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[Abolish the humiliating age limit of 65!].

https://arctichealth.org/en/permalink/ahliterature195893
Source
Lakartidningen. 2000 Dec 6;97(49):5828
Publication Type
Article
Date
Dec-6-2000
Author
B. Blomquist
Source
Lakartidningen. 2000 Dec 6;97(49):5828
Date
Dec-6-2000
Language
Swedish
Publication Type
Article
Keywords
Aged
Employment
Health Policy
Humans
Physicians
Prejudice
Private Sector
Public Sector
Sweden
PubMed ID
11188049 View in PubMed
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Accessing timely rehabilitation services for a global aging society? Exploring the realities within Canada's universal health care system.

https://arctichealth.org/en/permalink/ahliterature145394
Source
Curr Aging Sci. 2010 Jul;3(2):143-50
Publication Type
Article
Date
Jul-2010
Author
Michel D Landry
Sudha Raman
Elham Al-Hamdan
Author Affiliation
Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. mike.landry@utoronto.ca
Source
Curr Aging Sci. 2010 Jul;3(2):143-50
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aging
Canada
Cooperative Behavior
Delivery of Health Care, Integrated - organization & administration
Health Services Accessibility - organization & administration
Health Services Needs and Demand - organization & administration
Health Services for the Aged - organization & administration
Humans
Interinstitutional Relations
National health programs - organization & administration
Organizational Objectives
Physical Therapy Modalities - organization & administration
Private Sector - organization & administration
Public Sector - organization & administration
Time Factors
World Health
Abstract
The proportion of older persons is increasing in developed and developing countries: this aging trend can be viewed as a two-edged sword. On the one hand, it represents remarkable successes regarding advances in health care; and on the other hand, it represents a considerable challenge for health systems to meet growing demand. A growing disequilibrium between supply and demand may be particularly challenging within publicly funding health systems that 'guarantee' services to eligible populations. Rehabilitation, including physical therapy, is a service that if provided in a timely manner, can maximize function and mobility for older persons, which may in turn optimize efficiency and effectiveness of overall health care systems. However, physical therapy services are not considered an insured service under the legislative framework of the Canadian health system, and as such, a complex public/private mix of funding and delivery has emerged. In this article, we explore the consequences of a public/private mix of physical therapy on timely access to services, and use the World Health Organization (WHO) health system performance framework to assess the extent to which the emerging system influences the goal of aggregated and equitable health. Overall, we argue that a shift to a public/private mix may not have positive influences at the population level, and that innovative approaches to deliver services would be desirable to strengthening rather than weaken the publicly funded system. We signal that strategies aimed at scaling up rehabilitation interventions are required in order to improve health outcomes in an evolving global aging society.
PubMed ID
20158495 View in PubMed
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Access to and continuity of primary medical care of different providers as perceived by the Finnish population.

