Banks and Osterholtz Crumbling of the State Asylum

Investigating the sensitivity of projections of future long-term care expenditure in Germany, Spain, Italy and the United Kingdom to changes in assumptions about demography, dependency, informal care, formal care and unit costs.

BMC Health Services Research, 2012

Background: By measuring the quality of the organisation of palliative care with process and structure quality indicators (QIs), patients, caregivers and policy makers are able to monitor to what extent recommendations are met, like those of the council of the WHO on palliative care and guidelines. This will support the implementation of public programmes, and will enable comparisons between organisations or countries. Methods: As no European set of indicators for the organisation of palliative care existed, such a set of QIs was developed. An update of a previous systematic review was made and extended with more databases and grey literature. In two project meetings with practitioners and experts in palliative care the development process of a QI set was finalised and the QIs were categorized in a framework, covering the recommendations of the Council of Europe. Results: The searches resulted in 151 structure and process indicators, which were discussed in steering group meetings. Of those QIs, 110 were eligible for the final framework. Conclusions: We developed the first set of QIs for the organisation of palliative care. This article is the first step in a multi step project to identify, validate and pilot QIs.

2021

She has written extensively on social policies and social and political economy of care in East Asia. She teaches and researches on comparative social policy, specializing in family, gender, employment and migration policies in East Asia and Asia Pacific. She leads the Gender, Migration, and the Work of Care Program, and international partnership research project funded by Social Sciences and Humanities Research Council of Canada. She is also a distinguished fellow of Asia Pacific Foundation of Canada and a Research Associate at United Nations Research Institute for Social Development (UNRISD) and UN Women. Her new book (2017), co-edited with Sonya Michel, is called Gender, Migration and the Work of Care: A Multi-Scaler Approach to the Pacific Rim.

The Lancet Oncology, 2012

The burden of cancer in Asia is high; 6·1 million new cases were diagnosed in the continent in 2008, which accounted for 48% of new cases worldwide. Deaths from cancer are expected to continue to rise because of ageing populations and modifi able risk factors such as tobacco and alcohol use, diet, and obesity. Most patients who are diagnosed with cancer in Asia have advanced disease that is not amenable to curative treatment, which means that they are likely to have pain and other symptoms and psychosocial concerns. These burdens vary with the economic and political situation of the diff erent countries and are aff ected by such factors as an absence of screening programmes, insuffi cient cancer diagnostic and treatment services (especially in sparsely populated and rural areas), legal restrictions on access to drugs to relieve pain, and a medical culture in which quality-of-life considerations are undervalued in relation to imperatives to treat. These issues could be ameliorated by increased investment in cancer screening, removal of restrictions on prescription of opioids, and improvements in medical education to increase recognition of treatment futility. Supportive, palliative, and end-of-life care off er the potential to enhance quality of life, improve pain control, and reduce suff ering for patients with cancer and their families, and to give patients a dignifi ed death. All patients should have access to such care-in resource-rich regions these services should be integrated into oncology services, whereas in resource-poor regions they should be the main focus of treatment. The form of care should depend on the economic circumstances within and across countries, and recommendations are made across four resource classifi cations (basic to maximal) to take account of the diversity of settings in Asia. e493 www.thelancet.com/oncology Vol 13 November 2012 Review and nature of health-care systems in diff erent countries and are subject to change over time. For example, in the UK, terms related to palliative care have undergone several transitions, from hospice care and terminal care in the early period of the hospice movement (1960s and 1970s) to palliative care towards the turn of the century ; since 2008, end-of-life care has emerged as the preferred term. In this Review, we use the defi nitions provided in panel 1.

