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[3 reports on population health. Who will take care of my health?].

https://arctichealth.org/en/permalink/ahliterature225541
Source
Lakartidningen. 1991 Oct 16;88(42):3443-6, 3451-2
Publication Type
Article
Date
Oct-16-1991

Accounting for vulnerability to illness and social disadvantage in pandemic critical care triage.

https://arctichealth.org/en/permalink/ahliterature96997
Source
J Clin Ethics. 2010;21(1):23-9
Publication Type
Article
Date
2010
Author
Chris Kaposy
Author Affiliation
Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. christopher.kaposy@med.mun.ca
Source
J Clin Ethics. 2010;21(1):23-9
Date
2010
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Critical Care
Cultural Characteristics
Disaster Planning - trends
Disease Outbreaks
Health Care Rationing - ethics
Health Policy - trends
Humans
Indians, North American - statistics & numerical data
Influenza A Virus, H1N1 Subtype - isolation & purification
Influenza, Human - ethnology - mortality - virology
Intensive Care Units - organization & administration - standards
Inuits - statistics & numerical data
Newfoundland and Labrador - epidemiology
Patient Selection - ethics
Prognosis
Risk assessment
Social Class
Triage - methods - organization & administration - standards - trends
Vulnerable Populations
Abstract
In a pandemic situation, resources in intensive care units may be stretched to the breaking point, and critical care triage may become necessary. In such a situation, I argue that a patient's combined vulnerability to illness and social disadvantage should be a justification for giving that patient some priority for critical care. In this article I present an example of a critical care triage protocol that recognizes the moral relevance of vulnerability to illness and social disadvantage, from the Canadian province of Newfoundland and Labrador.
PubMed ID
20465071 View in PubMed
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The accumulated challenges of long-term care.

