Literatura científica selecionada sobre o tema "Health and medical services in society"

This article discusses the effectiveness of digital health services by looking at the challenges and obstacles for society. One form of public services implemented by the government for the community is meeting the need for quality public services and having an orientation to the effectiveness of services to the community that are needed. In the health sector itself, advances in information technology have greatly supported health services. This online system is of high quality to be implemented because the public and members of the medical system can receive and provide detailed and fast information with the help of computerized technology. Information technology has reached various fields of life including the health sector to help the efficiency and effectiveness of health services. Information technology that is properly implemented can support the management process to be effective and efficient. The corona pandemic is changing people's habits in visiting and consulting doctors at hospitals. However, digital-based health services have not been effectively accepted by the public from various service units. They still need improvements in terms of connectivity, content and clarity of regulations.

This article reviews the hegemonic understanding of health services research in the United States and in the Anglo-Saxon world, taking as a point of reference the recently published PAHO anthology, Health Services Research: An Anthology (which contains the classics in health services research). The author outlines the main characteristics of health services research in the United States, and criticizes the focus on medical care of most health services research literature and the narrow spectrum of positions presented in that literature. He concludes that there is an urgent need for analyses of the socioeconomic and political forces that determine the level of health and the type of health services that exist in any society, analyses that are usually avoided in health services research.

Aged people are challenged by serious complications from chronic diseases, such as mood disorder, diabetes, heart disease, and infectious diseases, which are also the most common causes of death in older people. Therefore, elderly care facilities are more important than ever. The most common causes of death in elderly care facilities were reported to be diabetes, cardiovascular disease, and pneumonia. Recently, the coronavirus disease 2019 (COVID-19) pandemic have a great impact on blind spots of safety where aged people were isolated from society. Elderly care facilities were one of the blind spots in the midst of the pandemic, where major casualties were reported from COVID-19 complications because most people had one or two mortality risk factors, such as diabetes or cardiovascular disease. Therefore, medical governance of public health center and hospital, and elderly care facility is becoming important issue of priority. Thus, remote health monitoring service by the Internet of Medical Things (IoMT) sensors is more important than ever. Recently, technological breakthroughs have enabled healthcare professionals to have easy access to patients in medical blind spots through the use of IoT sensors. These sensors can detect medically urgent situations in a timely fashion and make medical decisions for aged people in elderly care facilities. Real-time electrocardiograms and blood sugar monitoring sensors are approved by the medical insurance service. Real-time monitoring services in medical blind spots, such as elderly care facilities, has been suggested. Heart rhythm monitoring could play a role in detecting early cardiovascular disease events and monitoring blood glucose levels in the management of chronic diseases, such as diabetes, in aged people in elderly care facilities. This review presents the potential usefulness of remote monitoring with IoMT sensors in medical blind spots and clinical suggestions for applications.

Introduction. In the system of measures to improve citizens' social guarantees, their right to health care occupies an important place. The European Social Charter obliges states to create a health care system that will contribute to improving the level of public health, reduce the state's susceptibility to crisis phenomena, and increase labor productivity and the standard of living of all segments of the population. The health care system, like the economy of our country, is in a state of war, has a number of significant shortcomings that make it ineffective and needs to be adjusted taking into account the problems it is experiencing. World experience shows that there may be different ways of solving this problem. In general, they differ in the structure of health care financing sources and the organization of the provision of medical services. In this regard, the study of the development of health insurance as an effective tool for providing guarantees for the population regarding health care issues becomes important in this regard. Practice shows that the current budgetary model of financing the health care sector is not able to independently cover the needs of the population in terms of the amount of free medical care guaranteed by the country's legislation. Due to the lack of a clear distinction between guaranteed volumes and medical services provided to citizens on a paid basis, free medical care is replaced by various paid medical services, in particular, medical insurance. If we consider health insurance from a socio-economic point of view, it is one of the most important components of the effective functioning of national health care systems, the most effective form of social protection against risks that threaten the health and life of citizens, ensures availability, quality and complete satisfaction of various needs of the population in providing and receiving medical services. Purpose. To analyse the health index of citizens according to various indicators; to summarize the contents of the Medical Insurance Programs against COVID-19; to systematize the structure of types of health insurance as an important component of social guarantees of society and to determine directions for its improvement based on indicators of insurance premiums and insurance payments. Method (methodology). The authors used the abstract-logical method and the method of observation to form theoretical conditions and conclusions; structural method, comparative method for the analysis of health insurance and its development. Results. The article examines health insurance as a component of the development of social guarantees of society; the "health index" of citizens is highlighted; a rating of insurance companies providing voluntary health insurance services was carried out based on the indicators of insurance premiums and insurance payments; types of medical insurance were analyzed by gross/net insurance premiums and payments; the dynamics of health care expenditures in Ukraine are characterized; the content of the COVID-19 insurance programs is characterized; it was determined that the dynamics of wages is important for the wide use of social security services.

Health for everyone in life is the most important thing. Anyone who has been forced to use medical services at least once knows how important they are in society. The current expectations of the society related to medical care are growing and special emphasis is placed on the quality of services provided. The quality of medical services, including rehabilitation, aims to preserve health, prevent disease and injury as well as treat and reduce disability. The article presents the result of the evaluation of the quality of rehabilitation services provided by the Non-Public Healthcare Center “Diamed” in Czechowice-Dziedzice; For this purpose, the SERVQUAL method was used, which allows to measure the differences between expectations and the experiences of clients (patients) regarding the quality of services.

The article is devoted to the issue of aiming the activities of the healthcare system to meet the needs of society. The role of civil society institutions as consolidated customers of medical services is considered. The function of healthcare as a social institution responsible for the citizens’ well-being and health is described. The article focuses on the problem of introducing the practice and tools of public-state monitoring assessment into the healthcare organization system at the federal, regional, municipal levels and the levels of individual medical organizations. The article may be of interest to a wide range of readers, including employees of healthcare authorities, scientists and specialists in the field of philosophy, sociology, education, and law, medical workers, scientific and pedagogical workers of higher and secondary professional medical education, representatives of public organizations.

Abstract Universal access to quality medical care at an affordable cost for both citizens and society is considered a basic need, representing one of the shared values and principles of the health systems in the European Union. In this process, Romania must ensure quality services to European standards for every citizen. To resonate with the vision of the European Union, the Government started and implemented the health reform both through the Strategy in the field of health for the period 2014-2020 and through the Multiannual Strategy for the Development of Human Resources in Health 2022-2030” which has among its objectives the implementation of health policies human resources, activities and processes regarding the diversity of medical equipment at the management level of hospital units.