https://arctichealth.org/en/permalink/ahliterature164689
Source
Scand J Prim Health Care. 2007 Mar;25(1):27-32
Publication Type
Article
Date
Mar-2007
Author
Pekka Mäntyselkä
Pirjo Halonen
Arto Vehviläinen
Jorma Takala
Esko Kumpusalo
Author Affiliation
Department of Public Health and Clinical Nutrition, Unit of Family Practice, University of Kuopio, Kuopio, Finland. pekka.mantyselka@uku.fi
Source
Scand J Prim Health Care. 2007 Mar;25(1):27-32
Date
Mar-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Chronic Disease - therapy
Community Health Centers - standards - statistics & numerical data
Continuity of Patient Care
Family Practice - standards - statistics & numerical data
Finland
Health Services Accessibility
Humans
Middle Aged
Occupational Health Services - standards - statistics & numerical data
Patient satisfaction
Primary Health Care - standards - statistics & numerical data
Private Sector
Public Sector
Questionnaires
Abstract
To study people's views on the accessibility and continuity of primary medical care provided by different providers: a public primary healthcare centre (PPHC), occupational healthcare (OHC), and a private practice (PP).
A nationwide population-based questionnaire study.
Finland.
A total of 6437 (from a sample of 10,000) Finns aged 15-74 years.
Period of time (in days) to get an appointment with any physician was assessed via a single structured question. Accessibility and continuity were evaluated with a five-category Likert scale. Values 4-5 were regarded as good.
Altogether 72% had found that they could obtain an appointment with a physician within three days, while 6% had to wait more than two weeks. Older subjects and subjects with chronic diseases perceived waiting times as longer more often than younger subjects and those without chronic diseases. The proportion of subjects who perceived access to care to be good was 35% in a PPHC, 68% in OHC, and 78% in a PP. The proportion of subjects who were able to get successive appointments with the same doctor was 45% in a PPHC, 68% in OHC, and 81% in a PP. A personal doctor system was related to good continuity and access in a PPHC.
Access to and continuity of care in Finland are suboptimal for people suffering from chronic diseases. The core features of good primary healthcare are still not available within the medical care provided by public health centres.
Notes
Cites: Fam Pract. 2000 Jun;17(3):236-4210846142
Cites: Br J Gen Pract. 2000 Nov;50(460):882-711141874
Cites: Scand J Prim Health Care. 2001 Jun;19(2):131-4411482415
Cites: Br J Gen Pract. 2002 Jun;52(479):459-6212051209
Cites: Health Serv Res. 2002 Oct;37(5):1403-1712479503
Cites: Scand J Prim Health Care. 2006 Sep;24(3):140-416923622
Cites: Scand J Prim Health Care. 1992 Dec;10(4):290-41480869
Cites: J Fam Pract. 2004 Dec;53(12):974-8015581440
Cites: CMAJ. 2006 Jan 17;174(2):177-8316415462
Cites: Scand J Prim Health Care. 2006 Mar;24(1):1-216464807
Cites: Ann Fam Med. 2003 Sep-Oct;1(3):149-5515043376
PubMed ID
17354156 View in PubMed
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Actor-network theory: a tool to support ethical analysis of commercial genetic testing.

https://arctichealth.org/en/permalink/ahliterature180338
Source
New Genet Soc. 2003 Dec;22(3):271-96
Publication Type
Article
Date
Dec-2003
Author
Bryn Williams-Jones
Janice E Graham
Author Affiliation
Centre for Family Research & Homerton College, University of Cambridge, UK.
Source
New Genet Soc. 2003 Dec;22(3):271-96
Date
Dec-2003
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - genetics
Canada
Diffusion of Innovation
Female
Genes, BRCA1
Genes, BRCA2
Genetic Counseling
Genetic Research
Genetic Services - economics - ethics - trends
Genetic Testing - economics - ethics - methods
Health Services Accessibility
Humans
Industry
Internationality
Marketing
Models, organizational
Patents as Topic
Private Sector
Public Policy
Public Sector
Research Support as Topic
Sensitivity and specificity
Technology Assessment, Biomedical
Technology Transfer
Abstract
Social, ethical and policy analysis of the issues arising from gene patenting and commercial genetic testing is enhanced by the application of science and technology studies, and Actor-Network Theory (ANT) in particular. We suggest the potential for transferring ANT's flexible nature to an applied heuristic methodology for gathering empirical information and for analysing the complex networks involved in the development of genetic technologies. Three concepts are explored in this paper--actor-networks, translation, and drift--and applied to the case of Myriad Genetics and their commercial BRACAnalysis genetic susceptibility test for hereditary breast cancer. Treating this test as an active participant in socio-technical networks clarifies the extent to which it interacts with, shapes and is shaped by people, other technologies, and institutions. Such an understanding enables more sophisticated and nuanced technology assessment, academic analysis, as well as public debate about the social, ethical and policy implications of the commercialization of new genetic technologies.
PubMed ID
15115034 View in PubMed
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Adverse events associated with lay emergency response programs: the public access defibrillation trial experience.

