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The 2-year costs and effects of a public health nursing case management intervention on mood-disordered single parents on social assistance.

https://arctichealth.org/en/permalink/ahliterature191135
Source
J Eval Clin Pract. 2002 Feb;8(1):45-59
Publication Type
Article
Date
Feb-2002
Author
Maureen Markle-Reid
Gina Browne
Jacqueline Roberts
Amiram Gafni
Carolyn Byrne
Author Affiliation
System-Linked Research Unit on Health and Social Service Utilization, School of Nursing, McMaster University, Room 3N46, 1200 Main Street West, Hamilton, Ontario, L8N 3Z5, Canada. mreid@mcmaster.ca
Source
J Eval Clin Pract. 2002 Feb;8(1):45-59
Date
Feb-2002
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Case Management - economics
Child
Cost-Benefit Analysis
Depressive Disorder - economics - nursing - rehabilitation
Employment
Female
Health Care Costs
Health Services - utilization
Health Services Accessibility
Humans
Male
Ontario
Public Assistance
Public Health Nursing - economics
Single Parent - psychology
Social Adjustment
Abstract
This randomized controlled trial was designed to evaluate the 2-year costs and effects of a proactive, public health nursing case management approach compared with a self-directed approach for 129 single parents (98% were mothers) on social assistance in a Canadian setting. A total of 43% of these parents had a major depressive disorder and 38% had two or three other health conditions at baseline.
Study participants were recruited over a 12 month period and randomized into two groups: one receiving proactive public health nursing and one which did not.
At 2 years, 69 single parents with 123 children receiving proactive public health nursing (compared with 60 parents with 91 children who did not receive public health nursing services) showed a slightly greater reduction in dysthymia and slightly higher social adjustment. There was no difference between the public health and control groups in total per parent annual cost of health and support services. However, costs were averted due to a 12% difference in non-use of social assistance in the previous 12 months for parents in the public health nursing group. This translates into an annual cost saving of 240,000 dollars (Canadian) of costs averted within 1 year for every 100 parents.
In the context of a system of national health and social insurance, this study supports the fact that it is no more costly to proactively service this population of parents on social assistance.
PubMed ID
11882101 View in PubMed
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The 6 dimensions of promising practice for case managed supports to end homelessness, part 1: contextualizing case management for ending homelessness.

https://arctichealth.org/en/permalink/ahliterature130590
Source
Prof Case Manag. 2011 Nov-Dec;16(6):281-7; quiz 288-9
Publication Type
Article
Author
Katrina Milaney
Author Affiliation
Calgary Homeless Foundation, AB, Canada. kmilaney@calgaryhomeless.com
Source
Prof Case Manag. 2011 Nov-Dec;16(6):281-7; quiz 288-9
Language
English
Publication Type
Article
Keywords
Canada
Case Management
Community Health Services
Concept Formation
Continuity of Patient Care
Cooperative Behavior
Decision Making
Homeless Persons
Housing - statistics & numerical data
Humans
Models, organizational
Physician's Practice Patterns - statistics & numerical data
Program Development - methods
Program Evaluation
Abstract
Homelessness is a social condition increasing in frequency and severity across Canada. Interventions to end and prevent homelessness include effective case management in addition to an affordable housing provision. Little standardization exists for service providers to guide their decision making in developing and maintaining effective case management programs. The purpose of this 2-part article is to articulate dimensions of promising practice for case managers working in a "Housing First" context. Part 1 discusses research processes and findings and part-2 articulates the 6 Dimensions of Quality.
Practice settings include community-based organizations that employ and support case managers whose primary role is moving people from homelessness into permanent housing.
Six dimensions of promising practice are critically important to reducing barriers, improving sector collaboration, and ensuring case managers have appropriate and effective training and support. Dimensions of promising practice are: (1) collaboration and cooperation-a true team approach; (2) right matching of services-person-centered; (3) contextual case management-culture and flexibility; (4) the right kind of engagement-relationships and advocacy; (5) coordinated and well managed system-ethics and communication; and (6) evaluation for success-support and training.
Effective, coordinated case management, in addition to permanent affordable housing has the potential to reduce a person or family's homelessness permanently. Organizations and professionals working in this context have the opportunity to improve processes, reduce burnout, collaborate and standardize, and most importantly, efficiently and permanently end someone's homelessness with the help of dimensions of quality for case management.
PubMed ID
21986969 View in PubMed
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The 6 dimensions of promising practice for case managed supports to end homelessness: part 2: the 6 dimensions of quality.

