scholarly journals Universal access to ambulance does not increase overall demand for ambulance services in Queensland, Australia

2013 ◽  
Vol 37 (1) ◽  
pp. 121 ◽  
Author(s):  
Vivienne C. Tippett ◽  
Ghasem (Sam) Toloo ◽  
David Eeles ◽  
Joseph Y. S. Ting ◽  
Peter J. Aitken ◽  
...  
Keyword(s):  
Health Services ◽  
Universal Access ◽  
Public Awareness ◽  
Evidence Base ◽  
Ambulance Service ◽  
Funding Policy ◽  
Service Demand ◽  
The Impact ◽  
Emergency Health Services

Objective. To determine the impact of the introduction of universal access to ambulance services via the implementation of the Community Ambulance Cover (CAC) program in Queensland in 2003–04. Method. The study involved a 10-year (2000–01 to 2009–10) retrospective analysis of routinely collected data reported by the Queensland Ambulance Service (QAS) and by the Council of Ambulance Authorities. The data were analysed for the impact of policy changes that resulted in universal access to ambulance services in Queensland. Results. QAS is a statewide, publically funded ambulance service. In Queensland, ambulance utilisation rate (AUR) per 1000 persons grew by 41% over the decade or 3.9% per annum (10-year mean = 149.8, 95% CI: 137.3–162.3). The AUR mean after CAC was significantly higher for urgent incidents than for non-urgent ones. However projection modelling demonstrates that URs after the introduction of CAC were significantly lower than the projected utilisation for the same period. Conclusions. The introduction of universal access under the Community Ambulance Cover program in Queensland has not had any significant independent long-term impact on demand overall. There has been a reduction in the long-term growth rate, which may have been contributed to by an ‘appropriate use’ public awareness program. What is known about the topic? It is generally well accepted that the demand for emergency health services is increasing however the drivers for demand are poorly understood. In Queensland in particular, growth in demand for services exceeds that seen in other states and territories. Some commentators have pointed at service funding policy and costs to end users as potential reasons for excess demand for services. What does this paper add? The assumption that forced subsidisation creates a perception of entitlement amongst consumers is challenged in this paper. We are able to demonstrate that demand for emergency health services did not increase beyond what would have been expected under a mandatory subscription system known as Community Ambulance Cover (CAC). This paper contributes to the developing body of knowledge about drivers for emergency health service demand. What are the implications for practitioners? There is a need to continue analysis of the system to determine drivers for demand and develop an evidence base on which to formulate emergency health policy, including funding models, for the future. Purely economic drivers for service demand seem unlikely to hold up and policy makers need to understand the complex relationships between service systems; end user perceptions and health literacy; and the costs of services in order to effect policy reform.

Impact of the Active Healthy Kids Canada Report Card: A 10-Year Analysis

2014 ◽  
Vol 11 (s1) ◽  
pp. S3-S20 ◽  
Author(s):  
Mark S. Tremblay ◽  
Joel D. Barnes ◽  
Jennifer Cowie Bonne
Keyword(s):  
Physical Activity ◽  
Knowledge Translation ◽  
Public Awareness ◽  
Report Card ◽  
Children And Youth ◽  
Synthesis Mechanism ◽  
Intermediate Outcomes ◽  
Stakeholder Needs ◽  
The Impact

For 20 years Active Healthy Kids Canada (AHKC) has worked to inspire the country to engage all children and youth in physical activity (PA). The primary vehicle to achieve this is the AHKC Report Card on Physical Activity for Children and Youth, which has been released annually since 2005. Using 10 years of experience with this knowledge translation and synthesis mechanism, this paper aggregates and consolidates diverse evidence demonstrating the impact of the Report Card and related knowledge translation activities. Over the years many evaluations, consultations, assessments, and surveys have helped inform changes in the Report Card to improve its impact. Guided by a logic model, the various assessments have traversed areas related to distribution and reach, meeting stakeholder needs, use of the Report Card, its influence on policy, and advancing the mission of AHKC. In the past 10 years, the Report Card has achieved > 1 billion media impressions, distributed > 120,000 printed copies and > 200,000 electronic copies, and benefited from a collective ad value > $10 million. The Report Card has been replicated in 14 countries, 2 provinces, 1 state and 1 city. AHKC has received consistent positive feedback from stakeholders and endusers, who reported that the Report Card has been used for public awareness/education campaigns and advocacy strategies, to strengthen partnerships, to inform research and program design, and to advance and adjust policies and strategies. Collectively, the evidence suggests that the Report Card has been successful at powering the movement to get kids moving, and in achieving demonstrable success on immediate and intermediate outcomes, although the long-term goal of improving the PA of Canadian children and youth remains to be realized.

