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Hrbatá, Veronika. « No International Organization is an Island . . . the WTO’s Relationship with the WIPO : A Model for the Governance of Trade Linkage Areas ? » Journal of World Trade 44, Issue 1 (1 février 2010) : 1–47. http://dx.doi.org/10.54648/trad2010001.
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Trade has fuzzy boundaries where it overlaps with many different fields – be it the environment, intellectual property, or other. The World Trade Organization (WTO) is thus required to interact with other international institutions in order to come to an arrangement for dealing with these ‘trade and ?’ linkage areas. The relationship between the WTO and the World Intellectual Property Organization (WIPO) could in many respects serve as a model. The picture that emerges when the various forms of interaction of the two organizations are assessed is that they benefit most from complementarity. Thus, for example, the WIPO offers detailed intellectual property rules, whilst the WTO supplements this with effective dispute settlement. This advantage may largely be due to the fact that the WTO has incorporated many of the WIPO rules into its own law. One of the recommendations put forward here is for other ‘trade and ?’ spheres to do the same. On the other hand, the analysis highlights a number of problems that occur when two institutions cross paths. One such difficulty is a potential conflict of law. To help to resolve it, the WTO dispute settlement system should give greater consideration to the provisions of non-WTO law. Some hope for this is given in the US-Copyright case, but it is questioned whether this still holds in view of more recent caselaw. The interplay between the WTO and the WIPO thus forms the basis for a number of recommendations for better governance of trade linkage areas.
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Flowers, Zachary. « The Role of Precedent and Stare Decisis in the World Trade Organization's Dispute Settlement Body ». International Journal of Legal Information 47, no 02 (2019) : 90–104. http://dx.doi.org/10.1017/jli.2019.21.
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AbstractThe World Trade Organization was established in 1995 and brought together countries from around the world for the purpose of fairly regulating the trade of goods, services, and intellectual property between its member states. While treaties and other trade agreements have existed between countries for hundreds of years, the WTO's most significant innovation is its dispute settlement process through the Dispute Settlement Body. Countries agree to be bound to the decisions of the DSB upon their admittance into the WTO. The DSB is a two-tiered adjudicative system consisting of the lower panels and the higher Appellate Body.The United States, under both the Obama and Trump administrations, has blocked the appointment of AB judges. This tactic has limited the number of active judges to three. The AB normally has seven members. The United States has listed a number of reasons for their boycott of the system, among them is that the AB is functioning as if its reports are to be binding precedent on the lower panel and to future DSB cases, in a manner similar to stare decisis. This issue has been observed over the years and there is conflict between interpretations of precedent under Article 3:2 of the Dispute Settlement Understanding and Article IX:2 of the WTO Agreement. Caselaw of the DSB from over the years has also raised interesting questions and the appearance of the use of precedent.This article will be examining the historical fundamentals and use of precedent and the doctrine of stare decisis. It will then turn into an examination of the institutional and regulatory framework of the WTO, particularly Article 3:2 of the DSU and Article IX:2 of the WTO Agreement, and whether it allows or leaves room for a system of binding precedent. Finally, jurisprudence of the DSB will be surveyed for evidence of this system. Reports that will be examined are Japan-Alcoholic Beverages, India-Patents, India-Autos, and Australia-Plain Packaging Tobacco.
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BOWN, CHAD P., et PETROS C. MAVROIDIS. « WTO Case Law of 2014 : A Busy Year ». World Trade Review 15, no 2 (27 janvier 2016) : 183–87. http://dx.doi.org/10.1017/s147474561500066x.
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The WTO adjudicating bodies were busy in 2014, as they issued 22 reports, a net increase of 15 reports when compared to 2013. In fact, the WTO was forced to hire additional staff to work on disputes, since the caseload overwhelmed the existing limited administrative capacity dedicated to dispute settlement.
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Pauwelyn, Joost, et Weiwei Zhang. « Busier than Ever ? A Data-Driven Assessment and Forecast of WTO Caseload ». Journal of International Economic Law 21, no 3 (30 août 2018) : 461–87. http://dx.doi.org/10.1093/jiel/jgy035.
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Chen, Chao-Hung, Yi-Hua Chen, Hsiu-Chen Lin et Herng-Ching Lin. « Association Between Physician Caseload and Patient Outcome for Sepsis Treatment ». Infection Control & ; Hospital Epidemiology 30, no 6 (juin 2009) : 556–62. http://dx.doi.org/10.1086/597509.
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Objective.The purpose of this study was to investigate whether physicians with larger sepsis caseloads provide better outcomes, defined as lower in-hospital mortality rates, for patients with sepsis.Design.Retrospective cross-sectional study.Method.This study used pooled data from the 2002-2004 Taiwan National Health Insurance Research Database. A total of 48,336 patients hospitalized with a principal diagnosis of septicemia were selected and assigned to 1 of 4 caseload groups on the basis of their treating physician's sepsis caseload during the 3 years reflected in the pooled data (low caseload, less than 39 cases; medium caseload, 39–88 cases; high caseload, 89–176 cases; and very high caseload, more than 176 cases). Generalized estimating equation models were used for analysis.Results.Receipt of treatment from physicians in the very high, high, and medium caseload groups decreased patients' odds of inhospital mortality by 49% (95% confidence interval [CI], 0.41-0.67; P < .001 ), 40% (95% CI, 0.53-0.68; P < .001 ), and 18% (95% CI, 0.73-0.92; P < .001), respectively, compared with the odds for patients treated by low-caseload physicians. These findings persisted after partitioning out systematic physician-specific and hospital-specific variation and isolating the effects of most hospital, physician, and patient confounders.Conclusion.Patients treated by physicians who had a larger sepsis caseload had a substantially lower in-hospital mortality rate than did patients treated by physicians in the other caseload groups, and the difference was statistically significant. This result supports the “practice makes perfect” hypothesis.
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Imran, Nadia, et Omair Niaz. « Suicides in Barnsley – an IHBTT project ». BJPsych Open 7, S1 (juin 2021) : S327. http://dx.doi.org/10.1192/bjo.2021.860.
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AimsWe wanted to see whether an increase in IHBTT(Intensive Home based treatment team) case load correlated with the recent increase in suicides. We also wanted to investigate the common factors between patients who died by suicide.BackgroundThis was a study completed by IHBTT in Barnsley (South Yorkshire), looking into recent suicides with the caseload from April 2009 to November 2019. There were a total of six suicides.MethodWe Calculated mean IHBTT caseload size from November 2008 to November 2019 . There were 6 suicides in this period. We plotted this against caseload, investigating if increase in caseload correlated with these. We also analysed the common themes and trends associates with these patients who died by suicide. We compared the trends we found locally against a National Survey. (National Confidential Inquiry into Suicide and Safety in Mental Health; Annual Report: England, Northern Ireland, Scotland, Wales October 2018 University of Manchester).ResultWe found that four out of six suicides occurred during periods of high activity.. Common themes we found around patients who had died by suicide included middle aged men who lived alone, with a diagnosis of adjustment disorder, recent financial stress and relationship breakdown, upcoming court case, abusing drugs or alcohol. This does compare somewhat to national trends, however alcohol and drug misuse, upcoming court case and financial stressors and relationship breakdown are higher in our patients who died by suicide compared to nationally.ConclusionWe acknowledge the small sample size and hence the need to take results cautiously. However there is a clear increase in suicides as caseload increases, we hypothesised this was due to the same levels of staff despite increase in caseload. We were also able to conclude the factors our patients who died by suicide had in common locally, and how this compared to national data. We wondered if this could be used to guide resource allocation, i.e. interventions to help patient manage their finances, accommodation and substance misuse. Consideration may need to be given to reviewing IHBTT staffing levels, given the significant decrease in inpatient bed numbers.