GMB, 2020

Personalisation challenges orthodox understandings of what it means to be 'a professional' because the professional care worker is not a 'know-it-all' expert. Instead, the expertise of the care worker must be deployed to enable service-users in complex circumstances, with complex care or support needs, to co-design or direct their support and care. 25 HM Government et al, 'Putting People First: A shared vision and commitment to the transformation of Adult Social Care' (HM Government, 2007). 26 Department of Health (fn24). 27 In England, service-users must be allocated, and informed of, a personal budget (see s26, Care Act 2014). Their personal budget can be spent on their behalf by the local authority or allocated directly to them in the form of a direct payment (see s31-33, Care Act 2014). There are also options for a personal budget to be managed by third-parties Department of Health and Social Care, 'Care and support statutory guidance' (updated 26 October 2018) https://www.gov.uk/government/publications/care-actstatutory-guidance/care-and-support-statutory-guidance#Chapter11 accessed

Journal of Clinical Oncology, 2009

Purpose In 1998, the American Society of Clinical Oncology (ASCO) published a special article regarding palliative care and companion recommendations. Herein we summarize the major accomplishments of ASCO regarding palliative cancer and highlight current needs and make recommendations to realize the Society's vision of comprehensive cancer care by 2020. Methods ASCO convened a task force of palliative care experts to assess the state of palliative cancer care in the Society's programs. We reviewed accomplishments, assessed current needs, and developed a definition of palliative cancer. Senior ASCO members and the Board of Directors reviewed and endorsed this article for submission to Journal of Clinical Oncology. Results Palliative cancer care is the integration into cancer care of therapies that address the multiple issues that cause suffering for patients and their families and impact their life quality. Effective provision of palliative cancer care requires an interdiscip...

Interview, 2024

Care is a situation-driven polysemantic term. Acclimatizing to di ferent contexts, like a shape-shi ter, it interacts with the corporeal world in diverse ways. Although the type of care required varies with the context, the need for care remains constant. In this interview with Professor Maurice Hamington, conducted via a chain of emails in April 2024, we discuss this variety of philosophical understandings of care. Maurice Hamington, philosopher and feminist ethicist, is a professor at Portland State University. He has written and edited teen books, numerous book chapters, and research articles, which has contributed to consolidating "care" as a eld of study. We also brie ly discuss his latest book, Revolutionary Care: Commitment and Ethos (2024). More so, this interview covers a wide range of di ferent contexts for performing and thinking care, such as altruism, feminism, religion, and posthumanism. Pragya Dev & Binod Mishra: Care has been tethered to health (health care) in its rudimentary but widespread understanding. How can we overcome this limited understanding? Maurice Harrington: Care is a ubiquitous term that is employed in a variety of ways. Indeed, care is most closely associated with medical treatment. Depending upon the international context, "care" is interpreted di ferently. For example, Italian theorists[1] tell me that "care" is understood as the e fort toward "cure" in Italian contexts. However, whatever the name given to care, including compassion, tenderness, tending to, meeting needs, and the like, care is essential to human survival and lourishing. Newborn babies require care to survive, and of course, those ill and hurt need care, but the truth is

2009

BMC pregnancy and childbirth, 2016

This study aims to give insight into the opinions of maternity care professionals and other stakeholders on the integration of midwife-led care and obstetrician-led care and on the facilitating and inhibiting factors for integrating maternity care. Qualitative study using interviews and focus groups from November 2012 to February 2013 in the Netherlands. Seventeen purposively selected stakeholder representatives participated in individual semi-structured interviews and 21 in focus groups. One face-to-face focus group included a combined group of midwives, obstetricians and a paediatrician involved in maternity care. Two online focus groups included a group of primary care midwives and a group of clinical midwives respectively. Thematic analysis was performed using Atlas.ti. Two researchers independently coded the interview and focus group transcripts by means of a mind map and themes and relations between them were described. Three main themes were identified with regard to integrat...

BMC Palliative Care, 2020

Background Despite the high potential to improve the quality of life of patients and families, palliative care services face significant obstacles to their use. In countries with high-resource health systems, the nonfinancial and nonstructural obstacles to palliative care services are particularly prominent. These are the cognitive barriers -knowledge and communication barriers- to the use of palliative care. To date no systematic review has given the deserved attention to the cognitive barriers and facilitators to palliative care services utilization. This study aims to synthesize knowledge on cognitive barriers and facilitators to palliative care use in oncology and hemato-oncology from the experiences of health professionals, patients, and their families. Methods A systematic review was conducted. PubMed, PsycINFO, International Association for Hospice and Palliative Care/Cumulative Index of Nursing and Allied Health Literature (IAHPC/CINAHL), and Communication & Mass Media Compl...

