Statut socio-économique et utilisation des services de santé à Montréal

National health insurance was implemented in Quebec in late 1970. Previously reported surveys carried out in Montreal in 1969-70 and 1971-72 showed that while there was no change in overall volume of services, there was a redistribution, with increases among the poor and decreases among the wealthy. We conducted a survey in late 1974 to determine the "steady-state" impact of l’assurance-maladie on social class differences in health care utilization. In a socially heterogeneous area of Montreal 1,559 households were surveyed. When reported morbidity status was taken into account, physician visit rates in the past two weeks were 21.6 per cent, 20.2 per cent, and 20.4 per cent in low, middle and high economic classes respectively, confirming the disparity of access has been reduced. However, relative to the non-poor, the poor still made considerable use of hospital clinics and emergency rooms for primary care and more of their visits entailed prescriptions and physician-initiated requests to return. The latter may indicate that the poor still consult the doctor for more advanced conditions than the non-poor. There is no evidence of abuse of "free" medical care by the poor. In contrast to the equalization in use of physician services, dental services are still unequally distributed, although compared with the 1969-70 and 1971-72 surveys, utilization rates were higher in 1974 in all social classes. The overall increase in per capita physician visits was confirmed by statistics of the Régie de l’assurance-maladie du Québec. A parallel increase in the supply of physicians kept the workload of the average physician at a constant level

Statut socio-économique et utilisation des services de santé à Montréal

National health insurance was implemented in Quebec in late 1970. Previously reported surveys carried out in Montreal in 1969-70 and 1971-72 showed that while there was no change in overall volume of services, there was a redistribution, with increases among the poor and decreases among the wealthy. We conducted a survey in late 1974 to determine the "steady-state" impact of l’assurance-maladie on social class differences in health care utilization. In a socially heterogeneous area of Montreal 1,559 households were surveyed. When reported morbidity status was taken into account, physician visit rates in the past two weeks were 21.6 per cent, 20.2 per cent, and 20.4 per cent in low, middle and high economic classes respectively, confirming the disparity of access has been reduced. However, relative to the non-poor, the poor still made considerable use of hospital clinics and emergency rooms for primary care and more of their visits entailed prescriptions and physician-initiated requests to return. The latter may indicate that the poor still consult the doctor for more advanced conditions than the non-poor. There is no evidence of abuse of "free" medical care by the poor. In contrast to the equalization in use of physician services, dental services are still unequally distributed, although compared with the 1969-70 and 1971-72 surveys, utilization rates were higher in 1974 in all social classes. The overall increase in per capita physician visits was confirmed by statistics of the Régie de l’assurance-maladie du Québec. A parallel increase in the supply of physicians kept the workload of the average physician at a constant level.

Learning from a distance : the experience of remote students

While there has been research into the provision of &lsquo;distance&rsquo; and &lsquo;off-campus&rsquo; education, both in relation to technology and to curriculum, little attention has been given to the experiences of students studying in geographically remote locations, where the remoteness has been an aspect of investigation. This study aimed to investigate the experiences of such students, and to suggest strategies to support them. The students recruited for this project were undergraduate and postgraduate students from remote locations around Australia who had studied at Deakin University between 2003 through 2007. They were interviewed by telephone. The three key issues identified by participants were a sense of isolation, the attitudes and knowledge of the teaching staff; and students&rsquo; knowledge and use of learning technologies.<br /

Clinical academic career pathway for nursing and allied health professionals: clinical academic role descriptors

The clinical academic pathway outlined highlights the range of typical practice and research-focused activities that a practitioner on a clinical academic career pathway might normally engage in at different levels and points along this career path. The activities are intended as a guide for practitioners interested in learning more about the practice and research components of a clinical academic career, as well as those already employed in clinical academic roles. They may also be useful for health care organisations and Higher Education Institutions as a tool for developing clinical academic roles

