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Sample records for attempt case management

  1. Clinical Characteristics of the Suicide Attempters Who Refused to Participate in a Suicide Prevention Case Management Program.

    PubMed

    Park, Soyoung; Choi, Kyoung Ho; Oh, Youngmin; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai; Lee, Kyoung-Uk

    2015-10-01

    Case management interventions for suicide attempters aimed at helping adjust their social life to prevent reattempts have high nonparticipation and dropout rates. We analyzed the clinical characteristics of the group who refused to participate in the suicide prevention program in Korea. A total of 489 patients with a suicide attempt who visited Uijeongbu St. Mary's Hospital, the Catholic University of Korea, from December 2009 to December 2013 were analyzed. All patients were divided into the participation group (n = 262) and the refusal group (n = 227) according to their participation in the case management program. Demographic and clinical characteristics of each group were examined. Results showed that the refusal group had low risks for suicide in terms of risk factors related with psychopathologies and presenting suicide behavior. That is, the refusal group had less patients with co-morbid medical illnesses and more patients with mild severity of depression compared to the participation group. However, the refusal group had more interpersonal conflict, more isolation of social integrity, and more impaired insight about suicide attempt. The results suggest that nonparticipation in the case management program may depend upon the patient's impaired insight about the riskiness of suicide and lack of social support. PMID:26425048

  2. A very unusual case of attempted suicide.

    PubMed

    Misiak, Piotr; Jabłoński, Sławomir; Dziwińska, Katarzyna; Terlecki, Artur

    2016-06-01

    We would like to present a case report of a very unusual suicide attempt. A 48-year-old female patient tried to commit suicide by stabbing herself with a kitchen knife into her neck. Suicide by self-stabbing is uncommon, constituting only 1-3% of suicide attempts. Patients with self-inflicted stab wounds may have a higher incidence of surgical interventions based on the stab location. Surprisingly, the mortality associated with this kind of wound is low. Most medical centers have very limited experience with this infrequent injury. There are only a few case reports and small series published in the literature of the subject. PMID:27516789

  3. A very unusual case of attempted suicide

    PubMed Central

    Jabłoński, Sławomir; Dziwińska, Katarzyna; Terlecki, Artur

    2016-01-01

    We would like to present a case report of a very unusual suicide attempt. A 48-year-old female patient tried to commit suicide by stabbing herself with a kitchen knife into her neck. Suicide by self-stabbing is uncommon, constituting only 1-3% of suicide attempts. Patients with self-inflicted stab wounds may have a higher incidence of surgical interventions based on the stab location. Surprisingly, the mortality associated with this kind of wound is low. Most medical centers have very limited experience with this infrequent injury. There are only a few case reports and small series published in the literature of the subject. PMID:27516789

  4. [Attempted suicide by snake bite. Case report and literature survey].

    PubMed

    Strubel, T; Birkhofer, A; Eyer, F; Werber, K D; Förstl, H

    2008-05-01

    Unusual suicide attempts often remain undetected, and bizarre methods can be a clue to psychotic origin. We report a suicide attempt by proxy--the bite of a puff adder--and provide a brief literature survey about further archaic self-injurious behaviour. Due to the easy availability of venomous snakes and the close networking of suicidal patients via the Internet, an increase in similar cases can be anticipated. A failed suicide attempt should always be considered in patients surviving bizarre accidents. PMID:18365165

  5. Zolpidem-induced suicide attempt: a case report

    PubMed Central

    2013-01-01

    Zolpidem is a popular drug indicated for the short-term treatment of insomnia. Side effects are not uncommon with zolpidem. Herein we describe an Iranian 27-year-old man with no known mood disorder or neuropsychological disease who attempted suicide upon taking zolpidem. There are two interesting facts about this case: Firstly, the patient had not history of suicide attempt or thinking. Secondly, this case had experienced suicide ideation after taking 20 mg of zolpidem, suggesting a possible correlation between zolpidem psychological effects and dangerous psychological behaviors. PMID:24359886

  6. Inverted Takotsubo cardiomyopathy after attempted suicidal hanging--two cases.

    PubMed

    Sengupta, Shantanu; Mungulmare, Kunda; Wadaskar, Nitin; Pande, Abhishek

    2016-04-01

    We report two cases of "Inverted Takotsubo cardiomyopathy" following attempted suicidal hanging. Both the patients presented with heart failure and had desaturation 8-12h after the suicidal attempt. Electrocardiography (ECG) showed ischemic changes. On echocardiography, the left ventricle (LV) showed ballooning and hypokinesia of the basal segments with apical sparing. Both patients underwent coronary angiograms considering the possibility of acute coronary syndrome. However, their coronary angiograms were normal. After 3-4 days of hospitalization, both recovered; their ECG had reversed and the LV contractility was normal on echocardiography. PMID:27056654