The health system of the Republic of Moldova is organized according to the principles of universal access to basic medical services, equity and solidarity in financing medical services both by the state and by citizens through AOAM mechanisms. Compulsory health care means that every person can benefit from quality medical services in order to prevent disease, treatment itself, but also rehabilitation and palliative care. The year 2019 continued to be a challenge for the compulsory health insurance system, both in order to increase access to health services and to improve their quality, having as benchmarks demographic trends, expectations of society and the rapid development of information technologies.

Medical and health public services are closely related to citizens' lives and have always been widely concerned about people's livelihood. With the rapid development of domestic economy and society, the public's pursuit of health is also increasing, and the demand for medical and health public services has also taken diversified forms. The public's demand for the quality of medical and health public services provided by the government is also getting higher and higher. Therefore, how to improve public satisfaction with public health care services has become a popular topic of current research. This paper uses the method of empirical research to conduct a multiple linear regression analysis of the factors influencing satisfaction with health care public services based on CGSS data by using the main influencing variables including herd mentality, public perception of the government's responsibility to provide health care services, health state, medical insurance participation, family economic status, public social status, and age. On this basis, the actual influence effect is standardized and budgeted to provide directions and ideas for improving the satisfaction of health care public services.

Given the increasing pressures on health care budgets, economic evaluation is used in many countries to assist decision-making regarding the optimal use of competing health care technologies. Although the standard methods of estimating cost-effectiveness underpinning these decisions have gained widespread acceptance, concerns have been raised that many technologies would not be considered for funding, due to scarcity of evidence. However, as long as the amount and quality of evidence used for the analysis are properly characterized, scarce evidence per se should not be seen as a hindrance to perform cost-effectiveness analyses. Characterizing uncertainty appropriately, though, may pose a challenge even when there is a large body of evidence available, and even more so when evidence is scarce. The aims of this thesis are to apply a methodological framework of cost-effectiveness analysis and explore methods for characterising uncertainty when evidence is scarce. Three case studies associated with limited evidence provide economic evaluations on current decision problems, investigate the feasibility of using the framework, and explore methods for characterizing uncertainty when evidence is scarce. The results of the case studies showed that, given current information, providing transfemoral amputees with C-Leg and Airsonett Airshower to patients with perennial allergic asthma could be considered cost-effective whereas screening for hyperthrophic cardiomyopathy among young athletes is unlikely to be cost-effective. In the cases of C-Leg and Airsonett Airshower conducting further research is likely to be cost-effective. The case studies indicate that it is feasible to apply methods of cost-effectiveness in health care for technologies not commonly evaluated due to lack of evidence. The analysis showed that failing to account for individual experts’ might have a substantial effect on the interpretation of the results of cost-effectiveness analysis. Formal expert elicitation is a promising method of characterizing uncertainty when evidence is missing, and thus enable cost-effectiveness and value of further research to be appropriately estimated in such situations. In conclusion, this thesis shows that scarcity of evidence should not preclude the use of cost-effectiveness analysis. On the contrary, in such cases it is probably more important than ever to use a framework that enable us to define key parameters for a decision problem and identify available evidence in order to determine cost-effectiveness given current information and provide guidance on further data collection.
In the list of included articles in the Ph.D. thesis the title of manuscript IV is "Cost-effectiveness of screening for hypertrophic cardiomyopathy in young athletes" but the title of the included article in the Ph.D. thesis is "Screening for hypertrophic cardiomyopathy in young athletes: A cost-effectiveness analysis".

Syfte:

Syftet med studien var att studera erfarenheter, inställning och önskemål inför arbete med förskrivning av fysik aktivitet på recept, FaR, på vårdcentraler i Stockholms innerstad. Ytterligare ett syfte var att ge förslag på modeller för hur vårdcentralerna kan arbeta med FaR, bland annat gällande samordningsfunktionen mellan olika aktörer.

Metod:

En enkätstudie genomfördes på totalt 13 vårdcentraler på Kungsholmen, Norrmalm, Vasastaden, City, Östermalm, Hjorthagen och Gärdet. Totalt 119 enkäter besvarades av läkare, sjuksköterskor och undersköterskor. En intervju genomfördes med en person anställd på Beställarkontor Vård, Stockholms läns landsting för att ta reda på hur de ser på hinder, möjligheter och genomförbarhet av FaR och FYSS inom SLL.

Resultat:

Från enkätundersökningen framkom bland annat att en klar majoritet svarande ställde sig positiva till att arbeta med fysisk aktivitet på recept både i preventivt och behandlande syfte. Mer information och utbildning efterfrågades av många. Ungefär hälften av personalen på vårdcentralerna angav att de kände till FYSS respektive FaR. 104 av de svarande uppgav att de idag rekommenderar fysisk aktivitet muntligt. Endast 14 gav en skriftlig rekommendation. En övervägande andel av de tillfrågade var positiva till arbetsformer såsom skriftlig rekommendation, motiverande samtal, arbeta med en koordinatorfunktion samt tillämpning av hälsotest. Från enkätundersökningen framkom vidare att det finns en oklarhet kring metoderna för att hjälpa patienten till lämplig aktivitet samt för motivation och uppföljning av patienten. Hela 82 tillfrågade upplevde inte att det fanns några hinder för att arbeta med FaR. De vanligaste hindren i arbetet med FaR uppgavs vara osäkerhet om vart man kan skicka patienten med receptet, osäkerhet kring förskrivningen av FaR samt tidsbrist.

Slutsats:

I enkätundersökningen framkom således att det fanns ett stort intresse för att arbeta med FaR i Stockholms innerstad. I dag saknas dock utarbetade metoder för arbetsprocessen med FaR samt friskvårdsaktörer att skicka patienterna till. Från tidigare studier har framkommit att för ett lyckat arbete med FaR krävs utbildning i FaR och FYSS hos vårdpersonalen, motiverande samtal med patienten, en koordinator med kontakt till friskvårdsaktörer samt uppföljning av patienten med receptet.

Aim:

The aim of this study was to look at the experience, attitude and needs in the primary care in the city of Stockholm in order to work with FaR (physical activity by prescription) and the book FYSS (Physical activity in health prevention and medical treatment). Another purpose was to make a suggestion for a model of how the primary care may work with FaR, for example with a co-ordinator function.