https://arctichealth.org/en/permalink/ahliterature168751
Source
Resuscitation. 2006 Jul;70(1):59-65
Publication Type
Article
Date
Jul-2006
Author
Mary Ann Peberdy
Lois Van Ottingham
William J Groh
Jerris Hedges
Thomas E Terndrup
Ronald G Pirrallo
N Clay Mann
Ruchir Sehra
Author Affiliation
Virginia Commonwealth University Health System, Box 908204, Richmond, VA 23298, USA. mpeberdy@aol.com
Source
Resuscitation. 2006 Jul;70(1):59-65
Date
Jul-2006
Language
English
Publication Type
Article
Keywords
Canada
Cardiopulmonary Resuscitation - adverse effects - education - psychology
Community Health Services - methods - statistics & numerical data
Defibrillators - adverse effects
Electric Countershock - adverse effects
Emergency Medical Services - methods - statistics & numerical data
Heart Arrest - therapy
Humans
Public Sector - statistics & numerical data
United States
Volunteers - education - psychology
Abstract
The adverse event (AE) profile of lay volunteer CPR and public access defibrillation (PAD) programs is unknown. We undertook to investigate the frequency, severity, and type of AE's occurring in widespread PAD implementation.
A randomized-controlled clinical trial.
One thousand two hundred and sixty public and residential facilities in the US and Canada.
On-site, volunteer, lay personnel trained in CPR only compared to CPR plus automated external defibrillators (AEDs).
Persons experiencing possible cardiac arrest receiving lay volunteer first response with CPR+AED compared with CPR alone.
An AE is defined as an event of significance that caused, or had the potential to cause, harm to a patient or volunteer, or a criminal act. AE data were collected prospectively.
Twenty thousand three hundred and ninety six lay volunteers were trained in either CPR or CPR+AED. One thousand seven hundred and sixteen AEDs were placed in units randomized to the AED arm. There were 26,389 exposure months. Only 36 AE's were reported. There were two patient-related AEs: both patients experienced rib fractures. There were seven volunteer-related AE's: one had a muscle pull, four experienced significant emotional distress and two reported pressure by their employee to participate. There were 27 AED-related AEs: 17 episodes of theft involving 20 devices, three involved AEDs that were placed in locations inaccessible to the volunteer, four AEDs had mechanical problems not affecting patient safety, and three devices were improperly maintained by the facility. There were no inappropriate shocks and no failures to shock when indicated (95% upper bound for probability of inappropriate shock or failure to shock = 0.0012).
AED use following widespread training of lay-persons in CPR and AED is generally safe for the volunteer and the patient. Lay volunteers may report significant, usually transient, emotional stress following response to a potential cardiac arrest. Within the context of this prospective, randomized multi-center study, AEDs have an exceptionally high safety profile when used by trained lay responders.
PubMed ID
16784998 View in PubMed
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[Allergen decontamination and public sector]

https://arctichealth.org/en/permalink/ahliterature15815
Source
Ugeskr Laeger. 1997 Jan 6;159(2):180-2
Publication Type
Article
Date
Jan-6-1997
Author
F F Madsen
Author Affiliation
H:S Rigshospitalet, RHIMA Centeret, lungemedicinsk klinik.
Source
Ugeskr Laeger. 1997 Jan 6;159(2):180-2
Date
Jan-6-1997
Language
Danish
Publication Type
Article
Keywords
Adult
Air Pollution, Indoor - legislation & jurisprudence
Animals
Asthma - etiology - prevention & control
Cats
Denmark
English Abstract
Environmental Illness - etiology - prevention & control
Female
Humans
Public Sector
Abstract
Reduction of allergen exposure is one way to reduce exacerbations in allergic asthma. According to Danish legislation, the local authorities have to support initiatives which can reduce clinically relevant inhouse allergen exposure. A case of grotesque bureaucracy and ignorance of basic allergological facts is presented. Local administration confused allergy to cat dander with allergy to house dust mite and two appeal boards only reviewed legal aspects, not medical. After inquiry by the ombudsman, the case was reviewed by one appeal board and the patient was granted help. After three years the patient had moved to another district and the case was started all over again. It is recommended that direct contact between physicians should be preferred, in order to avoid misinterpretation of specialist statements. Original documents should always be requested to avoid transcription errors. Local public administration should respect legislation and improve the quality of their medical advisors.
PubMed ID
9012091 View in PubMed
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Allergic rhinitis alone or with asthma is associated with an increased risk of sickness absences.