  7. Case management.

    PubMed

    Rosenstein, A H; Propotnik, T

    1997-03-01

    Providing cost-effective high quality healthcare services ranks as the number one concern for anyone involved with the healthcare delivery system. While quality of care should always be the number one priority, controlling healthcare costs receives most of the attention. With limited healthcare dollars and providers assuming more of the financial risk for services rendered, a whole assortment of cost-containment strategies are being introduced in an effort to maintain some semblance of financial viability. Healthcare providers can approach cost control from two different angles. On the fixed-cost operational overhead side, traditional cost-containment techniques have focused on downsizing, maximizing productivity, staffing redesign, improved purchasing contracts, standardization, inventory control, and other more individualized restructured service models. On the variable-cost clinical side, cost control has been approached by introducing a variety of cost-containment strategies designed to improve efficiency and effectiveness of provider performance. While many of these strategies, previously discussed in the Journal of Healthcare Resource Management have stressed the importance of education, guidelines, pathways, and other clinical "tools for improvement," the success of many of these tools resides in the ability to provide real-time intervention. Real-time intervention rather than the more passive retrospective variance analysis has the greatest potential for producing cost savings by actually making a recommendation that prevents the unwanted event from occurring. In many institutions, the case manager bears the responsibility for monitoring and managing these programs. This article describes various case management models currently used by different institutions. PMID:10166062

  8. Case Management Directors

    PubMed Central

    Bankston White, Cheri; Birmingham, Jackie

    2015-01-01

    Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care of patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. This is Part 2 of a two-part article written for case management directors, particularly new ones. Part 1 covered the first 4 of 7 tracks: (1) Staffing and Human Resources, (2) Compliance and Accreditation, (3) Discharge Planning and (4) Utilization Review and Revenue Cycle. Part 2 addresses (5) Internal Departmental Relationships (Organizational), (6) External Relationships (Community Agency), and (7) Quality and Program Outcomes. This article attempts to answer the following questions: Are case management directors prepared for an expanded role that affects departments and organizations outside of their own?How does a case management director manage the transition of care of patients while managing required relationships outside the department?How does the director manage program outcomes in such a complex department? Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems and have frontline case managers (CMs) reporting to them. Findings/Conclusions: Part 1 found that case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. The same conclusion applies to Part 2, which addresses the director's responsibilities outside her immediate department. Leadership and management skills apply as well to building strong, productive relationships across a broad spectrum of external organizations

  9. [Suicide attempt by an interstitial cystitis patient : a case report].

    PubMed

    Suzuki, Takahisa; Otsuka, Atsushi; Kato, Taiki; Furuse, Hiroshi; Ozono, Seiichiro

    2014-11-01

    We report a suicide attempt by an interstitial cystitis patient. A 68-year-old woman consulted several clinics with complaints of urinary frequency and bladder pain, but her symptoms did not improve. She was admitted to our hospital and diagnosed with interstitial cystitis. Hydrodistention was performed, and the urethral catheter removed one day after surgery. The next day, the patient was afraid that her symptoms had not improved and, due to this physical and mental distress, cut her wrist with a razor. Vascular anastomosis and neuroanastomosis were performed accordingly. Eighteen months after hydrodistention, the patient's symptoms of interstitial cystitis have much improved. PMID:25511944

  10. Penetrating Brain Injury after Suicide Attempt with Speargun: Case Study and Review of Literature

    PubMed Central

    Williams, John R.; Aghion, Daniel M.; Doberstein, Curtis E.; Cosgrove, G. Rees; Asaad, Wael F.

    2014-01-01

    Penetrating cranial injury by mechanisms other than gunshots are exceedingly rare, and so strategies and guidelines for the management of PBI are largely informed by data from higher-velocity penetrating injuries. Here, we present a case of penetrating brain injury by the low-velocity mechanism of a harpoon from an underwater fishing speargun in an attempted suicide by a 56-year-old Caucasian male. The case raised a number of interesting points in management of low-velocity penetrating brain injury (LVPBI), including benefit in delaying foreign body removal to allow for tamponade; the importance of history-taking in establishing the social/legal significance of the events surrounding the injury; the use of cerebral angiogram in all cases of PBI; advantages of using dual-energy CT to reduce artifact when available; and antibiotic prophylaxis in the context of idiosyncratic histories of usage of penetrating objects before coming in contact with the intracranial environment. We present here the management of the case in full along with an extended discussion and review of existing literature regarding key points in management of LVPBI vs. higher-velocity forms of intracranial injury. PMID:25071701

  11. Serious Suicide Attempts: Evidence on Variables for Manage and Prevent this Phenomenon.

    PubMed

    Mento, Carmela; Presti, Eleonora Lo; Mucciardi, Massimo; Sinardi, Angelo; Liotta, Marco; Settineri, Salvatore

    2016-07-01

    The aim of this study is to investigate the variables shown to be linked to serious suicide attempts. Cases requiring emergency admission to intensive care were collected from medical records of the University Hospital in Messina (Italy) for the years 2006-2010. 107 cases of serious attempted suicide were examined, 39 of which ended in the death of the patient. The results showed the following variables to be linked highly significantly (P < 0.01) and have good nominal association (V > 0.30) with a fatal suicidal attempt: the year of the attempt, deceased father, history of physical illness prior to hospitalization and method used to carry out the suicide attempt. These results confirm the severity and the multidisciplinary importance of this phenomenon. PMID:26399518

  12. Managing Case Managers: Case Management in Service Integration. Resource Brief.

    ERIC Educational Resources Information Center

    Marks, Ellen L.