Method:

A questionnaire was handed out to 13 healthcare centres at Kungsholmen, Norrmalm, Vasastaden, City, Östermalm, Hjorthagen and Gärdet. 119 questionnaires were answered and handed in. The people participating in the study were doctors and nurses. One person at BKV, SLL, (BKV decides what the healthcare in Stockholm should focus on and not) was interviewed, to find out how they look upon obstacles, possibilities and if and how FaR and FYSS is an alternative in SLL.

Results:

The study showed that the big majority were in favour of working with FaR an FYSS both in health prevention and health care. Many of those who participated in the study wanted more information and education. About half of the respondents knew what FYSS respectively FaR were. 104 answered that they gave an oral recommendation to their patients. Only 14 prescribed written recommendations. A majority were in favour of working with written recommendations, motivating conversations, working with a co-ordinator and applying some kind of health test. Another result from the study was that there are a lot of questionmarks when it comes to helping the patient to start with a suitable activity, motivation and evaluation. Interestingly 82 of the respondents did not see any obstacles working with FaR. The most frequent obstacles suggested were insecurity of where to send the patient, insecurity of how to work with the process of prescription and the lack of time.

Conclusion:

In this study it was concluded that there is a big interest in working with FaR. Today there is a lack of effective working methods and activities to send the patients to. Earlier studies have shown that for FaR to work successfully it requires education in FaR and FYSS for the health care staff, motivating conversations with the patients, a co-ordinator with contacts with the prophylaxis and a follow up

Syfte och frågeställningar

Syftet med denna uppsats var att utifrån intervjuer med representanter för olika företag belysa och problematisera hur den särskilda sjukförsäkringsavgiften kommer att påverka företagens personalpolitik.

Frågeställningar var:

- Hur påverkar den särskilda sjukförsäkringsavgiften företag?

- Vad är företags åtgärder för att möta den särskilda sjukförsäkringsavgiften?

- Hur långt ska företagens ansvar för individens hälsa sträcka sig?

Metod

Utifrån ovan nämnda syfte valdes en kvalitativ undersökning. Sex representanter från olika företag intervjuades varpå innehållet i det material som erhölls tolkades och problematiserades; eventuella motsägelser i respondenternas tankebanor lyftes fram likväl som orsak- och verkansamband mellan olika aspekter belystes. Dessa aspekter knöts sedan an till relevant teori eller litteratur för att avslutningsvis diskuteras i ett större perspektiv.

Resultat

Den särskilda sjukförsäkringsavgiften kommer för de intervjuade företagen att innebära en ökad kostnad som många gånger upplevs som orättvis och en följd av införandet kan bli att företagen i framtiden blir försiktigare vid nyrekryteringar. Företagens strategi för att bemöta sjukpenningsreformen är i första hand en ökad fokusering på rehabilitering. Ansvaret för individens hälsa anser företagen vara gemensamt, deras huvudsakliga uppgift är dock att skapa goda förutsättningar för medarbetarna under arbetstimmarna.

Slutsatser

Det faktum att rehabilitering är den åtgärd som företagen huvudsakligen fokuserar på i dagsläget kan tolkas som att det på de intervjuade företagen råder ett sjukdomssynsätt. Detta innebär att hälsa är detsamma som frånvaro av sjukdom och ett hälsoarbete innebär då att man behandlar och förebygger sjukdom. Man tar således inte bort orsaken till problemet vilket kan liknas vid att när ett badkar svämmar över, endast torka upp vattnet på golvet istället för att stänga av kranen.

Aim

The aim of this essay was, based on interviews with representatives from different corporations, to enlighten and problemize how the co-financing reform will affect the corporate policies regarding human resources.

The questions were:

- How will the co-financing reform affect corporations?

- What is the corporate measures to co-financing reform?

- How far does the corporations´ responsibility for the employees´ health reach?

Method

Based on the aim a qualitative research was chosen. Six representatives from various corporations were interviewed whereas the content of the material given was interpreted and problemized; contradictions in the respondents thoughts were high lightened as well as cause- and effect between different aspects were enlightened. These aspects were then connected to relevant theory and literature and finally discussed in a larger perspective.

Results

The co-financing reform will, for the interviewed corporations, lead to an increase in cost that may seem unjust and a result of the introduction can lead to the corporations being more cautious when employing. The corporate strategy to answer to the co-financing reform is primarily an increase in focus on rehabilitation. The responsibility for the individuals´ health is in the mind of the corporation shared; their prime task is though to create possibilities for the employees during work hours.

Conclusions

The fact that rehabilitation is the measure the corporations are primarily focusing on today can be interpreted as that there is a view of illness. This means that health equals lack of illness and health work in this sense means treating illness, rather than eliminate the cause of the problem.

Aim

The aim with this essay was to find out what the personal in the primary care of Värmdö have for attitude to work with physical activity in prevention and treatment of diseases, how they work with the method today and how they think about working with the method in the future. Following questions were in focus of the study: How are they working in the primary care of Värmdö today with physical activity in prevention and treatment of diseases? What is the attitude to work with physical activity in prevention and treatment of diseases? And how do they want to work with physical activity in prevention and treatment of diseases in the future?

Method

The study includes all doctors, nurses and physiotherapists in Gustavsberg and Djurö primary care in Värmdö. To get answers on the question of issue was a questionnaire handed out. 82 % answered, which means that 45 of totally 55 employed in both primary care units answered the questinnaire.

Results

44 of 45 asked reported that they give verbal advice about physical activity to their patients today. 10 doctors and nurses answered that they sometimes complete the verbal advice with a written prescription on physical activity. 42 of 45 were very positive adjusted to work with physical activity in prevention of diseases. 40 of 45 were very positive adjusted to work with physical activity as a treatment of diseases.

Discussion

The study showed that almost all asked were positive adjusted to work with physical activity in prevention and treatment of diseases and that almost all are given verbal advice about physical activity today. It is however few that gives prescription on physical activity. The results indicate a lack of structure in both primary care units about how you should work with the moments that is included in a prescription on physical activity. It was few that saw any obstacle to work with physical activity on prescription and almost all was positive to work with physical activity on prescription including those methods that could lead to a more structure work with physical activity in this primary care units.

Syfte och frågeställningar

Syftet med denna studie var att ta reda på vad personalen på vårdcentralerna i Värmdö har för inställning till att arbeta med fysisk aktivitet som sjukdomsprevention och sjukdomsbehandling, hur de arbetar med metoden idag samt hur de kan tänka sig arbeta med den i framtiden. Frågeställningarna var: Hur arbetar man på vårdcentralerna i Värmdö med fysisk aktivitet som sjukdomsprevention och sjukdomsbehandling idag? Vad har man för inställning till att arbeta med fysisk aktivitet i sjukdomspreventivt syfte och som sjukdomsbehandling? Hur vill man arbeta med fysisk aktivitet som prevention och behandling i framtiden?