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Harrison, Melody, Thomas A. Page, Jacob Oleson, Meredith Spratford, Lauren Unflat Berry, Barbara Peterson, Anne Welhaven, Richard M. Arenas et Mary Pat Moeller. « Factors Affecting Early Services for Children Who Are Hard of Hearing ». Language, Speech, and Hearing Services in Schools 47, no 1 (janvier 2016) : 16–30. http://dx.doi.org/10.1044/2015_lshss-14-0078.
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PurposeTo describe factors affecting early intervention (EI) for children who are hard of hearing, we analyzed (a) service setting(s) and the relationship of setting to families' frequency of participation, and (b) provider preparation, caseload composition, and experience in relation to comfort with skills that support spoken language for children who are deaf and hard of hearing (CDHH).MethodParticipants included 122 EI professionals who completed an online questionnaire annually and 131 parents who participated in annual telephone interviews.ResultsMost families received EI in the home. Family participation in this setting was significantly higher than in services provided elsewhere. EI professionals were primarily teachers of CDHH or speech-language pathologists. Caseload composition was correlated moderately to strongly with most provider comfort levels. Level of preparation to support spoken language weakly to moderately correlated with provider comfort with 18 specific skills.ConclusionsResults suggest family involvement is highest when EI is home-based, which supports the need for EI in the home whenever possible. Access to hands-on experience with this population, reflected in a high percentage of CDHH on providers' current caseloads, contributed to professional comfort. Specialized preparation made a modest contribution to comfort level.
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Hasson, Natalie, Bernard Camilleri, Caroline Jones, Jodie Smith et Barbara Dodd. « Discriminating disorder from difference using dynamic assessment with bilingual children ». Child Language Teaching and Therapy 29, no 1 (24 décembre 2012) : 57–75. http://dx.doi.org/10.1177/0265659012459526.
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The DAPPLE (Dynamic Assessment of Preschoolers’ Proficiency in Learning English) is currently being developed in response to a clinical need. Children exposed to English as an additional language may be referred to speech and language therapy because their proficiency in English is not the same as their monolingual peers. Some, but not all, of these children are likely to have a core language learning difficulty. Clinicians need to be able to distinguish disorder from difference due to a child’s language learning context. The assessment used a test–teach–test format to examine children’s ability to learn vocabulary, sentence structure and phonology. The assessment, which takes less than 60 minutes to administer, was given to 26 children who were bilingual: 12 currently on a speech and language therapy caseload and 14 children matched for age and socio-economic status who had never been referred to speech and language therapy. The DAPPLE data clearly discriminated the two groups. The caseload group required a greater amount of prompting to identify targeted words in the receptive vocabulary assessment and performed less well in the post-teaching expressive component. For sentence structure, the caseload group required more cues to acquire the targeted clause elements in the teaching phase. The caseload group made more phoneme errors at the initial and final assessments than the controls, and the type of errors made differed. Teaching resulted in greater positive change in percent phonemes correct for the caseload participants. Qualitative analyses of individual children’s performance on the DAPPLE suggested that it has the potential to discriminate core language deficits from difference due to a bilingual language learning context. Future directions for development of the test are considered.
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Hadebe, Ruth, Paul T. Seed, Diana Essien, Kyle Headen, Saheel Mahmud, Salwa Owasil, Cristina Fernandez Turienzo et al. « Can birth outcome inequality be reduced using targeted caseload midwifery in a deprived diverse inner city population ? A retrospective cohort study, London, UK ». BMJ Open 11, no 11 (novembre 2021) : e049991. http://dx.doi.org/10.1136/bmjopen-2021-049991.
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Objectives(1) To report maternal and newborn outcomes of pregnant women in areas of social deprivation in inner city London. (2) To compare the effect of caseload midwifery with standard care on maternal and newborn outcomes in this cohort of women.DesignRetrospective observational cohort study.SettingFour council wards (electoral districts) in inner city London, where over 90% of residents are in the two most deprived quintiles of the English Index of Multiple Deprivation (IMD) (2019) and the population is ethnically diverse.ParticipantsAll women booked for antenatal care under Guys and St Thomas’ National Health Service Foundation Trust after 11 July 2018 (when the Lambeth Early Action Partnership (LEAP*) caseload midwifery team was implemented) until data collection 18 June 2020. This included 523 pregnancies in the LEAP area, of which 230 were allocated to caseload midwifery, and 8430 pregnancies from other areas.Main outcome measuresTo explore if targeted caseload midwifery (known to reduce preterm birth) will improve important measurable outcomes (preterm birth, mode of birth and newborn outcomes).ResultsThere was a significant reduction in preterm birth rate in women allocated to caseload midwifery, when compared with those who received traditional midwifery care (5.1% vs 11.2%; risk ratio: 0.41; p=0.02; 95% CI 0.18 to 0.86; number needed to treat: 11.9). Caesarean section births were significantly reduced in women allocated to caseload midwifery care, when compared with traditional midwifery care (24.3% vs 38.0%; risk ratio: 0.64: p=0.01; 95% CI 0.47 to 0.90; number needed to treat: 7.4) including emergency caesarean deliveries (15.2% vs 22.5%; risk ratio: 0.59; p=0.03; 95% CI 0.38 to 0.94; number needed to treat: 10) without increase in neonatal unit admission or stillbirth.ConclusionThis study shows that a model of caseload midwifery care implemented in an inner city deprived community improves outcome by significantly reducing preterm birth and birth by caesarean section when compared with traditional care. This data trend suggests that when applied to targeted groups (women in higher IMD quintile and women of diverse ethnicity) that the impact of intervention is greater.
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Mabry-Price, Lisa. « School Matters : Kids Don't Have Strokes—Do They ? » ASHA Leader 18, no 9 (septembre 2013) : 34–35. http://dx.doi.org/10.1044/leader.scm.18092013.34.
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Beenstock, Michael. « The Productivity of Judges in the Courts of Israel ». Israel Law Review 35, no 2-3 (2001) : 249–65. http://dx.doi.org/10.1017/s0021223700012206.
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AbstractThe output of Israel's judiciary, as measured by the number of completed cases, does not vary with judicial inputs, as measured by the number of judges. The appointment of additional judges lowers the caseload of existing judges, who respond by lowering their productivity. The percentage fall in productivity is equal to the percentage increase in the number of judges, implying that the output of the courts remains unchanged. This evidence undermines the conventional approach for determining the number of judges, which assumes that the productivity of judges does not depend upon their caseload.
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Allen, Stephanie, et Karen Morgan. « Reflections on lymphoedema deployment into community services during the pandemic ». British Journal of Community Nursing 26, Sup10 (1 octobre 2021) : S30—S35. http://dx.doi.org/10.12968/bjcn.2021.26.sup10.s30.
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During the second wave of the COVID-19 pandemic, district nursing teams were overwhelmed with their caseload due to the palliative care needs of their patients. This led to patients with wet legs and chronic wounds deteriorating due to staffing levels. Therefore, the Swansea Bay University Health Board and Lymphoedema Network Wales teams redeployed two working time equivalents (WTE) into the community to take over the management of these patients with chronic wounds for 4 months. The clinicians came from a variety of different backgrounds, including nursing, physiotherapy, emergency medicine and occupational therapy. Between the teams, 866 visits were carried out over the 4-month period, where patients' compression therapy was altered to promote healing and reduce oedema. At the end of the 4-month period, 21% of the patients were discharged off the district nursing caseload completely, while of the 60% who were still active caseload patients, 35% were in increased compression and 20% had reduced need for visits.
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Bowman, G. « Using Therapeutic Metaphor in Adjustment Counseling ». Journal of Visual Impairment & ; Blindness 86, no 10 (décembre 1992) : 440–42. http://dx.doi.org/10.1177/0145482x9208601009.
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This article presents a general overview of the process of designing and using metaphors in adjustment counseling by rehabilitation teachers and other professionals who work with persons who are blind. The metaphorical stories contained in this article were taken from the author's caseload as a rehabilitation teacher.
