scholarly journals Geographic distribution of Multiple Sclerosis (MS) mortality rates in Canada, 1975-2009

2015 ◽  
Vol 42 (S1) ◽  
pp. S34-S35
Author(s):  
SA Warren ◽  
W Janzen ◽  
KG Warren ◽  
LW Svenson ◽  
D Schopflocher
Keyword(s):  
Mortality Rates ◽  
Care Practice ◽  
Female Mortality ◽  
Health Care Practice ◽  
University Of Alberta ◽  
Data Centre ◽  
Populations At Risk ◽  
Statistics Canada ◽  
Rate Ratios ◽  
Canada Data

Background: Our study examined whether there are differences in MS mortality rates across regions of Canada, which might suggest differences in environment or health care practice that influence outcome. Methods: Statistics Canada data on deaths due to MS and populations at risk, 1975-2009, were derived from the Research Data Centre, University of Alberta. Mortality rates and 95% confidence intervals (CIs) were calculated per 100,000 population for the Atlantic Provinces, Quebec, Ontario and Western Provinces (including Northwest Territories, Yukon, Nunavut), age-standardized to the 2006 population. Results: The average annual MS mortality rates for 1975-2009 per 100,000 population (CIs) were: Atlantic Provinces 1.09 (0.43,1.74); Quebec 1.30 (0.89,1.71); Ontario 1.08 (0.77,1.38); Western Provinces 1.39 (0.99,1.78). Female mortality rates were consistently higher than male rates but there were no differences in the female:male mortality rate ratios across regions. Trend analysis showed that rates were stable over the 35 year time span in 3 regions with non-significant average annual per cent increases/decreases of: Atlantic Provinces –0.43%; Quebec +0.12%; and Western Provinces +0.27%. Only Ontario showed a slight but significant increase of +0.81% (p<0.05). Conclusions: MS mortality rates are similar across the Canadian regions, suggesting that patients are not disadvantaged in terms of mortality by their place of residence.

A Measure of Family Functioning for Health Care Practice and Research in Israel

1984 ◽  
Vol 15 (2) ◽  
pp. 211-230 ◽  
Author(s):  
S. Linder-Pelz ◽  
S. Levy ◽  
A. Tamir ◽  
T. Spenser ◽  
L. M. Epstein
Keyword(s):  
Health Care ◽  
Family Functioning ◽  
Care Practice ◽  
Health Care Practice

Ethical Visions for the Development of Patient Care in the Health Care Practice

2019 ◽  
Vol 2 (1) ◽  
pp. 27-34
Author(s):  
Richard Moreno ◽  
◽  
Cristinel Ștefănescu ◽  
Beatrice Gabriela Ioan ◽  
Mariana Cuceu ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Care Practice ◽  
Health Care Practice

scholarly journals Internal barriers to efficiency: why disinvestments are so difficult. Identifying and addressing internal barriers to disinvestment of health technologies

2021 ◽  
pp. 1-16
Author(s):  
Bjørn Hofmann
Keyword(s):  
Health Care ◽  
Health Economics ◽  
Cognitive Biases ◽  
Care Practice ◽  
Core Concept ◽  
Health Care Practice ◽  
Health Technologies ◽  
Sound Foundation ◽  
Internal Barriers ◽  
Efficient Care

Abstract Although efficiency is a core concept in health economics, its impact on health care practice still is modest. Despite an increased pressure on resource allocation, a widespread use of low-value care is identified. Nonetheless, disinvestments are rare. Why is this so? This is the key question of this paper: why are disinvestments not more prevalent and improving the efficiency of the health care system, given their sound foundation in health economics, their morally important rationale, the significant evidence for a long list of low-value care and available alternatives? Although several external barriers to disinvestments have been identified, this paper looks inside us for mental mechanisms that hamper rational assessment, implementation, use and disinvestment of health technologies. Critically identifying and assessing internal inclinations, such as cognitive biases, affective biases and imperatives, is the first step toward a more rational handling of health technologies. In order to provide accountable and efficient care we must engage in the quest against the figments of our minds; to disinvest in low-value care in order to provide high-value health care.

