Health & place
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Despite the growing international interest in place of death and its relationship to healthcare policy, virtually nothing is known about where people die in Australia. To address this gap our study employs a longitudinal, population-based retrospective cohort study of people who died in Western Australia over a 30-month period. Mortality, morbidity and palliative care service data sets from the Western Australian Data Linkage System were examined to provide demographic and disease-specific characteristics and healthcare service use in the last year of life for the 26882 people who died during this time. ⋯ People who accessed community-based specialist palliative care had a seven times higher chance of dying in their usual place of residence. Importantly, this information is provided, not just for cancer deaths, as has been the practice to date, but for a range of other painful and life-limiting conditions considered amenable to palliative care. The unique population data on palliative care service use, made possible by the data linkage system, provides a basis for planning health services and policies.
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This paper highlights the need for health geographers to consider the social and cultural geographies of who gets to train as a doctor. The paper presents a case study of a scheme intended to widen access to medical education for working class students from inner London. ⋯ It employs ethnographic data to consider how 'non-traditional' learners acclimatise to medical school. Our findings indicate that the students who succeed best are those who can see themselves as belonging within the education system, regardless of their social and cultural background.
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This review examines the association between dog ownership and adult physical activity levels. While there is evidence to suggest that dog ownership produces considerable health benefit and provides an important form of social support that encourages dog owners to walk, there is limited evidence on the physical environmental and policy-related factors that affect dog owners walking with their dog. With the high level of dog ownership in many industrialized countries, further exploration of the relationship between dog ownership and physical activity levels may be important for preventing declining levels of physical activity and the associated detrimental health effects.
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This paper seeks to raise questions about the growing emphasis on public participation in decision-making in the health service. It examines the case study of lay participation on Local Research Ethics Committees (LRECs'). ⋯ It examines members' own conceptualisations of lay involvement and the contributions they are able to make in meetings as a result of these conceptualisations. It concludes that without better-defined roles for lay members on these committees they do not possess the authority or knowledge to challenge the experts' technical rendering of research.
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This paper examines spatial variation in the delivery of out of hours care through general practice, in two Health Authorities in northwest England. It demonstrates considerable variations in the type of care provided to patients in different parts of the region. ⋯ Rather, the type of out of hours care delivered depends much more on variations in the structure and organization of service delivery. These factors, in turn, largely reflect the history of service development in each area and the ethos of individual general practitioners instrumental in establishing the service.