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Haney, Craig. « Mental Health Issues in Long-Term Solitary and “Supermax” Confinement ». Crime & ; Delinquency 49, no 1 (janvier 2003) : 124–56. http://dx.doi.org/10.1177/0011128702239239.
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This article discusses the recent increase in the use of solitary-like confinement, especially the rise of so-called supermax prisons and the special mental health issues and challenges they pose. After briefly discussing the nature of these specialized and increasingly widespread units and the forces that have given rise to them, the article reviews some of the unique mental-health-related issues they present, including the large literature that exists on the negative psychological effects of isolation and the unusually high percentage of mentally ill prisoners who are confined there. It ends with a brief discussion of recent caselaw that addresses some of these mental health issues and suggests that the courts, though in some ways appropriately solicitous of the plight of mentally ill supermax prisoners, have overlooked some of the broader psychological problems these units create.
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Adams, Leah M., Benjamin H. Balderson, Kathy Brown, Staci E. Bush et Bruce J. Packett. « Who Starts the Conversation and Who Receives Preexposure Prophylaxis (PrEP) ? A Brief Online Survey of Medical Providers’ PrEP Practices ». Health Education & ; Behavior 45, no 5 (20 janvier 2018) : 723–29. http://dx.doi.org/10.1177/1090198117752789.
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Uptake of preexposure prophylaxis (PrEP) has been slow, but is increasing. Although PrEP is indicated for many patients, it has been concentrated among men who have sex with men (MSM). Awareness of PrEP is limited among non-MSM individuals, and among some MSM. As such, individuals at risk for HIV who are unaware of PrEP must rely on their medical providers to initiate conversations about PrEP. Members of a national professional organization of HIV specialists with prescribing privileges, including physicians, nurse practitioners, and physician assistants, participated in an online survey ( n = 342) to characterize their PrEP prescribing behaviors and the demographic membership of their PrEP patients. Results indicated that when discussing PrEP with their patients, providers who more frequently initiated these conversations had a higher percentage of non-MSM patients in their PrEP caseload (e.g., women, people who inject drugs, transgender patients). Encouraging providers to initiate discussions about PrEP with their patients and helping them locate support to offset the cost may help increase uptake, particularly among at-risk patients who are underrepresented in PrEP adoption.
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Newman, Christy E., John B. F. de Wit, Levinia Crooks, Robert H. Reynolds, Peter G. Canavan et Michael R. Kidd. « Challenges of providing HIV care in general practice ». Australian Journal of Primary Health 21, no 2 (2015) : 164. http://dx.doi.org/10.1071/py13119.
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As the management of HIV changes and demand for HIV health services in primary care settings increases, new approaches to engaging the general practice workforce with HIV medicine are required. This paper reports on qualitative research conducted with 47 clinicians who provide HIV care in general practice settings around Australia, including accredited HIV s100 prescribers as well as other GPs and general practice nurses. Balanced numbers of men and women took part; less than one-quarter were based outside of urban metropolitan settings. The most significant workforce challenges that participants said they faced in providing HIV care in general practice were keeping up with knowledge, navigating low caseload and regional issues, balancing quality care with cost factors, and addressing the persistent social stigma associated with HIV. Strategic responses developed by participants to address these challenges included thinking more creatively about business and caseload planning, pursuing opportunities to share care with specialist clinicians, and challenging prejudiced attitudes amongst patients and colleagues. Understanding and supporting the needs of the general practice workforce in both high and low HIV caseload settings will be essential in ensuring Australia has the capacity to respond to emerging priorities in HIV prevention and care.
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Douglas, Emily M. « Symptoms of Posttraumatic Stress among Child Welfare Workers Who Experience a Maltreatment Fatality on their Caseload ». Journal of Evidence-Based Social Work 10, no 4 (juillet 2013) : 373–87. http://dx.doi.org/10.1080/15433714.2012.664058.
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Hewitt, David. « Something less than ready access to the courts : Section 139 & ; Local Authorities ». International Journal of Mental Health and Capacity Law, no 3 (8 septembre 2014) : 75. http://dx.doi.org/10.19164/ijmhcl.v0i3.325.
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<p align="LEFT">Psychiatric patients who wish to bring legal proceedings against those responsible for their detention or treatment can face an obstacle of which better-favoured litigants are free: because of a provision contained in section 139 of the Mental Health Act 1983 they will often have to obtain the prior leave of the High Court.</p><p align="LEFT">This paper will consider the origins of that provision. It will then focus on two of its key elements - the requirement for leave itself and the exceptions to it - and will analyse their impact upon subsequent caselaw and upon current legal practice.</p><p align="LEFT">In so doing, this paper will describe an anomaly which continues to bedevil intending claimants, and will assess the extent to which it is attributable to the legal and political events of a generation ago, and to a legislative impulse which is even more keenly felt today.</p>
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Intahchomphoo, Channarong, André Vellino, Odd Erik Gundersen, Christian Tschirhart et Eslam Shaaban. « References to Artificial Intelligence in Canada's Court Cases ». Legal Information Management 20, no 1 (mars 2020) : 39–46. http://dx.doi.org/10.1017/s1472669620000080.
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AbstractArtificial intelligence (AI) is a widely discussed topic in many fields including law. Legal studies scholars, particularly in the domain of technology and internet law, have expressed their hopes and concerns regarding AI. This project aims to study how Canada's courts have referred to AI, given the importance of the reasonings of justices to the policy makers who determine society's rules for the usage of AI in the future. Decisions from all levels of both Canada's provincial and federal courts are used as the data sources for this research. The findings indicate that there are four legal contexts in which AI has been referred to in the Canadian caselaw including: legal research, investment tax credits, trademarks and access to government records. In this article the authors use these findings to make suggestions for legal information management professionals on how to develop collections and reference services that are in line with the new information needs of their users regarding AI and the rule of law.
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Diem, Elizabeth, Denise Alcock, Elaine Gallagher, Douglas Angus et Jennifer Medves. « Looking Beyond Caseload Numbers for Long-Term Home-Care Case Managers ». Care Management Journals 3, no 1 (janvier 2001) : 2–7. http://dx.doi.org/10.1891/1521-0987.3.1.2.
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Determining the best use of case managers’ time is difficult both because of the great variability in the factors and the lack of outcome studies. In place of the outcome studies, the responses to focus group questions of 89 experienced case managers from across Canada were used to indicate a value for case management functions in the areas of direct care, indirect care management, and program management. The case managers identified greater value for direct care with clients and families who are new to home care or who have complex problems in comparison to clients in more stable or manageable situations. Case managers were frustrated by the lack of agency and community policies and resources to allow case managers to properly support people in their homes. The case managers valued addressing problems on a program or community basis rather than the usual case-by-case. Although preliminary, the approach could be useful in assessing the efficient and effective use of a scarce resource, case managers’ time.
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Gelfer, Marylou Pausewang. « Voice Treatment for the Male-to-Female Transgendered Client ». American Journal of Speech-Language Pathology 8, no 3 (août 1999) : 201–8. http://dx.doi.org/10.1044/1058-0360.0803.201.
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Male-to-female transsexuals are sometimes a part of a speech-language pathologist’s voice caseload. This article is intended to provide information and a suggested treatment approach to speech-language pathologists who work with this small but fascinating population. Aspects of the transition process, interviewing strategies, selection of a target frequency, and suggested treatment techniques are presented.
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Steinberg, Mary Anne, Cheryl Walther, Maria Herbst, Jennifer West, Dixie Wingler et John Smith. « Learning Specialists in College Athletics : Who are they and what do they do ? » Journal of Higher Education Athletics & ; Innovation, no 4 (7 décembre 2018) : 77–118. http://dx.doi.org/10.15763/issn.2376-5267.2018.1.4.77-118.
