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.
Research in the context of the dental school has traditionally been focused on institutional/faculty accomplishments and generating new knowledge to benefit the profession. Only recently have significant efforts been made to expand the overall research programming into the formal dental curriculum, to provide students with a baseline exposure to the research and critical thinking processes, encourage evidence-based decision-making, and stimulate interest in academic/research careers. Various approaches to curriculum reform and the establishment of multiple levels of student research opportunities are now part of the educational fabric of many dental schools worldwide. Many of the preliminary reports regarding the success and vitality of these programs have used outcomes measures and metrics that emphasize cultural changes within institutions, student research productivity, and student career preferences after graduation. However, there have not been any reports from long-standing programs (a minimum of 25 years of cumulative data) that describe dental school graduates who have had the benefit of research/training experiences during their dental education. The University of Manitoba Faculty of Dentistry initiated a BSc Dent program in 1980 that awarded a formal degree for significant research experiences taking place within the laboratories of the Faculty-based researchers and has continued to develop and expand this program. The success of the program has been demonstrated by the continued and increasing demands for entry, the academic achievements of the graduates, and the numbers of graduates who have completed advanced education/training programs or returned to the Faculty as instructors. Analysis of our long-term data validates many recent hypotheses and short-term observations regarding the benefits of dental student research programs. This information may be useful in the design and implementation of dental student research programs at other dental schools.
Abortion, particularly later-term abortion, and neonaticide, selective non-treatment of newborns, are feasible management strategies for fetuses or newborns diagnosed with severe abnormalities. However, policy varies considerably among developed nations. This article examines abortion and neonatal policy in four nations: Israel, the US, the UK and Denmark. In Israel, late-term abortion is permitted while non-treatment of newborns is prohibited. In the US, on the other hand, later-term abortion is severely restricted, while treatment to newborns may be withdrawn. Policy in the UK and Denmark bridges some of these gaps with liberal abortion and neonatal policy. Disparate policy within and between nations creates practical and ethical difficulties. Practice diverges from policy as many practitioners find it difficult to adhere to official policy. Ethically, it is difficult to entirely justify perinatal policy in these nations. In each nation, there are elements of ethically sound policy, while other aspects cannot be defended. Ethical policy hinges on two underlying normative issues: the question of fetal/newborn status and the morality of killing and letting die. While each issue has been the subject of extensive debate, there are firm ethical norms that should serve as the basis for coherent and consistent perinatal policy. These include 1) a grant of full moral and legal status to the newborn but only partial moral and legal status to the late-term fetus 2) a general prohibition against feticide unless to save the life of the mother or prevent the birth of a fetus facing certain death or severe pain or suffering and 3) a general endorsement of neonaticide subject to a parent's assessment of the newborn's interest broadly defined to consider physical harm as well as social, psychological and or financial harm to related third parties. Policies in each of the nations surveyed diverging from these norms should be the subject of public discourse and, where possible, legislative reform.