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Design of a behavioral health program for urban American Indian/Alaska Native youths: a community informed approach.

https://arctichealth.org/en/permalink/ahliterature126319
Source
J Psychoactive Drugs. 2011 Oct-Dec;43(4):337-42
Publication Type
Article
Author
Daniel L Dickerson
Carrie L Johnson
Author Affiliation
United American Indian Involvement, Inc., Los Angeles, CA, USA.
Source
J Psychoactive Drugs. 2011 Oct-Dec;43(4):337-42
Language
English
Publication Type
Article
Keywords
Adolescent
Alaska - ethnology
Behavior Therapy
Child
Community Networks
Culture
Female
Health services needs and demand
Humans
Indians, North American - ethnology - psychology
Los Angeles
Male
Mental Disorders - ethnology - psychology - therapy
Mental health
Research Design
Retrospective Studies
Abstract
American Indian/Alaska Native (AI/AN) urban youths experience significant mental health and substance use problems. However, culturally relevant treatment approaches that incorporate community perspectives within the urban setting are limited. This study analyzes community perspectives from AI/AN parents, AI/AN youths, and services providers within Los Angeles County. Information gathered was utilized to develop a needs assessment for AI/AN youths with mental health and substance use problems and to design a community-informed treatment approach. Nine focus groups and key informant interviews were conducted. The Los Angeles County community strongly expressed the need for providing urban AI/AN youths with traditional healing services and cultural activities within their treatment program. However, various barriers to accessing mental health and substance abuse treatment services were identified. An integrated treatment approach was subsequently designed as a result of input derived from community perspectives. The community believed that providing urban AI/AN youths with an integrated treatment approach has the potential to decrease the risk of mental health and substance abuse problems in addition to enhancing their cultural identity and self esteem.
PubMed ID
22400466 View in PubMed
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Aftercare, emergency department visits, and readmission in adolescents.

https://arctichealth.org/en/permalink/ahliterature126698
Source
J Am Acad Child Adolesc Psychiatry. 2012 Mar;51(3):283-293.e4
Publication Type
Article
Date
Mar-2012
Author
Corine E Carlisle
Muhammad Mamdani
Russell Schachar
Teresa To
Author Affiliation
Hospital for Sick Children, Toronto, Ontario, Canada. corine.carlisle@sickkids.ca
Source
J Am Acad Child Adolesc Psychiatry. 2012 Mar;51(3):283-293.e4
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Aftercare - methods - psychology - standards
Canada
Confidence Intervals
Continuity of Patient Care - organization & administration
Emergency Services, Psychiatric - standards - statistics & numerical data
Female
Health services needs and demand
Humans
Information Systems - statistics & numerical data
Length of Stay - statistics & numerical data
Male
Mental Disorders - diagnosis - therapy
Outcome and Process Assessment (Health Care)
Patient Discharge - standards
Patient Readmission - statistics & numerical data
Psychiatric Status Rating Scales
Young Adult
Abstract
U.S. and Canadian data demonstrate decreasing inpatient days, increasing nonurgent emergency department (ED) visits, and short supply of child psychiatrists. Our study aims to determine whether aftercare reduces ED visits and/or readmission in adolescents with first psychiatric hospitalization.
We conducted a population-based cohort analysis using linked health administrative databases with accrual from April 1, 2002, to March 1, 2004. The study cohort included all 15- to 19-year-old adolescents with first psychiatric admission. Adolescents with and without aftercare in the month post-discharge were matched on their propensity to receive aftercare. Our primary outcome was time to first psychiatric ED visit or readmission. Secondary outcomes were time to first psychiatric ED visit and readmission, separately.
We identified 4,472 adolescents with first-time psychiatric admission. Of these, 57% had aftercare in the month post-discharge. Propensity-score-based matching, which accounted for each individual's propensity for aftercare, produced a cohort of 3,004 adolescents. In matched analyses, relative to those with no aftercare in the month post-discharge, those with aftercare had increased likelihood of combined outcome (hazard ratio [HR] = 1.22, 95% confidence interval [CI] = 1.05-1.42), and readmission (HR = 1.38, 95% CI = 1.14-1.66), but not ED visits (HR = 1.14, 95% CI = 0.95-1.37).
Our results are provocative: we found that aftercare in the month post-discharge increased the likelihood of readmission but not ED visit. Over and above confounding by severity and Canadian/U.S. systems differences, our results may indicate a relative lack of psychiatric services for youth. Our results point to the need for improved data capture of pediatric mental health service use.
PubMed ID
22365464 View in PubMed
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Palliative care for vulnerable populations.

