkelsen
Author Affiliation
Research Group for Meal Science & Public Health Nutrition, Department of Development and Planning, Aalborg University, Lautrupvang 1A, DK-2750 Ballerup, Denmark.
Source
Int J Pediatr Obes. 2011 Oct;6 Suppl 2:12-5
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Child
Child, Preschool
Cross-Sectional Studies
Curriculum
Denmark
Environment
Health Behavior - ethnology
Health Knowledge, Attitudes, Practice - ethnology
Health Policy - trends
Health promotion
Humans
Life Style
Motor Activity
Questionnaires
Schools
Abstract
This paper reports on associations between physical activity, pedagogue's attitudes towards promoting physical activity and the physical activity policies (PAP) in kindergarten. The paper deals with data on physical activity of 3-6 year olds in kindergarten which originates from a cross-sectional study conducted in 2006 among all Danish kindergartens. A questionnaire of 48 questions based on pedagogues assessment regarding the health related polcies and praxis in kindergarten and the attitudes of pedagogues was mailed (n = 4200) to all institutions in the country. In total, 1149 kindergartens and 693 integrated institutions returned the survey. The results show a relation between pedagogue's attitudes towards promoting children's physical activity and the number of children having moderately intense physical activity for at least one hour a day. The study also shows a positive association between policies and pedagogue's attitudes towards promoting children's physical activity and the number of days that pedagogues initiated games that made the children physically active. The study suggests that the social and organizational environment in the kindergarten is an important determinant for the level of physical activity among children. This means that the individual norms and attitudes of pedagogues along with the collective intentions and values expressed in written and adopted organizational policies (a Physical Activity Policy--PAP) are important aspects to be worked upon if kindergarten should play an active role in the promotion of healthy lifestyle among kindergarten aged children. Strong municipal and institutional leadership as well as educational interventions in the curricula of pedagogues could be important ways to bring about such change.
PubMed ID
21923289 View in PubMed
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Attitudes to sharing personal health information in living kidney donation.

https://arctichealth.org/en/permalink/ahliterature144792
Source
Clin J Am Soc Nephrol. 2010 Apr;5(4):717-22
Publication Type
Article
Date
Apr-2010
Author
Patricia Hizo-Abes
Ann Young
Peter P Reese
Phil McFarlane
Linda Wright
Meaghan Cuerden
Amit X Garg
Author Affiliation
London Kidney Clinical Research Unit, Room ELL-101, Westminster, London Health Sciences Centre, 800 Commissioners Road East, London, Ontario N6A 4G5, Canada.
Source
Clin J Am Soc Nephrol. 2010 Apr;5(4):717-22
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Access to Information - legislation & jurisprudence
Adult
Aged
Attitude of Health Personnel
Confidentiality - legislation & jurisprudence - psychology
Cross-Sectional Studies
Female
Health Knowledge, Attitudes, Practice
Health Policy
Health Records, Personal
Humans
Informed Consent - legislation & jurisprudence - psychology
Kidney Transplantation - legislation & jurisprudence - psychology
Living Donors - legislation & jurisprudence - psychology
Male
Middle Aged
Ontario
Patient Education as Topic
Practice Guidelines as Topic
Questionnaires
Abstract
In living kidney donation, transplant professionals consider the rights of a living kidney donor and recipient to keep their personal health information confidential and the need to disclose this information to the other for informed consent. In incompatible kidney exchange, personal health information from multiple living donors and recipients may affect decision making and outcomes.
We conducted a survey to understand and compare the preferences of potential donors (n = 43), potential recipients (n = 73), and health professionals (n = 41) toward sharing personal health information (in total 157 individuals).
When considering traditional live-donor transplantation, donors and recipients generally agreed that a recipient's health information should be shared with the donor (86 and 80%, respectively) and that a donor's information should be shared with the recipient (97 and 89%, respectively). When considering incompatible kidney exchange, donors and recipients generally agreed that a recipient's information should be shared with all donors and recipients involved in the transplant (85 and 85%, respectively) and that a donor's information should also be shared with all involved (95 and 90%, respectively). These results were contrary to attitudes expressed by transplant professionals, who frequently disagreed about whether such information should be shared.
Future policies and practice could facilitate greater sharing of personal health information in living kidney donation. This requires a consideration of which information is relevant, how to put it in context, and a plan to obtain consent from all concerned.
Notes
Cites: Am J Transplant. 2003 Jul;3(7):830-412814474
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Cites: Can J Surg. 2004 Dec;47(6):408-1315646438
Cites: Transplantation. 2005 Mar 27;79(6 Suppl):S53-6615785361
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Cites: Ann Intern Med. 2006 Aug 1;145(3):185-9616880460
Cites: J Pers Assess. 2006 Dec;87(3):305-1617134338
Cites: Clin J Am Soc Nephrol. 2006 Nov;1(6):1148-5317699340
Cites: Am J Transplant. 2008 Sep;8(9):1878-9018671676
Cites: Nephrol Dial Transplant. 2008 Oct;23(10):3316-2418599559
Cites: N Engl J Med. 2009 Mar 12;360(11):1096-10119279341
Cites: J Med Ethics. 2009 Apr;35(4):270-119332587
Cites: Kidney Int. 2009 May;75(10):1088-9819225540
Cites: Am J Transplant. 2004 Oct;4(10):1553-415367208
PubMed ID
20299371 View in PubMed
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Attitudes towards priority-setting and rationing in healthcare -- an exploratory survey of Swedish medical students.