    As the case management approach has become increasingly popular, a new phenomenon has emerged. A client may have several case managers, each employed by a different project, and these managers may not be aware of each other. The National Center for Children in Poverty has recently conducted research on case management in service integration…

  13. Alcohol Abuse and Suicide Attempt in Iran: A Case-Crossover Study

    PubMed Central

    Ghanbari, Behrooz; Malakouti, Seyed Kazem; Nojomi, Marzieh; Leo, Diego De; Saeed, Khalid

    2016-01-01

    Alcohol use and its disorders are associated with increased risk of suicidal behaviors Research has shown that 6-8% of those who use alcohol have a history of suicide attempt. Given the prohibition of alcohol use legally, the increased alcohol consumption, and the lack of strong evidence in favor of its use associated with suicide in Iran, this study was conducted to determine the link between suicide attempt and alcohol abuse. The case-crossover method was used in this research. Out of 305 referrals to the emergency room due to a suicide attempt, 100 reported drinking alcohol up to six hours before their attempt. Paired Matching and Usual Frequency were employed to analyze the data with STATA 12.0. The probability of attempting suicide up to six hours after drinking alcohol appeared increased by 27 times (95% CI: 8.1-60.4). Separate analysis for each of these hours from the first to the sixth hour after alcohol use was also performed. Fifty percent of attempted suicides happened one hour after alcohol use. Relative risk for the first and second hour was 10% and 5% respectively. Alcohol use is a strong proximal risk factor for attempted suicide among Iranian subjects. Prevention of alcohol use should be considered in setting up of the national Suicide attempt prevention program. PMID:26925903

  14. Suicide attempt and melancholic depression in a male with erotomania: case report.

    PubMed

    Kovács, Attila; Vörös, Viktor; Fekete, Sándor

    2005-01-01

    Erotomania is a delusional disorder, which is more common among women. A case of erotomania in a 34-year-old male associated with depression and suicidal behavior is presented. At the time he attempted suicide his erotomania fulfilled the diagnostic criteria of "pure" erotomania, described by de Clérambault. A depressive picture with melancholic features emerged four months later. Antidepressant medication was given and two months later he became euthymic. The erotomanic delusion disappeared in the third month of the euthymic state. In this case primary erotomania was associated with a depressive illness, presumably unipolar depression. The patient developed delusional guilt and suicidal ideation before the unequivocal change in his mood. To the authors' knowledge this is the first reported case where the erotomanic symptomatology led to suicidal attempt. PMID:16179333

  15. "Tuberculosis Case Management" Training.

    ERIC Educational Resources Information Center

    Knebel, Elisa; Kolodner, Jennifer

    2001-01-01

    The need to isolated health providers with critical knowledge in tuberculosis (TB) case management prompted the development of "Tuberculosis Case Management" CD-ROM. Features include "Learning Center,""Examination Room," and "Library." The combination of audio, video, and graphics allows participants to practice acquired skills in a simulated…

  16. Attempted Serial Neonaticides: Case Report and a Brief Review of the Literature.

    PubMed

    Barros, Alcina Juliana Soares; Rosa, Regis Goulart; Telles, Lisieux Elaine de Borba; Taborda, José Geraldo Vernet

    2016-01-01

    Neonaticide is an infant murder occurring on the day of birth. The case reports found in the literature are often focused on the mother as the agent in the context of pregnancy denial, dissociative symptoms, or psychosis. However, this report describes a rare case of attempted serial neonaticides, in which the acts were committed by a nurse at the nursery of a referral hospital in Brazil. The authors describe a forensic psychiatric evaluation for criminal responsibility and correlate the information from this particular case with relevant forensic themes, namely neonaticide, Munchausen by proxy syndrome, and serial healthcare killers. PMID:26259153

  17. [Chronic pain and suicide attempt in the elderly through a case narration].

    PubMed

    Gaillardou, Denise; Matusevich, Daniel

    2014-01-01

    We sought to reconstruct the case of an elderly patient who made a suicide attempt. We have isolated and identified certain risk factors which could have determined the patient's final decision, such as chronic pain, social isolation, narcissistic personality traits, depression and family suicidality. We analyze the difficulties and limitations found in the current treatment of these patients, with an aim to raise greater interest in the research and treatment of them. PMID:25546546

  18. Takotsubo Cardiomyopathy as a Delayed Complication with a Herbicide Containing Glufosinate Ammonium in a Suicide Attempt: A Case Report

    PubMed Central

    Tominaga, Keiichiro; Izumi, Manabu; Suzukawa, Masayuki; Shinjo, Takafumi; Izawa, Yoshimitsu; Yonekawa, Chikara; Ano, Masaki; Yamashita, Keisuke; Muronoi, Tomohiro; Mochiduki, Reiko

    2012-01-01

    Background. Glufosinate ammonium has a famous delayed complication as respiratory failure, however, delayed cardiogenic complication is not well known. Objectives. The aim of this study is to report a takotsubo cardiomyopathy as a delayed complication of glufosinate ammonium for suicide attempt. Case Report. A 75-year-old woman ingested about 90 mL of Basta, herbicide for suicide attempt at arousal during sleep. She came to our hospital at twelve hours after ingesting. She was admitted to our hospital for fear of delayed respiratory failure. Actually, she felt down to respiratory failure, needing a ventilator with intubation at 20 hours after ingesting. Procedure around respiratory management had smoothly done with no delay. Her vital status had been stable, however, she felt down to circulatory failure and diagnosed as Takotsubo cardiomyopathy at about 41 hours after ingestion. There was no trigger activities or events to evoke mental and physical stresses. Conclusion. We could successfully manage takotsubo cardiomyopathy resulted in circulatory failure in a patient with glufosinate poisoning for suicide attempt. Takotsubo cardiomyopathy should be taken into consideration if circulatory failure is observed for unexplained reasons. PMID:23319956