Metod

Studien innefattade samtliga läkare, sjuksköterskor, sjukgymnaster och arbetsterapeuter på Gustavsberg och Djurö vårdcentral i Värmdö. För att få svar på studiens frågeställningar utformades ett enkätformulär. Svarsfrekvensen uppgick till 82 % vilket innebär att 45 av totalt 55 anställda personer på de båda vårdcentralerna har svarat på enkäten.

Resultat

44 av 45 tillfrågade uppgav att de idag ger muntliga rekommendationer om fysisk aktivitet som sjukdomsprevention eller sjukdomsbehandling till sina patienter. 10 läkare och sjuksköterskor uppgav att de ibland kompletterar den muntliga rekommendationen med ett recept på fysisk aktivitet. 42 av 45 tillfrågade var mycket positivt inställda till att arbeta med fysisk aktivitet i sjukdomspreventivt syfte. 40 av 45 tillfrågade var mycket positivt inställda till att arbeta med fysisk aktivitet som sjukdomsbehandling.

Diskussion

Studien visade att i stort sett alla tillfrågade var positivt inställda till att arbeta med fysisk aktivitet som sjukdomsprevention och sjukdomsbehandling och att de flesta idag ger muntliga rekommendationer om fysisk aktivitet. Det är dock få som kompletterar den muntliga rekommendationen med en skriftlig ordination. Resultaten indikerar att det saknas en tydlig struktur på vårdcentralen för hur man ska arbeta med de moment som en ordination av fysisk aktivitet på recept innefattar. Det var få som såg hinder för att arbeta med ordination av fysisk aktivitet i primärvården och de allra flesta var positivt inställda till att arbeta med de metoder som skulle kunna leda till ett mer strukturerat arbete kring skriftliga ordinationer av fysisk aktivitet.

Syftet med studien var att genomföra och undersöka effekten av ett Fysiskt, Mentalt och Socialt friskvårdskoncept på patienter i primärvården i Botkyrka kommun. Konceptet bestod av hälsoundersökning med enkäter, motiverande samtal och fysiologiska tester, före och efter en sju veckors period, med ledarledd fysisk aktivitet förskrivet på recept (FaR) och teoretiska pass om hälsa.

Metod: Sammanlagt 12 patienter från två vårdcentraler i Botkyrka kommun erhöll varsitt FaR-recept. Alla recept var identiskt formulerade. Undersöknings- och kontrollgrupp utgjordes av sex personer vardera. För undersökningsgruppen användes ”FMS Personalprofil” innefattandes enkätundersökningar om livsstilsvanor och KASAM (känsla av sammanhang), fysiologiska tester och motiverande samtal. Kontrollgruppens individer, som skulle bedriva fysisk aktivitet i egen regi, svarade på utvalda livsstilsfrågor och en reducerad grupp genomförde fysiologiska tester. För undersökningsgruppen bedrevs gemensam gruppträning två dagar i veckan under en sju veckors period. Även ett eget träningspass skulle bedrivas per vecka som skulle registreras i en träningsdagbok. Utöver träningen hölls fem teoripass vilka behandlade motion, kost, hjärta och puls, stress och återhämtning samt beteendeförändring. Under projekttiden fick deltagarna även besöka en naprapat för behandling och rådgivning.

Resultat: Efter studien upplevde fyra av sex personer i undersökningsgruppen en bättre hälsa och samtliga hade ökat sin fysiska aktivitetsnivå. Försökspersonernas KASAM-värde var i stort sett oförändrat efter projektet. Alla deltagare, undantaget en, förbättrades i benstyrketestet, där den mest markanta styrkeökningen noterades generellt för gruppen. De mest framträdande förbättringarna vid rörlighetstesterna sågs i rygg och höftled. Samtliga deltagare förbättrade sitt balanstest. Ingen nämnvärd förändring av undersökningsgruppens kondition före och efter träningsperioden noterades. En majoritet av kontrollgruppens individer visade under projekttiden en oförändrad eller försämrad upplevd hälsa. Inte heller sågs under projekttiden några generella förändringar av de fysiologiska testerna för kontrollgruppen som helhet som endast i detta avseende var reducerad.

Slutsats: Våra resultat visar på att enbart ett recept med fysisk aktivitet inte leder till några nämnvärda förbättringar av livsstilsvanor eller fysiologiska test. Efter genomfört friskvårdskoncept syntes, trots den relativt korta perioden, förbättringar inom livsstilsvanor såsom fysisk aktivitetsnivå, upplevd hälsa samt kostvanor. Även vissa fysiologiska förbättringar kunde ses inom framförallt rörlighet, styrka och balans. Det hade varit önskvärt att undersöka om fler betydelsefulla hälsoförbättringar kunde ha uppnåtts om konceptet fått fortskrida över en längre period.

Aim: To implement and evaluate the effectiveness of a Physical, Mental and Social healthcare concept on primary care patients in the municipality of Botkyrka. This included a medical examination with questionnaires, motivational interviewing and a physical examination before and after a seven week period with physical activity on prescription led by an instructor and theoretical sessions about health.

Method: All together twelve patients from two health centres in municipality Botkyrka received physical activity on prescription. All the prescriptions were identically formulated. Both the intervention group and control group consisted of six patients each. For the intervention group a “FMS Personal profile” was used which comprised of questionnaires based on behavioural habits and KASAM, a physical examination and motivational interviewing. The control group, which had to carry out the physical activity on its own, answered predetermined questions about their behavioural habits and a reduced group carried out physical examination. Physical activity in a group was carried out for the intervention group twice a week during a seven week period. Another training session was to take place weekly single-handed and was to be recorded in a journal. As well as physical activity, five theoretical sessions were held which consisted of exercise, nutrition, heart and pulse, stress and recuperation and behavioural changing. During the project the participants were also able to visit a dr. of naparapathy for treatment and consultation.

Results: After the project, four out of six participants in the intervention group experienced a better health and all had increased their level of physical activity. The participants’ level of KASAM was overall unchanged after the project. All the subjects except for one increased their leg strength which was the most appreciable strength gain noted generally for the intervention group. The most significant improvement within the movability tests was seen in the back and hip-joint tests. All participants improved their balance. No significant change was seen on the cardiac output test within the intervention group after the training period. The majority of the participants in the control group showed an unchanged or a deteriorated evaluated health during the time of the project. Neither was any considerable change to be seen generally on the physical examination within the reduced control group.

