Nurse led care

What's the difference between medical and nursing care? The answer is not straightforward, but shortages in the medical workforce mean that nurses are increasingly called on to undertake work that was previously done by doctors (such as undertaking surgery,1 prescribing drugs, performing triage in emergency departments), whereas shortages in the nursing workforce mean that healthcare assistants now do many tasks that nurses are trained to do. This fluidity in professional roles and competencies enables the health workforce to respond to need, but are outcomes for patients being improved? Do these benefits come at an additional cost, and if so, are they worth paying for

Utilizing Dance/Movement Therapy to Help Alleviate the Physical and Emotional Effects of Thoracic Outlet Syndrome: A Literature Review

This capstone thesis literature review investigates dance/movement therapy as a complementary intervention to address the physical, mental and emotional effects of thoracic outlet syndrome. No research currently exists linking DMT and TOS in any capacity, so the author analyzes her own experience of utilizing various DMT techniques throughout her TOS recovery and reviews literature regarding DMT and conditions with similar symptoms to TOS, such as chronic pain, chronic illness, chronic fatigue syndrome, fibromyalgia, depression, stress and anxiety. The author hypothesizes that dance/movement therapy would be an effective complementary treatment to combat the physical, mental and emotional effects of TOS. The work presented in this literature review indicates that the author’s hypothesis has merit, because the research demonstrates a positive correlation between DMT and all conditions and symptoms that were investigated. The author states that further research is needed to explore and test this hypothesis, and she proposes a research method that could do so. This method utilizes a control group with TOS that does not receive any mental health services, a control group with TOS that is provided traditional talk therapy in a group setting, and a test group with TOS that is provided DMT group therapy interventions

From data to decisions: Navigating the “So What?” and “What’s Next?” conversation around nearshore data

Ever wonder what happens to all those data being collected? In Island County, we are fortunate to be the focus of a plethora of data collection efforts. We have comprehensive nearshore assessments that describe where our habitats are and how those habitats are built. We have habitat assessments that are a collaborative effort between citizen science groups and state agencies. We have long-term status and trends data sets on intertidal habitats and presence for a few specific species. We have a high resolution shoreline armor dataset and we have a predictive probability model for coastal flood risk. But what do we do with all of these data? What kind of information can be extrapolated from all this hard work? Most importantly, how is it helping us make a difference to our nearshore management? Island County’s Department of Natural Resources is working with our partners and committees to utilize this information to help guide and inform their decisions. We are finding that there are two broad categories of data sets – those that are most useful in informing decisions and those that are most useful in communication and outreach. We will discuss which sets fall into which category, and how we are working to evolve our datasets into useful next steps

Morbidity burden and community-based palliative care are associated with rates of hospital use by people with schizophrenia in the last year of life: A population-based matched cohort study

Objective: People with schizophrenia face an increased risk of premature death from chronic diseases and injury. This study describes the trajectory of acute care health service use in the last year of life for people with schizophrenia and how this varied with receipt of community based specialist palliative care and morbidity burden. Method: A population-based retrospective matched cohort study of people who died from 01/01/ 2009 to 31/12/2013 with and without schizophrenia in Western Australia. Hospital inpatient, emergency department, death and community-based care data collections were linked at the person level. Rates of emergency department presentations and hospital admissions over the last year of life were estimated. Results: Of the 63508 decedents, 1196 (1.9%) had a lifetime history of schizophrenia. After adjusting for confounders and averaging over the last year of life there was no difference in the overall rate of ED presentation between decedents with schizophrenia and the matched cohort (HR 1.09; 95%CI 0.99–1.19). However, amongst the subset of decedents with cancer, choking or intentional self-harm recorded on their death certificate, those with schizophrenia presented to ED more often. Males with schizophrenia had the highest rates of emergency department use in the last year of life. Rates of hospital admission for decedents with schizophrenia were on average half (HR 0.53, 95%CI 0.44–0.65) that of the matched cohort although this varied by cause of death. Of all decedents with cancer, 27.5% of people with schizophrenia accessed community-based specialist palliative care compared to 40.4% of the matched cohort (p\u3c0.001). Rates of hospital admissions for decedents with schizophrenia increased 50% (95% CI: 10%-110%) when enrolled in specialist palliative care. Conclusion: In the last year of life, people with schizophrenia were less likely to be admitted to hospital and access community-based speciality palliative care, but more likely to attend emergency departments if male. Community-based specialist palliative care was associated with increased rates of hospital admissions

Economic evaluation of a nursing-led intermediate care unit

Objectives: The aim of this paper is to examine the costs of introducing a nursing-led ward program together with examining the impact this may have on patients' outcomes. Methods; The study had a sample size of 177 patients with a mean age of 77, and randomized to either a treatment group (care on a nursing-led ward, n = 97) or a control group (standard care usually on a consultant-led acute ward, n = 80). Resource use data including length of stay, tests and investigations performed, and multidisciplinary involvement in care were collected. Results: There were no significant differences in outcome between the two groups. The inpatient costs for the treatment group were significantly higher, due to the longer length of stay in this group. However, the postdischarge costs were significantly lower for the treatment group. Conclusions: The provision of nursing-led intermediate care units has been proposed as a solution to inappropriate use of acute medical wards by patients who require additional nursing rather than medical care. Whether the treatment group is ultimately cost-additive is dependent on how long reductions in postdischarge resource use are maintained

Best practices for sustainable NGO/CBO agricultural marketing interventions. Proceedings of a workshop held at Hotel Africana, Kampala, Uganda 29 January 2003 (NRI report no. 2722)

The purpose of this one-day workshop was to present, discuss and build upon preliminary findings from a research project on best practices for agricultural marketing initiatives by Non-Government Organisations (NGOs) and Community-Based Organisations (CBOs). The workshop aimed to inform relevant policy processes and project or programme interventions within Uganda. Fifty-nine people attended the event representing NGOs, government institutions, donor agencies, producer organisations and agribusiness firms. Presentations by research team members were followed by panel group discussions, in which guest speakers offered additional insights into the topics under review. Active discussions during the plenary and working group sessions further enhanced research findings and provided guidance for the preparation of the final research report and future dissemination activities. The workshop assessed the role of farmer groups and possible strategies to build their capacity as well as that of organisations supporting their development. The experience of FOODNET in providing market information services was also shared during the workshop, and ways to improve the effectiveness of such services and to ensure financial and institutional sustainability were examined. Discussions were informed by on-going policy and institutional reform processes, in particular the Programme for the Modernisation of Agriculture (PMA) and the National Agricultural Advisory Services (NAADS)

Constitutional Law—The Privileges and Immunities Clause of Article IV: Fundamental Rights Revived—Baldwin v. Fish & Game Commission, 436 U.S. 371 (1978)

In Montana, nonresident sportsmen wishing to hunt solely for elk must purchase a big game combination license, though residents may acquire a separate elk license. In addition, Montana imposes substantially higher license fees on nonresidents, effectively requiring them to pay 28.2 times more than residents for the privilege of hunting elk. Plaintiffs challenged Montana\u27s elk-hunting license fee scheme, charging that it discriminated against nonresident elk hunters in violation of the privileges and immunities clause of article IV, section 2 of the Constitution. A divided three-judge district court denied plaintiffs\u27 demand for declaratory and other relief. In Baldwin v. Fish & Game Commission, the United States Supreme Court affirmed, holding that the scope of the privileges and immunities clause extends only to fundamental rights of citizenship and that equal access to Montana elk by nonresident hunters is not a fundamental privilege protected by the clause. Montana\u27s licensing scheme, therefore, withstood the challenge