  19. Complications and management of attempted suicide by intrapleural injection of prallethrin

    PubMed Central

    Bashini, M. Madhu; Rajavel, V. P.; Rahulan, Vigil

    2016-01-01

    We describe the unusual presentation and management of complications of intrapleural prallethrin injection in this case report. The pathologic process is distinct from the usual toxicity secondary to effect on ionic channels of the nervous system. PMID:27076732

  20. A STUDY OF HOPELESSNESS, SUICIDAL INTENT AND DEPESSION IN CASES OF ATTEMPTED SUICIDE

    PubMed Central

    Jain, V.; Singh, H.; Gupta, S.C.; Kumar, S.

    1999-01-01

    The aim of the present study was to determine the severity and relationship of depression, hopelessness & sucide intent in individuals attempting suicides. Individuals admitted to a northern India hospital emergency services between 1st Jan. ′94 to 31st Dec. ′94 with suicide attempt were taken up for study and assessed with the help of different tools. 79 patients were screened for the study and 56 patients were included (33 male & 23 female). Majority of the sample was below 30 years of age (82.1%). Organophosphorus consumption and drug overdose was most common (75%) psychiatric illness was present in 57% cases, depression being most common 37.5% (p< 0.001) 22 subjects showed mild to moderate suicide intent (39.28%) & 16% subjects showed hopelessness score above 9. Variables taken up for the study have a highly significan correlation with each other i.e. suicidal intent, hopelessness and depression. PMID:21455374

  1. A study of hopelessness, suicidal intent and depession in cases of attempted suicide.

    PubMed

    Jain, V; Singh, H; Gupta, S C; Kumar, S

    1999-04-01

    The aim of the present study was to determine the severity and relationship of depression, hopelessness & sucide intent in individuals attempting suicides. Individuals admitted to a northern India hospital emergency services between 1st Jan. '94 to 31st Dec. '94 with suicide attempt were taken up for study and assessed with the help of different tools. 79 patients were screened for the study and 56 patients were included (33 male & 23 female). Majority of the sample was below 30 years of age (82.1%). Organophosphorus consumption and drug overdose was most common (75%) psychiatric illness was present in 57% cases, depression being most common 37.5% (p< 0.001) 22 subjects showed mild to moderate suicide intent (39.28%) & 16% subjects showed hopelessness score above 9. Variables taken up for the study have a highly significan correlation with each other i.e. suicidal intent, hopelessness and depression. PMID:21455374

  2. An Unusual Case of Suicide Attempt Using Intravenous Injection of Kerosene.

    PubMed

    Hasan, M N; Sutradhar, S R; Ahmed, S M; Chowdhury, I H

    2016-07-01

    Kerosene belongs to the hydrocarbon group of compounds, used as a fuel for lamps, as well as heating and cooking in developing countries. Accidental kerosene poisoning and intoxication usually occur by inhalation or by occupational percutaneous absorption. Adults usually ingest kerosene for the purpose of self-harm, and children may ingest accidentally. Suicidal attempt using intravenous kerosene is an extra ordinary and very rare occurrence. A very few data are available regarding effects of intravenous administration of kerosene and its management. PMID:27612910

  3. A Case of Attempted Suicide in Huntington's Disease: Ethical and Moral Considerations.

    PubMed

    Furfari, Kristin; Zehnder, Nichole; Abbott, Jean

    2016-01-01

    A 62-year-old female with Huntington's disease presented after a suicide attempt. Her advance directive stated that she did not want intubation or resuscitation, which her family acknowledged and supported. Despite these directives, she was resuscitated in the emergency department and continued to state that she would attempt suicide again. Her suicidality in the face of a chronic and advancing illness, and her prolonged consistency in her desire to take her own life, left careproviders wondering how to provide ethical, respectful care to this patient. Tension between the ethical principles of autonomy and beneficence is central in this case. The patient's narrative demonstrated that her suicide was an autonomous decision, free from coercion or disordered thinking from mental illness. Beneficence then would seem to necessitate care aligned with the patient's desire to end her life, which created ethical uneasiness for her family and careproviders. The case highlights several end-of-life ethical considerations that have received much recent attention. With ongoing discussions about the legalization of aid in dying across the country, caregivers are challenged to understand what beneficence means in people with terminal illnesses who want a say in their death. This case also highlights the profound moral distress of families and careproviders that arises in such ethically challenging scenarios. PMID:27045303