Conclusions: Our results show that one single prescription with physical activity does not lead to any improvements worth mentioning within behavioural habits or physical status. After participating in the healthcare concept, in spite of the relatively short period, improvements were to be seen within behaviour habits such as level of physical activity, experienced health and nutrition habits. Also some physical status improvements were to be seen with regard to movability, strength and balance. We should have liked our research to continue further on to find out if more important health gains could have been achieved over a longer period of time.

Syfte

Syftet med denna uppsats var att undersöka hur de anställda på Spångagården (som är ett korttidsboende för personer som fått någon form av funktionshinder) i Torshälla och folktandvården på Forskliniken och Eskilshemkliniken i Eskilstuna ställer sig till friskvård och hur de använder sig av friskvårdstimmen, och i vilken form friskvårdstimmen erbjuds av arbetsgivaren. Ytterligare en avsikt är att se varför inte alla utnyttjar friskvårdstimmen och vilka åtgärder som behövs för att fler ska utnyttja den.

Metod

Jag har använt mig av en enkät som jag delat ut till de anställda på Spångagården i Torsälla och folktandvården Fors och Eskilshem i Eskilstuna för att granska i hur stor utsträckning friskvårdstimmen används och vad de anställda tycker om den. Resultaten har behandlats i programmet Excel.

Totalt delades 90 enkäter ut men endast 45 personer deltog i undersökningen. Personerna var mellan 23 år och 64 år, och medelåldern var 48 år.

Resultat

Friskvårdstimmen erbjuds i olika former i Eskilstuna och Torshälla. I Eskilstuna är det respektive enhetschef som bestämmer om friskvårdstimmen och hur den ska utnyttjas. Torshälla har däremot en policy och erbjuder alla anställda att utnyttja friskvård en timme per vecka på arbetstid. En vanlig form för finansiering från arbetsgivaren är betalning av friskvårdsaktivitet vid uppvisande av kvitto.

De flesta som deltog i undersökningen använde sin friskvårdstimme. Det var endast en handfull som inte utnyttjade friskvårdstimmen.

Då friskvårdstimmen inte utnyttjades var det oftast på grund av att man inte kunde gå ifrån arbetet, eller att man hellre motionerade på fritiden. Men majoriteten uppskattade friskvårdstimmen och var positivt inställda till dem.

Slutsats

De flesta är mycket positivt inställda till friskvårdstimmen och den används flitigt av personalen. För att kunna nå ut till dem som inte utnyttjar sin friskvårdstimme behövs vissa insatser.

Aim

The aim with this paper is to examine how the employees on Spångagården (which is a short term accommodation for persons with some moulds of disabilities) in Torshälla and the National Dental Service on Forskliniken and Eskilshemkliniken in Eskilstuna feels about health care and how they use the health care hour. The aim is furthermore to analyse how the health care hour is offered of the employer.

Method

I have used a questionnaire that I distributed to the employees on Spångagården in Torshälla and the National Dental Service Fors and Eskilshem in Eskilstuna in order to investigate the extent of which the health care hour is used and what the employees think of it.

A further intention is to see why not everybody use the health care hour and what measures are needed in order to get more people to use it.

Results

The health care hour is offered in different shapes in Eskilstuna and Torshälla. In Eskilstuna, it is the respective unit director who decides about the health care hour and how it should be used. Torshälla has on the other hand a policy and offers all employees to use health care one hour per week during working hours. A common form of financing from the employer is payment of health care activity upon presenting a receipt.

Most of the participants in the survey used the health care hour. It was only a handful individuals who did not.

When the health care hour was not used it was often due to lack of time or rather to exercise after working hours.

Conclusion

Most people were very positive to the health care hour and it was used to a great extent among the personnel. However, in order to reach those how did not use the health care hour certain initiatives were needed.

This thesis is concerned with social stratification of psychosocial factors and social position measurement in population samples collected in mid-Sweden 2000-2006. Traditional resource-based measures of social position (occupation, education) and so far less explored prestige-based measures (subjective status, status incongruence) are tested with respect to their associations with psychosocial factors, emotions, and selfrated health. Three papers in this thesis are based on data from the Life Conditions, Stress, and Health (LSH) study, using a randomly selected population sample. Data for the fourth paper is a regional sample drawn from the health-related survey “Liv och Hälsa 2000”. Statistical methods range from correlation analysis to logistic regression and repeated measures analyses. Results from studies I and IV show that psychosocial factors are unequally distributed within the population in a linear manner, so that the lower the socioeconomic position (SEP), the more unfavourable levels. This is independent of whether we study this in a highly unequal setting such as Russia, or in a more egalitarian society such as Sweden. The stability of psychometric instruments over two years tend to be lower for all instruments among low SEP groups, and differ significantly for self-esteem and perceived control among groups with high and low education, and for cynicism among groups with high and low occupational status. Results from studies II and III point to the relevance of individuals’ own thoughts about themselves, and the potential impact on the self by normative judgements of social position in a certain hierarchical setting. In paper II, the prestige-based measure of subjective status was influenced by resource-based measures, such as self-rated economy and education, but also by life satisfaction and psychosocial factors. The importance of self-evaluation was especially obvious from the study on status incongruence (study III) where the traditionally protective effecs of a high education seem to disappear when combined with a lowstatus occupation. Shaming experiences may play an important role here for our understanding of self-perception.

There is an on going debate in academia on the health of immigrants in their host countries. Many studies have indicated that immigrants tend to have poor health as compared to the native born population. Researchers in this field however hold divergent views on the causes of the poor health of immigrants. One school of thought attributes poor health of immigrants to premigration period. The contenders of this theory argue that during this period immigrants experience and are subjected to hardships which will affect their health later on in their lives. On the other hand, some researchers view post migration period as an ultimate determinant of the poor health of immigrants in their host country. These researchers ascertain that during this

period immigrants are faced with many challenges of adaptation and most often lack good integration in their host countries which hampers their health.

The aim of this study is to explore and describe the impact of migration and integration on the health of African immigrants in the Swedish society. A combination of both qualitative and quantitative methods was used to collect and analyze data with the help of the “triangulation “technique. A structured questionnaire was used as a guideline to the in-depth interviews conducted with African immigrants who have lived in Sweden for a period of five to twenty

years and plus. Twentyfive African immigrants from fourteen African countries took part in this research. This study was conducted in the city of Linköping in Sweden.