https://arctichealth.org/en/permalink/ahliterature146298
Source
Health Aff (Millwood). 2010 Jan-Feb;29(1):29-34
Publication Type
Article
Author
David Barton Smith
Zhanlian Feng
Author Affiliation
Center for Health Equality, School of Public Health, at Drexel University, in Philadelphia, Pennsylvania, USA. david.b.smith@drexel.edu
Source
Health Aff (Millwood). 2010 Jan-Feb;29(1):29-34
Language
English
Publication Type
Article
Keywords
Chronic Disease
Cost Control - methods
Health Policy - trends
Health Services Accessibility - statistics & numerical data - trends
Health Services for the Aged
Health Services, Indigenous - economics - supply & distribution
Healthcare Disparities
Humans
Long-Term Care - methods - organization & administration - standards - trends
Medicaid
Organizational Objectives
Quality of Health Care - standards
United States
Abstract
During the past century, long-term care in the United States has evolved through five cycles of development, each lasting approximately twenty years. Each, focusing on distinct concerns, produced unintended consequences. Each also added a layer to an accumulation of contradictory approaches--a patchwork system now pushed to the breaking point by increasing needs and financial pressures. Future policies must achieve a better synthesis of approaches inherited from the past, while addressing their unintended consequences. Foremost must be assuring access to essential care, delivery of high-quality services in an increasingly deinstitutionalized system, and a reduction in social and economic disparities.
PubMed ID
20048357 View in PubMed
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Adherence to beta-blocker therapy under drug cost-sharing in patients with and without acute myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature162000
Source
Am J Manag Care. 2007 Aug;13(8):445-52
Publication Type
Article
Date
Aug-2007
Author
Sebastian Schneeweiss
Amanda R Patrick
Malcolm Maclure
Colin R Dormuth
Robert J Glynn
Author Affiliation
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St (Ste 3030), Boston, MA 02120, USA. schneeweiss@post.harvard.edu
Source
Am J Manag Care. 2007 Aug;13(8):445-52
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
Acute Disease
Adrenergic beta-Antagonists - economics - therapeutic use
Aged
Aged, 80 and over
British Columbia
Case-Control Studies
Cohort Studies
Comorbidity
Cost Sharing
Deductibles and Coinsurance
Diabetes Complications
Female
Health Policy - trends
Humans
Male
Medical Record Linkage
Myocardial Infarction - drug therapy - economics
Patient Compliance - statistics & numerical data
Prescription Fees
Vascular Diseases
Abstract
To evaluate the effects of patient copayment and coinsurance policies on adherence to therapy with beta-adrenergic blocking agents (beta-blockers) and on the rate of initiation of beta-blocker therapy after acute myocardial infarction (MI) in a population-based natural experiment.
Three sequential cohorts included British Columbia residents age 66 years and older who initiated beta-blocker therapy during time intervals with full drug coverage (2001), a $10 or $25 copayment (2002), and 25% coinsurance (2003-2004). We used linked data on all prescription drug dispensings, physician services, and hospitalizations. Follow-up of each cohort was 9 months after the policy changes.
We measured the proportion of subjects in each cohort who were adherent to beta-blocker therapy over time, with adherence defined as having >80% of days covered. We also measured the proportion of patients initiating beta-blocker therapy after acute MI. Policy effects were evaluated using multivariable regression.
Adherence to beta-blocker therapy was marginally reduced as a consequence of the copayment policy (-1.3 percentage points, 95% confidence interval [CI] = -2.5 , -0.04) or the coinsurance policy (-0.8 percentage points, 95% CI = -2.0, 0.3). The proportion of patients initiating beta-blockers after hospitalization for acute MI remained steady at about 61% during the study period, similar to that observed in a control population of elderly Pennsylvania residents with full drug coverage.
Fixed patient copayment and coinsurance policies had little negative effect on adherence to relatively inexpensive beta-blocker therapy, or initiation of beta-blockers after acute MI.
Notes
Cites: N Engl J Med. 1991 Oct 10;325(15):1072-71891009
Cites: J Chronic Dis. 1987;40(5):373-833558716
Cites: J Hypertens Suppl. 1993 Jun;11(4):S61-738104243
Cites: Arch Intern Med. 1995 Apr 10;155(7):701-97695458
Cites: Pharmacoeconomics. 1996;10 Suppl 2:37-4710163434
Cites: JAMA. 1997 Jan 8;277(2):115-218990335
Cites: J Clin Epidemiol. 1997 Jan;50(1):105-169048695
Cites: Eur Heart J. 1998 Oct;19(10):1434-5039820987
Cites: Lancet. 1999 Feb 20;353(9153):611-610030325
Cites: J Am Coll Cardiol. 1999 Jun;33(7):2092-19710362225
Cites: BMJ. 1999 Jun 26;318(7200):1730-710381708
Cites: Health Aff (Millwood). 2004 Jan-Jun;Suppl Web Exclusives:W4-79-9315451969
Cites: Health Aff (Millwood). 2004 Jan-Jun;Suppl Web Exclusives:W4-354-6215451957
Cites: Arch Intern Med. 2005 May 23;165(10):1147-5215911728
Cites: Health Econ. 2005 Sep;14(9):909-2316127675
Cites: Am J Manag Care. 2005 Oct;11(10):621-816232003
Cites: Clin Ther. 2006 Jun;28(6):964-78; discussion 962-316860179
Cites: Pharmacoepidemiol Drug Saf. 2006 Aug;15(8):565-74; discussion 575-716514590
Cites: Circulation. 2007 Apr 24;115(16):2128-3517420348
Cites: Lancet. 1999 Nov 20;354(9192):1751-610577635
Cites: Lancet. 2000 Dec 9;356(9246):1955-6411130523
Cites: Eur Heart J. 2001 Aug;22(16):1374-45011482917
Cites: CMAJ. 2001 Oct 16;165(8):1011-911699696
Cites: Med Care. 2001 Dec;39(12):1293-30411717571
Cites: N Engl J Med. 2002 Mar 14;346(11):822-911893794
Cites: Am J Hypertens. 1997 Jul;10(7 Pt 1):697-7049234822
Cites: Health Aff (Millwood). 2002 Mar-Apr;21(2):31-4611900185
Cites: Health Aff (Millwood). 2002 Mar-Apr;21(2):13-3011900153
Cites: BMJ. 1998 Sep 12;317(7160):703-139732337
Cites: CMAJ. 2002 Jun 25;166(13):1655-6212126319
Cites: JAMA. 2002 Jul 24-31;288(4):455-6112132975
Cites: J Clin Pharm Ther. 2002 Aug;27(4):299-30912174032
Cites: J Clin Epidemiol. 2002 Aug;55(8):833-4112384199
Cites: Clin Pharmacol Ther. 2003 Oct;74(4):388-40014534526
Cites: N Engl J Med. 2003 Dec 4;349(23):2224-3214657430
Cites: BMJ. 2004 Mar 6;328(7439):56014982865
Cites: JAMA. 2004 May 19;291(19):2344-5015150206
Cites: Med Care. 2004 Jul;42(7):653-6015213490
Cites: Am Heart J. 2004 Jul;148(1):99-10415215798
Cites: Circulation. 2004 Aug 3;110(5):588-63615289388
Cites: Health Aff (Millwood). 2004 Sep-Oct;23(5):217-2515371388
Cites: N Engl J Med. 1980 Oct 30;303(18):1038-416999345
Cites: Milbank Q. 1993;71(2):217-528510601
PubMed ID
17685825 View in PubMed
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An assessment of US and Canadian smoking reduction objectives for the year 2000.