https://arctichealth.org/en/permalink/ahliterature129049
Source
Prof Case Manag. 2012 Jan-Feb;17(1):4-12; quiz 13-4
Publication Type
Article
Author
Katrina Milaney
Author Affiliation
Calgary Homeless Foundation, Calgary, Alberta, Canada. kmilaney@calgaryhomeless.com
Source
Prof Case Manag. 2012 Jan-Feb;17(1):4-12; quiz 13-4
Language
English
Publication Type
Article
Keywords
Canada
Case Management - standards - statistics & numerical data
Cooperative Behavior
Delivery of Health Care - organization & administration - standards
Health Services Accessibility
Health services needs and demand
Homeless Persons - statistics & numerical data
Humans
Models, Theoretical
Patient care team
Patient-Centered Care - methods
Physician's Practice Patterns - standards - statistics & numerical data
Professional Competence
Quality of Health Care - standards - statistics & numerical data
Abstract
Homelessness is a social condition increasing in frequency and severity across Canada. Interventions to end and prevent homelessness include effective case management in addition to an affordable housing provision. Little standardization exists for service providers to guide their decision making in developing and maintaining effective case management programs. The purpose of this 2-part article is to articulate dimensions of promising practice for case managers working in a "Housing First" context. Part 1 discusses research processes and findings and Part 2 articulates the 6 dimensions of quality.
Practice settings include community-based organizations that employ and support case managers whose primary role is moving people from homelessness into permanent supportive housing.
Six dimensions of promising practice are critically important to reducing barriers, improving sector collaboration, and ensuring that case managers have appropriate and effective training and support. Dimensions of promising practice are (1) collaboration and cooperation-a true team approach; (2) right matching of services-person-centered; (3) contextual case management-culture and flexibility; (4) the right kind of engagement-relationships and advocacy; (5) coordinated and well-managed system-ethics and communication; and (6) evaluation for success-support and training.
Effective, coordinated case management, in addition to permanent affordable housing has the potential to reduce a person's or family's homelessness permanently. Organizations and professionals working in this context have the opportunity to improve processes, reduce burnout, collaborate and standardize, and, most importantly, efficiently and permanently end someone's homelessness with the help of dimensions of quality for case management.
PubMed ID
22146635 View in PubMed
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21st century rural nursing: Navajo Traditional and Western medicine.

https://arctichealth.org/en/permalink/ahliterature187143
Source
Nurs Adm Q. 2002;26(5):47-57
Publication Type
Article
Date
2002
Author
Barbara L O'Brien
Rosemary M Anslow
Wanda Begay
Sister Benvinda A Pereira
Mary Pat Sullivan
Author Affiliation
Magnetic Health Care Strategies, LLC, Middletown, New Jersey, USA.
Source
Nurs Adm Q. 2002;26(5):47-57
Date
2002
Language
English
Publication Type
Article
Keywords
Arizona
Case Management - organization & administration
Health Services, Indigenous - organization & administration
Humans
Indians, North American
Medicine, Traditional
New Mexico
Nurse practitioners
Rural health services - organization & administration
Abstract
Past experiences enhance the future. Health care providers gaining expertise in creative thinking, traditional medicine, spirituality, and cultural sensitivity is an essential requirement for 21st century health care. We must stay mindful that poverty, isolation, and rural living may create new forms of social exclusion because of lack of communication and rapidly changing technology. Conversely, sensory overload resulting from a faster paced lifestyle and rapid enhancements in technology may cause increased tension and stress. This article reviews successes that may offer the reader ideas on coping with the provision of health care services in such a volatile changing environment, while honoring tradition and cultural competency.
PubMed ID
12515233 View in PubMed
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The 2009 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 2--therapy.

