HLAD 520 Introduction to Long-Term Care

Course syllabus for HLAD 520 Introduction to Long-Term Care Course description: This course provides a basic orientation to the long-term care continuum, including both nursing homes and non-institutional alternatives such as home health agencies and adult day care. It examines the long-term care needs of the elderly, and actual and proposed public policy responses to those needs

HLAD 410 Introduction to Long Term Health Care

Course syllabus for HLAD 410 Introduction to Long Term Care Course description: This course provides a basic orientation to the field of long-term care. Includes historical development, issues and problems and the impact of current health care policies and programs. Examines issues relating to diseases, care, rehabilitation of the chronically ill, aged, and disabled

HLAD 413 Long-Term Health Care Management

Course syllabus for HLAD 413 Long-Term Health Care Management Course description: This course examines principles in the management of skilled nursing facilities and related institutions for the chronically ill and disabled elderly. It explores issues in the regulation and reimbursement of nursing homes in Illinois

Whose voices count? From public records to public memory

Traditionally, accession policies of national archive institutions world-wide gave preference, if not exclusivity, to public records. This approach is nowadays under challenge in a number of archives. Private records, often in the form of oral testimony, are gradually finding their place side by side with their public counterparts. The National Archives of Malta recently embraced this approach. Through a project called MEMORJA archivists are becoming not only appraisers of records but actual co-creators (Farrugia 2006). This paper aims to address the question of whose voices count when applied to a real life scenario in particular on the MEMORJA project. The venture had direct implications on the functioning of the leading and participating archivists. Instead of managing the accessions process, they are now going out there in search of oral testimonies, ephemera and audio-visual documentation. This approach poses new challenges. And these are the issues analysed in this paper.peer-reviewe

Clinical features and outcomes of influenza and RSV coinfections: a report from Canadian immunization research network serious outcomes surveillance network

Abstract Background Influenza and RSV coinfections are not commonly seen but are concerning as they can lead to serious illness and adverse clinical outcomes among vulnerable populations. Here we describe the clinical features and outcomes of influenza and RSV coinfections in hospitalized adults. Methods A cohort study was performed with pooled active surveillance in hospitalized adults ≥ 50 years from the Serious Outcomes Surveillance Network of the Canadian Immunization Research Network (CIRN SOS) during the 2012/13, 2013/14, and 2014/15 influenza seasons. Descriptive statistics summarized the characteristics of influenza/RSV coinfections. Kaplan-Meier estimated the probability of survival over the first 30 days of hospitalization. Results Over three influenza seasons, we identified 33 cases of RSV and influenza coinfection, accounting for 2.39 cases per 1,000 hospitalizations of patients with acute respiratory illnesses. Adults aged 50 + years commonly reported cough (81.8%), shortness of breath (66.7%), sputum production (45.5%), weakness (33.3%), fever (27.3%), and nasal congestion (24.2%) as constitutional and lower respiratory tract infection symptoms. The mortality rate was substantial (12.1%), and age, comorbidity burden, and frailty were associated with a higher risk for adverse clinical outcomes. Conclusions Older adults are at higher risk for complications from influenza and RSV coinfections, especially those over 65 with a high comorbidity burden and frailty

How well do ICD-9 physician claim diagnostic codes identify confirmed pertussis cases in Alberta, Canada? A Canadian Immunization Research Network (CIRN) Study

Abstract Background Rates of Bordetella pertussis have been increasing in Alberta, Canada despite vaccination programs. Waning immunity from existing acellular component vaccines may be contributing to this. Vaccine effectiveness can be estimated using a variety of data sources including diagnostic codes from physician billing claims, public health records, reportable disease and laboratory databases. We sought to determine if diagnostic codes from billing claims (administrative data) are adequately sensitive and specific to identify pertussis cases among patients who had undergone disease-specific laboratory testing. Methods Data were extracted for 2004–2014 from a public health communicable disease database that contained data on patients under investigation for B. pertussis (both those who had laboratory tests and those who were epidemiologically linked to laboratory-confirmed cases) in Alberta, Canada. These were deterministically linked using a unique lifetime person identifier to the provincial billing claims database, which contains International Classification of Disease version 9 (ICD-9) diagnostic codes for physician visits. We examined visits within 90 days of laboratory testing. ICD-9 codes 033 (whooping cough), 033.0 (Bordetella pertussis), 033.1 (B. parapertussis), 033.8 (whooping cough, other specified organism), and 033.9 (whooping cough, other unspecified organism) in any of the three diagnostic fields for a claim were classified as being pertussis-specific codes. We calculated sensitivity, specificity, positive (PPV) and negative (NPV) predictive values. Results We identified 22,883 unique patients under investigation for B. pertussis. Of these, 22,095 underwent laboratory testing. Among those who had a laboratory test, 2360 tested positive for pertussis. The sensitivity of a pertussis-specific ICD-9 code for identifying a laboratory-confirmed case was 38.6%, specificity was 76.9%, PPV was 16.0%, and NPV was 91.6%. Conclusion ICD-9 codes from physician billing claims data have low sensitivity and moderate specificity to identify laboratory-confirmed pertussis among persons tested for pertussis