https://arctichealth.org/en/permalink/ahliterature90452
Source
Scand J Public Health. 2009 Mar;37(2):122-30
Publication Type
Article
Date
Mar-2009
Author
Omar Faisal
Tinghög Gustav
Tinghög Petter
Carlsson Per
Author Affiliation
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. faisal.omar@liu.se
Source
Scand J Public Health. 2009 Mar;37(2):122-30
Date
Mar-2009
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Cost-Benefit Analysis
Cross-Sectional Studies
Decision Making
Education, Medical
Female
Health Care Rationing - economics - ethics
Health Policy - economics
Health Priorities - economics - ethics
Humans
Male
Primary Health Care - economics - ethics
Questionnaires
Students, Medical - psychology
Sweden
Abstract
BACKGROUND: Healthcare priority-setting is inextricably linked to the challenge of providing publicly funded healthcare within a limited budget, which may result in difficult and potentially controversial rationing decisions. Despite priority-setting's increasing prominence in policy and academic discussion, it is still unclear what the level of understanding and acceptance of priority-setting is at different levels of health care. AIMS: The aim of this study is threefold. First we wish to explore the level of familiarity with different aspects of priority-setting among graduating medical students. Secondly, to gauge their acceptance of both established and proposed Swedish priority-setting principles. Finally to elucidate their attitudes towards healthcare rationing and the role of different actors in decision making, with a particular interest in comparing the attitudes of medical students with data from the literature examining the attitudes among primary care patients in Sweden. METHODS: A cross-sectional survey containing 14 multiple choice items about priority-setting in healthcare was distributed to the graduating medical class at Linkoöping University. The response rate was 92% (43/47). RESULTS: Less than half of respondents have encountered the notion of open priority-setting, and the majority believed it to be somewhat or very unclear. There is a high degree of awareness and agreement with the established ethical principles for priority-setting in Swedish health care; however respondents are inconsistent in their application of the cost-effectiveness principle. A larger proportion of respondents were more favourable to physicians and other health personnel being responsible for rationing decisions as opposed to politicians. CONCLUSIONS: Future discussion about priority-setting in medical education should be contextualized within an explicit and open process. There is a need to adequately clarify the role of the cost-effectiveness principle in priority-setting. Medical students seem to acknowledge the need for rationing in healthcare to a greater extent when compared with previous results from Swedish primary care patients.
PubMed ID
19141543 View in PubMed
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Being born in Manitoba: a look at perinatal health issues.

https://arctichealth.org/en/permalink/ahliterature186717
Source
Can J Public Health. 2002 Nov-Dec;93 Suppl 2:S33-8
Publication Type
Article
Author
Patricia J Martens
Shelley Derksen
Teresa Mayer
Randy Walld
Author Affiliation
Manitoba Centre for Health Policy, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB. Pat_Martens@cpe.umanitoba.ca
Source
Can J Public Health. 2002 Nov-Dec;93 Suppl 2:S33-8
Language
English
Publication Type
Article
Keywords
Birth Rate - trends
Breast Feeding - statistics & numerical data
Cross-Sectional Studies
Health Policy
Health promotion
Health Status Indicators
Humans
Infant
Infant care
Infant Mortality - trends
Infant Welfare - ethnology - statistics & numerical data
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Manitoba - epidemiology
Population Surveillance
Regional Health Planning
Registries
Risk factors
Rural Health
Social Class
Urban health
Abstract
The Manitoba Centre for Health Policy was commissioned by Manitoba's provincial health department to examine the health of newborns born 1994 through 1998, using three indicators: preterm birth (
PubMed ID
12580388 View in PubMed
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Canadian opinions on publicly financed dental care.

https://arctichealth.org/en/permalink/ahliterature154001
Source
Can J Public Health. 2007 Nov-Dec;98(6):495-9
Publication Type
Article
Author
Carlos R Quiñonez
David Locker
Author Affiliation
Community Dental Health Services Research Unit, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada. carlos.quinonez@utoronto.ca
Source
Can J Public Health. 2007 Nov-Dec;98(6):495-9
Language
English
Publication Type
Article
Keywords
Canada
Cross-Sectional Studies
Delivery of Health Care - economics - organization & administration
Dental Care - economics - organization & administration
Dental Health Services - economics - organization & administration
Female
Government Programs
Health Policy - economics
Health Services Accessibility - economics
Humans
Interviews as Topic
Logistic Models
Male
Odds Ratio
Patient Acceptance of Health Care
Public Opinion
Questionnaires
Retrospective Studies
Abstract
Inequalities in oral health and care are long recognized in Canada, with public health environments increasingly focusing on issues of equity and access to care. How does Canada publicly insure for diseases that are largely preventable, minimally experienced by the majority, but that still cause tremendous suffering among the socially marginalized? We consider this dynamic by asking Canadians their opinions on publicly financed dental care.
Data were collected from 1,006 Canadian adults through a telephone interview survey using random digit dialling and computer-assisted telephone interview technology. Simple descriptive and bivariate analyses were undertaken to assess relationships among variables, with logistic regression odds ratios calculated for significant relations.
Canadians support the idea of universal coverage for dental care, also recognizing the need for care to specific groups. Generally preferring to access public care through the private sector, Canadians support the idea of opting out, and expect those who access such care to financially contribute at point of service.
Support for publicly financed dental care is indicative of a general support for a basic right to health care. Within the limits of economy, the distribution of oral disease, and Canadian values on health, the challenge remains to define what we think is equitable within this sector of the health care system. This question is ultimately unanswerable through any survey or statistical means, and must, to become relevant, be openly promoted and debated in the social arena, engaging Canadians and their sense of individual and social responsibility.
PubMed ID
19039890 View in PubMed
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