https://arctichealth.org/en/permalink/ahliterature127037
Source
Palliat Support Care. 2012 Mar;10(1):37-42
Publication Type
Article
Date
Mar-2012
Author
Deborah Stienstra
Harvey Max Chochinov
Author Affiliation
Disability Studies, University of Manitoba, Winnipeg, Canada.
Source
Palliat Support Care. 2012 Mar;10(1):37-42
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Canada
Health Services Accessibility
Health services needs and demand
Hospice Care
Humans
Palliative Care
Prognosis
Quality Assurance, Health Care
Terminal Care
Vulnerable Populations
Abstract
The purpose of this article is to identify how inclusive and accessible palliative care can be achieved for all, including those labelled as vulnerable populations.
Drawing on a review of existing literature as well the research of the Vulnerable Persons and End-of-Life New Emerging Team (VP-NET), this article reflects on what changes can be made within palliative care to make it more inclusive.
Experiences of marginalization often result, intentionally or unintentionally, in differential treatment in healthcare. This increased vulnerability may result from attitudes of healthcare providers or from barriers as a result of "normal" care practices and policies that may exclude or stigmatize certain populations. This may include identifying when palliative care is necessary, who receives palliative care and where, and what is necessary to complement palliative care.
Inclusive and accessible palliative care can become possible through building on the existing strengths in palliative care, as well as addressing existing barriers. This may include treating the whole person and that person's support team, including paid support workers, as part of the unit of care. It involves ensuring physically accessible hospice and palliative care locations, as well as thinking creatively about how to include those excluded in traditional locations. Inclusive palliative care also ensures coordination with other care services. Addressing the barriers to access, and inclusion of those who have been excluded within existing palliative care services, will ensure better palliative and end-of-life care for everyone.
PubMed ID
22329935 View in PubMed
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Top-level managers' and politicians' worries about future care for older people with complex and acute illnesses: a Nordic study.

https://arctichealth.org/en/permalink/ahliterature127046
Source
Int J Older People Nurs. 2012 Jun;7(2):163-72
Publication Type
Article
Date
Jun-2012
Author
Elisabeth Finnbakk
Kirsti Skovdahl
Ellen Störe Blix
Lisbeth Fagerström
Author Affiliation
School of Health and Medical Sciences, Örebro University, Örebro, Sweden. elisabeth.finnbakk@ldh.no
Source
Int J Older People Nurs. 2012 Jun;7(2):163-72
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Acute Disease - therapy
Administrative Personnel - psychology
Adult
Aged
Chronic Disease - therapy
Community-Institutional Relations
Denmark
Female
Finland
Health Resources
Health services needs and demand
Health Services for the Aged - standards - trends
Humans
Interviews as Topic
Male
Middle Aged
Norway
Nursing Care
Patient care team
Politics
Population Dynamics
Quality Assurance, Health Care - standards
Sweden
Abstract
The growing aging population, with its associated complex needs and illnesses, will in the future become an even more important challenge for the Nordic countries.
The aim of the study was to describe and explore the perceptions and views of top-level managers and politicians in regard to an optimal future care for older people during the next decade.
The study has a qualitative, descriptive design.
Top-level managers (n = 11) and politicians (n = 8) were interviewed in Sweden, Finland, Denmark and Norway in 2009. The data material was analysed through manifest and latent content analyses.
Future care should substantially focus on the individual needs and dignity of older people. The respondents also recommended a preventive perspective on future care. They anticipate that older people's needs will be complex, requiring nursing competence on an advanced level within home care and nursing homes, and point to the importance of leadership abilities and workplace image. Limited resources and the use of health technology will be dominant issues, entailing the need for open-mindedness to reorganise future care. The latent theme expressed was 'A creative willingness to act - but with an underlying worry about the future'.
The findings reveal a multifaceted scenario of optimal future care; older people will have significant, acute and complex needs but resources will be limited. In the near future, medical treatment and nursing care for older people at advanced and specialised levels within primary health care will be needed.
To meet demands, a clear need exists for the advanced clinical competence of nurses. There is also a clear need to reorganise health care services for older people, develop the leadership abilities of nurse managers and make workplaces more attractive.
PubMed ID
22329682 View in PubMed
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Home mechanical ventilation and specialised health care in the community: Between a rock and a hard place.

