981 resultados para mixed race


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Timely and convenient access to primary healthcare is essential for the health of the population as delays can incur additional health and financial costs. Access to health care is under increasing scrutiny as part of the drive to contain escalating costs, while attempting to maintain equity in service provision. The objective was to compare primary care services in Republic of Ireland and Northern Ireland, and to report on perceived and reported access to GP services in universal access and mixed private/public systems. A questionnaire study was performed in Northern Ireland (NI) and the Republic of Ireland (ROI). Patients of 20 practices in the ROI and NI were contacted (n = 22,796). Main outcome measures were overall satisfaction and the access to GP services. Individual responses and scale scores were derived using the General Practice Assessment Questionnaire (G-PAQ). The response rate was 52% (n = 11,870). Overall satisfaction with GP practices was higher in ROI than in NI (84.2% and 80.9% respectively). Access scores were higher in ROI than in NI (69.2% and 57.0% respectively) Less than 1 in 10 patients in ROI waited two or more working days to see a doctor of choice (8.1%) compared to almost half (45.0%) in NI. In NI overall satisfaction decreased as practice size increased; 82.8%, 80.4%, and 75.8%. In both systems, in large practices, accessibility is reduced when compared to smaller practices. The faster access to GP services in ROI may be due to the deterrent effect of the consultation charge freeing up services although, as it is the poorest and sickest who are deterred by the charge this improved accessibility may come at a significant cost in terms of equity. The underlying concern for policy makers centres around provision of equitable services.

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It is difficult, even excruciating, to imagine the staggering descent from high optimism to despondency experienced by many African Americans who lived between emancipation and the dawn of the twentieth century. For historians living in the post–civil rights era, recapturing the scale, velocity, and brutality of that dramatic fall has been hampered by two conceptual problems. The first of these, undergirded by prominent trends in the formerly “new” social history, is a widely shared enthusiasm for illuminating those hidden corners of daily life where men and women on the receiving end of Jim Crow continued to wield a degree of control. “Agency” has been the buzzword for a generation of scholarship that emphasizes the staying power and persistence of black Southerners in the face of relentless assaults on their social and economic status, their civil rights, and even, at times, their collective existence. This is, in many ways, an understandable reaction to an earlier consensus that relegated black historical initiative to the margins of a national fable cleansed of unseemly violence and sharp social conflict, but it can also be problematic.