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As the number of at-risk collegiate student athletes continues to rise and their academic success continues to be scrutinized, the role of the learning specialist is becoming increasingly important. The purpose of this research was to determine the essential duties of learning specialists in collegiate athletics, possible correlations between the learning specialist’s degree and the frequency of their tasks, as well as the possible connection between conference, number of learning specialists on staff, and tasks assigned and number of students on the learning specialists’ caseload. A survey was completed by 90 individuals who self-identified as learning specialists and members of N4A. Results indicate that the three tasks most frequently performed by learning specialists are developing learning strategies with individual students, sending reminders, and holding study hall and these tasks remain consistent regardless of their educational background, conference or number of learning specialists on staff. Implications of these findings and future research recommendations are also discussed.
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Hummel, Lauren J., et Barry M. Prizant. « A Socioemotional Perspective for Understanding Social Difficulties of School-Age Children With Language Disorders ». Language, Speech, and Hearing Services in Schools 24, no 4 (octobre 1993) : 216–24. http://dx.doi.org/10.1044/0161-1461.2404.216.
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Recent research clearly has established that many school-age children with language disabilities have significant socioemotional problems. These children likely make up a significant portion of the caseload of school speech-language pathologists. This article provides a perspective for recognizing, understanding, and treating the social behavior problems of children with language disorders who have or who are at risk for developing emotional or behavioral disorders. This view is derived from studies of social and emotional development of children who are normally developing and those who are socioemotionally challenged.
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Curry, William T., Michael W. McDermott, Bob S. Carter et Fred G. Barker. « Craniotomy for meningioma in the United States between 1988 and 2000 : decreasing rate of mortality and the effect of provider caseload ». Journal of Neurosurgery 102, no 6 (juin 2005) : 977–86. http://dx.doi.org/10.3171/jns.2005.102.6.0977.
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Object. The goal of this study was to determine the risk of adverse outcomes after contemporary surgical treatment of meningiomas in the US and trends in patient outcomes and patterns of care. Methods. The authors performed a retrospective cohort study by using the Nationwide Inpatient Sample covering the period of 1988 to 2000. Multivariate regression models with disposition end points of death and hospital discharge were used to test patient, surgeon, and hospital characteristics, including volume of care, as outcome predictors. Multivariate analyses revealed that larger-volume centers had lower mortality rates for patients who underwent craniotomy for meningioma (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.59–0.93, p = 0.01). Adverse discharge disposition was also less likely at high-volume hospitals (OR 0.71, 95% CI 0.62–0.80, p < 0.001). With respect to the surgeon caseload, there was a trend toward a lower rate of mortality after surgery when higher-caseload providers were involved, and a significantly less frequent adverse discharge disposition (OR 0.71, 95% CI 0.62–0.80, p <, 0.001). The annual meningioma caseload in the US increased 83% between 1988 and 2000, from 3900 patients/year to 7200 patients/year. In-hospital mortality rates decreased 61%, from 4.5% in 1988 to 1.8% in 2000. Reductions in the mortality rates were largest at high-volume centers (a 72% reduction in the relative mortality rate at largest-volume-quintile centers, compared with a 6% increase in the relative mortality rate at lowest-volume-quintile centers). The number of US hospitals where craniotomies were performed for meningiomas increased slightly. Fewer centers hosted one meningioma resection annually, whereas the largest centers had disproportionate increases in their caseloads, indicating a modest centralization of meningioma surgery in the US during this interval. Conclusions. The mortality and adverse hospital discharge disposition rates were lower when meningioma surgery was performed by high-volume providers. The annual US caseload increased, whereas the mortality rates decreased, especially at high-volume centers.
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Salazar, Ronald J., Jifu Wang et Sharon Oswald. « A Model For Technology Adoption In China : Extending Caselli And Coleman ». Journal of Applied Business Research (JABR) 27, no 4 (20 juin 2011) : 79. http://dx.doi.org/10.19030/jabr.v27i4.4658.
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<span>Focusing on China, a country pushing toward a more market-oriented system at warped speed, we suggest that previous models of technology adoption and/or diffusion may not be suitable for countries migrating from centralized control. We support the work of Au and Yeung (2007), who suggest that China may suffer from a risk avoidance attitude at the firm level based on previous attitudes of control. Relying on the literature and supported by an in-depth analysis of the Chinese machine tool industry we extend the work of Caselli and Coleman (2001, 2002) and advance an expanded model of technology adoption specific to emerging markets, such as China, experiencing a transformation from centrally controlled economy toward a market one.</span>
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Toohill, Jocelyn, Emily Callander, Haylee Fox, Daniel Lindsay, Jenny Gamble, Debra Creedy et Jennifer Fenwick. « Socioeconomic differences in access to care in Australia for women fearful of birth ». Australian Health Review 43, no 6 (2019) : 639. http://dx.doi.org/10.1071/ah17271.
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Objective Fear of childbirth is known to increase a woman’s likelihood of having a Caesarean section. Continuity of midwifery care is known to reduce this risk, but less than 8% of women have access to this relationship-based, primary care model. The aims of this study were to determine whether healthcare use and access to continuity models are equal across different indicators of socioeconomic status for women who are fearful of birth. Methods A secondary analysis was conducted of data obtained during a randomised controlled trial of a psychoeducation intervention by trained midwives to minimise childbirth fear (the Birth Emotions and Looking to Improve Expectant Fear (BELIEF) study). In all, 1410 women were screened, with 339 women reporting high levels of fear (Wijma-Delivery Expectancy/Experience Questionnaire ≥66). Demographic, obstetric information, birth preference and psychosocial measures were collected at recruitment and at 36 weeks gestation for the 339 fearful women, with the birth method and health service use returned by 183 women at 6 weeks after the birth. Results Univariate analysis revealed no significant difference in the number of general practitioner and midwife visits between women of high and low income and high and low education. However, women with higher levels of education had 2.51-fold greater odds of seeing the same midwife throughout their pregnancy than women with lower education (95% confidence interval 1.25–5.04), after adjusting for age, parity and hospital site. Conclusions Given the known positive outcomes of continuity of midwifery care for women fearful of birth, health policy makers need to provide equity in access to evidence-based models of midwifery care. What is known about this topic? Caseload midwifery care is considered the gold standard care due to the known positive outcomes it has for the mother and baby during the perinatal period. Pregnant women who receive caseload midwifery care are more likely to experience a normal vaginal birth. What does this paper add? There is unequal access to midwifery caseload care for women fearful of birth across socioeconomic boundaries. Midwifery caseload care is not used for all fearful mothers during the perinatal period. What are the implications for practitioners? Health policy makers seeking to provide equity in access to maternity care should be aware of these inequalities in use to target delivery of care at this specific cohort of mothers.
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Shi, Qi, et Margaux H. Brown. « School Counselors’ Impact on School-Level Academic Outcomes : Caseload and Use of Time ». Professional School Counseling 23, no 1_part_3 (janvier 2020) : 2156759X2090448. http://dx.doi.org/10.1177/2156759x20904489.
Texte intégralRésumé :
Using the High School Longitudinal Study of 2009, we investigated school counselors’ caseloads, how they spent their time, and the impact of those factors on schools’ academic outcomes. Results showed that approximately 85% of the school counselors had a caseload of 455 or fewer students, with roughly one quarter reporting caseloads equal to or less than 250, and that school counselors spent more of their time on college, scheduling, and personal/social/academic/career development. We also found that how school counselors spent their time was predictive of ninth-grade retention rates, the percentage of students who enrolled in Advanced Placement (AP) courses, and the percentage of students who enrolled in 4-year universities. We provide discussion and implications for school counselors.
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Carlin, Charles H., Katie Boarman et Erin E. Brady. « Guiding Student Clinicians as They Develop AAC Goals and Monitor Progress During School-Based Externship ». Perspectives of the ASHA Special Interest Groups 1, no 12 (31 mars 2016) : 29–37. http://dx.doi.org/10.1044/persp1.sig12.29.