Global Health, Vulnerable Populations, and Law

2013 ◽  
Vol 41 (1) ◽  
pp. 42-47
Author(s):  
Solomon R. Benatar
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Universal Access ◽  
Human Condition ◽  
Right To Health Care ◽  
Legal Provisions ◽  
Access To Health ◽  
Access To Medical Care ◽  
The Impact ◽  
Emergency Health Services

The most common response to the challenge of protecting health through law is to focus on protecting the rights of vulnerable individuals and to enhance their access to health care. Each one of us is vulnerable or potentially vulnerable because of the fragile, existential nature of the human condition. Catastrophic and unexpected events could instantaneously transform us from a state of total independence and potential vulnerability to one of extreme vulnerability and complete dependence. Some legal provisions have the potential to provide a modicum of protection when we find ourselves in those situations (for example, through legislation, effective emergency health services can be created to reduce the impact of our potential vulnerability). There are also legal provisions that contribute to beneficial social circumstances; for example, legislation enabling universal access to medical care, and operationalizing respect for the individual’s right to health care, as advocated for by other authors in this issue.

Health Service Impact from Mass Gatherings: A Systematic Literature Review

2016 ◽  
Vol 32 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Jamie Ranse ◽  
Alison Hutton ◽  
Toby Keene ◽  
Shane Lenson ◽  
Matt Luther ◽  
...  
Keyword(s):  
Health Care ◽  
Health Service ◽  
Health Services ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Ambulance Service ◽  
Local Health ◽  
Mass Gathering ◽  
Mass Gatherings ◽  
The Impact

AbstractBackgroundDuring a mass gathering, some participants may receive health care for injuries or illnesses that occur during the event. In-event first responders provide initial assessment and management at the event. However, when further definitive care is required, municipal ambulance services provide additional assessment, treatment, and transport of participants to acute care settings, such as hospitals. The impact on both ambulance services and hospitals from mass-gathering events is the focus of this literature review.AimThis literature review aimed to develop an understanding of the impact of mass gatherings on local health services, specifically pertaining to in-event and external health services.MethodThis research used a systematic literature review methodology. Electronic databases were searched to find articles related to the aim of the review. Articles focused on mass-gathering health, provision of in-event health services, ambulance service transportation, and hospital utilization.ResultsTwenty-four studies were identified for inclusion in this review. These studies were all case-study-based and retrospective in design. The majority of studies (n=23) provided details of in-event first responder services. There was variation noted in reporting of the number and type of in-event health professional services at mass gatherings. All articles reported that patients were transported to hospital by the ambulance service. Only nine articles reported on patients presenting to hospital. However, details pertaining to the impact on ambulance and hospital services were not reported.ConclusionsThere is minimal research focusing on the impact of mass gatherings on in-event and external health services, such as ambulance services and hospitals. A recommendation for future mass-gathering research and evaluation is to link patient-level data from in-event mass gatherings to external health services. This type of study design would provide information regarding the impact on health services from a mass gathering to more accurately inform future health planning for mass gatherings across the health care continuum.RanseJ, HuttonA, KeeneT, LensonS, LutherM, BostN, JohnstonANB, CrillyJ, CannonM, JonesN, HayesC, BurkeB. Health service impact from mass gatherings: a systematic literature review. Prehosp Disaster Med. 2017;32(1):71–77.

The Role of Non-Pharmacologic Approaches in the Management of Fibromyalgia

CNS Spectrums ◽  
2009 ◽  
Vol 14 (S16) ◽  
pp. 10-12
Author(s):  
David A. Williams
Keyword(s):  
Patient Education ◽  
Behavioral Therapy ◽  
Well Being ◽  
Evidence Base ◽  
Tender Point ◽  
Clinical Criteria ◽  
The Impact ◽  
Term Benefit