Flower Valley se ondervinding in die blombedryf, 2006 tot 2008

Flower Valley Conservation Trust is 'n gemeenskapsorganisasie wat hom tot die volhoubare oes van veldblomme beywer in die hoop dat dit tot die bewaring van fynbosveld sal lei. Fynbos is die wereld se kleinste, mees diverse en moontlik mees bedreigde plantkoningkryk - daar kom ongeveer negeduisend plantspesies in 'n gebied van slegs 8.8 miljoen hektaar voor, en daar word geraam dat reeds 29% van die oorspronklike verspreidingsgebied van fynbos verlore is (Rouget et al, 2003). As bewaringsinitiatief was Flower Valley tot dusver so besig om te bewys dat veldblomme 'n lewensvatbare biodiversiteitsbesigheid is, dat daar nie genoeg gedoen is om die doel, oogmerke en belangrikste resultate van die trust met die gemeenskap tot wie se voordeel die trust werk, te deel nie. Die bladskrif is die eerste poging om die leemte te vul

The core minimum dataset for measuring pain outcomes in pain services across Scotland. Developing and testing a brief multi-dimensional questionnaire

BACKGROUND: There is currently no agreed minimum dataset to inform specialist chronic pain service provision. We aimed to develop a Core Minimum Dataset (CMD) for pain services in Scotland and perform preliminary analysis to evaluate its psychometric properties in adults with chronic pain. METHODS: The questionnaire was developed following a review of existing relevant data collection instruments and national consultation. The CMD questionnaire was completed alongside a routine pre-clinic questionnaire by patients attending two pain services over 3 months. Concurrent validity was tested by comparing scores between the CMD and pre-existing questionnaires. Reliability was assessed by test-retest and discriminative validity via receiver operating characteristic (ROC) curves. RESULTS: The final CMD questionnaire consisted of five questions on four domains: pain severity (Chronic Pain Grade [CPG] Q1); pain interference (CPG Q5); emotional impact (Patient Health Questionnaire-2 [PHQ-2], two questions); and quality of life (Short Form Health Survey-36 [SF-36] Q1). 530 patients completed the questionnaire. Strong correlation was found with the Hospital Anxiety and Depression Scale (r(s) = 0.753, p < 0.001). Moderate correlations were found with the Brief Pain Inventory for pain interference (r(s) = 0.585, p < 0.001) and pain severity (r(s) = 0.644, p < 0.001). Moderate to good reliability was demonstrated (Intra-class Correlation Coefficient = 0.572–0.845). All items indicated good discrimination for relevant health states. CONCLUSIONS: The findings represent initial steps towards developing an accurate questionnaire that is feasible for assessing chronic pain in adults attending specialist pain clinics and measuring service improvements in Scotland. Further validation testing, in clinical settings, is now required

MoDOT Pavement Preservation Research Program

The following report documents a research project on pavement preservation performed by the Missouri University of Science and Technology (Missouri S&T) and the University of Missouri-Columbia (UMC) on behalf of the Missouri Department of Transportation (MoDOT). the report consists of a Summary Report followed by six detailed technical reports. to achieve the goal of reducing maintenance costs and improving minor road ratings, MoDOT has embarked upon a plan of formalizing its maintenance/preservation planning. to assist in developing the plan, MoDOT contracted with the Missouri S&T and UMC to conduct a research project, entitled MoDOT Pavement Preservation Research Program . the product of this research would become a part of MoDOT’s overall Pavement Management System. the overall objective of the research was to provide a process that would allow MoDOT to do more selective planning, better engineering and more effective maintenance to minimize costs while maintaining adequate safety and performance of Missouri’s pavements. Six Guidance Documents were to ultimately be created which would act as guidelines for MoDOT’s Pavement Specialists and Engineers. the work was divided into six Tasks, each with its own research team

Listing Occupational Carcinogens

The occupational environment has been a most fruitful one for investigating the etiology of human cancer. Many recognized human carcinogens are occupational carcinogens. There is a large volume of epidemiologic and experimental data concerning cancer risks in different work environments. It is important to synthesize this information for both scientific and public health purposes. Various organizations and individuals have published lists of occupational carcinogens. However, such lists have been limited by unclear criteria for which recognized carcinogens should be considered occupational carcinogens, and by inconsistent and incomplete information on the occupations and industries in which the carcinogenic substances may be found and on their target sites of cancer. Based largely on the evaluations published by the International Agency for Research on Cancer, and augmented with additional information, the present article represents an attempt to summarize, in tabular form, current knowledge on occupational carcinogens, the occupations and industries in which they are found, and their target organs. We have considered 28 agents as definite occupational carcinogens, 27 agents as probable occupational carcinogens, and 113 agents as possible occupational carcinogens. These tables should be useful for regulatory or preventive purposes and for scientific purposes in research priority setting and in understanding carcinogenesis