scholarly journals Ongoing processes of managing consent: the empirical ethics of using video-recording in clinical practice and research

2011 ◽  
Vol 6 (4) ◽  
pp. 179-185 ◽  
Author(s):  
Michelle O'Reilly ◽  
Nicola Parker ◽  
Ian Hutchby
Keyword(s):  
Health Care ◽  
Video Recording ◽  
Empirical Ethics ◽  
Video Data ◽  
Care Practice ◽  
Reflecting Team ◽  
Recording Equipment ◽  
Health Care Practice ◽  
Ethical Concerns ◽  
Sensitive Topics

Using video to facilitate data collection has become increasingly common in health research. Using video in research, however, does raise additional ethical concerns. In this paper we utilize family therapy data to provide empirical evidence of how recording equipment is treated. We show that families made a distinction between what was observed through the video by the reflecting team and what was being recorded onto videotape. We show that all parties actively negotiated what should and should not go ‘on the record’, with particular attention to sensitive topics and the responsibility of the therapist. Our findings have important implications for both clinical professionals and researchers using video data. We maintain that informed consent should be an ongoing process and with this in mind we present some arguments pertaining to the current debates in this field of health-care practice.

scholarly journals Mortality in Dementia from 1996 to 2015: A National Registry-Based Cohort Study

2021 ◽  
Vol 79 (1) ◽  
pp. 289-300
Author(s):  
Lærke Taudorf ◽  
Ane Nørgaard ◽  
Gunhild Waldemar ◽  
Thomas Munk Laursen
Keyword(s):  
Elderly People ◽  
Age Groups ◽  
Mortality Rates ◽  
Similar Rate ◽  
National Registry ◽  
Healthcare Data ◽  
Appropriate Care ◽  
People With Dementia ◽  
Rate Ratios ◽  
Annual Mortality

Background: It remains unclear whether the increased focus on improving healthcare and providing appropriate care for people with dementia has affected mortality. Objective: To assess survival and to conduct a time trend analysis of annual mortality rate ratios (MRR) of dementia based on healthcare data from an entire national population. Methods: We assessed survival and annual MRR in all residents of Denmark ≥65 years from 1996–2015 using longitudinal registry data on dementia status and demographics. For comparison, mortality and survival were calculated for acute ischemic heart disease (IHD) and cancer. Results: The population comprised 1,999,366 people (17,541,315 person years). There were 165,716 people (529,629 person years) registered with dementia, 131,321 of whom died. From 1996–2015, the age-adjusted MRR for dementia declined (women: 2.76 to 2.05; men: 3.10 to 1.99) at a similar rate to elderly people without dementia. The sex-, age-, and calendar-year-adjusted MRR was 2.91 (95%CI: 2.90–2.93) for people with dementia. MRR declined significantly more for acute IHD and cancer. In people with dementia, the five-year survival for most age-groups was at a similar level or lower as that for acute IHD and cancer. Conclusion: Although mortality rates declined over the 20-year period, MRR stayed higher for people with dementia, while the MRR gap, compared with elderly people without dementia, remained unchanged. For the comparison, during the same period, the MRR gap narrowed between people with and without acute IHD and cancer. Consequently, initiatives for improving health and decreasing mortality in dementia are still highly relevant.

scholarly journals Nurses lived experiences of conscience reaction: a qualitative phenomenological study

2012 ◽  
Vol 2 (3) ◽  
pp. 3-9 ◽  
Author(s):  
Parkhideh Hasani ◽  
Rostam Jalali ◽  
Zhila Abedsaeedi
Keyword(s):  
Lived Experience ◽  
Phenomenological Study ◽  
Quality Care ◽  
Care Practice ◽  
Professional Lives ◽  
Personal Integrity ◽  
Next Of Kin ◽  
Health Care Practice ◽  
Qualitative Phenomenological ◽  
Qualitative Phenomenological Study