The optimal management of fibromyalgia (FM) is comprised of both pharmacologic and nonpharmacologic approaches. This multidimensional approach is preferred given that FM is not only a pain condition, but involves a number of other symptoms as is reflected in the new clinical criteria being developed by Wolfe and colleagues. Proper management of FM should be informed through multidimensional assessment of the clinically relevant domains described previously in this supplement. Pharmacologic and nonpharmacologic approaches work together to provide the broadest possible coverage of these domains, minimize the impact of each domain on functioning and well-being, and facilitate long-term adaptations to one's lifestyle.The use of nonpharmacologic strategies in the management of FM has varying levels of evidence. The strongest evidence currently exists for aerobic exercise, cognitive-behavioral therapy (CBT), and for patient education or self-management. Moderate evidence exists for strength training, acupuncture, hypnotherapy, and biofeedback modalities. Weaker evidence exists for manual massage therapy. Currently, there is no evidence of long-term benefit for tender point injections or flexibility exercise modalities, although these options may be beneficial in the short term. This article will focus on the three areas that have the strongest evidence base: patient education, exercise, and CBT.Educational programs are typically offered in the context of primary care or in specialty practices. In their simplest form, these programs try to dispel myths about FM and provide patients with the most up-to-date knowledge about the condition.

scholarly journals National telemental health responses to a major bushfire disaster

2012 ◽  
Vol 18 (4) ◽  
pp. 226-230 ◽  
Author(s):  
Lennart Reifels ◽  
Bridget Bassilios ◽  
Jane Pirkis
Keyword(s):  
Health Services ◽  
Disaster Response ◽  
Telemental Health ◽  
Service Access ◽  
Service Demand ◽  
Counselling Services ◽  
Related Service ◽  
Health Services Need ◽  
Crisis Support ◽  
The Impact

In response to the Victorian bushfire disaster in 2009, various telemental health services were provided by three national agencies: Kids Helpline (BoysTown), MensLine Australia (Crisis Support Services) and Lifeline Australia. All provider agencies used their existing national service structures and staff resources, which were expanded to respond to bushfire-related service demand. We examined service provider reports and conducted key informant interviews. Despite a lack of quantitative data on consumer outcomes and perspectives, it appears that all three telemental health services experienced significant increases in overall service uptake levels in the wake of the bushfires. Uptake of specialized telephone-, web-, email- and crisis counselling services was substantial, although that of callback services was very limited. Potential clients encountered specific barriers in relation to service access and the callback model. The bushfire experience highlighted the impact of transitory living circumstances and the increased complexity of post-disaster calls on service provision. Telemental health services need to be integrated into mainstream services and disaster response structures.

Lessons from long-term predator control: a case study with the red fox

2014 ◽  
Vol 41 (3) ◽  
pp. 222 ◽  
Author(s):  
Roger Kirkwood ◽  
Duncan R. Sutherland ◽  
Stuart Murphy ◽  
Peter Dann
Keyword(s):  
Population Size ◽  
Prey Species ◽  
Public Awareness ◽  
Control Period ◽  
Control Technique ◽  
Effective Control ◽  
Predator Control ◽  
Red Foxes ◽  
The Impact

Context Predator-control aims to reduce an impact on prey species, but efficacy of long-term control is rarely assessed and the reductions achieved are rarely quantified. Aims We evaluated the changing efficacy of a 58-year-long campaign against red foxes (Vulpes vulpes) on Phillip Island, a 100-km2 inhabited island connected to the Australian mainland via a bridge. The campaign aimed to eliminate the impact of foxes on ground-nesting birds, particularly little penguins (Eudyptula minor). Methods We monitored the success rate of each fox-control technique employed, the level of effort invested if available, demographics of killed foxes, the numbers of penguins killed by foxes and penguin population size. Key results The campaign began as a bounty system that ran for 30 years and was ineffective. It transitioned into a coordinated, although localised, control program from 1980 to 2005 that invested considerable effort, but relied on subjective assessments of success. Early during the control period, baiting was abandoned for less effective methods that were thought to pose fewer risks, were more enjoyable and produced carcasses, a tangible result. Control was aided by a high level of public awareness, by restricted fox immigration, and by a clear, achievable and measurable target, namely, to prevent little penguin predation by foxes. Carcasses did prove valuable for research, revealing the genetic structure and shifts in fox demographics. The failure of the program was evident after scientific evaluation of fox population size and ongoing fox impacts. In 2006, the campaign evolved into an eradication attempt, adopting regular island-wide baiting, and since then, has achieved effective knock-down of foxes and negligible predation on penguins. Conclusions Effective predator control was achieved only after employing a dedicated team and implementing broad-scale baiting. Abandoning widespread baiting potentially delayed effective control for 25 years. Furthermore, both predator and prey populations should be monitored concurrently because the relationship between predator abundance and impact on prey species is not necessarily density dependent. Implications Critical to adopting the best management strategy is evaluating the efficacy of different methods independently of personal and public biases and having personnel dedicated solely to the task.