  4. Case Management Directors

    PubMed Central

    Bankston-White, Cheri; Birmingham, Jackie

    2015-01-01

    Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care for patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. The purpose of this two-part article is to provide case management directors, particularly new ones, with a framework for understanding and fulfilling their role. We have divided the guide into seven tracks of responsibility. Part 1 discusses the first four tracks: (1) staffing and human resources, (2) compliance and accreditation, (3) discharge planning, and (4) utilization review and revenue cycle. Part 2 addresses (5) internal departmental relationships (organizational), (6) external relationships (Community agency), and (7) quality and program outcomes. Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems, and have frontline case managers reporting to them. Findings/Conclusions: Case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. New directors would benefit from mentoring and networking with one another. Implications for Case Management: As new regulations and models of care bring increased emphasis and focus to transitions of care, the role of the case management director continues to evolve, growing in importance and complexity. The growing financial impact of readmissions also brings added scrutiny and increased pressure to get the transitions of care right the first time. To operate most effectively, case management directors must understand the full range of their

  5. A case of family dysfunction and teenage suicide attempt: applicability of a family systems paradigm.

    PubMed

    Koopmans, M

    1995-01-01

    A large body of research indicates that suicidal behavior in adolescence is related to dysfunctional family processes. The purpose of this paper was to investigate this relationship focusing on the concepts of boundary transgression, double bind interactions, and the demarcation of kinship roles in the family. The possibility is explored that suicidal behavior is a double bind response to contradictions in the way roles and responsibilities are distributed in the family, and that as a response, suicide attempts may contain a simultaneous appeal for help and an assertion of independence from the family. A case vignette is presented to illustrate these processes. PMID:7625266

  6. Juvenile perpetrators of homicides and attempted homicides--a case control study.

    PubMed

    Britvić, Dolores; Urlić, Ivan; Definis-Gojanović, Marija

    2006-03-01

    The aim of this study was to explore the influence of certain aspects of family dynamics, as well as some behavior and psychological development disorders on the occurrence of homicides and attempted homicides among juveniles in the Split Dalmatian County over a period of 10 years (1989-1998). A retrospective case-control study was performed to compare juvenile murderers and attempted murderers with minors who committed other offences, i.e. property crimes. The subjects were paired according to demographic and socio-economic background. The data obtained from County Court's files included social anamnesis, specialists' observation and psychiatric expertise results. There was a significant difference between the study group and their controls in the frequency of physical violence and parental rejection during childhood. Neuropsychological and neurophysiological abnormalities were more frequent in the experimental than in the control group. Stealing occurred more often in the control group. No significant differences were found for other studied risk factors. There is no unique type of juvenile murderer. A juvenile homicide is committed under the influence of various developmental characteristics, family milieu, and constitution combined with environmental factors and perpetrator's perception of the victim. PMID:16617589

  7. A Case Report of Prolonged Apnea during ECT in a Patient with Suicidal Attempt by Organophosphorus Poison

    PubMed Central

    Moudi, Sussan; Alijanpour, Ebrahim; Manouchehri, Ali-asghar; Jafarian, Hasan

    2012-01-01

    Organophosphorus pesticides have been used in some cases for suicidal attempts. Such poison can affect plasma cholinesterase activity. The case was a 47-year-old man hospitalized due to suicide attempt with swallowing agricultural poison. The patient, diagnosed with major depressive disorder (MDD), underwent treatment with electroconvulsive therapy (ECT). At the first ECT session, the patient developed apnea for 45 minutes following receiving 20 mg succinylcholine. The patient was intubated; after restoration of respiration depth and rate, the patient was extubated. Collectively, in cases with history of suicide attempts, taking organophosphorus pesticides should be warn for pre-ECT anesthesia. PMID:24644472

  8. A Case Report of Prolonged Apnea during ECT in a Patient with Suicidal Attempt by Organophosphorus Poison.

    PubMed

    Moudi, Sussan; Alijanpour, Ebrahim; Manouchehri, Ali-Asghar; Jafarian, Hasan

    2012-01-01

    Organophosphorus pesticides have been used in some cases for suicidal attempts. Such poison can affect plasma cholinesterase activity. The case was a 47-year-old man hospitalized due to suicide attempt with swallowing agricultural poison. The patient, diagnosed with major depressive disorder (MDD), underwent treatment with electroconvulsive therapy (ECT). At the first ECT session, the patient developed apnea for 45 minutes following receiving 20 mg succinylcholine. The patient was intubated; after restoration of respiration depth and rate, the patient was extubated. Collectively, in cases with history of suicide attempts, taking organophosphorus pesticides should be warn for pre-ECT anesthesia. PMID:24644472

  9. An attempt at the computer-aided management of HIV infection

    NASA Astrophysics Data System (ADS)

    Ida, A.; Oharu, Y.; Sankey, O.

    2007-07-01

    The immune system is a complex and diverse system in the human body and HIV virus disrupts and destroys it through extremely complicated but surprisingly logical process. The purpose of this paper is to make an attempt to present a method for the computer-aided management of HIV infection process by means of a mathematical model describing the dynamics of the host pathogen interaction with HIV-1. Treatments for the AIDS disease must be changed to more efficient ones in accordance with the disease progression and the status of the immune system. The level of progression and the status are represented by parameters which are governed by our mathematical model. It is then exhibited that our model is numerically stable and uniquely solvable. With this knowledge, our mathematical model for HIV disease progression is formulated and physiological interpretations are provided. The results of our numerical simulations are visualized, and it is seen that our results agree with medical aspects from the point of view of antiretroviral therapy. It is then expected that our approach will take to address practical clinical issues and will be applied to the computer-aided management of antiretroviral therapies.