https://arctichealth.org/en/permalink/ahliterature134271
Source
BMC Health Serv Res. 2011;11:115
Publication Type
Article
Date
2011
Author
Knut Dybwik
Erik W Nielsen
Berit S Brinchmann
Author Affiliation
Department of Anesthesiology, Nordland Hospital, N-8092 Bodø, Norway. kdybwik@gmail.com
Source
BMC Health Serv Res. 2011;11:115
Date
2011
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Community Health Services - methods - organization & administration
Continuity of Patient Care
Focus Groups
Health Services Accessibility
Health services needs and demand
Home Care Services
Humans
Norway
Qualitative Research
Residence Characteristics
Respiration, Artificial - instrumentation - methods
Abstract
Home mechanical ventilation probably represents the most advanced and complicated type of medical treatment provisioned outside a hospital setting. The aim of this study was both to explore the challenges experienced by health care professionals in community health care services when caring for patients dependent on home mechanical ventilation, continual care and highly advanced technology, and their proposed solutions to these challenges.
Using qualitative research methods, a grounded theory influenced approach was used to explore the respondents' experiences and proposed solutions. A total of 34 multidisciplinary respondents from five different communities in Norway were recruited for five focus groups.
The core category in our findings was what health care professionals in community health care services experience as "between a rock and a hard place," when working with hospitals, family members, and patients. We further identified four subcategories, "to be a guest in the patient's home," "to be accepted or not," "who decides," and "how much can we take." The main background for these challenges seems to stem from patients living and receiving care in their private homes, which often leads to conflicts with family members. These challenges can have a negative effect on both the community health caregivers' work environment and the community health service's provision of professional care.
This study has identified that care of individuals with complex needs and dependent on home mechanical ventilation presents a wide range of immense challenges for community health care services. The results of this study point towards a need to define the roles of family caregivers and health care professionals and also to find solutions to improve their collaboration. The need to improve the work environment for caregivers directly involved in home-care also exists. The study also shows the need for more dialogue concerning eligibility requirements, rights, and limitations of patients in the provision and use of ventilatory support in private homes.
Notes
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PubMed ID
21605365 View in PubMed
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Breast cancer and screening information needs and preferred communication medium among Iranian immigrant women in Toronto.

