The need for safe, accessible, client-centred, alcohol withdrawal services for seniors was recognized by health service workers in Victoria. A partnership of health and support service organizations developed and implemented a pilot project for treating alcohol withdrawal in the home. The project provided service that integrated well with a substance-abuse treatment program for seniors.
Experimental autoimmune glomerulonephritis (EAG) was induced in brown Norway (BN) rats by a single i.m. injection of collagenase-solubilized homologous glomerular basement membrane (GBM) in Freund's complete adjuvant. This model of anti-GBM disease is characterized by the development, over several weeks, of circulating and deposited anti-GBM antibodies, accompanied by albuminuria. We examined the effects of treatment with oral cyclosporin A (CsA) at different doses, starting at the time of immunization and during the course of the disease. Pretreatment with CsA 5 mg kg daily produced a moderate reduction in circulating anti-GBM antibody levels, reduced deposition of antibody on the GBM and decreased albuminuria. Doses of 10 and 20 mg/kg CsA produced a marked reduction in circulating antibody, absence of detectable deposited antibody and virtual absence of albuminuria. Renal function remained normal in CsA-treated and control animals. When CsA treatment was introduced at 2 or 4 weeks after immunization, there were significant effects on the subsequent autoimmune response and albuminuria at 10 and 20 mg/kg daily. These studies demonstrate that CsA in conventional doses has a therapeutic effect in this model of anti-GBM disease, and suggest a role for T lymphocytes in the pathogenesis of EAG.
The Geriatric Day Program (GDP) of the Capital Health Region in Victoria, BC, is concerned with effective team processes, accountability for health service outcomes, and improving the quality of programs. The GDP identified a need to improve its interdisciplinary processes and generate useful patient outcome data.
To determine whether Goal Attainment Scaling (GAS) could be introduced to facilitate interdisciplinary processes and to generate useful health outcome data.
The GAS procedures were incorporated into clinical routines based on published guidelines. The authors determined GAS outcome scores for patients who completed the program and developed outcome scores for specific geriatric problem areas requiring intervention. Outcome scores were made available to the clinical care team and to program managers for continuous quality improvement purposes.
The GAS process was successfully implemented and was acceptable to clinicians and managers at the GDP. Team processes were thought to be improved by focusing on patient goals in a structured way. The GAS provided data on both patient outcomes and outcomes of interventions in specific problem areas. Accountability for patient care increased. Goal Attainment Scaling provided indicators of care for which clinicians could develop program quality improvements.
Cites: J Am Geriatr Soc. 1996 Jul;44(7):835-88675935
Cites: J Am Geriatr Soc. 1996 Jul;44(7):847-568675938
Cites: Can Fam Physician. 1996 Jan;42:110-5, 1178924803
Cites: Neuroepidemiology. 1996;15(6):330-88930946
Cites: Drug Intell Clin Pharm. 1982 Feb;16(2):145-537075465
Cites: Community Ment Health J. 1982 Fall;18(3):230-417172619
Cites: N Engl J Med. 1984 Dec 27;311(26):1664-706390207
Cites: J Am Geriatr Soc. 1989 Jun;37(6):562-92654260
Cites: CMAJ. 1989 Nov 15;141(10):1045-82804826
Cites: Arch Phys Med Rehabil. 1991 Feb;72(2):138-431991015