  10. Case Management: A Resource Manual.

    ERIC Educational Resources Information Center

    Adams, Anne Thomas; Franklin, Sundra; Taylor, Rebecca

    This resource manual has been developed to assist both case managers and management staff in implementing a case management system as an infrastructure for delivering services that will facilitate the positive growth and development of youth and the achievement of individual and organizational performance goals. (The goal of case managers is to…

  11. Copycat suicidal attempt by a 7 year old boy after watching homicidal behavior in media: a case report

    PubMed Central

    2009-01-01

    Introduction Suicidal behavior in media may promote others towards suicide. No published study was found about suicidal attempt in children less than 10 years old after watching a homicidal behavior. Case presentation This is a report of a 7 year old boy referred because he hanged himself after watching homicidal behavior of hanging in a fictional movie. Discussion To the author's knowledge, there was no published report of copycat suicidal attempt in a 7 year old child after watching a homicidal behavior in media. This report warns about an imitative effect of movie watching of homicidal behavior on suicidal attempt. PMID:19138418

  12. Characteristics of Impulsive Suicide Attempts and Attempters.

    ERIC Educational Resources Information Center

    Simon, Thomas R.; Swann, Alan C.; Powell, Kenneth E.; Potter, Lloyd B.; Kresnow, Marcie-jo; O'Carroll, Patrick W.

    2002-01-01

    Examined impulsive suicide attempts within a population-based, case-control study of nearly lethal suicide attempts among adolescents and young adults. Impulsive attempts were more likely among those who had been in a physical fight and less likely among those who were depressed. Findings suggest inadequate control of aggressive impulses as a…

  13. Acute clenbuterol overdose manifestations in a suicide attempt--a case report.

    PubMed

    Nawrocka, Izabela; Kowalczys, Maria H; Abramczyk, Piotr

    2015-12-01

    A 30-year-old man was admitted to the intensive care unit after a suicide attempt with respiratory difficulties, tremor, sinus tachycardia and significant hypokalemia. On examination, the patient was lucid, fully conscious and did not exhibit positive symptoms. Sings were not typical for overdosing olanzapine, alprazolam and alcohol as declared by the patient. Additional anamnesis revealed high doses of ingested clenbuterol, a selective β2-adrenergic agonist. Due to its anabolic and lipolytic properties, clenbuterol has become a commonly abused drug in bodybuilding industry and is not routinely detected by toxicology screens. This is the first known report of suicide attempt by clenbuterol overdosing. PMID:26802692

  14. Mental pain, communication difficulties, and medically serious suicide attempts: a case-control study.

    PubMed

    Levi-Belz, Yossi; Gvion, Yari; Horesh, Netta; Fischel, Tsvi; Treves, Ilan; Or, Evgenia; Stein-Reisner, Orit; Weiser, Mark; David, Haim Shem; Apter, Alan

    2014-01-01

    Medical severe suicide attempts (MSSA) are epidemiologically very similar to individuals who complete suicide. Thus the investigation of individuals who have made MSSAs may add to our understanding of the risk factors for completed suicide. The aim of this study was to assess the role of mental pain and communication difficulties in MSSA. A total of 336 subjects were divided into 4 groups: 78 meeting criteria for MSSA compared with116 subjects who made a medically non-serious suicide attempt (MNSSA), 47 psychiatric controls with no history of suicidal behavior, and 95 healthy controls. Mental pain variants (e.g., hopelessness), facets of communication difficulties (e.g., self-disclosure), as well as socio-demographic and clinical characteristics were assessed. The MSSA had significantly higher communication difficulties than the other 3 groups. Moreover, the interaction between mental pain and communication difficulties explained some of the variance in suicide lethality, above and beyond the contribution of each component alone. This report underlines the importance of mental pain for suicide attempts in general while difficulties in communication abilities play a critical role in differentiating MSSA from MNSSA. The co-existence of unbearable mental pain with difficulties in communication significantly enhances the risk for more lethal forms of suicidal behavior. PMID:24350568

  15. Sleep disturbance and attempted suicide in rural China: a case-control study.

    PubMed

    Jia, Cun-Xian; Zhang, Wen-Chao; Wei, Li; Zhang, Ji-Yu; Liu, Xian-Chen

    2015-06-01

    This study aimed to examine the association between sleep disturbance and attempted suicide in rural China. The study group included 409 suicide attempters from six rural counties in Shandong Province, China and an equal number of controls matched on age, sex, and residency. Sleep disturbance was assessed by the item "sleep restless" in the Center for Epidemiologic Studies Depression Scale. Sleep disturbance was reported more frequently in suicide attempters than in controls (1-2 days/week, 9.0% vs. 4.4%; 3-4 days/week, 11.5% vs. 2.4%; ≥5 days/week, 30.3% vs. 7.5%, χ 2= 128.72, p < 0.001). Suicide risk was significantly associated with increased frequency of sleep disturbance (OR = 3.98, 95% CI = 1.62-9.74 for 1-2 days/week; OR = 3.28, 95% CI = 1.21-8.84 for 3-4 days/week; OR = 2.41, 95% CI = 1.26-4.60 for ≥5 days/week) even after adjusting for potential psychosocial confounding factors and mental disorders. This finding may have important implications for early intervention and prevention of suicide. PMID:25974056