https://arctichealth.org/en/permalink/ahliterature142913
Source
Respir Med. 2010 Nov;104(11):1654-8
Publication Type
Article
Date
Nov-2010
Author
Paula Kauppi
Paula Salo
Riina Hakola
Jaana Pentti
Tuula Oksanen
Mika Kivimäki
Jussi Vahtera
Tari Haahtela
Author Affiliation
Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland. paula.kauppi@hus.fi
Source
Respir Med. 2010 Nov;104(11):1654-8
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Asthma - economics - epidemiology
Female
Finland - epidemiology
Humans
Male
Middle Aged
Occupational Health
Prevalence
Prospective Studies
Public Sector - statistics & numerical data
Rhinitis, Allergic, Perennial - economics - epidemiology
Risk factors
Sick Leave - economics - statistics & numerical data
Young Adult
Abstract
The aim of the study is to examine the risk of sickness absence in public sector employees with allergic rhinitis or asthma or both conditions combined. This is a prospective cohort study of 48,296 Finnish public sector employees. Data from self-reported rhinitis and asthma were obtained from survey responses given during either the 2000-2002 or 2004 periods. Follow-up data on sickness absences for the public sector employees surveyed were acquired from records kept by the employers. During the follow-up, mean sick leave days per year for respondents were 17.6 days for rhinitis alone, 23.8 days for asthma alone and 24.2 days for both conditions combined. Respondents with neither condition were absent for a mean of 14.5 days annually. The impact of asthma and rhinitis combined on the risk of sick leave days was marginal compared to asthma alone (RR 1.1; 95% CI 1.0-1.3). In the subgroup analysis (those with current asthma or allergy medication), the risk ratio for medically certified sickness absence (>3 days) was 2.0 (95% CI 1.9-2.2) for those with asthma and rhinitis combined. Rhinitis, asthma and both these conditions combined increased the risk of days off work.
PubMed ID
20542677 View in PubMed
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Allocating limited resources in a time of fiscal constraints: a priority setting case study from Dalhousie University Faculty of Medicine.

https://arctichealth.org/en/permalink/ahliterature113649
Source
Acad Med. 2013 Jul;88(7):939-45
Publication Type
Article
Date
Jul-2013
Author
Craig Mitton
Adrian Levy
Diane Gorsky
Christina MacNeil
Francois Dionne
Tom Marrie
Author Affiliation
Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada. craig.mitton@ubc.ca
Source
Acad Med. 2013 Jul;88(7):939-45
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Budgets - organization & administration
Decision Making
Faculty, Medical
Health Care Rationing - organization & administration
Humans
Models, organizational
Nova Scotia
Organizational Case Studies
Public Sector - economics
Resource Allocation - organization & administration
Schools, Medical - economics
Abstract
Facing a projected $1.4M deficit on a $35M operating budget for fiscal year 2011/2012, members of the Dalhousie University Faculty of Medicine developed and implemented an explicit, transparent, criteria-based priority setting process for resource reallocation. A task group that included representatives from across the Faculty of Medicine used a program budgeting and marginal analysis (PBMA) framework, which provided an alternative to the typical public-sector approaches to addressing a budget deficit of across-the-board spending cuts and political negotiation. Key steps to the PBMA process included training staff members and department heads on priority setting and resource reallocation, establishing process guidelines to meet immediate and longer-term fiscal needs, developing a reporting structure and forming key working groups, creating assessment criteria to guide resource reallocation decisions, assessing disinvestment proposals from all departments, and providing proposal implementation recommendations to the dean. All departments were required to submit proposals for consideration. The task group approved 27 service reduction proposals and 28 efficiency gains proposals, totaling approximately $2.7M in savings across two years. During this process, the task group faced a number of challenges, including a tight timeline for development and implementation (January to April 2011), a culture that historically supported decentralized planning, at times competing interests (e.g., research versus teaching objectives), and reductions in overall health care and postsecondary education government funding. Overall, faculty and staff preferred the PBMA approach to previous practices. Other institutions should use this example to set priorities in times of fiscal constraints.
PubMed ID
23702521 View in PubMed
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276 records – page 1 of 28.