Texte intégralRésumé :
Student clinicians find goal writing and progress monitoring to be difficult tasks to learn, especially when children on the caseload have complex communication needs (CCNs). School-based externship supervisors play an important role in developing students' understanding and competence in these skills. This article provides supervisors with strategies for instructing student clinicians to write goals and evaluate the effectiveness of services for children who use augmentative and alternative communication (AAC). Additionally, the authors adapt the Continuum of Supervision Model (Anderson, 1988) for supervisors who train students to write goals and monitor progress for children who use AAC.
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Carlin, Charles H., Katie Boarman et Erin E. Brady. « Guiding Student Clinicians as They Develop AAC Goals and Monitor Progress During School-Based Externship ». Perspectives of the ASHA Special Interest Groups 1, no 12 (31 mars 2016) : 32–40. http://dx.doi.org/10.1044/persp1.sig12.32.
Texte intégralRésumé :
Student clinicians find goal writing and progress monitoring to be difficult tasks to learn, especially when children on the caseload have complex communication needs (CCNs). School-based externship supervisors play an important role in developing students' understanding and competence in these skills. This article provides supervisors with strategies for instructing student clinicians to write goals and evaluate the effectiveness of services for children who use augmentative and alternative communication (AAC). Additionally, the authors adapt the Continuum of Supervision Model (Anderson, 1988) for supervisors who train students to write goals and monitor progress for children who use AAC.
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Harati, Pravara M., Janet R. Cummings et Nicoleta Serban. « Provider-Level Caseload of Psychosocial Services for Medicaid-Insured Children ». Public Health Reports 135, no 5 (9 juillet 2020) : 599–610. http://dx.doi.org/10.1177/0033354920932658.
Texte intégralRésumé :
Objective We estimated the caseload of providers, practices, and clinics for psychosocial services (including psychotherapy) to Medicaid-insured children to improve the understanding of the current supply of such services and to inform opportunities to increase their accessibility. Methods We used 2012-2013 Medicaid claims data and data from the 2013 National Plan and Provider Enumeration System to identify and locate therapists, psychiatrists, and mental health centers along with primary, rehabilitative, and developmental care providers in the United States who provided psychosocial services to Medicaid-insured children. We estimated the per-provider, per-location, and state-level caseloads of providers offering these services to Medicaid-insured children in 34 states with sufficiently complete data to perform this analysis, by using the most recent year of Medicaid claims data available for each state. We measured caseload by calculating the number of psychosocial visits delivered by each provider in the selected year. We compared caseloads across states, urbanicity, provider specialty (eg, psychiatry, psychology, primary care), and practice setting (eg, mental health center, single practitioner). Results We identified 63 314 providers, practices, or centers in the Medicaid claims data that provided psychosocial services to Medicaid-insured children in either 2012 or 2013. The median provider-level per-year caseload was <25 children and <250 visits across all provider types. Providers with a mental health center–related taxonomy accounted for >40% of visits for >30% of patients. Fewer than 10% of providers and locations accounted for >50% of patients and visits. Conclusions Psychosocial services are concentrated in a few locations, thereby reducing geographic accessibility of providers. Providers should be incentivized to offer care in more locations and to accept more Medicaid-insured patients.
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Feigin, Anita, Carol El-Hayek, Margaret Hellard, Alisa Pedrana, Ellen Donnan, Christopher Fairley, B. K. Tee et Mark Stoové. « Increases in newly acquired HIV infections in Victoria, Australia : epidemiological evidence of successful prevention ? » Sexual Health 10, no 2 (2013) : 166. http://dx.doi.org/10.1071/sh12064.
Texte intégralRésumé :
Background Rates of newly acquired HIV notifications provide useful data for monitoring transmission trends. Methods: We describe 10-year (2001–10) trends in newly acquired HIV notifications in Victoria, Australia. We also examine recent trends in HIV testing and incidence and risk behaviours among gay and other men who have sex with men (MSM) attending four high MSM caseload clinics. Results: Between 2001 and 2010 there was a significant increasing linear trend in newly acquired HIV that was driven primarily by increases between 2009–2010. MSM accounted for 85% of newly acquired HIV notifications. Between 2007–10, the total number of HIV tests per year at the high caseload clinics increased 41% among MSM and HIV incidence declined by 52%; reported risk behaviours remained relatively stable among these MSM. Conclusion: More newly acquired HIV notifications may reflect recent increased testing among MSM; continued scrutiny of surveillance data will assess the sustained effectiveness of testing as prevention, health promotion and the contribution of risk and testing behaviours to HIV surveillance outcomes.
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Kenny, Mary Anne, Nicholas Procter et Carol Grech. « Mental health and legal representation for asylum seekers in the ‘legacy caseload’ ». Cosmopolitan Civil Societies : An Interdisciplinary Journal 8, no 2 (26 juillet 2016) : 84–103. http://dx.doi.org/10.5130/ccs.v8i2.4976.
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This article examines the legal challenges asylum seekers arriving by boat to Australia experience when seeking assistance with their claims and its impact on their mental health. The authors outline the experiences of asylum seekers in the “legacy caseload” group who have been waiting up to four years to have their protection claims assessed. The complex interplay between legal assistance to support refugee claims and the way those making claims inevitably struggle to understand, engage and participate in the process is analysed. It is argued that provision of legal assistance for this group will be essential to ensuring that the refugee status determination process is fair and allows asylum seekers to understand and participate more fully in the process. Recent changes to the assessment of claims combined with a reduction in funding for legal assistance create significant hurdles and combine to compound existing stress and emotional trauma leading to detrimental outcomes on the mental health of asylum seekers.
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DB, Shubha, Malathesh Undi, Rachana Annadani et Ayesha Siddique. « Comparison of Measures adopted to combat COVID 19 Pandemic by different countries in WHO regions ». Indian Journal of Community Health 32, no 2 (Supp) (20 avril 2020) : 288–99. http://dx.doi.org/10.47203/ijch.2020.v32i02supp.023.
Texte intégralRésumé :
Since the emergence of Corona Virus Disease 19 (COVID 19) in China in December 2019, a lot of significant decisions have been taken by the World Health Organization (WHO) and several countries across the globe. As the world reels under the threat of rapid increase in the number of cases and is planning strategies with the limited information available on the virus, it is essential to learn from the experience of countries across the globe. Hence, we selected a few countries in five WHO regions based on their COVID 19 caseload, management strategies and outcome and compared some of the important measures taken by them to contain the spread of infection. Strategies like extensive testing and contact tracing, strict quarantine and isolation measures, Hospital preparedness, complete restriction of non-essential travel, strict border control measures and social distancing measures play a vital role in containment of the spread. All the countries faced the novel strain of virus and implemented similar strategies as per the guidance of WHO, but the extent of preparedness, swiftness with which the decisions were made and the scale of measures made the difference.
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Dymond, Stacy K., Magen Rooney-Kron, Meghan M. Burke et Martin Agran. « Characteristics of Secondary Age Students With Intellectual Disability Who Participate in School-Sponsored Extracurricular Activities ». Journal of Special Education 54, no 1 (31 mai 2019) : 51–62. http://dx.doi.org/10.1177/0022466919851194.
Texte intégralRésumé :
This study investigated the relation between grade level, support needs, and use of augmentative and alternative communication (AAC) and the participation of secondary age students with intellectual disability in school-sponsored extracurricular activities. Participants were special education teachers with at least one student with an intellectual disability on their caseload who participated in a school-sponsored extracurricular activity ( N = 498). Data were collected using an online questionnaire sent to members of a national listserv for transition professionals. Teachers reported students participated in a variety of extracurricular activities within the categories of sports/fitness, school clubs, special events, and performing arts. The majority of students participated in activities for less than 3 hr per week and did not participate in activities that only included students with disabilities. Support needs and use of AAC were related to the type of extracurricular activities in which students participated, the amount of time students spent in extracurricular activities each week, and the extent to which students participated in extracurricular activities that only included students with disabilities. Grade-level differences were nonsignificant, except in relation to activities that only included students with disabilities.