Results from this study revealed that majority of African immigrants self rated their health as being good. Many affirm to be in good health. However, a majority of African immigrants reported psychosomatic symptoms such as stress, fatigue, and other illnesses such as high blood pressure, and diabetes. It was also observed that African immigrants hardly seek medical help except when necessary. Health as defined by immigrants is “a combination of physical and

mental well being”,” health is ” happiness and joy”, health is “self realization and self esteem”, health is “vitality”, Health is a “sine qua non condition to good life”. However mastery of the Swedish language, and flexible opportunities, which will enable immigrants to access the labor market and be self-sufficient, may improve the immigrants health condition. Also integration of immigrants’ health professionals in the Swedish health care system may be a vital tool to

encourage immigrants to seek health attention and improve their health condition.

AbstractAlthough the social structure of Turkish society has changed from a broad family order to a nuclear family, family relations still hold an important place, where traditional elements dominate. Still, elderly people are cared for by their family in their home environment. Thus, the role of family members is crucial in taking care of elderly individuals. In Turkey, the responsibility of care is largely on women; the elderly’s wife, daughter, or daughter-in-law most often provides the care. Family members who provide care need support so that they can maintain their physical, psychological and mental health. At this point, Antonovsky’s salutogenic health model represents a positive and holistic approach to support individual’s health and coping. The salutogenic understanding of health emphasizes both physical, psychological, social, spiritual and cultural resources which can be utilized not only to avoid illness, but to promote health.With the rapidly increasing ageing population globally, health expenditures and the need for care are increasing accordingly. This increase reveals the importance of health-promoting practices in elderly care, which are important for the well-being and quality of life of older individuals and their families, as well as cost effectiveness. In Turkey, the emphasis on health-promoting practices is mostly focused in home-care services including examination, treatment, nursing care, medical care, medical equipment and device services, psychological support, physiotherapy, follow-up, rehabilitation services, housework (laundry, shopping, cleaning, food), personal care (dressing, bathroom, and personal hygiene help), 24-h emergency service, transportation, financial advice and training services within the scope of the social state policy for the elderly 65 years and older, whereas medical management of diseases serves elderly over the age of 85. In the Turkish health care system, salutogenesis can be used in principle for two aims: to guide health-promotion interventions in health care practice, and to (re)orient health care practice and research. The salutogenic orientation encompasses all elderly people independently of their position on the ease-/dis-ease continuum. This chapter presents health-promotion practices in the care of elderly home-dwelling people living in Turkey.

The Italian public-owned Academic Medical Centers (AMCs) are hospitals where the activities of scientific research, teaching, and patients care are fully integrated. AMCs have an enormous impact on society and country health. Recently, policymakers and practitioners give more and more great importance to the AMCs’ scientific activity for both welfare and national competitivity. The scientific production and its impact on the research community could be obviously affected by different factors related to the structural and operational characteristics of each AMC. Healthcare institutions could be different for the typology of services that they offer, their geolocation, the presence/absence of Emergency Departments, the number of employees, and so forth. In this sense, our study aims to investigate and determine which are the possible factors impacting the research productivity of AMCs. We develop a model to assess the academic value of AMCs by taking into account these factors and how they are related to healthcare performance, measured in terms of scientific production (e.g. scientific publications) and impact on the research field (e.g. citations). To face this issue, for each of the public AMCs we collect data about research productivity from bibliographic indexing databases (e.g. Web of Science, PubMed) and we retrieve structural information mainly from their official websites. This work has been partially financed by the research project “Leading Change in Academic Medical Centers”, funded by the competitive call for projects V:ALERE 2019. The project aims to provide evidence, advice, and remarks to help the agents of the public health system to address the many challenges that they face.

AbstractPrimary care is understood as the first contact point to medical care. It operates at the interface between the social and the health systems, between the patient with his or her family and the professional environment, and refers to the local population, while primary health care, following WHO, is defined as a whole-of-society approach envisioned to contribute to universal health coverage and equality. This chapter is dedicated primarily to the application of salutogenesis in primary care. Since primary care services are a complex of strongly interrelated professional practice, research, and supporting policy, applying salutogenesis in primary care comprehensively should introduce salutogenesis in all these fields simultaneously.This chapter examines how salutogenesis is addressed and discussed in policy, research, and practice of primary care and discusses the application of salutogenesis as an orientation, a model, and the construct of ‘sense of coherence’. Thus, it contributes to supporting the application of salutogenesis in primary care and provides an outlook on further research needs.

The medical travel market industry is growing as millions of people are crossing borders to seek healthcare services every year. Yet there is not sufficient empirical research around medical travel. People typically call all medical travelers “medical tourists,” a practice that is not helpful. Therefore, from a public health perspective, it is important to understand the definition of medical travel, the motivations behind travel, and how to overcome public health challenges that may occur as a result of this practice. Since medical travel is an experience that does not finish with obtaining health services, it is important to gather medical travelers' profiles before and after they access healthcare services. This will allow healthcare professionals to follow medical travelers' outcomes and assess their health-related quality of life. A robust evidence base will promote better future decisions related to medical travel. Creating an evidence base for medical travel will support upstream policies and strategies aimed at regulating the medical travel market.

This With the advancement of technology and social development, health is becoming an increasingly important proposition for the development of human society. The new crown epidemic has made health-related issues such as crisis response, epidemic prevention and disease prevention, aging trends, and quality of medical services more acute and urgent.In the digital era, design, as a thinking method for problem solving and a mechanism for crisis prevention, is deeply involved in solving health problems in the relationship between people and society. Smart Health Design aims to explore design intervention in the field of great health, integrate humanistic care through intelligent technology, reconstruct the standards and methods of health design in the digital era from the perspective of design intelligence, achieve health and social harmony, construct a contemporary smart health living system, and establish a smart and healthy lifestyle.Through the design case of industry-university-research project cooperation, the article focuses on healthy lifestyle, explores the demand for digital products and services in the health field, and proposes the value proposition of smart health from passive medical treatment to active health with the concept of humanistic care and the integration of intelligent technology and digital intelligence design methods, and constructs a new scene of smart health life in a multi-dimensional way, so that smart health life can reflect the emotion and temperature of "computing" in the digital era.

