259 research outputs found
Making a Difference: A Qualitative Study on Care and Priority Setting in Health Care
The focus of the study is the conflict between care and concern for particular patients, versus considerations that take impartial considerations of justice to be central to moral deliberations. To examine these questions we have conducted qualitative interviews with health professionals in Norwegian hospitals. We found a value norm that implicitly seemed to overrule all others, the norm of ‘making a difference for the patients’. We will examine what such a statement implies, aiming to shed some light over moral dilemmas interwoven in bedside rationing
Comparative Network Analysis of Preterm vs. Full-Term Infant-Mother Interactions
Several studies have reported that interactions of mothers with preterm infants show differential characteristics compared to that of mothers with full-term infants. Interaction of preterm dyads is often reported as less harmonious. However, observations and explanations concerning the underlying mechanisms are inconsistent. In this work 30 preterm and 42 full-term mother-infant dyads were observed at one year of age. Free play interactions were videotaped and coded using a micro-analytic coding system. The video records were coded at one second resolution and studied by a novel approach using network analysis tools. The advantage of our approach is that it reveals the patterns of behavioral transitions in the interactions. We found that the most frequent behavioral transitions are the same in the two groups. However, we have identified several high and lower frequency transitions which occur significantly more often in the preterm or full-term group. Our analysis also suggests that the variability of behavioral transitions is significantly higher in the preterm group. This higher variability is mostly resulted from the diversity of transitions involving non-harmonious behaviors. We have identified a maladaptive pattern in the maternal behavior in the preterm group, involving intrusiveness and disengagement. Application of the approach reported in this paper to longitudinal data could elucidate whether these maladaptive maternal behavioral changes place the infant at risk for later emotional, cognitive and behavioral disturbance
Adolescence and the next generation.
Adolescent growth and social development shape the early development of offspring from preconception through to the post-partum period through distinct processes in males and females. At a time of great change in the forces shaping adolescence, including the timing of parenthood, investments in today's adolescents, the largest cohort in human history, will yield great dividends for future generations
Social and ethical criteria for prioritizing patients: a survey of students and health professionals in Portugal
O estudo quali-quantitativo explora
o dilema ético da microalocação dos recursos da
saúde. Objetiva identificar e comparar a opinião
de dois grupos da sociedade portuguesa - estudantes
e profissionais de saúde sobre a importância
das caracterÃsticas pessoais dos pacientes no momento
de os priorizar e se as escolhas se explicam
por referenciais bioéticos de caráter utilitaristas ou
deontológicos. Os dados foram recolhidos através
de um questionário aplicado a uma amostra de
180 estudantes universitários e 60 profissionais de
saúde. Os respondentes perante hipotéticos cená-
rios de emergência clÃnica tiveram de escolher de
entre dois pacientes (distinguidos por idade, sexo,
responsabilidade social, situação económica e laboral,
comportamentos lesivos da saúde e registo
criminal) quem tratar e justificar a escolha. Foram
usados testes estatÃsticos de associação para
comparar as respostas dos dois grupos e análise
de conteúdo para categorizar as justificações. Os
resultados sugerem a existência de diferenças nas
escolhas dos dois grupos, com os profissionais de
saúde a revelarem aceitar menos a utilização de
critérios sociais em contexto de escassez e coexistência
de critérios utilitaristas e deontológicos,
com predomÃnio da eficiência por parte dos profissionais
de saúde e da equidade por parte dos
estudantesThis qualitative/quantitative study examines
the ethical dilemma of microallocation of
health resources. It seeks to identify and compare
the opinion of two groups in Portuguese society
– students and health professionals – on the importance
of personal characteristics of patients at
the moment of prioritizing them and if the choices
can be explained by bioethical references of a
utilitarian or deontological nature. Data were
collected by means of a questionnaire administered
to a sample of 180 students and 60 health
professionals. Faced with hypothetical emergency
scenarios, the respondents had to choose between
two patients (distinguished by: age, gender, social
responsibility, economic and employment
situation, harmful health behaviors and criminal
record), duly selecting who to treat and then
justifying their choice. The results suggest the existence
of differences in choices between the two
groups, with health professionals revealing they
are less prepared to accept the use of social criteria
in a context of scarce resources and co-existence
of utilitarian and deontological criteria, with a
predominance of efficiency on the part of health
professionals and equity on the part of students.info:eu-repo/semantics/publishedVersio
Arbeitsangebotseffekte einer subventionierten Altersteilzeitregelung in Österreich
In this paper we evaluate the impact of the old-age part-time scheme (OAPT) on the Austrian labor market which was a policy to allow flexible retirement options for the elderly with an aim to increase labor supply. According to our matching estimates, employment probability increases slightly; especially in the first two years after entrance into the programme. Furthermore, the programme seems to reduce the measured unemployment risk. However, the total number of hours worked is significantly reduced by OAPT. While the policy is meant to reduce early exit from the labor force by allowing part-time work, our analysis indicates that most workers substitute part-time work for full-time work and thus the overall effect is rather negative
Progress in adolescent health and wellbeing: tracking 12 headline indicators for 195 countries and territories, 1990–2016
Background: Rapid demographic, epidemiological, and nutritional transitons have brought a pressing need to track progress in adolescent health. Here, we present country-level estimates of 12 headline indicators from the Lancet Commission on adolescent health and wellbeing, from 1990 to 2016.