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Durkan, Claire, et Lisa Farndon. « Managing fire risk in housebound people who smoke and require air-alternating pressure-relieving equipment ». British Journal of Community Nursing 27, no 12 (2 décembre 2022) : 596–602. http://dx.doi.org/10.12968/bjcn.2022.27.12.596.
Texte intégralRésumé :
Air-alternating pressure mattresses are advised for housebound patients with poor mobility and at risk of developing pressure ulcers. However, those patients who smoke are under significant dangers of fire risks, especially as the pump to provide alternating pressure requires oxygen. This article describes the development and introduction of a comprehensive risk assessment to help guide community nurses' discussions with any patient on their caseload who smokes and also requires air alternative mattresses. A questionnaire was developed by the Task and Finish Group comprising of nurses from the community and tissue viability teams, members from South Yorkshire Fire and Rescue and a trust fire officer. This questionnaire was developed to guide clinicians when discussing the problem of smoking and the risk of fire with patients, their families and general practitioners. The questionnaire was shared with all teams who visited patients at home, who met the criteria to promote its use. Further work is planned to audit the use of this questionnaire and to ascertain how it can help the decision-making process when discussing risks with this vulnerable and at-risk group of patients.
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Verheyden, Camille, Frank Van Holen, Delphine West et Johan Vanderfaeillie. « Secondary traumatic stress, burnout and compassion satisfaction among Flemish foster care workers during the COVID-19 lockdown ». Developmental Child Welfare 2, no 4 (décembre 2020) : 227–43. http://dx.doi.org/10.1177/2516103220987227.
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This study examines secondary traumatic stress (STS), burnout and compassion satisfaction (CS) in Flemish foster care workers (FCW) during the COVID-19 lockdown. Even though child welfare workers are at increased risk for STS and burnout, these constructs have not been studied in FCW so far. Additionally, the COVID-19 measures severely impacted Flemish FCW’s work, personal and client environment, possibly stimulating the onset of STS and burnout and weakening CS. Moreover, this study aims to identify the work, client and personal factors determining high levels of STS and burnout and low levels of CS among FCW during the lockdown. STS, burnout and CS levels from 434 Flemish FCW were inquired with the Professional Quality of Life Scale. Low mean levels of STS and moderate mean levels of burnout and CS were reported during the lockdown. FCW who experienced a negative impact of COVID-19 measures on their work, had a high amount of worrisome placements due to birth parents in their caseload and low emotional stability are an at-risk group for both STS and burnout during the lockdown. CS was strongly determined by the impact of the COVID-19 measures on work and personality traits. Emotional stability determined the three outcome variables, making this a key characteristics for FCW during the lockdown. Consequently, during adverse circumstances, foster care agencies should pay extra attention and offer additional support to those FCW they estimate emotionally less stable and who struggle with the birth parents in their caseload.
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Mcauley, A., et A. J. Forsyth. « The impact of drug-related death on staff who have experienced it as part of their caseload : An exploratory study ». Journal of Substance Use 16, no 1 (28 octobre 2010) : 68–78. http://dx.doi.org/10.3109/14659891.2010.487555.
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Fary, Robyn E., Helen Slater, Jason Chua et Andrew M. Briggs. « Translating Policy into Practice for Community-Based Management of Rheumatoid Arthritis : Targeting Professional Development Needs among Physiotherapists ». International Journal of Rheumatology 2012 (2012) : 1–9. http://dx.doi.org/10.1155/2012/240689.
Texte intégralRésumé :
Introduction. Contemporary health policy promotes delivery of community-based health services to people with musculoskeletal conditions, including rheumatoid arthritis (RA). This emphasis requires a skilled workforce to deliver safe, effective care. We aimed to explore physiotherapy workforce readiness to co-manage consumers with RA by determining the RA-specific professional development (PD) needs in relation to work and educational characteristics of physiotherapists in Western Australia (WA).Methods. An e-survey was sent to physiotherapists regarding their confidence in co-managing people with RA and their PD needs. Data including years of clinical experience, current RA clinical caseload, professional qualifications, and primary clinical area of practice were collected.Results. 273 physiotherapists completed the survey. Overall confidence in managing people with RA was low (22.7–58.2%) and need for PD was high (45.1–95.2%). Physiotherapists with greater years of clinical experience, a caseload of consumers with RA, postgraduate qualifications in musculoskeletal physiotherapy, or who worked in the musculoskeletal area were more confident in managing people with RA and less likely to need PD. Online and face-to-face formats were preferred modes of PD delivery.Discussion. To enable community-based RA service delivery to be effectively established, subgroups within the current physiotherapy workforce require upskilling in the evidence-based management of consumers with RA.
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Lambert, Stephen M., Andrew N. Page, Johannes Wittmann, Jeremy S. Hayllar, Clint W. Ferndale, Tanya M. Bain et Graeme A. Macdonald. « General practitioner attitudes to prescribing hepatitis C antiviral therapy in a community setting ». Australian Journal of Primary Health 17, no 3 (2011) : 282. http://dx.doi.org/10.1071/py10069.
Texte intégralRésumé :
There is a growing debate about the prescription of hepatitis C virus (HCV) antiviral therapies within a community setting in Australia. This study aimed to identify interest and confidence among general practitioners (GPs) in prescribing HCV antiviral therapy in a community setting. Data from 580 GPs who responded to a cross-sectional population-based survey were analysed to measure: self-reported interest and confidence in initiating HCV antiviral therapy; and/or prescribing maintenance antiviral therapy; and self-perceived education needs about HCV antiviral therapy. Forty-two percent of respondents indicated they would be interested in prescribing HCV antiviral therapy. Most were not confident to initiate therapy (80%). Higher proportions indicated that they would be more confident in prescribing maintenance therapy (35%) rather than initiating (7%) therapy (z = 10.5, P < 0.001). Confidence in prescribing was related to a higher caseload of patients with HCV (P = 0.001) and being a HIV community-based prescriber (P = 0.002). Fifty-three percent of respondents expressed an interest in education about HCV antiviral therapy. The initial step to recruit potential primary care prescribers of HCV antiviral therapies should be to develop an integrated education program. Recruitment to this program might be most efficient from GPs with a high caseload of patients with HCV.
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Richerme, Lauren Kapalka. « The Hidden Neoliberalism of CASEL's Social Emotional Learning Framework : Concerns for Equity ». Bulletin of the Council for Research in Music Education, no 232 (1 avril 2022) : 7–25. http://dx.doi.org/10.5406/21627223.232.01.
Texte intégralRésumé :
Abstract Social emotional learning (SEL) initiatives play an increasingly important role in American prekindergarten through 12th-grade education. Given the focus on equity by both SEL leaders and the music education community, it is important to examine how SEL initiatives might promote or inhibit equity. The purpose of this philosophical inquiry is to consider the relationship between the Collaborative for Academic, Social, and Emotional Learning (CASEL) SEL Framework and equity through the lens of neoliberalism. After examining how neoliberal practices contribute to economic and social inequities, I demonstrate three areas of alignment between CASEL's SEL Framework and neoliberalism. First, proponents of CASEL's SEL Framework and neoliberalism conceive of individuals as separate, responsible beings who can independently control their own economic and life destinies; they understand failure as a personal, rather than societal, problem. Second, neoliberalism demands ongoing self-surveillance in order to create more productive workers, and SEL initiatives extend existing surveillance techniques within schools to the affective realm, including through both student self-surveillance and teacher surveillance of students’ emotions. Third, both emphasize traditional morals, including those related to discipline and delayed gratification. The extensive alignment between neoliberal ideals and the CASEL SEL Framework suggests that such policies often work in tension with equity initiatives. Yet, given that students marginalized because of their race, class, gender identity, or other qualities often endure more emotional trauma than other student populations, the absence of attention to students’ emotional well-being may further existing inequities. I conclude by offering a reimagining of SEL policy initiatives that focuses on four guiding questions.
