Background Regionalised models of health care delivery have important implications for people with disabilities and chronic illnesses yet the ethical issues surrounding disability and regionalisation have not yet been explored. Although there is ethics-related research into disability and chronic illness, studies of regionalisation experiences, and research directed at improving health systems for these patient populations, to our knowledge these streams of research have not been brought together. Using the Canadian province of Ontario as a case study, we address this gap (...) by examining the ethics of regionalisation and the implications for people with disabilities and chronic illnesses. The critical success factors we provide have broad applicability for guiding and/or evaluating new and existing regionalised health care strategies. Discussion Ontario is in the process of implementing fourteen Local Health Integration Networks (LHINs). The implementation of the LHINs provides a rare opportunity to address systematically the unmet diverse care needs of people with disabilities and chronic illnesses. The core of this paper provides a series of composite case vignettes illustrating integration opportunities relevant to these populations, namely: (i) rehabilitation and services for people with disabilities; (ii) chronic illness and cancer care; (iii) senior's health; (iv) community support services; (v) children's health; (vi) health promotion; and (vii) mental health and addiction services. For each vignette, we interpret the governing principles developed by the LHINs – equitable access based on patient need, preserving patient choice, responsiveness to local population health needs, shared accountability and patient-centred care – and describe how they apply. We then offer critical success factors to guide the LHINs in upholding these principles in response to the needs of people with disabilities and chronic illnesses. Summary This paper aims to bridge an important gap in the literature by examining the ethics of a new regionalisation strategy with a focus on the implications for people with disabilities and chronic illnesses across multiple sites of care. While Ontario is used as a case study to contextualize our discussion, the issues we identify, the ethical principles we apply, and the critical success factors we provide have broader applicability for guiding and evaluating the development of – or revisions to – a regionalised health care strategy. (shrink)
We define a notion of genericity for genericity subgroups of groups interpretable in a simple theory. and show that a type generic for such a group is generic for the minimal hyperdefinable supergroup (the definable hull). In particular, at least one generic type of the definable hull is finitely satisfiable in the original subgroup. If the subgroup is a subfield, then the additive and the multiplicative definable hull both have bounded index in the smallest hyperdefinable superfield.
1. We show that if p is a real type which is internal in a set $\sigma$ of partial types in a simple theory, then there is a type p' interbounded with p, which is finitely generated over $\sigma$ , and possesses a fundamental system of solutions relative to $\sigma$ . 2. If p is a possibly hyperimaginary Lascar strong type, almost \sigma-internal$ , but almost orthogonal to $\sigma^{\omega}$ , then there is a canonical non-trivial almost hyperdefinable polygroup which multi-acts (...) on p while fixing $\sigma$ generically. In case p is $\sigma-internal$ and T is stable, this is the binding group of p over \sigma$. (shrink)
In recent work, the authors have established the group configuration theorem for simple theories, as well as some of its main applications from geometric stability theory, such as the binding group theorem, or in the ω-categorical case, the characterization of the forking geometry of a finitely based non-trivial locally modular regular type as projective geometry over a finite field and the equivalence of pseudolinearity and local modularity. The proof necessitated an extension of the model-theoretic framework to include almost hyperimaginaries, and (...) the study of polygroups. (shrink)
We study local strengthenings of the simplicity condition. In particular, we define and study a local Lascar rank, as well as short, low, supershort and superlow theories. An example of a low, non supershort theory is given.
We show that if p is a real type which is almost internal in a formula φ in a simple theory, then there is a type p' interalgebraic with a finite tuple of realizations of p, which is generated over φ. Moreover, the group of elementary permutations of p' over all realizations of φ is type-definable.
If K is a field of finite Morley rank, then for any parameter set $A \subseteq K^{eq}$ the prime model over A is equal to the model-theoretic algebraic closure of A. A field of finite Morley rank eliminates imaginaries. Simlar results hold for minimal groups of finite Morley rank with infinite acl( $\emptyset$ ).
A structure (M, $ ,...) is called quasi-o-minimal if in any structure elementarily equivalent to it the definable subsets are exactly the Boolean combinations of 0-definable subsets and intervals. We give a series of natural examples of quasi-o-minimal structures which are not o-minimal; one of them is the ordered group of integers. We develop a technique to investigate quasi-o-minimality and use it to study quasi-o-minimal ordered groups (possibly with extra structure). Main results: any quasi-o-minimal ordered group is abelian; any quasi-o-minimal (...) ordered ring is a real closed field, or has zero multiplication; every quasi-o-minimal divisible ordered group is o-minimal; every quasi-o-minimal archimedian densely ordered group is divisible. We show that a counterpart of quasi-o-minimality in stability theory is the notion of theory of U-rank 1. (shrink)
An ω-categorical supersimple group is finite-by-abelian-by-finite, and has finite SU-rank. Every definable subgroup is commensurable with an acl( $\emptyset$ )-definable subgroup. Every finitely based regular type in a CM-trivial ω-categorical simple theory is non-orthogonal to a type of SU-rank 1. In particular, a supersimple ω-categorical CM-trivial theory has finite SU-rank.
If G is an omega-stable group with a normal definable subgroup H, then the Sylow-2-subgroups of G/H are the images of the Sylow-2-subgroups of G. /// Sei G eine omega-stabile Gruppe und H ein definierbarer Normalteiler von G. Dann sind die Sylow-2-Untergruppen von G/H Bilder der Sylow-2-Untergruppen von G.
We define a generalized version of CM-triviality, and show that in the presence of enough regular types, or solubility, a stable CM-trivial group is nilpotent-by-finite. A torsion-free small CM-trivial stable group is abelian and connected. The first result makes use of a generalized version of the analysis of bad groups.
If * is a binary partial function which happens to be a group law on some infinite subset of some model of a stable theory, then this subset can be embedded into a definable group such that * becomes the group operation.
We develop a Sylow theory for stable groups satisfying certain additional conditions (2-finiteness, solvability or smallness) and show that their maximal p-subgroups are locally finite and conjugate. Furthermore, we generalize a theorem of Baer-Suzuki on subgroups generated by a conjugacy class of p-elements.
We generalise various properties of quasiendomorphisms from groups with regular generic to small abelian groups. In particular, for a small abelian group such that no infinite definable quotient is connected-by-finite, the ring of quasi-endomorphisms is locally finite. Under some additional assumptions, it decomposes modulo some nil ideal into a sum of finitely many matrix rings.
We prove that a stable solvable group G which satisfies xn = 1 generically is of finite exponent dividing some power of n. Furthermore, G is nilpotent-by-finite. A second result is that in a stable group of finite exponent, involutions either have big centralisers, or invert a subgroup of finite index (which hence has to be abelian).
We define an R-group to be a stable group with the property that a generic element (for any definable transitive group action) can only be algebraic over a generic. We then derive some corollaries for R-groups and fields, and prove a decomposition theorem and a field theorem. As a nonsuperstable example, we prove that small stable groups are R-groups.
We define the notion of generic for an arbitrary subgroup H of a stable group, and show that H has a definable hull with the same generic properties. We then apply this to the theory of stable fields.