Background and objectives: Conscience is a cornerstone of ethics, affecting both our private and professional lives. Everyday health care practice raises questions about conscience and how to understand its role. Conscience has also been described as inducing self-growth and protecting personal integrity. Nurses views on their reactions to behaviors consistent or contrary to conscience could therefore help us to understand the meaning of the reactions of conscience. This study aimed to illuminate meanings of nurses lived experience of conscience reaction in their daily practices.Material and methods: Interviews with nine nurses were interpreted using a phenomenological hermeneutic (Colaizzi, 1978) method. Data was collected in 2010 among nurses working in various hospitals in Kermanshah. The nurses were selected for participation purposively.Results: The nurses lived experience of conscience reaction was formulated in three themes and ten sub-themes. The first theme is ‘being peace, which includes three sub-themes: Being calm, being pleased, and being satisfying. The second theme is ‘trouble conscience’ which includes four subthemes: guilt, thinking engagement, discomfort, and fretfulness. The third theme is responding which includes three sub-themes: expressing, compensation, and lack of repeat.Conclusions: The nurses lived experience of conscience reaction showed that nurses considered conscience reaction to be an important factor in the exercise of their profession, as revealed by the descriptive categories: being peace when they act consistent with conscience; trouble conscience when they act contrary on conscience; and responding after doing an anti conscience practice. They perceived that conscience played a role in nursing actions involving patients and next of kin, and guided them in their efforts to provide high quality care.  DOI: http://dx.doi.org/10.3329/bioethics.v2i3.10257Bangladesh Journal of Bioethics 2011;2(3):3-9

scholarly journals Febrile Neutropenia and Long-term Risk of Infection Among Patients Treated With Chemotherapy for Malignant Diseases

2018 ◽  
Vol 5 (10) ◽  
Author(s):  
Josefine Nordvig ◽  
Theis Aagaard ◽  
Gedske Daugaard ◽  
Peter Brown ◽  
Henrik Sengeløv ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Mortality Rates ◽  
Risk Of Infection ◽  
Increased Risk ◽  
Competing Events ◽  
Adjusted Incidence Rate ◽  
New Treatment ◽  
Rate Ratios

Abstract Background Febrile neutropenia (FN) is a common complication to chemotherapy, associated with increased short-term morbidity and mortality. However, the long-term outcomes after FN are poorly elucidated. We examined the long-term risk of infection and mortality rates in cancer patients with and without FN. Methods Patients aged &gt;16 years treated with firstline chemotherapy were followed from 180 days after initiating chemotherapy until first infection, a new treatment with chemotherapy, death, or end of follow-up. Risk factors for infections were analyzed by competing risks regression, with death or another treatment with chemotherapy as competing events. Adjusted incidence rate ratios (aIRRs) of infection and death were analyzed using Poisson regression. In analyses of mortality, infection was included as a time-updated variable. Results We included 7190 patients with a median follow-up (interquartile range) of 0.58 (0.20–1.71) year. A total of 1370 patients had an infection during follow-up. The aIRRs of infection were 1.86 (95% confidence interval [CI], 1.56–2.22) and 2.19 (95% CI, 1.54–3.11) for patients with 1 or &gt;1 episode of FN compared with those without FN. Mortality rate ratios were 7.52 (95% CI, 6.67–8.48) &lt;1 month after, 4.24 (95% CI, 3.80–4.75) 1–3 months after, 2.33 (95% CI, 1.63–3.35) 3–6 months after, and 1.09 (95% CI, 0.93–1.29) &gt;6 months after an infection, compared with the time before infection. Conclusions FN during chemotherapy is associated with a long-term increased risk of infection. Mortality rates are substantially increased for 6 months following an infection.

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