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Jones, Loring Paul, Elizabeth Gross et Irene Becker. « The Characteristics of Domestic Violence Victims in a Child Protective Service Caseload ». Families in Society : The Journal of Contemporary Social Services 83, no 4 (août 2002) : 405–15. http://dx.doi.org/10.1606/1044-3894.14.
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The objective of this research was to identify case characteristics of domestic violence cases in a child protective services (CPS) caseload. The sample was drawn from a large California county, and consisted of 442 children chosen at random from among all children who had a newly substantiated abuse case over a 6-month period. Files of sample children were reviewed to derive study data. There were 187 children (42.3%) from families with at least one domestic violence incident. Parents with a domestic violence incident were significantly more likely to have problem characteristics such as substance abuse, and to have more previous CPS referrals than nondomestic violence families. Domestic violence victims were more likely to rely on public assistance, and were less likely to have an employed parent than nonvictims. Domestic violence cases were more likely than nondomestic violence cases to contain a charge of physical abuse, emotional abuse, or failure to protect, and were more likely to have been reported to CPS by the police. Domestic violence victims received more services, conditions in the service plan, and contact from their social workers than nonvictims. Variables that predicted new referrals during a 6-month follow-up period were examined in logistic regression. Domestic violence, previous referrals to CPS, the number of social work contacts, and having an unemployed father were variables that predicted a new referral. More contact with social workers predicted new referrals. These findings suggest that either interventions with domestic violence cases are ineffective or the chronic nature of domestic violence makes new referrals for child maltreatment more likely because mandated reporters such as police intervene with domestic violence.
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Pelatti, Christina Yeager, Erin J. Bush, Kelly Farquharson, Whitney Schneider-Cline, Judy Harvey et Mary W. Carter. « Speech-Language Pathologists' Comfort Providing Intervention to Children With Traumatic Brain Injury : Results From a National Survey ». American Journal of Speech-Language Pathology 28, no 4 (19 novembre 2019) : 1611–24. http://dx.doi.org/10.1044/2019_ajslp-19-0029.
Texte intégralRésumé :
Purpose This exploratory study examined speech-language pathologists' (SLPs) clinical experience and work environment characteristics impacting comfort with providing intervention to children with traumatic brain injury (TBI). Method This study included 162 SLPs who responded to a national survey about their comfort providing intervention to children with TBI, clinical experience (i.e., years of experience treating children with TBI, TBI preprofessional training and professional development, and licensure/credentialing), and work environment (i.e., work setting, caseload size, geographic location). Results Findings from latent class analysis revealed 3 distinct groups of SLPs based on their comfort with providing services to children with TBI: those with low comfort, moderate comfort, and high comfort. Further analyses revealed statistically significant differences across the 3 groups in the areas of years of experience treating children with TBI, professional development, work setting, TBI caseload size, and geographic location. Conclusions Our findings reveal that most SLPs feel comfortable providing intervention to children with TBI; however, differences in characteristics across groups suggest that specific steps can be taken to ensure increased comfort for all SLPs working with this population. Practicing SLPs may increase their level of comfort through professional development and hands-on, mentored experience with TBI. Efforts such as these may influence the quality of service provision and expand the population of SLPs who feel comfortable treating children with TBI. Future research is needed to further examine how comfort and SLP characteristics directly impact the quality of speech and language intervention and long-term outcomes of children with TBI.
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Jones, Anthony, Shiva Fouladi-Nashta, Nicole Eady, Simon Bedeau et Hannah Hafezi. « 'Just Say No' (Or at Least Ask Why) STOMP Medication Reviews in Tower Hamlets Community Learning Disability Service ». BJPsych Open 8, S1 (juin 2022) : S182. http://dx.doi.org/10.1192/bjo.2022.504.
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Aims'STOMP stands for stopping over medication of people with a learning disability, autism or both with psychotropic medicines. It is a national project involving many different organizations which are helping to stop the over use of these medicines. STOMP is about helping people to stay well and have a good quality of life'. Our aim was to reduce the percentage of psychotropic burden on the LD and/or autism caseload in Tower Hamlets.MethodsWe reviewed the internal LD caseload that fit STOMP eligibility criteria (prescribed antipsychotics without an indicated mental health diagnosis).We calculated the% of BNF maximum dose for individual service users, aimed to reduced this, and reviewing the cumulative dose reduction achieved across the service, before and after an intervention.The primary intervention was the introduction of a pharmacy led clinic for service users meeting the criteria. This allowed closer f/u from LD pharmacist, thorough medication histories independent of their routine psychiatric reviews, and using GASS and BAI scales to quantify change achieved to their quality of life.We used early and rigourous people participation to consider the role medications (and their overprescription) in service users quality of life, and asked what service users want out of these medication reviews. Several focus groups were ran without People Participation Lead.ResultsPrior to starting of clinic - Of 29 STOMP eligible patients within TH CLDS, we have reduced antipsychotics in 8 of them through general raising awareness of STOMP (presentations to staff, reviews of GP letters to identify service users within the caseload who are likely to benefit and/or be receptive to dose reductions etc). So far total reduction of 45.4%, (and a total of three patients have been stopped all together).ConclusionThe majority of the results and intervention are yet to be collated, and we are collecting these over the next 2 months, but provisionally we hope to conclude that by reducing the quantity of psychotropic medication we prescribe will improve the quality of life for our service users
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Li, Lambert, Steven L. Bokshan, Shayna R. Mehta et Brett D. Owens. « Disparities in Cost and Access by Caseload for Arthroscopic Rotator Cuff Repair : An Analysis of 18,616 Cases ». Orthopaedic Journal of Sports Medicine 7, no 6 (1 juin 2019) : 232596711985050. http://dx.doi.org/10.1177/2325967119850503.
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Background: Surgeon caseload has been shown to affect both health and economic outcomes in arthroscopic rotator cuff repair. Although previous studies have investigated disparities in access to care, little is known about disparities between low- and high-volume surgeons and facilities. Purpose: To identify where disparities may exist regarding access to high-volume surgeons and facilities. Study Design: Cross-sectional study. Methods: Univariate analysis was performed to analyze differences in the caseload between low- and high-volume surgeons and facilities. Cutoff values were set at 50 cases per year for high-volume surgeons and 125 cases annually for high-volume facilities. Multiple linear regression was then used to develop a cost model incorporating all variables significant under univariate analysis. We collected 18,616 cases with Current Procedural Terminology code 29827 (“arthroscopic rotator cuff repair”) from the 2014 Florida State Ambulatory Surgery and Services Databases. Results: A greater proportion of the caseload for low-volume surgeons and facilities was composed of patients who were of lower socioeconomic status, had government-subsidized insurance, or lived in areas with low-income ZIP codes. Low-volume surgeons and facilities also had higher total charges, higher postoperative admission rates, and lower distal clavicle excision rates ( P < .001). In our cost model, a low facility volume significantly increased costs. Subacromial decompression, postoperative admission, distal clavicle excision, male sex, and government-subsidized insurance were all significant factors for increased costs in multivariate cost analysis. Conclusion: There are disparities in access to high-volume surgeons and facilities for patients undergoing arthroscopic rotator cuff repair in Florida. Patients with a lower socioeconomic status, government-subsidized insurance, and low income all faced decreased access to these high-volume groups. High-volume surgeons and facilities were associated with lower total charges, higher rates of distal clavicle excision, and lower readmission rates. Low-volume facilities added a significant amount of cost, even when controlling for all other significant variables. It is important for providers to be aware of these disparities and work to address them in their own practices.