  16. Cervical Mass Following Carotid Attempt at Interventional Repair of Aortic Coarctation: A Case Report

    PubMed Central

    Dabbagh, Ali; Hekmat, Manuchehr; Ghanavati, Arash; Ghasemi, Abdolrahim

    2010-01-01

    A 4-month-old boy was admitted to our hospital following an unsuccessful attempt at interventional repair of aortic coarctation via the right carotid artery, which seemed to have given rise to the formation and growth of a cervical mass overlying the entry site. Despite the initial anticipation of difficulty during intubation due to the pressure effect of the mass, anesthesia progressed uneventfully, the mass, which was a hematoma, was evacuated, and the coarctation was repaired. The patient was discharged after the operation. At three weeks’ follow-up, there was no significant lesion in the neck and transthoracic echocardiography demonstrated no residual coarctation. PMID:23074567

  17. Electronic case management with homeless youth.

    PubMed

    Bender, Kimberly; Schau, Nicholas; Begun, Stephanie; Haffejee, Badiah; Barman-Adhikari, Anamika; Hathaway, Jessica

    2015-06-01

    Case management, a widely practiced form of service brokerage, is associated with a variety of positive outcomes for homeless youth, but it may be difficult to implement, as youth face logistical barriers to attending in-person meetings. As part of a larger clinical trial, the current study investigates the feasibility of providing electronic case management (ECM) to homeless youth, using cell-phones, texts, email, and Facebook. Youth were given prepaid cell-phones and a case manager who provided four ECM sessions every 2-3 weeks over a 3-month period. Contact logs were used to record how many youth engaged in ECM, how many attempts were necessary to elicit engagement, and youths' preferred technology methods for engaging. Although engagement in the number of ECM sessions varied, the majority of youth (87.5%) engaged in at least one ECM session. Youth (41%) most commonly needed one contact before they engaged in an ECM session, and the majority responded by the third attempt. While youth most commonly answered calls directly, their chosen method of returning calls was texting. The majority of youth (80%) described ECM positively, reporting themes of convenience, connection, and accountability. The use of ECM, particularly of texting, offers promising implications for providing services to homeless youth. PMID:25748603

  18. Double fracture and wedging of a sewing needle interdentally in an attempt at self-treatment: a case report.

    PubMed

    Harper, Kenneth A

    2002-03-01

    Dental pain occurring whilst abroad may present the patient with a difficult decision: to try and bear it with self-medication until he/she returns home or to seek professional help. This case report outlines a Korean girl's attempt at self-treatment, which resulted in not one but two fragments of a sewing needle wedging between her teeth, the second fracturing as she tried to dislodge the first. Her self-treatment exacerbated her problem and resulted in the need for surgical access to the site to retrieve the broken fragments. The case also illustrates the use of parallax radiography in determining the position of the fragments. PMID:11928345

  19. Analysis of hydrogen cyanide in air in a case of attempted cyanide poisoning.

    PubMed

    Magnusson, R; Nyholm, S; Åstot, C

    2012-10-10

    A 32-year-old man attempted to poison his ex-girlfriend with hydrogen cyanide by hiding the pesticide Uragan D2 in her car. During the police investigation, chemical analysis of the air inside the car was performed. Hydrogen cyanide was detected through on-site air analysis using a portable Fourier transform infrared (FTIR) spectroscopy gas analyzer and colorimetric gas detection tubes. Furthermore, impinger air-sampling was performed for off-site sample preparation and analysis by gas chromatography-mass spectrometry (GC-MS). All three independent techniques demonstrated the presence of hydrogen cyanide, at concentrations of 14-20 ppm. Owing to the high volatility of hydrogen cyanide, the temperature and the time since exposure have a substantial effect on the likelihood of detecting hydrogen cyanide at a crime scene. The prevailing conditions (closed space, low temperature) must have supported the preservation of HCN in the car thus enabling the identification even though the analysis was performed several days after the hydrogen cyanide source was removed. This paper demonstrates the applicability of combining on-site FTIR measurements and off-site GC-MS analysis of a crime scene in order to ensure fast detection as well as unambiguous identification for forensic purposes of hydrogen cyanide in air. PMID:22704552

  20. The human face behind an ethical dilemma: reflecting on attempted suicide and outcomes of a case study.

    PubMed

    Sneesby, Ludmilla

    2009-09-01

    This paper presents a challenging case study that reflects on the ethical and legal obligations of health-care workers. The case raised issues about the rights of terminally ill patients to refuse or reject treatment, and changed practice with the formulation of procedures and guidelines about self-harm, the wider issue of euthanasia, and the responsibilities of health-care workers in such cases. This case study is the story of Bernie (pseudonym), an 84-year-old man, from his admission to the palliative care outreach service, to his death. At the time of his attempted suicide, he was a patient of a palliative care outreach team at an Austalian hospital. The right of a person to take their own life, respect for autonomy and the actions of health-care workers are the basis of discussion. PMID:19957456