Introduction: In 2018, the Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE), a National Health and Medical Research Council (NHMRC) Centre of Research Excellence was funded to develop a suite of state-wide medicinal cannabis prescribing guidance documents. At this time, regulatory changes in Australia were enabling broader access to medicinal cannabis in a medical model. The initiative funded through the New South Wales (NSW) Government’s Clinical Cannabis Medicines Program enabled the development of practical resources to support NSW medical practitioners in prescribing medicinal cannabis to patients for conditions where cannabinoids are perceived to have some benefit. Aim: To provide interim guidance to support medical practitioners in the prescription of medicinal cannabis where they are perceived to have potential benefit. Methods: A team of clinical pharmacologists, pharmacists and clinicians collaborated in the development of the first tranche of prescribing guidance documents. The suite of six medicinal cannabis prescribing guidance documents covered the most common indications for which prescriptions for medicinal cannabis were being sought by NSW patients: dementia; anorexia and cachexia; nausea; chemotherapy-induced nausea and vomiting; spasticity; and chronic non-cancer pain. In 2019, the draft guidance documents underwent a comprehensive review and consultation process involving fifty key stakeholders before publication. Results: The ACRE medicinal cannabis prescribing guidance documents have been widely adopted, both in NSW and around the world. The prescribing guidance documents are now recommended as a health professional educational resource by the Australian national medicines regulator the Therapeutic Goods Administration and state health departments. The prescribing guidance on epilepsy from the second tranche of guidance documents has recently been published in the British Journal of Clinical Pharmacology. National medicinal cannabis prescribing pattern data and enquiries to the first-of-kind, state-government funded medicinal cannabis advisory service for medical practitioners informed the themes of the second tranche of six medicinal cannabis prescribing guidance documents being developed in 2022. Conclusions: ACRE medicinal cannabis prescribing guidance documents delivered interim guidance to Australian medical practitioners on the evidence-based and best-practice prescription of medicinal cannabis. Prescribing guidance document themes align with Australian medicinal cannabis prescribing patterns and areas where medical practitioners are seeking further information and advice. It is anticipated that the prescribing guidance documents will be updated periodically as further evidence becomes available. Acknowledgements: NSW Government through the NSW Clinical Cannabis Medicines Program supported development of the NSW Cannabis Medicines Prescribing Guidance. ACRE was established and is funded through the National Health and Medical Research Council Centres of Research Excellence scheme.

Purpose – to identify the prerequisites for organizational changes of the emerging health insurance system in Vietnam. Research methodology - comparative analysis, statistical analysis, case study. Findings – the obligatory health insurance in Vietnam performs its functions only partially. There is still high level of out-of-pocket spending on medical services. First we identified one of the most important challenges to the health insurance system in Vietnam, namely, the population aging. Secondly, we identified and analyzed and the prerequisites (the pre-existing conditions), which can become the basis for the reorganization of the existing health insurance system without major reforms: (1) the cultural values of Asian society, which allow to build a community-based type model of living for the elderly on the basis of “equal with equal”; (2) technological advances in medicine that extend the healthy life of the elderly, (3) trust in traditional medicine, which allows widen the coverage of the poorest “elderly households”. Practical implications - the results of the study require attention from the government and insurance providers when rethinking of organizing process for mandatory medical insurance. Originality/Value – we have identified the ways of possible organizational changes for the health insurance system, making the most of the existing prerequisites. This can help to get closer to the goal of full coverage with health insurance services while achieving a positive social effect. The identified internal reserves make it possible to imple- ment organizational changes without major reforms of the established health insurance system. No studies have been conducted in this perspective.

In the past 40 years, China has experienced the largest and fastest urbanization development in the world. The infrastructure, urban environment and medical services of cities have been improved significantly. The health impacts are manifested in the decrease of the incidence of infectious diseases and the significant increase of the life span of residents. However, the development of urbanization in China has also created many problems, including the increasing pollution of urban environment such as air, water and soil, the disorderly spread of urban construction land, the fragmentation of natural ecological environment, dense population, traffic congestion and so on. With the process of urbanization and motorization, the lifestyle of urban population has changed, and the disease spectrum and the sequence of death causes have changed. Chronic noncommunicable diseases have replaced acute infectious diseases and become the primary threat to urban public health. According to the data published by the famous medical journal The LANCET on China's health care, the economic losses caused by five major non-communicable diseases (ischemic heart disease, cerebrovascular disease, diabetes mellitus, breast cancer and chronic obstructive pulmonary disease) will reach US$23 trillion between 2012 and 2030, more than twice the total GDP of China in 2015 (US$11.7 trillion). Therefore, China proposes to implement the strategy of "Healthy China" and develop the policy of "integrating health into ten thousand strategies". Integrate health into the whole process of urban and rural planning, construction and governance to form a healthy, equitable and accessible production and living environment. China is building healthy cities through the above four strategies. The main strategies from national system design to local planning are as follows. First of all, the top-level design of the country. There are two main points: one point, the formulation of the Healthy China 2030 Plan determines the first batch of 38 pilot healthy cities and practices the strategy of healthy city planning; the other point, formulate and implement the national health city policy and issue the National Healthy City. The evaluation index system evaluates the development of local work from five aspects: environment, society, service, crowd and culture, finds out the weak links in the work in time, and constantly improves the quality of healthy city construction. Secondly, the reform of territorial spatial planning. In order to adapt to the rapid development of urbanization, China urban plan promote the reform of spatial planning system, change the layout of spatial planning into the fine management of space, and promote the sustainable development of cities. To delimit the boundary line of urban development and the red line of urban ecological protection and limit the disorderly spread of urban development as the requirements of space control. The bottom line of urban environmental quality and resource utilization are studied as capacity control and environmental access requirements. The grid management of urban built environment and natural environment is carried out, and the hierarchical and classified management unit is determined. Thirdly, the practice of special planning for local health and medical distribution facilities. In order to embody the equity of health services, including health equity, equity of health services utilization and equity of health resources distribution. For the elderly population, vulnerable groups and patients with chronic diseases, the layout of community health care facilities and intelligent medical treatment are combined to facilitate the "last kilometer" service of health care. Finally, urban repair and ecological restoration design are carried out. From the perspective of people-oriented, on the basis of studying the comfortable construction of urban physical environment, human behavior and the characteristics of human needs, to tackle "urban diseases" and make up for "urban shortboard". China is building healthy cities through the above four strategies. Committed to the realization of a constantly developing natural and social environment, and can continue to expand social resources, so that people can enjoy life and give full play to their potential to support each other in the city.

