Dying to Care: How can we provide sustainable quality care to persons living with advanced life limiting illness in British Columbia?
Notice bibliographique
Résumé
Around the world, the oldest segment of the population is expected to grow the fastest. Within the OECD (Organisation for Economic Co-operation and Development) countries the population share of those 80 years and over is expected to increase from 4% in 2010 to 9.4% in 2050.1 As of July 1, 2010, seniors aged 65 years and over accounted for 14.1% of the Canadian population. Projections show that seniors could account for more than 20% of the population as soon as 2026 and could exceed 25% of the population by 2056. Seniors aged 80 years and over now represent 3.9% of the total Canadian population; the number of people over 80 residing in Canada by the year 2061 is projected to be 5.1 million. In addition, the fastest growing age groups within the 2009/2010 period were people aged 90 years and over.2 As a consequence of the aging of our population, more people are living with advancing, chronic and life-limiting illness and often with multiple, interacting medical and social problems. At some point in this advancing illness trajectory, people die, and about 80% of these deaths will be caused by end stage chronic diseases such as cardiovascular, lung, and kidney disease, cancer, and dementias.3 In Western Canada, however, only 16% to 30% of people who die are identified as dying and receive palliative care services.4 The majority who access these services have cancer, a unique chronic disease as it can often be predicted when the end of life may be approaching. This is not the case with most chronic diseases. Consequently, most individuals with advancing chronic life-limiting conditions such as heart disease, chronic obstructive pulmonary disease, kidney disease and dementias, do not access palliative care services but dwell “in the indistinct zone of chronic illness that has no specific care delivery system”. 5 While specialist palliative care services are critical for those with complex care needs, such a model, alone, cannot meet current and future demand for the larger population outside of the traditional recipients of cancer care. The result is that many people who require and would benefit from a palliative approach are not served by specialized palliative care. Historically, these specialized models were not developed for those with advancing chronic non-malignant disease and such models are neither feasible nor desirable for the larger numbers affected by and dying from chronic illness.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,012 | 0,002 |
| Communication savante | 0,006 | 0,003 |
| Science ouverte | 0,003 | 0,004 |
| Intégrité de la recherche | 0,003 | 0,005 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,023 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».