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At least 145 records · Page 8Linked to original sources
PubMed2001

Funding ESRD care through charity: the paradigm of the National Kidney Foundation of Singapore.

Given the prohibitive costs of end-stage renal disease (ESRD) care for certain countries and the increasing incidence of ESRD worldwide, alternative methods of funding dialysis care are increasingly necessary. We describe the paradigm of the National Kidney Foundation of Singapore (NKF-S), the provider of subsidized dialysis care and comprehensive rehabilitative services to approximately 60% of all ESRD patients in the country, whose activities are funded entirely by charitable public donations. Unique to the NKF-S model are the considerations of the donor as an "investor" in the health care of NKF-S dialysis patients, the personal responsibility of the dialysis patient as a recipient of this "investment" to play an active role in achieving good clinical and rehabilitative outcomes, and the fostering of community-based support systems to facilitate patient rehabilitation such as partnerships with employers willing to employ dialysis patients. The success of the system is shown by its clinical outcomes, which approximate those observed in the United States. We believe that several aspects of the NKF-S model for ESRD care may be implemented in other communities, particularly in countries that have yet to develop financially and clinically mature dialysis programs.

Charities↗
PubMed2005

Wheelchair charity: a useless benevolence in community-based rehabilitation.

PURPOSE: Hand rim-propelled manual wheelchairs (WC) are conventionally distributed to persons with dysfunctioning lower limbs for independent ambulation in community-based rehabilitation. The purpose of the present study was to survey the fate of the donated WCs and the difficulties encountered by the users by identifying the cause of rejection, and to evaluate the performance by assessing physiological strain on the recipients during their routine ambulation using cardiorespiratory parameters. METHODS: Personal interview was arranged for the recipients and they were to answer regarding the fate of the donated WC and the cause of rejection for the recipients who rejected their WC. A simple field test was also administered to the users to evaluate the ambulatory performance using the WC. The energetics of WC propulsion at freely chosen speed was studied. RESULTS: Of the WC, 10.49% were for attendant-dependent ambulation, 57.4% were not used, 14.19% were sold and 7.4% were in regular use and 10.5% in occasional use. Most of the recipients rejected their WC due to pain, fatigue and discomfort and lack of habitat adaptability. The cardiorespiratory response was higher in occasional users than regular users. Locomotive tasks using WC are highly energy demanding and contribute to physiological strain. CONCLUSIONS: Hand rim-propelled manual WC are unsuitable for outdoor ambulation due to low speed and high physiological demand; they are also of little use indoors as they are difficult to maneuver under the environmental conditions and architectural restraints. So, they should not be recommended without proper assessment of the user's activity level and requirements.

Activities of Daily Living↗