“If you want to sit on your butts you’ll get nothing!” Community activism in response to threats of rural hospital closure in southern New Zealand

Barnett, Ross; Barnett, Pauline

doi:10.1016/s1353-8292(02)00019-9

Cited by 64 publications

(47 citation statements)

References 28 publications

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“…The great sanitary movement in late-18th century Britain, for example, was driven chiefly by local activists appalled by the living and working conditions of the urban poor (Porter, 1999). Other social movements and activism, from the feminist health movement to AIDS activism, have restructured health-related issues, including treatment services, health care reform, AIDS policy, and the destigmatization of particular groups (Banzhaf et al, 1992;Barnett and Barnett, 2003;DeMacro and Johnsen, 2003).…”

Section: Localized Action: the Harm Reduction Movement As Disease Prementioning

confidence: 99%

Placing the dynamics of syringe exchange programs in the United States

Tempalski

2007

Health & Place

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Drawing upon the broader health, social, and political geography literature this paper outlines a framework for considering place-based processes through which syringe exchange availability may be understood. It is argued that the geographic distribution of syringe exchange programs (SEPs) in the United States is linked to the social and political conditions of particular localities through three place characteristics: (1) structural constraints; (2) social and spatial distancing of injection drug users; and (3) localized action. Although SEPs remain a controversial issue and face ongoing obstacles from the government, law enforcement and local communities, they continue to operate through the efforts of grassroots organizations and local activists. Action on this issue occurs locally, and the characteristics of place-based factors will affect whether particular areas adopt SEPs.

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Section: Localized Action: the Harm Reduction Movement As Disease Prementioning

confidence: 99%

Placing the dynamics of syringe exchange programs in the United States

Tempalski

2007

Health & Place

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“…Hospitals are considered as a special and important type of indoor public place (Banse 2013;Barnett and Barnett 2003) where poor air quality can affect not only the health of the employees but also of patients (due to suppressed immune system, they are more susceptible to external influences). Assessment of risks to these occupants resulting from exposure to airborne particulates includes measurements of PM concentration levels and their related toxicity in terms of trace metals (or ions).…”

Section: Introductionmentioning

confidence: 99%

Trace metals in size-fractionated particulate matter in a Portuguese hospital: exposure risks assessment and comparisons with other countries

Slezáková

Morais

Pereira

2013

Environ Sci Pollut Res

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Hospitals are considered as a special and important type of indoor public place where air quality has significant impacts on potential health outcomes. Information on indoor air quality of these environments, concerning exposures to partic-ulate matter (PM) and related toxicity, is limited though. This work aims to evaluate risks associated with inhalation exposure to ten toxic metals and chlorine (As, Ni, Cr, Cd, Pb, Mn, Se, Ba, Al, Si, and Cl) in coarse (PM2.5-10) and fine (PM2.5) particles in a Portuguese hospital in comparison with studies representative of other countries. Samples were collected during 1 month in one urban hospital; elemental PM characterization was determined by proton-induced X-ray emission. Noncarcinogenic and carcinogenic risks were assessed according to the methodology provided by the United States Environmental Protection Agency (USEPA; Region III Risk-Based Concentration Table) for three different age categories of hospital personnel (adults, >20, and <65 years) and patients (considering nine different age groups, i.e., children of 1-3 years to seniors of >65 years). The estimated noncarcinogenic risks due to occupational inhalation exposure to PM2.5-bound metals ranged from 5.88×10−6 for Se (adults, 55-64 years) to 9.35×10 −1 for As (adults, 20-24 years) with total noncarcinogenic risks (sum of all metals) above the safe level for all three age categories. As and Cl (the latter due to its high abundances) were the most important contributors (approximately 90 %) to noncarcinogenic risks. For PM2.5-10, noncarcinogenic risks of all metals were acceptable to all age groups. Concerning carcinogenic risks, for Ni and Pb, they were negligible (<1×10 −6 ) in both PM fractions for all age groups of hospital personnel; potential risks were observed for As and Cr with values in PM2.5 exceeding (up to 62 and 5 times, respectively) USEPA guideline across all age groups; for PM2.5-10, increased excess risks of As and Cr were observed particularly for long-term exposures (adults, 55-64 years). Total carcinogenic risks highly (up to 67 times) exceeded the recommended level for all age groups, thus clearly showing that occupational exposure to metals in fine particles pose significant risks. If the extensive working hours of hospital medical staff were considered, the respective noncarcinogenic and carcinogenic risks were increased, the latter for PM2.5 exceeding the USEPA cumulative guideline of 10 . For adult patients, the estimated noncarcinogenic and carcinogenic risks were approximately three times higher than for personnel, with particular concerns observed for children and adolescents.

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“…Previous studies have focused on documenting differences in patient outcomes from administrative or survey data. 5,6 Other studies have focused on changes due to distance traveled, [12][13][14] rural hospital closure, [15][16][17][18][19][20] and staffi ng changes.…”

Section: Discussionmentioning

confidence: 99%

Effect of Closure of a Local Safety-Net Hospital on Primary Care Physicians' Perceptions of Their Role in Patient Care

Walker¹,

Clarke²,

Ryan³

et al. 2011

The Annals of Family Medicine

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PURPOSEWe examined how the closure of a large safety-net hospital in Los Angeles County, California, affected local primary care physicians. METHODSWe conducted semistructured interviews with 42 primary care physicians who practiced in both underserved and nonunderserved settings in Los Angeles County. Two investigators independently reviewed and coded transcripts. Three investigators used pile-sorting to sort the codes into themes.RESULTS Overall, 28 of 42 physicians (67%) described some effect of the hospital closure on their practices. Three major themes emerged regarding the impact of the closure on the affected physicians: (1) reduced local access to specialist consultations, direct hospital admissions, and timely emergency department evaluation; (2) more patient delays in care and worse health outcomes because of poor patient understanding of the health care system changes; and (3) loss of colleagues and opportunities to teach residents and medical students.CONCLUSIONS Physicians in close proximity to the closed hospital-even those practicing in nonunderserved settings-reported diffi culty getting their patients needed care that extended beyond the anticipated loss of inpatient services. There is a need for greater recognition of and support for the role primary care physicians play in coordinating care; promoting continuity of care; and informing patients, clinic administrators and policy makers about system changes during such transitions.

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“If you want to sit on your butts you’ll get nothing!” Community activism in response to threats of rural hospital closure in southern New Zealand

Cited by 64 publications

References 28 publications

Placing the dynamics of syringe exchange programs in the United States

Placing the dynamics of syringe exchange programs in the United States

Trace metals in size-fractionated particulate matter in a Portuguese hospital: exposure risks assessment and comparisons with other countries

Effect of Closure of a Local Safety-Net Hospital on Primary Care Physicians' Perceptions of Their Role in Patient Care

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