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In: Sosiologisk tidsskrift: journal of sociology, Band 24, Heft 2, S. 162-164
ISSN: 1504-2928
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In: Sosiologisk tidsskrift: journal of sociology, Band 24, Heft 2, S. 162-164
ISSN: 1504-2928
In: Tidsskrift for Forskning i Sygdom og Samfund: tidsskrift for idéhistorie, Heft 21
ISSN: 1904-7975
Til tross for betydelige statlige investeringer over flere år, er ikke telemedisin en etablert behandlingsform i norsk helsevesen. Lav utbredelse forklares ofte med at leger og andre helseprofesjonelle fungerer som portvakter. Etter vår mening er det behov for å heve blikket og supplere forklaringene på individnivå. I denne artikkelen presenterer vi en empirisk analyse inspirert av Bourdieus maktperspektiv. Vi har brukt intervju, observasjons og dokumentmateriale fra to empiriske case, teleslag og teledermatologi. I begge casene var legene positive til bruk av telemedisin, men løsningene ble lite brukt. Analysen får frem hvordan telemedisin er mer enn nye verktøy for klinkerne, og faktisk trigger diskusjoner om selve kjernen i helsefeltets autonomi; spørsmålet om hva som er den riktige behandling. Vi konkluderer med at mottagelsen av telemedisin i klinisk praksis må forstås i lys av pågående maktkamper i helsefeltet, mellom statlige styringsinteresser på den ene siden og profesjonell autonomi på den andre.Telemedicine; power disruptions in health careAlthough the development of telemedicine has been a priority in Norwegian public health care for over 20 years, only a limited number of applications have been established as routine services. Dominant explanations of slow diffusion points to clinicians and their role as gatekeepers. We argue there is a need to look beyond the ubiquitous accounts of individual influences, and include power structures in the analysis of telemedicine diffusion. In this paper, we present an empirical analysis inspired by Bourdieu's conceptual framework. The data consist of interviews, observations, and public- and project documents from two case studies; telestroke and teledermatology. In both cases, the clinicians were positive and involved in the implementation of telemedicine. Nevertheless, the services were not developed into routine practice; in fact, they were rarely used. Telemedicine touches upon the core value of health care activity: how to define the best patient treatment. The paper argues telemedicine might disrupt and be disrupted by existing power struggles in the health care sector. We conclude that slow diffusion of telemedicine should be understood in light of ongoing negotiations and power struggles between state regulatory powers on the one hand and health professional autonomy on the other.
In: Social theory & health, Band 8, Heft 3, S. 280-287
ISSN: 1477-822X
In: Social science & medicine, Band 215, S. 36-44
ISSN: 1873-5347
Scientific discoveries that provide strong evidence of antitumor effects in preclinical models often encounter significant delays before being tested in patients with cancer. While some of these delays have a scientific basis, others do not. We need to do better. Innovative strategies need to move into early stage clinical trials as quickly as it is safe, and if successful, these therapies should efficiently obtain regulatory approval and widespread clinical application. In late 2009 and 2010 the Society for Immunotherapy of Cancer (SITC), convened an "Immunotherapy Summit" with representatives from immunotherapy organizations representing Europe, Japan, China and North America to discuss collaborations to improve development and delivery of cancer immunotherapy. One of the concepts raised by SITC and defined as critical by all parties was the need to identify hurdles that impede effective translation of cancer immunotherapy. With consensus on these hurdles, international working groups could be developed to make recommendations vetted by the participating organizations. These recommendations could then be considered by regulatory bodies, governmental and private funding agencies, pharmaceutical companies and academic institutions to facilitate changes necessary to accelerate clinical translation of novel immune-based cancer therapies. The critical hurdles identified by representatives of the collaborating organizations, now organized as the World Immunotherapy Council, are presented and discussed in this report. Some of the identified hurdles impede all investigators; others hinder investigators only in certain regions or institutions or are more relevant to specific types of immunotherapy or first-in-humans studies. Each of these hurdles can significantly delay clinical translation of promising advances in immunotherapy yet if overcome, have the potential to improve outcomes of patients with cancer.