https://arctichealth.org/en/permalink/ahliterature204593
Source
Am J Public Health. 1998 Sep;88(9):1362-7
Publication Type
Article
Date
Sep-1998
Author
C. Pechmann
P. Dixon
N. Layne
Author Affiliation
Graduate School of Management, University of California, Irvine 92697, USA. cpechman@uci.edu
Source
Am J Public Health. 1998 Sep;88(9):1362-7
Date
Sep-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Canada - epidemiology
Female
Forecasting
Goals
Health Policy - trends
Humans
Male
Middle Aged
Prevalence
Probability
Sex Distribution
Smoking - epidemiology - trends
Smoking Cessation - statistics & numerical data
Stochastic Processes
United States - epidemiology
Abstract
This study assessed whether US and Canadian smoking reduction objectives for the year 2000 are attainable. The United States seeks to cut smoking in its population to 15%; the Canadian goal is 24%.
Smoking data were obtained for the United States (1974-1994) and Canada (1970-1995) for the overall populations and several age-sex subpopulations. Analyses estimated trends, future prevalences, and the likelihood of goal attainment. Structural time-series models were used because of their ability to fit a variety of trends.
The findings indicate that smoking has been declining steadily since the 1970s, by approximately 0.7 percentage points a year, in both countries. Extrapolating these trends to the year 2000, the US prevalence will be 21% and the Canadian prevalence 24%.
If the current trends continue, the Canadian goal seems attainable, but the US goal does not. The US goal is reachable only for 65-to 80-year-olds, who already have low smoking prevalences. It appears that both countries must increase their commitment to population-based tobacco control.
Notes
Cites: JAMA. 1989 Jan 6;261(1):49-552908994
Cites: JAMA. 1989 Jan 6;261(1):61-52908996
Cites: Can J Public Health. 1992 Nov-Dec;83(6):404-61286438
Cites: Prev Med. 1990 Sep;19(5):552-612235922
Cites: Med Clin North Am. 1992 Mar;76(2):289-3031548962
Cites: CMAJ. 1990 Nov 1;143(9):905-62224718
PubMed ID
9736877 View in PubMed
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An examination of the self-care concept uncovers a new direction for healthcare reform.

https://arctichealth.org/en/permalink/ahliterature181374
Source
Nurs Leadersh (Tor Ont). 2003;16(4):48-62
Publication Type
Article
Date
2003
Author
Dianne McCormack
Author Affiliation
University of New Brunswick, Saint John.
Source
Nurs Leadersh (Tor Ont). 2003;16(4):48-62
Date
2003
Language
English
Publication Type
Article
Keywords
Canada
Delivery of Health Care - organization & administration
Forecasting
Health Care Reform - organization & administration
Health Policy - trends
Health services needs and demand
Humans
Leadership
Models, Nursing
National health programs - organization & administration
Nurse's Role
Nursing - organization & administration
Nursing Theory
Organizational Objectives
Patient-Centered Care - organization & administration
Philosophy, Nursing
Public Policy
Self Care - trends
Abstract
The concept of self-care is multidimensional, with many defining elements. This paper describes the origin of this comprehensive concept. It examines the response of the nursing discipline to citizen self-care initiatives and the subsequent effects this response has had on the development of nursing knowledge. The evolution of self-care as a core concept within Canadian health policy is presented; the potential readiness fo citizens to accept self-care as an aspect of healthcare delivery is explored, identifying potential benefits and obstacles. The paper concludes with a proposed self-care approach to healthcare reform in Canada and the subsequent influence this approach may have on the discipline of nursing. The congruency between a self-care healthcare delivery system and the theoretical foundations and perspective of healthcare delivery held by the nursing discipline is discussed. The role nurses might assume in shaping a self-care healthcare delivery system is delineated.
PubMed ID
14983922 View in PubMed
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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

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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[A strategy of health for all--are we reaching our target to reduce mortality?]

https://arctichealth.org/en/permalink/ahliterature24547
Source
Tidsskr Nor Laegeforen. 1992 Jan 10;112(1):57-63
Publication Type
Article
Date
Jan-10-1992
Author
B. Guldvog
Author Affiliation
Seksjon for forebyggende og helsefremmende arbeid, Statens Institutt for Folkehelse, Oslo.
Source
Tidsskr Nor Laegeforen. 1992 Jan 10;112(1):57-63
Date
Jan-10-1992
Language
Norwegian
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cause of Death
Child
Child, Preschool
English Abstract
Female
Health Policy - trends
Health promotion
Humans
Infant
Infant mortality
Infant, Newborn
Life Expectancy - trends
Male
Middle Aged
Mortality
Norway - epidemiology
World Health Organization
Abstract
In the late seventies the World Health Organization developed a strategy of Health for all towards year 2000, to which Norwegian health authorities have consented. This article presents and discusses the sub-goals for expectation of life and mortality, and analyzes the possibilities of reaching them. The desired reduction of at least 25% in accident mortality rates and cardiovascular mortality rates in relation to the reference period 1976-80 will probably be reached. In addition, the desired 15% reduction in cancer mortality is likely to be reached for persons under 40 years of age. Infant mortality does not appear to be declining, cancer mortality for people over 40 years of age is increasing, and the suicidal and homicidal rates are increasing faster than any other cause of death. The possibilities of reversing this development require a structured plan and comprehensive changes in the way society is organized, with more emphasis on care, social network planning and reduction of the multicausal risk load that modern life implies. Some of the sub-goals are not sufficiently founded on accessible information, and should be revised.
PubMed ID
1553648 View in PubMed
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152 records – page 1 of 16.