https://arctichealth.org/en/permalink/ahliterature134356
Source
Health Soc Care Community. 2011 Nov;19(6):626-35
Publication Type
Article
Date
Nov-2011
Author
Mandana Vahabi
Author Affiliation
Ryerson University, Daphne Cockwell School of Nursing, Toronto, Ontario, Canada. mvahabi@ryerson.ca
Source
Health Soc Care Community. 2011 Nov;19(6):626-35
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Access to Information
Adult
Aged
Breast Neoplasms - diagnosis - ethnology
Consumer Health Information - methods
Emigrants and Immigrants
Female
Health services needs and demand
Humans
Interviews as Topic
Iran - ethnology
Middle Aged
Ontario
Women
Abstract
Few studies have investigated what information women from minority immigrant groups need about breast cancer and screening. Nor has much research been conducted about how such women would prefer to receive this information. Mere translation of breast cancer and screening information from generic materials, without considering and respecting women's unique historical, political, and cultural experiences, is insufficient. This study explored breast cancer and screening information needs and preferred methods of communication among Iranian immigrant women. A convenience sample of 50 women was recruited and interviewed over a 4-month period (June-September 2008); all resided in Toronto Canada, and had no history of breast cancer. Tape-recorded interviews were transcribed and analysed using a thematic analysis technique. While generic breast health communication focusing on physiological risk information meets some of the needs of Iranian immigrant women, results showed that the needs of this group go beyond this basic information. This group is influenced by historical, sociopolitical, and cultural experiences pre- and post-immigration. Their experiences with chemical war, unsafe physical environment (air and water pollution), and their sociopolitical situation appear to have limited their access to accurate and reliable breast cancer and screening information in their homeland. Moreover, the behavioural and psychosocial changes they face after immigration appear to have a strong influence on their breast cancer and screening information needs. Considering their limited time due to their multiple demands post-migration, multi-media methods were highly preferred as a communication means by this group. The results of this study can be used to guide the design and implementation of culturally sensitive breast health information. For instance, video presentations conducted by a trusted Iranian healthcare professional focusing on socioculturally relevant breast cancer risk factors, symptoms, and screening methods, as well as a list of available breast health resources, could improve Iranian women's knowledge and uptake of breast health practices.
PubMed ID
21595770 View in PubMed
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Awareness and advocacy for adolescents and young adults with cancer.

https://arctichealth.org/en/permalink/ahliterature134411
Source
Cancer. 2011 May 15;117(10 Suppl):2311-5
Publication Type
Article
Date
May-15-2011
Author
Devon McGoldrick
Pamela Gordon
Myrna Whiteson
Heidi Adams
Paul Rogers
Simon Sutcliffe
Author Affiliation
LiveStrong, Austin, Texas 78702, USA. devon.mcgoldrick@livestrong.org
Source
Cancer. 2011 May 15;117(10 Suppl):2311-5
Date
May-15-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Canada
Health Knowledge, Attitudes, Practice
Health Priorities
Health services needs and demand
Humans
Neoplasms - diagnosis - psychology - therapy
Patient Advocacy
Young Adult
Abstract
Increasing the awareness of the clinical and psychosocial needs that are particular to adolescents and young adults (AYA) was a top priority, as was strengthening advocacy efforts to empower and support this group. To date, AYA advocates had some success in generating public awareness and building a solid clinical justification for increased focus on this population. It had been established that the economic burden of their mortality was significant, their cancers were unusual, their medical care was often inadequate, and their outcomes for many cancers had not improved in the past 3 decades. As the awareness and advocacy campaign continued to grow and evolve across the globe, it was an important goal to integrate the efforts of all stakeholders to ensure that it progressed with a single, consensual, focused message identifying a common priority for action. By coordinating the efforts of the scientific, medical, and advocacy communities, it was possible to amplify their separate efforts and activities and more efficiently achieve large-scale change in the world of AYA oncology.
PubMed ID
21523751 View in PubMed
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A review of Canadian health care and cancer care systems.