The Australian Child Maltreatment Study (ACMS) is a landmark study for our nation. The ACMS research team has generated the first nationally representative data on the prevalence of each of the five types of child maltreatment in Australia, and their associated health impacts through life. We also identified information about the context of maltreatment experiences, including how old children are when it occurs, and who inflicts it. This knowledge about which children are most at risk of which types of abuse and neglect, at which ages, and by whom, is needed to develop evidencebased population approaches required to reduce child maltreatment in Australia. The concerning prevalence of maltreatment and its devastating associated outcomes present an urgent imperative for nation-building reform to better protect Australian children and reduce associated costs to individuals, families, communities and broader society. The ACMS collected data from 8500 randomly selected Australians aged 16-65 years and older. We included an oversample of 3500 young people 16-24 years of aged to generate particularly strong data about child maltreatment in contemporary Australian society, to assess its associated impacts in adolescence and early adulthood, and to allow future prevalence studies to detect reductions in prevalence rates over time. Our participants aged 25 and over enabled us to understand prevalence trends at different times in Australian history, and to measure associated health outcomes through life. Participants provided information on childhood experiences of each of the five types of child abuse and neglect, and other childhood adversities, mental health disorders, health risk behaviours, health services utilisation, and more. Our findings provide the first nationally representative data on the prevalence of child maltreatment in Australia. Moreover, the ACMS is the first national study globally to examine maltreatment experiences and associated health and social outcomes of all five forms of child maltreatment. Taken together, our findings provide a deep understanding of the prevalence, context and impact of child abuse and neglect in Australia and make an important contribution to the international field. This brief report presents the main findings from the ACMS for a general public audience. These main findings are further detailed in seven peer-reviewed scholarly articles, published in a special edition of the Medical Journal of Australia, Australia’s leading medical journal. Forthcoming work will examine other important questions about the impacts of specific maltreatment experiences to generate additional evidence to inform governments and stakeholders about optimal prevention policy and practice. There is cause for hope. In recent years, there have been reductions in physical abuse, and in some types of sexual abuse. These reductions are extremely important. They mean that fewer children are suffering, and they indicate that change is possible. Policies and programs to reduce these types of maltreatment are having an effect. Yet, there are other concerning trends, with some types of maltreatment becoming even more common, including emotional abuse, some types of sexual abuse, and exposure to domestic violence. And new types of sexual victimisation are also emerging. As a society, we have much work to do. We know that child maltreatment can be reduced if we work together as governments, service sectors, and communities. We need to invest more, and invest better. It is a moral, social and economic imperative for Australian governments to develop a coordinated long-term plan for generational reform. We have found that: 1. Child maltreatment is widespread. 2. Girls experience particularly high rates of sexual abuse and emotional abuse. 3. Child maltreatment is a major problem affecting today’s Australian children and youth – it is not just something that happened in the past. 4. Child maltreatment is associated with severe mental health problems and behavioural harms, both in childhood and adulthood. 5. Child maltreatment is associated with severe health risk behaviours, both in childhood and adulthood. 6. Emotional abuse is particularly harmful, and is much more damaging than society has understood.

This report is part of a larger cross-country comparative project and constitutes an account and analysis of the measures comprising the Norwegian national response to the COVID-19 pandemic during the year of 2020. This time period is interesting in that mitigation efforts were predominantly of a non-medical nature. Mass vaccinations were in Norway conducted in early 2021. With one of the lowest mortality rates in Europe and relatively lower economic repercussions compared to its Nordic neighbours, the Norwegian case stands unique (OECD, 2021: Eurostat 2021; Statista, 2022). This report presents a summary of Norwegian response to the COVID-19 pandemic by taking into account its governance, political administration and societal context. In doing so, it highlights the key features of the Nordic governance model and the mitigation measures that attributed to its success, as well as some facets of Norway’s under-preparedness. Norway’s relative isolation in Northern Europe coupled with low population density gave it a geographical advantage in ensuring a slower spread of the virus. However, the spread of infection was also uneven, which meant that infection rates were concentrated more in some areas than in others. On the fiscal front, the affluence of Norway is linked to its petroleum industry and the related Norwegian Sovereign Wealth Fund. Both were affected by the pandemic, reflected through a reduction in the country’s annual GDP (SSB, 2022). The Nordic model of extensive welfare services, economic measures, a strong healthcare system with goals of equity and a high trust society, indeed ensured a strong shield against the impact of the COVID-19 pandemic. Yet, the consequences of the pandemic were uneven with unemployment especially high among those with low education and/or in low-income professions, as well as among immigrants (NOU, 2022:5). The social and psychological effects were also uneven, with children and elderly being left particularly vulnerable (Christensen, 2021). Further, the pandemic also at times led to unprecedented pressure on some intensive care units (OECD, 2021). Central to handling the COVID-19 pandemic in Norway were the three national executive authorities: the Ministry of Health and Care services, the National directorate of health and the Norwegian Institute of Public Health. With regard to political-administrative functions, the principle of subsidiarity (decentralisation) and responsibility meant that local governments had a high degree of autonomy in implementing infection control measures. Risk communication was thus also relatively decentralised, depending on the local outbreak situations. While decentralisation likely gave flexibility, ability to improvise in a crisis and utilise the municipalities’ knowledge of local contexts, it also brought forward challenges of coordination between the national and municipal level. Lack of training, infection control and protection equipment thereby prevailed in several municipalities. Although in effect for limited periods of time, the Corona Act, which allowed for fairly severe restrictions, received mixed responses in the public sphere. Critical perceptions towards the Corona Act were not seen as a surprise, considering that Norwegian society has traditionally relied on its ‘dugnadskultur’ – a culture of voluntary contributions in the spirit of solidarity. Government representatives at the frontline of communication were also open about the degree of uncertainty coupled with considerable potential for great societal damage. Overall, the mitigation policy in Norway was successful in keeping the overall infection rates and mortality low, albeit with a few societal and political-administrative challenges. The case of Norway is thus indeed exemplary with regard to its effective mitigation measures and strong government support to mitigate the impact of those measures. However, it also goes to show how a country with good crisis preparedness systems, governance and a comprehensive welfare system was also left somewhat underprepared by the devastating consequences of the pandemic.

This Emergency Medical Services (EMS) Home Rule State Law Fact Sheet discusses the collection of laws related to local government autonomy to establish and fund local EMS for five US states: Alabama, California, Georgia, Massachusetts, and Ohio. This fact sheet walks through the types of state laws analyzed by public health attorneys between January 2021 and January 2022.