5th ESPAnet conference, 2007

Since the 1980s, most western European countries have restructured home based elder care and this has created a new balance between the logic of the state, the market and the family. This paper analyses different types of policies introduced across countries in long-term care delivery to increase choice in long-term care delivery. Policies tend to draw on a range of different logics and the paper analyses the conflicts between these logics. The analysis also discusses the outcomes of the reforms for care receivers as well as for formal and informal carers.

Journal of Pain and Symptom Management, 2021

Context. This article provides a progress update on the development of palliative care in five countries in Africa-Kenya, Rwanda, South Africa, Tanzania, and Uganda-between 2017 and 2021, and explores the role of palliative care advocates and the Open Society Foundations in this process. Objectives. To provide a progress update on the development of palliative care in Kenya, Rwanda, South Africa, Tanzania, and Uganda between 2017 and 2021 and to examine the impact of twenty years of Open Society Foundations support for palliative care in the region on the integration of palliative care into publicly funded health systems. Methods. In the mid-2000s, palliative care pioneers in these five countries, supported by Open Society Foundations, began to train health care providers and engage policy makers to ensure that people with life-limiting illnesses and their families had access to appropriate services and essential medicines. In the late 2010s, it embraced an approach that mixed strategic communications and advocacy for inclusion of palliative care into universal health coverage with technical assistance. Results. By the mid-2010s, a vibrant palliative care community existed that worked closely with governments to develop palliative care policies, train providers, and ensure access to morphine. By 2021, Kenya and Rwanda had made significant progress scaling up palliative care services as part of the public health care system, and Uganda's government had instructed public hospitals to start providing these services. In South Africa and Tanzania, governments had yet to commit to publicly funded palliative care services. Conclusion. The experiences in these countries suggest that mixing advocacy, communications, and technical assistance can lead to substantial progress for patient access although full inclusion in universal health coverage remained uncertain in all but Rwanda.

BMC Health Services Research, 2021

Background The objective of this systematic review is to appraise evidence on the economic evaluations of advanced practice physiotherapy (APP) care compared to usual medical care. Methods Systematic searches were conducted up to September 2021 in selected electronic bibliographical databases. Economic evaluation studies on an APP model of care were included. Economic data such as health care costs, patient costs, productivity losses were extracted. Methodological quality of included studies was assessed with the Effective Public Health Practice Project tool and the Critical Appraisal Skills Programme checklist. Meta-analyses were performed and mean differences (MD) in costs per patient were calculated using random-effect inverse variance models. Certainty of the evidence was assessed with the GRADE Approach. Results Twelve studies (n = 14,649 participants) including four randomized controlled trials, seven analytical cohort studies and one economic modeling study were included. The...

2004

In dem Discussion-paper wird die Entwicklung der ambulanten, stationären und semi-stationären Pflegeinfrastruktur seit der Einführung der Pflegeversicherung analysiert und mit einer Darstellung niedrig-schwelliger Angebote auf lokaler Ebene ergänzt. Zugänglichkeit und Inanspruchnahme der vorhandenen Dienstleistungsangebote werden aus der Perspektive unterschiedlicher Gruppen älterer Menschen betrachtet. Die Ergebnisse basieren auf einer Analyse von Statistiken und Berichten sowie auf Interviews mit Experten/innen. Die Untersuchung bestätigt die Expansion ambulanter Pflegedienste seit Einführung der Pfle-geversicherung sowie die Modernisierung und zunehmende Diversifikation stationärer Wohnformen seit den 1980er Jahren. Der steigende Anteil von Empfängern/innen von Pflegeversicherungs-leistungen die in Pflegeheimen versorgt werden, verweist auf Probleme der Versorgung älterer Men-schen in der häuslichen Pflege. Dies betrifft den Ausbau und die inhaltliche Konzeption der semi-sta-tion...

British Journal of General Practice, 2013