https://arctichealth.org/en/permalink/ahliterature134415
Source
Cancer. 2011 May 15;117(10 Suppl):2241-4
Publication Type
Article
Date
May-15-2011
Author
Simon B Sutcliffe
Author Affiliation
Candian Partnership Against Cancer, Vancouver, BC, Canada. cci-cancercontrol@shaw.ca
Source
Cancer. 2011 May 15;117(10 Suppl):2241-4
Date
May-15-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Health Services
Adult
Canada
Child
Child Health Services
Delivery of Health Care - economics
Health services
Health services needs and demand
Humans
Neoplasms - therapy
Abstract
Canada is a westernized, market-economy nation with a publicly funded health care and cancer control system and has health indices reflective of a high-resource economy. Provision of health services is in accord with the Canada Health Act and is implemented through federal, provincial, and territorial relations wherein federal funding partly provides support for the provincial/territorial delivery of health services. Cancer services are provided within the acute health care system with dedicated entities existing in parallel in most provinces to provide services specific to the diagnosis, treatment, and support of cancer patients. Interprovincial and territorial collaboration to enhance and facilitate optimal cancer system performance is enabled through the Canadian Partnership Against Cancer (the Canadian national cancer control initiative). Adolescent and young adult (AYA) cancer patients use both the pediatric and adult cancer systems. There is recognition, however, that although AYA patients are numerically a small portion of all cancer patients, the negative personal, societal, and socioeconomic impacts of potential years of life lost are substantial and can be lessened through attention to awareness, education, redesign of care and care pathways, quality of life, developmental aspects related to adolescent-teen-adult transitions, continuity of care, and surveillance across pediatric and adult settings. Appropriate solutions need to be established within the framework of the Canadian Health Service by innovative rethinking and realignment of system capacity and performance to the special needs of AYA cancer patients.
PubMed ID
21523740 View in PubMed
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Adolescents and young adults with cancer: towards better outcomes in Canada. Preamble.

https://arctichealth.org/en/permalink/ahliterature134416
Source
Cancer. 2011 May 15;117(10 Suppl):2239-40
Publication Type
Article
Date
May-15-2011
Author
Ronald Barr
Paul Rogers
Brent Schacter
Author Affiliation
Pediatric Hematology/Oncology, McMaster University, Hamilton, Ontario, Canada. rbarr@mcmaster.ca
Source
Cancer. 2011 May 15;117(10 Suppl):2239-40
Date
May-15-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Health Services
Canada
Child
Child Health Services
Child, Preschool
Delivery of Health Care
Health services needs and demand
Healthcare Disparities
Humans
Neoplasms - therapy
PubMed ID
21523739 View in PubMed
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Access to dental care for low-income adults: perceptions of affordability, availability and acceptability.

https://arctichealth.org/en/permalink/ahliterature134419
Source
J Community Health. 2012 Feb;37(1):32-9
Publication Type
Article
Date
Feb-2012
Author
Bruce B Wallace
Michael I Macentee
Author Affiliation
Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada. bbw@interchange.ubc.ca
Source
J Community Health. 2012 Feb;37(1):32-9
Date
Feb-2012
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Attitude to Health
Canada
Community Health Services - economics
Dental Care - economics
Dentists - psychology
Female
Health Services Accessibility - economics
Health services needs and demand
Health Services Research
Humans
Male
Middle Aged
Models, Psychological
Poverty
Professional-Patient Relations
Qualitative Research
Social Work
Vulnerable Populations
Young Adult
Abstract
The objective of this study was to explore access to dental care for low-income communities from the perspectives of low-income people, dentists and related health and social service-providers. The case study included 60 interviews involving, low-income adults (N = 41), dentists (N = 6) and health and social service-providers (N = 13). The analysis explores perceptions of need, evidence of unmet needs, and three dimensions of access--affordability, availability and acceptability. The study describes the sometimes poor fit between private dental practice and the public oral health needs of low-income individuals. Dentists and low-income patients alike explained how the current model of private dental practice and fee-for-service payments do not work well because of patients' concerns about the cost of dentistry, dentists' reluctance to treat this population, and the cultural incompatibility of most private practices to the needs of low-income communities. There is a poor fit between private practice dentistry, public dental benefits and the oral health needs of low-income communities, and other responses are needed to address the multiple dimensions of access to dentistry, including community dental clinics sensitive to the special needs of low-income people.
PubMed ID
21590434 View in PubMed
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2355 records – page 1 of 236.