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In: Fox , BA , Schendel , D J , Butterfield , L H , Aamdal , S , Allison , J P , Ascierto , P A , Atkins , M B , Bartunkova , J , Bergmann , L , Berinstein , N , Bonorino , C C , Borden , E , Bramson , J L , Britten , C M , Cao , X , Carson , W E , Chang , A E , Characiejus , D , Choudhury , A R , Coukos , G , de Gruijl , T D , Dillman , R O , Dolstra , H , Dranoff , G , Durrant , L G , Finke , J H , Galon , J , Gollob , J A , Gouttefangeas , C , Grizzi , F , Guida , M , Hakansson , L , Hege , K , Herberman , R B , Hodi , F S , Hoos , A , Huber , C , Hwu , P , Imai , K , Jaffee , E M , Janetzki , S , June , C H , Kalinski , P , Kaufmann , H L , Kawakami , K , Kawakami , Y , Keilholtz , U , Khleif , S N , Kiessling , R , Kotlan , B , Kroemer , G , Lapointe , R , Levitsky , H I , Lotze , M T , Di Maio , M , Marschner , J P , Mastrangelo , M J , Masucci , G , Melero , I , Nelief , C , Murphy , W J , Nelson , B , Nicolini , A , Nishimura , M I , Odunsi , K , Ohashi , P S , O'Donnell-Tormey , J , Old , L J , Ottensmeier , C , Papamichail , M , Parmiani , G , Pawelec , G , Proietti , E , Qin , S , Rees , R , Ribas , A , Ridolfi , R , Ritter , G , Rivoltini , L , Romero , P J , Salem , M L , Scheper , R J , Seliger , B , Sharma , P , Shiku , H , Singh-Jasuja , H , Song , W , Straten , P T , Tahara , H , Tian , Z , van der Burg , S H , von Hoegen , P , Wang , E , Welters , M J , Winter , H , Withington , T , Wolchok , J D , Xiao , W , Zitvogel , L , Zwierzina , H , Marincola , F M , Gajewski , T F , Wigginton , J M & Disis , M L A 2011 , ' Defining the Critical Hurdles in Cancer Immunotherapy ' , Journal of Translational Medicine , vol. 9 , no. 1 , 214 . https://doi.org/10.1186/1479-5876-9-214
Scientific discoveries that provide strong evidence of antitumor effects in preclinical models often encounter significant delays before being tested in patients with cancer. While some of these delays have a scientific basis, others do not. We need to do better. Innovative strategies need to move into early stage clinical trials as quickly as it is safe, and if successful, these therapies should efficiently obtain regulatory approval and widespread clinical application. In late 2009 and 2010 the Society for Immunotherapy of Cancer (SITC), convened an "Immunotherapy Summit" with representatives from immunotherapy organizations representing Europe, Japan, China and North America to discuss collaborations to improve development and delivery of cancer immunotherapy. One of the concepts raised by SITC and defined as critical by all parties was the need to identify hurdles that impede effective translation of cancer immunotherapy. With consensus on these hurdles, international working groups could be developed to make recommendations vetted by the participating organizations. These recommendations could then be considered by regulatory bodies, governmental and private funding agencies, pharmaceutical companies and academic institutions to facilitate changes necessary to accelerate clinical translation of novel immune-based cancer therapies. The critical hurdles identified by representatives of the collaborating organizations, now organized as the World Immunotherapy Council, are presented and discussed in this report. Some of the identified hurdles impede all investigators; others hinder investigators only in certain regions or institutions or are more relevant to specific types of immunotherapy or first-in-humans studies. Each of these hurdles can significantly delay clinical translation of promising advances in immunotherapy yet if overcome, have the potential to improve outcomes of patients with cancer. © 2011 Fox et al; licensee BioMed Central Ltd.
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