scholarly journals Social Obstetrics as Niche-Development in Addressing Health Inequities

2021 ◽  
Vol 13 (22) ◽  
pp. 12814
Author(s):  
Lisa S. Barsties ◽  
Frank S. van Steenbergen ◽  
Derk Loorbach
Keyword(s):  
Current System ◽  
Obstetric Care ◽  
Health Inequities ◽  
Historical Narrative ◽  
Expert Interviews ◽  
Research Perspective ◽  
Starting Point ◽  
Transition Research ◽  
Desk Research ◽  
Care System

We apply a transition research perspective to the Dutch obstetric care system to analyze historic, current, and future shifts and find ways to overcome persistent health inequities. We present social obstetrics as an emerging niche that addresses perinatal health inequities by acknowledging their multifaceted origins and fostering collaborations across the medical, social, and public health sectors. We conducted desk research, in-depth semi-structured expert interviews, and interactive group sessions with change-inclined professionals that are relevant for the implementation of social obstetrics in six Dutch municipalities. The outcomes are synthesized in a historical narrative and perspectives on current obstacles and future systemic shifts. We argue that social obstetrics can be considered a sustainable addition to what is already present, instead of a disruptive transformation of the current system. Social obstetrics is innovative as it connects various societal systems and offers a framework for cross-sectoral collaboration. These collaborations, in turn, can be the starting point for the transformation of the obstetric care system as well as other relevant societal systems.

Progressing Towards a Freer Market in Australian Residential Aged Care

2021 ◽  
pp. 1-25
Author(s):  
Susan F Cochrane ◽  
Alice L Holmes ◽  
Joseph E Ibrahim
Keyword(s):  
Current System ◽  
Aged Care ◽  
Care Quality ◽  
Cultural Safety ◽  
Residential Aged Care ◽  
Royal Commission ◽  
Care Providers ◽  
Fit For Purpose ◽  
Market Driven ◽  
Care System

The Royal Commission into Aged Care Quality and Safety has again focussed attention on the failings of the Australian aged care system. Residential aged care in Australia has become increasingly market-driven since the major reforms of 1997. The aims of increased marketisation include providing residents with greater choice, higher quality services, and increasing providers’ efficiency and innovation. However, marketisation is not meeting these aims, predominantly due to asymmetries of knowledge and power between residents and aged care providers. These asymmetries arise from inadequate provision of information, geographic disparities, urgency for care as needs arise acutely, and issues surrounding safety, including cultural safety. We propose a human rights framework, supported by responsive regulation, to overcome the failings of the current system and deliver an improved aged care system which is fit for purpose.

Coin Circulation in the Balkans in Late Antiquity

2007 ◽  
Author(s):  
P. GUEST
Keyword(s):  
Late Antiquity ◽  
Careful Analysis ◽  
Historical Narrative ◽  
The Balkans ◽  
Notable Feature ◽  
Starting Point ◽  
The World ◽  
Two Phases ◽  
Archaeological Excavations ◽  
Early Byzantine

The archaeological excavations carried out on late Roman and early Byzantine sites in the Balkans has revolutionized our knowledge of this part of the world in Late Antiquity. How these sites are dated is obviously important as, without accurate and reliable dating, it is difficult to understand how they fit into the wider historical narrative. This chapter takes the coins excavated at Dichin as its starting point and, by careful analysis, proposes a general dating scheme for the two phases of occupation at the settlement. The lack of coins struck during the years 474–518 is a notable feature of the assemblage from Dichin, a pattern that is repeated at most sites in the region where coins of the emperor Zeno are particularly rare. By looking at both site finds and hoards from the region, however, these explanations need to be revised as they are based on a numismatic mirage rather than archaeological fact.

SUSTAINABLE DESIGN IN PROJECT DELIVERY: A DISCUSSION ON CURRENT AND FUTURE TRENDS

2016 ◽  
Vol 11 (2) ◽  
pp. 39-56 ◽  
Author(s):  
Karno Widjaja
Keyword(s):  
Construction Projects ◽  
Sustainable Design ◽  
Current System ◽  
Critical Role ◽  
Project Delivery ◽  
Starting Point ◽  
New Construction ◽  
Communication And Coordination ◽  
The Individual ◽  
Sustainability Principles

INTRODUCTION Sustainability principles have become an integral part of the design and construction process for many new construction projects. The selection of the project delivery method (PDM) is extremely important in the effective execution of the project, and plays a critical role in establishing communication and coordination between the key entities: owner, architect, and contractor. The goal of this paper is to hopefully serve as a starting point for further discussion to improve on the AEC industry's current integration of sustainability principles in PDMs. The first step consists of an assessment of current project delivery systems from a sustainable design perspective. This is followed by a determination of the current limitations, and examination of the various disruptions in the industry. Various literature sources are analyzed to form a framework to discuss improvements and optimization strategies beyond the current system. Thereafter, proposed solutions are introduced at both stakeholders, as well as PDM scales. In this paper, the focus for the conducted analysis and proposed methodologies is predicated on new construction projects instead of retrofits due to the resources available. However, the principles can similarly be applied to retrofit scenarios as well, depending on the specific requirements of the individual project at play.

