Browsing by Subject "regionalization"

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    A Canadian approach to the regionalization of testis cancer: A review
    (CUA, 2020) Nason, Gregory J.; Wood, Lori; Huddart, Robert A.; Albers, Peter; Rendon, Ricardo A.; Einhorn, Lawrence H.; Nichols, Craig R.; Kollmannsberger, Christian; Anson-Cartwright, Lynn; Sweet, Joan; Warde, Padraig; Jewett, Michael A. S.; Chung, Peter; Bedard, Philippe L.; Hansen, Aaron R.; Hamilton, Robert J.; Radiation Oncology, School of Medicine
    At the Canadian Testis Cancer Workshop, the rationale and feasibility of regionalization of testis cancer care were discussed. The two-day workshop involved urologists, medical and radiation oncologists, pathologists, radiologists, physician’s assistants, residents and fellows, and nurses, as well as patients and patient advocacy groups. This review summarizes the discussion and recommendations of one of the central topics of the workshop — the centralization of testis cancer in Canada. It was acknowledged that non-guideline-concordant care in testis cancer occurs frequently, in the range of 18–30%. The National Health Service in the U.K. stipulates various testis cancer care modalities be delivered through supra-regional network. All cases are reviewed at a multidisciplinary team meeting and aspects of care can be delivered locally through the network. In Germany, no such network exists, but an insurance-supported online second opinion network was developed that currently achieves expert case review in over 30% of cases. There are clear benefits to regionalization in terms of survival, treatment morbidity, and cost. There was agreement at the workshop that a structured pathway for diagnosis and treatment of testis cancer patients is required. Regionalization may be challenging in Canada because of geography; independent administration of healthcare by each province; physicians fearing loss of autonomy and revenue; patient unwillingness to travel long distances from home; and the inability of the larger centers to handle the ensuing increase in volume. We feel the first step is to identify the key performance indicators and quality metrics to track the quality of care received. After identifying these metrics, implementation of a “networks of excellence” model, similar to that seen in sarcoma care in Ontario, could be effective, coupled with increased use of health technology, such as virtual clinics and telemedicine.
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    Parallel worlds: attribute-defined regions in global human geography
    (2009-11-13T14:02:28Z) Ford, Of The; Dwyer, Owen J.; Wilson, Jeffrey S.; Pegg, Scott M.
    Global human regionalization often depends heavily on conventions, especially the country model. Standardized “countries” are used as default regions, and influence other regionalizations as well. Proposed here is the preference for multiple independent systems of regions based on empirical criteria specific to each field of inquiry. These regions, defined by attributes of the landscape, would subsume formal and functional regions alike, as well as the very similar “trait geographies” and “process geographies”. Two specific inquiries are studied, politics and language; in both cases, existing data tend towards the conventional. A primary empirical regionalization for politics can be based on effective government control. A primary empirical regionalization for language can be based on mutual intelligibility of vernacular dialects. Examined in political geography are concepts of juridical and empirical statehood and the question of state territoriality; examined in linguistic geography are the question of language versus dialect and the standard reference ‘Ethnologue’.