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Biomedical subjects

S Vail

Publications and source records attributed to S Vail.

30 records · Page 2Linked to original sources
PubMed1996

Does Canada have two-tier health care?

The concept of a two-tier health care system is an emotionally charged subject that will be the focus of much discussion over the next year. In August, the Canadian Medical Association's Annual General Council discussed the issue at length and approved a resolution to lead a national debate on the role of regulated private insurance for medical services. A number of physicians, politicians and other decision makers argue that two-tier health care already exists and that greater privatization is required. Is this really the case? Nurses can have a major impact on the level of discussion in this debate by helping to inform the public and others on the real issues involved.

Canada↗
PubMed1995

The move to regionalization.

Who should decide how health care services are funded and delivered in our communities? Increasingly, provincial governments are placing that responsibility on the shoulders of Regional Health Authorities (RHAs). But what are regional health authorities and why are they being embraced so enthusiastically across the country and around the world?

Canada↗
PubMed1995

Clarifying population health.

"Population health" is the latest buzzword in health policy discussions, and more recently used by politicians. In fact, it is currently used to describe a wide range of activities. Governments are referring to population health more frequently as they try to find ways to reduce pressures on their health care systems. Its significance, therefore, cannot be overstated. But does anyone know what population health really means?

Health Promotion↗
PubMed1995

Rationing health care.

What health services should governments pay for? Who should receive transplants or expensive procedures? What services should be available through private insurance? Should there be a two-tiered system? And, how do we decide on what services to publicly insure/fund? Many governments around the world are facing such questions. In Canada, the Government of Alberta and the Reform Party of Canada have recently expressed the need to re-think which health services are publicly funded, or the "comprehensiveness" of Canada's health care system.

Canada↗
PubMed1995

Is privatization the answer?

Concern is being expressed by some that Canada's publicly funded health care system can no longer be maintained and that a privately funded system will help ease the pressure on our public system. Indeed, the issue of privatizing Canada's health care system promises to be one of this fall's hottest debates.

Canada↗
PubMed1995

Making tough decisions.

It is amazing that so much money is spent on health care with little understanding and measurement of its effect on people's health status. But tightened health care budgets and the explosion of new and often expensive health care technologies have forced governments, providers and taxpayers to examine how best to maximize health dollars. This has led to greater reliance on economic evaluations to help make difficult choices.

Canada↗
PubMed1995

Managing health care.

By now we've heard about managed care at the client level, but what does the term mean in the context of the overall health system? As governments around the world strive to control health care costs, they are searching for better ways to manage the system and improve its efficiency. One approach has been the introduction of managed care models that integrate the financing and delivery of a range of health care services. So how do these models lead to better control and management of health care costs?

Canada↗
PubMed1992

Management of tracheocutaneous fistula.

Management of large tracheocutaneous fistulas is not well described in the otolaryngology literature. Some authors have focused on the excision of the fistula tract with or without the use of a strap muscle or sternocleidomastoid flap. Others have proposed staged closures over a period of months to allow secondary healing to occur in order to avoid complications of dehiscence, pneumomediastinum, and infection. We describe a simple technique that utilizes the fistula tract to facilitate closure of a large tracheocutaneous fistula. By using this technique, the surgeon avoids the complications generally associated with the closure of such defects and also the morbidity of waiting for secondary closure to occur.

Adult↗
PubMed1986

Effects of AV sequential versus asynchronous AV pacing on pulmonary hemodynamics.

We studied the effects of various pacing modes on cardiac hemodynamics and pulmonary gas alterations in chronic heart blocked dogs. Changing the pacing mode from an atrioventricular interval of 100 ms (AV100) to a ventriculo-atrial interval of 100 ms (VA100) caused a significant fall in left ventricular pressure (117.64 +/- 11.91 to 95.60 +/- 16.58 mmHg) and cardiac output from 2.18 +/- 0.24 to 1.46 +/- 0.20 L/min. Following the change in pacing mode from AV100 to VA100, there was an increase in the alveolar-arterial O2 gradient from 23.28 +/- 6.97 to 28.74 +/- 8.43 mmHg and a decrease in the arterial CO2 tension from 32.42 +/- 3.22 to 29.42 +/- 3.22 mmHg. There was also a decrease in arterial CO2 tension when the AV100 pacing mode was compared to asynchronous ventricular pacing (32.42 +/- 3.22 versus 30.56 +/- 2.82 mmHg). The minute volume of O2 also decreased when the pacing mode was changed from AV100 to asynchronous ventricular pacing (0.134 +/- 0.01 versus 0.126 +/- 0.01 L/min) and decreased further at VA100 to 0.114 +/- 0.01 L/min. Other significant changes were also observed: the percent of expired CO2 decreased when the pacing mode was changed from AV100 to VA100 (3.68 +/- 0.13 versus 3.37 +/- 0.26%) or to asynchronous ventricular pacing (3.40 +/- 0.31%). The end-expiratory O2 increased and CO2 decreased when the pacing mode was changed from AV100 to VA100. The breath-by-breath correlation of end-expiratory O2 and CO2 with left ventricular systolic pressure showed an almost immediate increase in O2 and reduction in CO2 concentration associated with decreasing systolic pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