Families

2005 ◽  
Author(s):  
John Dewar
Keyword(s):  
Twentieth Century ◽  
Social Behaviour ◽  
Family Law ◽  
Historical Narrative ◽  
Complex Interplay ◽  
Legal Concept ◽  
Dominant Theme ◽  
Starting Point ◽  
History Of

Family law is largely an aggregation of instrumental legislation, designed to achieve specific social and political purposes. Unlike disciplines that take a legal concept as its starting-point — such as contract, trust, or restitution — family law tends to be more than usually susceptible to shifts in politics and social behaviour, and the complex interplay between the two. This means that a dominant theme of family law scholarship has been that of change and transformation. This article offers a brief history of these transformations in family law, and describes how change has been described and analysed. This historical narrative provides a framework for a discussion of the debates that have characterized the discipline in the latter part of the twentieth century.

scholarly journals Occupational medicine - then and now: Where we could go from here

2014 ◽  
Vol 67 (5-6) ◽  
pp. 139-148 ◽  
Author(s):  
Karen Belkic ◽  
Olesja Nedic
Keyword(s):  
Work Stress ◽  
Occupational Medicine ◽  
Public Health Problem ◽  
Work Conditions ◽  
Theory And Practice ◽  
Working Environment ◽  
Major Public Health Problem ◽  
Research Perspective ◽  
Work Related ◽  
Starting Point

Occupational medicine has a long-standing history in the region of the former Yugoslavia with seminal contributions to the theory and practice of this discipline. This tradition should be expanded to incorporate psychosocial stressors. We review the sociological work stress models and empirical evidence gleaned thereby, and then the occupational stressor index, an additive burden model developed from a cognitive ergonomics perspective. In numerous studies, the occupational stressor index is significantly associated with risk behaviors: smoking, obesity and sedentariness and clinical outcomes: hypertension, ischemic heart disease, dyslipidemia and type 2 diabetes. The occupational stressor index characterizes the work conditions of physicians including surgeons and anesthesiologists; professional drivers and other groups at elevated risk for stress-related disorders. Much of these empirical data are from this region. Work-stress related health disorders are a major public health problem, with enormous human and economic costs. A more proactive role for physicians is needed vis-?-vis our working environment and that of patients. We physicians face a heavy job stressor burden strongly implicated with adverse health outcomes. The challenge is to identify effective strategies to lower the risk of work-stressor related illness. The critical gap is the lack of evidence-based guidelines. Intervention studies are needed in which job stressors are ameliorated as a therapeutic/preventive modality; the logical starting point is within our own profession. We also suggest how the relevant clinical competence could be enhanced. Alongside clinical enhancement should be the full restoration of physician empowerment to implement work-related recommendations. A participatory action research perspective by physicians for physicians and for our patients is needed.

Invited Article: The US health care system: Part 1: Our current system

Neurology ◽  
2008 ◽  
Vol 71 (23) ◽  
pp. 1907-1913 ◽  
Author(s):  
M. R. Nuwer ◽  
G. J. Esper ◽  
P. D. Donofrio ◽  
J. P. Szaflarski ◽  
G. L. Barkley ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Current System ◽  
The Us ◽  
System Part ◽  
Care System

Deployment of e-health services – a business model engineering strategy

2010 ◽  
Vol 16 (6) ◽  
pp. 344-353 ◽  
Author(s):  
Björn Kijl ◽  
Lambert JM Nieuwenhuis ◽  
Rianne MHA Huis in 't Veld ◽  
Hermie J Hermens ◽  
Miriam MR Vollenbroek-Hutten
Keyword(s):  
Health Services ◽  
Business Model ◽  
Early Stage ◽  
Expert Interviews ◽  
Quantitative Modelling ◽  
Value Network ◽  
Qualitative And Quantitative ◽  
Service Deployment ◽  
Engineering Strategy ◽  
Desk Research

We designed a business model for deploying a myofeedback-based teletreatment service. An iterative and combined qualitative and quantitative action design approach was used for developing the business model and the related value network. Insights from surveys, desk research, expert interviews, workshops and quantitative modelling were combined to produce the first business model and then to refine it in three design cycles. The business model engineering strategy provided important insights which led to an improved, more viable and feasible business model and related value network design. Based on this experience, we conclude that the process of early stage business model engineering reduces risk and produces substantial savings in costs and resources related to service deployment.

scholarly journals Patient Safety, Risk Reduction, and the Law

2018 ◽  
Author(s):  
Larry I. Palmer
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Health System ◽  
Systems Thinking ◽  
Health Care System ◽  
Error Reduction ◽  
Medical Liability ◽  
Starting Point ◽  
Care System

36 Houston Law Review 1609 (1999)"Patient safety" has come of age. With the publication of several empirical studies of medical injuries and the recent Institute of Medicine Report, To Err is Human: Building a Safe Health System, scholars from a variety of disciplines are advocating "systems thinking" as a way of preventing medical accidents. These scholars have been influenced by efforts to reduce accidents in other high risk industries such as aviation and scholarship in law proposing "no fault systems" for compensating medical accident victims. This article proposes that in order to incorporate "systems thinking" about medical error reduction, legal scholarship on the health care system must move beyond its preoccupation with the medical liability system. To develop a new framework for the role of law in enhancing patient safety, this article proposes that law's interaction with the public health system is the appropriate starting point for framing the legal analysis of patient safety. This framing of the issues acknowledges that the liability system may have a role to play in error reduction in medicine, but determining what this role is requires more empirical study of legal institutions as part of the emerging system of patient safety. To discover the appropriate role of law in the prevention of medical errors, this article encourages legal scholars to learn to pose empirical questions about how various institutions interact with the health care system.

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