Det sunde væsen og de syge brugere

The health service and sick users This article advocates applied social research, in particular cultural sociological analyses of welfare state policies. An example of this is the author’s own research in the con-cept of user and the meaning of that concept in the public health sector. The concept of user in the health sector is socially constructed and makes sense at the politi-cal and administrative levels, but it has little relevance to everyday experience. The layperson’s view-point is deter-mined by his or her everyday circumstances, and thus influenced by subjective, experiential factors. The article concludes that despite the emphasis on a user-centered approach in the health sector, the layperson’s perspective is still stifled

A population-based study of patients in Danish hospitals who are in their last year of life

Introduction: Little is known about the prevalence and distribution in Denmark of hospital inpatients who are in their last year of life. Knowledge about these patients could attract attention towards needs for their identification and for optimisation of end-of-life care initiatives. The aims of this study were to determine the proportion of prevalent in-patients who died during the following 12 months, to present characteristics among deceased and survivors, and to identify in which hospitals, departments or specialities imminently dying patients appear most frequently. Methods: This was a record-linkage cohort study of all patients, who were in public somatic hospitals in Denmark on 10 April 2013. Patients were followed for one year. Results: A total of 13,412 inpatients were resident in 26 Danish hospitals on 10 April 2013 (range: 1,173-106 patients per hospital). 22% died during the one-year follow-up (range: 17-37% per hospital. 24% men, 20% women); 27% in medical, 15% in surgical and 50% in oncological/haematological departments. The median time to death was 59 days (54/66 days for women/men). 61% died in hospital. Deceased patients were older than survivors (76 versus 64 years, median) and had longer hospital index-stays (13 versus six days, median). 25% of the deceased (n = 740) died during the index episode, corresponding to 5.5% of all the prevalent inpatients. Conclusions: More than one in five inpatients in Danish hospitals are imminently dying or in their last year of life. Knowledge of the patients’ uneven distribution in the hospital system can underpin organisational strategies to focus on end-of-life care provision

A population-based study of patients in Danish hospitals who are in their last year of life

Introduction: Little is known about the prevalence and distribution in Denmark of hospital inpatients who are in their last year of life. Knowledge about these patients could attract attention towards needs for their identification and for optimisation of end-of-life care initiatives. The aims of this study were to determine the proportion of prevalent in-patients who died during the following 12 months, to present characteristics among deceased and survivors, and to identify in which hospitals, departments or specialities imminently dying patients appear most frequently. Methods: This was a record-linkage cohort study of all patients, who were in public somatic hospitals in Denmark on 10 April 2013. Patients were followed for one year. Results: A total of 13,412 inpatients were resident in 26 Danish hospitals on 10 April 2013 (range: 1,173-106 patients per hospital). 22% died during the one-year follow-up (range: 17-37% per hospital. 24% men, 20% women); 27% in medical, 15% in surgical and 50% in oncological/haematological departments. The median time to death was 59 days (54/66 days for women/men). 61% died in hospital. Deceased patients were older than survivors (76 versus 64 years, median) and had longer hospital index-stays (13 versus six days, median). 25% of the deceased (n = 740) died during the index episode, corresponding to 5.5% of all the prevalent inpatients. Conclusions: More than one in five inpatients in Danish hospitals are imminently dying or in their last year of life. Knowledge of the patients’ uneven distribution in the hospital system can underpin organisational strategies to focus on end-of-life care provision

Siseveekogud : õpik kõrgkoolidele

Inimeste kõige tavalisemad seosed siseveekogudega on matkamine, kalapüük, suplemine, janu kustutamine ja taimede kastmine. Et veekogude ääres viibimine mõjub paljudele rahustavalt, on jõgedel-järvedel miljonivaadete kaudu kindel koht ka kinnisvaraäris. Veekogudeta ei saa läbi sportlased (purjetajad, sõudjad ja motohuvilised). Leidub selliseidki indiviide, keda meelitavad mittesöödavad või koguni palja silmaga nähtamatud vee-elanikud. Eesti on väike madal maa, millel on pikk mererand, aga kus leidub ka palju siseveekogusid. Eriline on kahe suure järve – Peipsi ja Võrtsjärve – asumine lähestikku. Seisuvete pindala osakaalu järgi kogu riigi pindalast on Eesti Euroopas pärast Soomet ja Rootsit koos Norraga kolmandal-neljandal kohal. Eesti ja tema ümbrus on puhta veega seni niisiis hästi varustatud, kuid see rikkus ühtlasi kohustab veekogusid heaperemehelikult ja jätkusuutlikult majandama. Ka Eestis on muresid nii veevarude, veekogude kui nende seisundiga. Sisevete uurimine on Eestis kestnud juba üle 100 aasta. Seda on süstemaatiliselt korraldanud nii Looduseuurijate Selts, Tartu Riiklik Ülikool, Teaduste Akadeemia kui Maaülikool. Suurte järvede kõrval pole unustatud väikesi järvi ega vooluveekogusid. Uurida vee ja veekogude omadusi, arendada ja kasvatada nende spetsialiste ongi mõistlik seal, kus on, mida tundma õppida. Üha enam leitakse seoseid looduslike ja inimtekkeliste mõjurite ning ökosüsteemide vastuste vahel. Ühtlasi ühendatakse neid seoseid sotsiaalmajanduslike küsimuste ja looduskaitsega. Eesti siseveekogude kohta on peale arvukate ja enamasti võõrkeelsete teadusartiklite ilmunud ka eestikeelseid raamatuid. Siin neist väike loetelu: väikejärved (Eesti järved, 1968; Mäemets, 1977; Laarmaa jt 2019); Võrtsjärv (1973, 2003); Peipsi (1999, 2008), vooluveed (Järvekülg jt 2001; Timm jt 2019). Kalaraamatuid esindavad Mikelsaar (1984) ning Hunt (2019), veetaimi „Eesti taimede määraja“ (2010). Silmaga nähtavate veeselgrootute ülevaate pakub Timm (2015). Ülevaatlikku eestikeelset õpikut siseveekogude ning nende talitlemise kohta seni polnud. Eesti ülikoolides on kõigil kolmel õppetasandil (bakalaureuse-, magistri- ja doktoriõpe) õppekavasid, kus vajatakse teadmisi siseveekogudest. Võõrkeelseid eeskujusid leidub päris mitu, kuid need käsitlevad enamasti kas ainult hüdrobioloogiat või limnoloogiat. Esimene on elustiku-, teine keskkonna-alase suunitlusega. Uus õpik sisaldab mõlemaid ning sobib loodetavasti paljudele loodusteaduslikele ja looduskaitselistele kursustele, eriti bakalaureusetasemel. Õpik koosneb kolmest suurest alajaotusest: (1) siseveekogude füüsikalis-keemiline iseloomustus, levik ja teke; (2) elupaigad veekogudes, olulised elustikurühmad ning nendevahelised suhted; (3) siseveekogude majandamine, kaitse ja tervendamine. Peamiselt vaadeldakse Eesti siseveekogusid, aga seda kogu maailma taustal. Koostajad loodavad, et raamat annab lugejatele nii vastuseid küsimustele kui ka süvendab huvi sisevete kui kaunite, põnevate ning inimestele eluliselt oluliste loodusobjektide suhtes.Õpik on valminud riikliku programmi „Eestikeelsete kõrgkooliõpikute koostamine ja väljaandmine (2008–2012)“ raames ning Eesti Maaülikooli ja Sihtasutuse Archimedes osalisel toel