https://arctichealth.org/en/permalink/ahliterature151164
Source
Can J Cardiol. 2009 May;25(5):287-98
Publication Type
Article
Date
May-2009
Author
Nadia A Khan
Brenda Hemmelgarn
Robert J Herman
Chaim M Bell
Jeff L Mahon
Lawrence A Leiter
Simon W Rabkin
Michael D Hill
Raj Padwal
Rhian M Touyz
Pierre Larochelle
Ross D Feldman
Ernesto L Schiffrin
Norman R C Campbell
Gordon Moe
Ramesh Prasad
Malcolm O Arnold
Tavis S Campbell
Alain Milot
James A Stone
Charlotte Jones
Richard I Ogilvie
Pavel Hamet
George Fodor
George Carruthers
Kevin D Burns
Marcel Ruzicka
Jacques DeChamplain
George Pylypchuk
Robert Petrella
Jean-Martin Boulanger
Luc Trudeau
Robert A Hegele
Vincent Woo
Phil McFarlane
Michel Vallée
Jonathan Howlett
Simon L Bacon
Patrice Lindsay
Richard E Gilbert
Richard Z Lewanczuk
Sheldon Tobe
Author Affiliation
Division of General Internal Medicine, University of British Columbia, Vancouver, Canada. nakhan@shaw.ca
Source
Can J Cardiol. 2009 May;25(5):287-98
Date
May-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - therapeutic use
Blood Pressure Determination - standards
Canada
Case Management - standards
Combined Modality Therapy
Diet, Sodium-Restricted
Female
Health Promotion - organization & administration
Humans
Hypertension - diagnosis - therapy
Life Style
Male
Middle Aged
Patient Education as Topic
Prognosis
Program Evaluation
Randomized Controlled Trials as Topic
Treatment Outcome
Abstract
To update the evidence-based recommendations for the prevention and management of hypertension in adults for 2009.
For lifestyle and pharmacological interventions, evidence from randomized controlled trials and systematic reviews of trials was preferentially reviewed. Changes in cardiovascular morbidity and mortality were the primary outcomes of interest. However, for lifestyle interventions, blood pressure lowering was accepted as a primary outcome given the lack of long-term morbidity and mortality data in this field. Progression of kidney dysfunction was also accepted as a clinically relevant primary outcome among patients with chronic kidney disease.
A Cochrane collaboration librarian conducted an independent MEDLINE search from 2007 to August 2008 to update the 2008 recommendations. To identify additional published studies, reference lists were reviewed and experts were contacted. All relevant articles were reviewed and appraised independently by both content and methodological experts using prespecified levels of evidence.
For lifestyle modifications to prevent and treat hypertension, restrict dietary sodium to less than 2300 mg (100 mmol)/day (and 1500 mg to 2300 mg [65 mmol to 100 mmol]/day in hypertensive patients); perform 30 min to 60 min of aerobic exercise four to seven days per week; maintain a healthy body weight (body mass index 18.5 kg/m(2) to 24.9 kg/m(2)) and waist circumference (smaller than 102 cm for men and smaller than 88 cm for women); limit alcohol consumption to no more than 14 units per week in men or nine units per week in women; follow a diet that is reduced in saturated fat and cholesterol, and that emphasizes fruits, vegetables and low-fat dairy products, dietary and soluble fibre, whole grains and protein from plant sources; and consider stress management in selected individuals with hypertension. For the pharmacological management of hypertension, treatment thresholds and targets should be predicated on by the patient's global atherosclerotic risk, target organ damage and comorbid conditions. Blood pressure should be decreased to lower than 140/90 mmHg in all patients, and to lower than 130/80 mmHg in those with diabetes mellitus or chronic kidney disease. Most patients will require more than one agent to achieve these target blood pressures. Antihypertensive therapy should be considered in all adult patients regardless of age (caution should be exercised in elderly patients who are frail). For adults without compelling indications for other agents, initial therapy should include thiazide diuretics. Other agents appropriate for first-line therapy for diastolic and/or systolic hypertension include angiotensin- converting enzyme (ACE) inhibitors (in patients who are not black), long-acting calcium channel blockers (CCBs), angiotensin receptor antagonists (ARBs) or beta-blockers (in those younger than 60 years of age). A combination of two first-line agents may also be considered as the initial treatment of hypertension if the systolic blood pressure is 20 mmHg above the target or if the diastolic blood pressure is 10 mmHg above the target. The combination of ACE inhibitors and ARBs should not be used. Other agents appropriate for first-line therapy for isolated systolic hypertension include long- acting dihydropyridine CCBs or ARBs. In patients with angina, recent myocardial infarction or heart failure, beta-blockers and ACE inhibitors are recommended as first-line therapy; in patients with cerebrovascular disease, an ACE inhibitor/diuretic combination is preferred; in patients with proteinuric nondiabetic chronic kidney disease, ACE inhibitors or ARBs (if intolerant to ACE inhibitors) are recommended; and in patients with diabetes mellitus, ACE inhibitors or ARBs (or, in patients without albuminuria, thiazides or dihydropyridine CCBs) are appropriate first-line therapies. All hypertensive patients with dyslipidemia should be treated using the thresholds, targets and agents outlined in the Canadian Cardiovascular Society position statement (recommendations for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease). Selected high-risk patients with hypertension who do not achieve thresholds for statin therapy according to the position paper should nonetheless receive statin therapy. Once blood pressure is controlled, acetylsalicylic acid therapy should be considered.
All recommendations were graded according to strength of the evidence and voted on by the 57 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here achieved at least 95% consensus. These guidelines will continue to be updated annually.
Notes
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PubMed ID
19417859 View in PubMed
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Accuracy of tele-oncology compared with face-to-face consultation in head and neck cancer case conferences.