Methods: Indicators included those of health outcomes (disability-adjusted life-years [DALYs] due to communicable, maternal, and nutritional diseases; injuries; and non-communicable diseases); health risks (tobacco smoking, binge drinking, overweight, and anaemia); and social determinants of health (adolescent fertility; completion of secondary education; not in education, employment, or training [NEET]; child marriage; and demand for contraception satisfied with modern methods). We drew data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016, International Labour Organisation, household surveys, and the Barro-Lee education dataset.
Findings: From 1990 to 2016, remarkable shifts in adolescent health occurred. A decrease in disease burden in many countries has been offset by population growth in countries with the poorest adolescent health profiles. Compared with 1990, an additional 250 million adolescents were living in multi-burden countries in 2016, where they face a heavy and complex burden of disease. The rapidity of nutritional transition is evident from the 324·1 million (18%) of 1·8 billion adolescents globally who were overweight or obese in 2016, an increase of 176·9 million compared with 1990, and the 430·7 million (24%) who had anaemia in 2016, an increase of 74·2 million compared with 1990. Child marriage remains common, with an estimated 66 million women aged 20–24 years married before age 18 years. Although gender-parity in secondary school completion exists globally, prevalence of NEET remains high for young women in multi-burden countries, suggesting few opportunities to enter the workforce in these settings.
Interpretation: Although disease burden has fallen in many settings, demographic shifts have heightened global inequalities. Global disease burden has changed little since 1990 and the prevalence of many adolescent health risks have increased. Health, education, and legal systems have not kept pace with shifting adolescent needs and demographic changes. Gender inequity remains a powerful driver of poor adolescent health in many countries.
Funding: Australian National Health and Medical Research Council, and the Bill & Melinda Gates Foundatio
Age and skill bias of trade liberalisation? : heterogeneous employment effects of EU Eastern Enlargement
This study analyses the 2004 Eastern Enlargement to the European Union to
obtain evidence on the employment effects of an increase in trade liberalisation. The
Enlargement is thought to generate a trade-induced demand shock with no (or only
limited) supply effects. Besides the variation over time induced by the Enlargement,
identification of the effects is based on a Melitz (2003) type productivity term to
differentiate firms by the extent of exposure to the demand shock. The idea is that the
effects of the demand shock should be driven by differences in firm-level productivity
from the period before the new member countries actually entered the EU. German
linked employer-employee data allow to observe the relation of initial establishment
productivity with employment changes over a long panel from 1995 to 2009. The
estimates show that the Enlargement had a negative effect on establishment-level
employment growth, which is driven by increased worker separations and increased
job destruction. Besides the overall employment effect, the study focuses on effect
heterogeneity across age and skill groups of the workforce. These estimates point to a
skill bias in the effect of the Enlargement that disadvantages low- and medium-skilled
workers in terms of higher worker separation and job destruction. In addition, lowskilled
workers suffer fewer accessions by firms, where against medium-skilled workers
enjoy increased accessions and creation of new jobs. Besides this indication for a skill
bias, there are no clear indications that point to an age bias in the employment effect
of the Eastern Enlargement
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