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Hill, Katya. « Data Collection and Monitoring AAC Intervention in the Schools ». Perspectives on Augmentative and Alternative Communication 18, no 2 (juin 2009) : 58–64. http://dx.doi.org/10.1044/aac18.2.58.
Texte intégralRésumé :
Abstract Speech-language pathologists working in the schools with students who rely on AAC are expected to measure progress to document gains in language competence. This article provides an overview of some of the basic considerations SLPs make in collecting clinical data to monitor building language competence. Three hypothetical students are used as examples to illustrate data collection through the three transitional stages in language development SLPs frequently encounter on a school caseload: (a) pragmatics to semantics, (b) semantics to syntax, (c) phonology to metaphonology. Examples of performance and outcomes data including language activity monitoring are provided for each transition. SLPs addressing the what, when, how, who, where, and why of data collection find AAC intervention manageable. Strong evidence from clinical practice is needed to optimize the language competence of students who rely on AAC.
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Randall, Jennifer, et Venera Bekteshi. « Dodecaphony : Enacting Support Brokerage in the Twelve Cash & ; Counseling Expansion States ». Care Management Journals 13, no 3 (septembre 2012) : 108–15. http://dx.doi.org/10.1891/1521-0987.13.3.108.
Texte intégralRésumé :
Support brokers are entities that provide information and assistance to self-directed clients in Medicaid waiver programs. Although all Cash & Counseling programs have support brokerage, each state has a great deal of liberty in determining how those functions are carried out, who provides those activities, which functions are emphasized, and how responsibility for support broker tasks coordinates with other support activities. In this article, we map out the various ways in which states have operationalized the support brokerage concept. Differences in title, qualifications, training, hiring preferences, and caseload are described, and further directions for research are suggested.
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Bates-Maves, Julie K., et Deirdre O’Sullivan. « Making the Case for Specialized Caseloads Among Vocational Rehabilitation Counselors Working With Ex-Offenders : A Pilot Study ». Rehabilitation Research, Policy, and Education 31, no 2 (2017) : 121–34. http://dx.doi.org/10.1891/2168-6653.31.2.121.
Texte intégralRésumé :
Purpose:This article outlines findings from a sample of 137 vocational rehabilitation counselors regarding their stigmatizing attitudes, burnout levels, work experience, caseload composition, and working alliance with clients who have a range of disabilities and a criminal history.Method:Electronic surveys were sent to vocational rehabilitation counselors in 3 states who met the following criteria: counselors with a master’s degree, counselors with diverse and active caseloads, and counselors from geographically diverse states. Data were analyzed using 2-tailed correlation analysis and subsequent regression analysis.Results:VR counselors with more ex-offenders on their caseloads did not have higher stigma or burnout but, surprisingly, did have stronger working alliance.Conclusion:Findings support further research to confirm if specialized caseloads comprised of clients with criminal histories enhance working alliances among VR counselors.
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Elksnin, Linda K., et Gilson J. Capilouto. « Speech-Language Pathologists’ Perceptions of Integrated Service Delivery in School Settings ». Language, Speech, and Hearing Services in Schools 25, no 4 (octobre 1994) : 258–67. http://dx.doi.org/10.1044/0161-1461.2504.258.
Texte intégralRésumé :
Results of a survey of speech-language pathologists who had adopted (i.e., adopters) or who were considering adopting (i.e., nonadopters) integrated speech and language services are presented. The survey was designed to obtain information regarding speech-language pathologists’ perceptions of their expertise and the expertise of classroom teachers (CTs), integrated service delivery approaches they had adopted, the types of speech and language services provided in the classroom, and the characteristics of students served. Adopters’ and nonadopters’ perceptions regarding factors that contribute to effective integrated service delivery are reported, along with perceived advantages and disadvantages for speech-language pathologists, CTs, caseload students, and noncaseload students. Implications of survey results for inservice and preservice training and the future implementation of integrated speech and language services are considered as well.
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Warwick, Hunter, Andrew George, Claire Howell, Cynthia Green, Thorsten M. Seyler et William A. Jiranek. « Immediate Physical Therapy following Total Joint Arthroplasty : Barriers and Impact on Short-Term Outcomes ». Advances in Orthopedics 2019 (8 avril 2019) : 1–7. http://dx.doi.org/10.1155/2019/6051476.
Texte intégralRésumé :
Background. Recent evidence suggests benefit to receiving physical therapy (PT) the same day as total joint arthroplasty (TJA), but relatively little is known about barriers to providing PT in this constrained time period. We address the following questions: (1) Are there demographic or perioperative variables associated with receiving delayed PT following TJA? (2) Does receiving immediate PT following TJA affect short-term outcomes such as length of stay, discharge disposition, or 30-day readmission? Methods. Primary TJA procedures at a single center were retrospectively reviewed. Immediate PT was defined as within eight hours of surgery. Demographic and perioperative variables were compared between patients who received immediate PT and those who did not. We identified an appropriately matched control group of patients who received immediate PT. Postoperative length of stay, discharge disposition, and 30-day readmissions were compared between matched groups. Results. In total, 2051 primary TJA procedures were reviewed. Of these, 226 (11.0%) received delayed PT. These patients had a higher rate of general anesthesia (25.2% versus 17.8%, p=0.006), later operative start time (13:26 [11:31-14:38] versus 9:36 [8:24-11:16], p<0.001), longer operative time (1.8 [1.5-2.2] versus 1.6 [1.4-1.8] hours, p=0.002), and higher overall caseload on the day of surgery (6 [4-9] versus 5 [4-8], p=0.002). A matched group of patients who received immediate PT was identified. There were no differences in postoperative length of stay or discharge disposition between matched immediate and delayed PT groups, but delayed PT (OR 4.54; 95% CI 1.61-12.84; p=0.004) was associated with a higher 30-day readmission rate. Conclusion. Barriers to receiving immediate PT following TJA included general anesthesia, later operative start time, longer operative time, and higher daily caseload. These factors present potential targets for improving the delivery of immediate postoperative PT. Early PT may help reduce 30-day readmissions, but additional research is necessary to further characterize this relationship.
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Sarkar, R., et SS Mohapatra. « Accident of a civil passenger aircraft at a military airfield : The Casevac experience ». Indian Journal of Aerospace Medicine 63 (3 octobre 2020) : 96–101. http://dx.doi.org/10.25259/ijasm_7_2019.
Texte intégralRésumé :
Introduction: There are many civil airports in India wherein the airfield and flying operations are controlled by the military whereas, the Airports Authority of India (AAI) controls the civil terminal. Accident of a civil aircraft on such a base poses unique challenges. This paper discusses the medical contingency plan of a Naval Air Station to deal with civil aircraft crashes based on a civil aircraft incident. Case Details: In the early morning of late Dec in 2016, a Mumbai bound civil flight (Boeing 737) took off from an Indian Navy controlled airfield. While initiating the take-off roll from RW, it veered off the runway towards right and came to halt along the perimeter road 230 m north of the runway edge, on hard rocky ground. There were 154 passengers and 7 crew members who were evacuated from the aircraft, through emergency chutes. Few passengers escaped through the over wing hatches. Twenty passengers sustained injuries, mostly involving the lower limbs. This was primarily due to jumping on hard rocky ground and falling and tripping on rocks while moving away from the aircraft. An analysis was done to understand the limitations on the existing medical contingency plan. Discussion: The ICAO Airport Services Manual Part 7 on Airport Emergency Planning (Doc 9137-AN/898 Part 7) is the guiding reference for all airports on Airport Disaster and Planning. The Medical Services portion delineates clearly the role of the Medical Aid Providers. In the instant case, the medical department had successfully handled the casualty evacuation and their medical management. SOP and the existing medical contingencies were effectively used. A post-accident analysis in the instant case revealed that 17 out of 25 checklist points were satisfied. The lessons learned from the incident have been discussed in the paper.