https://arctichealth.org/en/permalink/ahliterature19396
Source
J Telemed Telecare. 2001;7(6):338-43
Publication Type
Article
Date
2001
Author
J. Stalfors
S. Edström
T. Björk-Eriksson
C. Mercke
J. Nyman
T. Westin
Author Affiliation
Department of Otolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden. joacim.stalfors@orlforum.com
Source
J Telemed Telecare. 2001;7(6):338-43
Date
2001
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Case Management - organization & administration
Feasibility Studies
Female
Head and Neck Neoplasms - diagnosis - therapy
Humans
Male
Middle Aged
Physical Examination
Remote Consultation
Research Support, Non-U.S. Gov't
Telemedicine - methods
Abstract
Telemedicine was introduced for weekly tumour case conferences between Sahlgrenska University Hospital and two district hospitals in Sweden. The accuracy of tele-oncology was determined using simulated telemedicine consultations, in which all the material relating to each case was presented but without the patient in person. The people attending the conference were asked to determine the tumour ('TNM') classification and treatment. The patient was then presented in person, to give the audience the opportunity to ask questions and perform a physical examination. Then a new discussion regarding the tumour classification and the treatment plan took place, and the consensus was recorded. Of the 98 consecutive patients studied in this way, 80 could be evaluated by both techniques. Of these 80, 73 (91%) had the same classification and treatment plan in the telemedicine simulation as in the subsequent face-to-face consultation. In four cases the TNM classification was changed and for three patients the treatment plan was altered. The specialists also had to state their degree of confidence in the tele-oncology decisions. When they recorded uncertainty about their decision, it was generally because they wanted to palpate the tumour. In five of the seven patients with a different outcome, the clinical evaluation was stated to be dubious or not possible. The results show that telemedicine can be used safely for the management of head and neck cancers.
PubMed ID
11747635 View in PubMed
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Addressing ethical issues in geriatrics and long-term care: ethics education at the Baycrest Centre for Geriatric Care.

https://arctichealth.org/en/permalink/ahliterature196182
Source
Med Law. 2000;19(3):475-91
Publication Type
Article
Date
2000
Author
M. Gordon
L. Turner
E. Bourret
Author Affiliation
Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada.
Source
Med Law. 2000;19(3):475-91
Date
2000
Language
English
Publication Type
Article
Keywords
Aged
Case Management
Curriculum
Ethics Committees
Ethics, Medical
Geriatrics - education
Health Personnel - education
Humans
Inservice Training - organization & administration
Long-Term Care
Models, Educational
Ontario
Organizational Objectives
Patient care team
Program Development
Referral and Consultation - organization & administration
Skilled Nursing Facilities
Abstract
An innovative program in ethics education exists at Baycrest Centre for Geriatric Care. This program can serve as a helpful model for long-term care and geriatric care facilities seeking to implement formal training programs in bioethics. Various aspects of the ethics education program are examined. In addition to describing the role of the ethics committee and research ethics board, consideration is given to case consultations, ethics rounds, the training of junior physicians and medical students, grand rounds and the planning of conferences and guest lectures. With regard to educational content in bioethics, health law, professional guidelines and the principlist approach of Beauchamp and Childress are used to explore the ethical dimensions of particular cases. Given the clinical context of the educational initiatives, the pedagogical approach is predominately case-based. While the bioethics literature emphasizes the patient-physician relationship, ethics education at Baycrest recognizes the importance of multiple professions. Physicians, nurses, social workers, speech pathologists, nutritionists and other health care providers are involved in ethical deliberation and education.
PubMed ID
11143884 View in PubMed
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Adult bacterial meningitis-a quality registry study: earlier treatment and favourable outcome if initial management by infectious diseases physicians.