Chipped or Whole? Listening to Survivors’ Experiences With Disclosure Following Sexual Violence

2020 ◽  
pp. 088626052096774
Author(s):  
Arielle A. J. Scoglio ◽  
Alisa Lincoln ◽  
Shane W. Kraus ◽  
Beth E. Molnar
Keyword(s):  
Sexual Violence ◽  
Interpersonal Relationships ◽  
Public Awareness ◽  
Children And Youth ◽  
Social Responses ◽  
Perceived Impact ◽  
Constant Comparative Analysis ◽  
Difficult Times ◽  
The Impact

Sexual violence is a prevalent crime but vastly underreported and with serious long-term health consequences for survivors. Disclosure of sexual violence represents a social experience that may offer support towards healing or further traumatization depending on the response received. Although current research suggests that process of disclosure itself is important, as are social responses, there is a dearth of research examining the perceived impact of initial responses to disclosure on healing and relationships, particularly over time. The current study used data from nine focus groups with 45 survivors to explore the impact of initial disclosure reactions on recovery, from the survivors’ perspectives. Constant comparative analysis identified several themes, including subtypes of positive and negative responses to disclosure and long-term impacts on healing and relationships. Survivors disclosed to informal and formal support persons and although many identified responses as positive or negative, some also experienced mixed responses. Survivors identified perceived long-term impacts on healing, interpersonal relationships, and social justice. Our findings suggest disclosures are a critical point for potential intervention after sexual violence. It is through the disclosure process that survivors can be supported and empowered to connect with others and move further along in their journey towards healing and recovery. Public awareness and promotion of positive responses could be designed to reach children and youth, so that the next generation is equipped with the tools to support each other in difficult times, particularly in the aftermath of sexual violence.

scholarly journals The MSBase pregnancy, neonatal outcomes, and women’s health registry

2021 ◽  
Vol 14 ◽  
pp. 175628642110091
Author(s):  
Vilija G. Jokubaitis ◽  
Olga Skibina ◽  
Raed Alroughani ◽  
Ayse Altintas ◽  
Helmut Butzkueven ◽  
...  
Keyword(s):  
Women’S Health ◽  
Women's Health ◽  
Assisted Reproductive Technologies ◽  
Management Strategies ◽  
Reproductive Technologies ◽  
Evidence Base ◽  
Neonatal Outcomes ◽  
Health Registry ◽  
The Impact

Background: Family planning and pregnancy decisions are key considerations in the management of women with multiple sclerosis (MS), who are typically diagnosed between the ages of 20–40 years. Despite a strong evidence base that pregnancy is not harmful for women with MS, many knowledge gaps remain. These include: best management strategies through pregnancy in the era of highly effective disease-modifying therapies (DMT); foetal risks associated with DMT exposure in utero or in relation to breastfeeding; knowledge base around the use of assisted reproductive technologies; the long-term impact of pregnancy on disease outcomes, as well as the impact of long-term DMT use on women’s health and cancer risk. Methods: Here, we describe the new MSBase pregnancy, neonatal outcomes and women’s health registry. We provide the rationale for, and detailed description of, the variables collected within the registry, together with data acquisition details. Conclusion: The present paper will act as a reference document for future studies.

scholarly journals A national study of the impact of outpatient mental health services for children in long-term foster care

2010 ◽  
Vol 15 (4) ◽  
pp. 467-479 ◽  
Author(s):  
Jennifer L. Bellamy ◽  
Geetha Gopalan ◽  
Dorian E. Traube
Keyword(s):  
Mental Health ◽  
Foster Care ◽  
Mental Health Services ◽  
Health Services ◽  
The United States ◽  
Internalizing Behavior ◽  
Outpatient Mental Health ◽  
Children In Foster Care ◽  
The Impact

Despite the tremendous mental health need evidenced by children in foster care and high rates of use of mental health services among children in foster care, little is known about the impact of outpatient mental health services on the behavioral health of this population. This study utilizes data from the National Survey of Child and Adolescent Well-being (NSCAW), the first nationally representative study of child welfare in the United States. A subsample of 439 children who have experienced long-term foster care were included in this study. These data were used to estimate the impact of outpatient mental health services on the externalizing and internalizing behavior problems of children in long-term foster care. A propensity score matching model was employed to produce a robust estimate of the treatment effect. Results indicate that children who have experienced long-term foster care do not benefit from the receipt of outpatient mental health services. Study results are discussed in the context of earlier research on the quality of mental health services for children in foster care.

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