https://arctichealth.org/en/permalink/ahliterature275099
Source
Clin Microbiol Infect. 2015 Jun;21(6):560-6
Publication Type
Article
Date
Jun-2015
Author
Ö. Grindborg
P. Naucler
J. Sjölin
M. Glimåker
Source
Clin Microbiol Infect. 2015 Jun;21(6):560-6
Date
Jun-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - administration & dosage
Case Management
Early Diagnosis
Female
Hearing Loss - epidemiology
Humans
Intellectual Disability - epidemiology
Male
Meningitis, Bacterial - complications - diagnosis - drug therapy - mortality
Middle Aged
Physicians
Retrospective Studies
Secondary Prevention
Survival Analysis
Sweden
Time Factors
Treatment Outcome
Young Adult
Abstract
Acute bacterial meningitis (ABM) is challenging for the admitting physician because it is a rare but fulminant disease, usually presenting without typical symptoms, and rapid treatment is pivotal. The purpose of this study was to evaluate the effect of initial management by infectious diseases (ID) physicians vs. non-ID physicians. A total of 520 consecutive adults (>17 years old), 110 with initial ID management and 410 with non-ID management, registered in the Swedish quality registry for community-acquired ABM January 2008 to December 2013, were analysed retrospectively. Primary outcome was appropriate treatment with antibiotics and corticosteroids
PubMed ID
25752223 View in PubMed
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The Ahalaya case-management program for HIV-infected American Indians, Alaska Natives, and Native Hawaiians: quantitative and qualitative evaluation of impacts.

https://arctichealth.org/en/permalink/ahliterature2999
Source
Am Indian Alsk Native Ment Health Res. 2000;9(2):36-52
Publication Type
Article
Date
2000
Author
P D Bouey
B E Druan
Author Affiliation
The National Native American AIDS Prevention Center, 436 14th Street, Suite 1020, Oakland, CA 94612, USA. Paulbouey@nnaapc.org
Source
Am Indian Alsk Native Ment Health Res. 2000;9(2):36-52
Date
2000
Language
English
Publication Type
Article
Keywords
Adult
Alaska - epidemiology
Attitude to Health
Case Management - organization & administration
Ethnic Groups - statistics & numerical data
Female
HIV Infections - ethnology - psychology - therapy
Hawaii - epidemiology - ethnology
Humans
Indians, North American - statistics & numerical data
Inuits - statistics & numerical data
Male
Research Support, U.S. Gov't, P.H.S.
Treatment Outcome
United States - epidemiology
United States Indian Health Service - standards
Abstract
The Ahalaya case management model was designed to provide culturally sensitive services to HIV-positive American Indians (AI), Alaska Natives (AN), and Native Hawaiians (NH). This program started in 1991 and expanded across the country in 1994. The evaluation plan included a client satisfaction survey, along with focus groups and key informant interviews. Of the 389 active clients enrolled, 132 responded to the anonymous 35-item questionnaire. Responses were favorable regarding benefits of the programs. Self-reported quality of life changes after enrollment also were significantly improved (Wilcoxon Signed Rank Test: T=6.87, p=.000; n=131). Qualitative data highlighted other important issues. Social relationships-with staff, community, and family-were critical to client welfare, as a source of both strength and fear. While AI/AN/NH case management programs have been shown effective, services need to expand, and they have to facilitate resolutions to problems in clients social relationships.
PubMed ID
11279557 View in PubMed
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Alcohol withdrawal at home. Pilot project for frail elderly people.

https://arctichealth.org/en/permalink/ahliterature212064
Source
Can Fam Physician. 1996 May;42:937-45
Publication Type
Article
Date
May-1996
Author
D J Evans
S D Street
D J Lynch
Author Affiliation
Victoria Innovative Seniors Treatment Agency (VISTA), BC.
Source
Can Fam Physician. 1996 May;42:937-45
Date
May-1996
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Alcoholism - prevention & control
British Columbia
Case Management - organization & administration
Female
Frail Elderly
Geriatric Assessment
Home Care Services - organization & administration
Humans
Male
Pilot Projects
Program Evaluation
Social Support
Substance Withdrawal Syndrome - prevention & control
Abstract
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.
Notes
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PubMed ID
8688696 View in PubMed
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257 records – page 1 of 26.