  1. Five-Year Olds, but Not Chimpanzees, Attempt to Manage Their Reputations

    PubMed Central

    Engelmann, Jan M.; Herrmann, Esther; Tomasello, Michael

    2012-01-01

    Virtually all theories of the evolution of cooperation require that cooperators find ways to interact with one another selectively, to the exclusion of cheaters. This means that individuals must make reputational judgments about others as cooperators, based on either direct or indirect evidence. Humans, and possibly other species, add another component to the process: they know that they are being judged by others, and so they adjust their behavior in order to affect those judgments – so-called impression management. Here, we show for the first time that already preschool children engage in such behavior. In an experimental study, 5-year-old human children share more and steal less when they are being watched by a peer than when they are alone. In contrast, chimpanzees behave the same whether they are being watched by a groupmate or not. This species difference suggests that humans' concern for their own self-reputation, and their tendency to manage the impression they are making on others, may be unique to humans among primates. PMID:23119015

  2. Practices of Management Development: A Malaysian Case Study

    ERIC Educational Resources Information Center

    Law, Kian Aun

    2008-01-01

    This paper deals with a case study of Management Development (MD) practices at Malaysian Assurance Alliance (MAA). The aim of this research is to investigate how a large Malaysian insurance corporation developed and integrated MD initiatives with current organizational needs and tasks. Attempts were made to map and categorize the MD initiatives…

  3. What's funny about case management?

    PubMed

    Saxton, S E

    1997-01-01

    Humor is an effective tool to prevent and resolve burnout, a common problem associated with the practice of case management. Easily accessed by almost everyone, humor has many physiological and psychological benefits. The conscious use of humor in an organization requires a commitment at all levels in order for the organization to benefit as a whole. Offering formal seminars, using humor in company newsletters, and encouraging cartoon or joke sharing impacts on the physical and mental health of the employees. Techniques for bringing laughter to the workplace are outlined, as well as examples from the practice of case management. PMID:9335722

  4. Case Studies in Broadcast Management.

    ERIC Educational Resources Information Center

    Coleman, Howard W.

    This collection of case studies, based on factual situations which have challenged broadcast managers in recent years, is designed to stimulate thinking about and solving of "real world" problems in commercial radio and television operations. Topics of a serious, long-run nature include enlarging the radio audience; station revenue and economy;…

  5. Integrative Medicine and Case Management.

    PubMed

    Powell, Suzanne K

    2016-01-01

    The evolution of the integration of health care modalities has changed. The National Institutes of Health founded office of the National Center for Complementary and Alternative Medicine in the early 1990s to investigate integrative therapies through scientific research. In December 2014, the name and mission were updated to the National Center for Complementary and Integrative Health. Case managers, the coordinators of health care, must understand the changes to "integrative medicine" and the allure of the alternative modalities. PMID:27035081

  6. The impact of staff case manager-case management supervisor relationship on job satisfaction and retention of RN case managers.

    PubMed

    Hogan, Tierney D

    2005-01-01

    A positive relationship between staff RN case managers and their case management supervisor significantly impacts job satisfaction and retention in case managers. Literature review supports the premise that staff need to trust their supervisor and that there is a connection between this trust and job satisfaction. Staff case managers need to have a voice at work and feel empowered, and a supervisor's leadership style can influence job satisfaction and retention in their staff. PMID:16205207

  7. 75 FR 27375 - Postal Rate Case Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ... From the Federal Register Online via the Government Publishing Office POSTAL REGULATORY COMMISSION Postal Rate Case Management AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is seeking comments relevant to management of an anticipated exigent postal rate case. It...

  8. Retaining a Legacy while Avoiding Trademark Infringement: A Case Study of One University's Attempt to Develop a Consistent Athletic Brand Identity

    ERIC Educational Resources Information Center

    Alessandri, Sue Westcott

    2007-01-01

    This case study chronicles Syracuse University's athletic department's attempt to achieve consistency in its identity program by changing its identity during 2004, and then again in 2005. The changes were owing to high-level personnel changes on both the academic and athletic sides of the university. This case details the many issues arising from…

  9. Relationship between Personality Profiles and Suicide Attempt via Medicine Poisoning among Hospitalized Patients: A Case-Control Study

    PubMed Central

    Shafiee-Kandjani, Ali Reza; Amiri, Shahrokh; Arfaie, Asghar; Ahmadi, Azadeh; Farvareshi, Mahmoud

    2014-01-01

    Objectives. Inflexible personality traits play an important role in the development of maladaptive behaviors among patients who attempt suicide. This study was conducted to investigate the relationship between personality profiles and suicide attempt via medicine poisoning among the patients hospitalized in a public hospital. Materials and Methods. Fifty-nine patients who attempted suicide for the first time and hospitalized in the poisoning ward were selected as the experimental group. Sixty-three patients hospitalized in the other wards for a variety of reasons were selected as the adjusted control group. Millon Clinical Multiaxial Personality Inventory, 3rd version (MCMI-III) was used to assess the personality profiles. Results. The majority of the suicide attempters were low-level graduates (67.8% versus 47.1%, OR = 2.36). 79.7% of the suicide attempters were suffering from at least one maladaptive personality profile. The most common maladaptive personality profiles among the suicide attempters were depressive personality disorder (40.7%) and histrionic personality disorder (32.2%). Among the syndromes the most common ones were anxiety clinical syndrome (23.7%) and major depression (23.7%). Conclusion. Major depression clinical syndrome, histrionic personality disorder, anxiety clinical syndrome, and depressive personality disorder are among the predicators of first suicide attempts for the patients hospitalized in the public hospital due to the medicine poisoning. PMID:27433491

  10. Management of Multiple Impacted Teeth: A Case Report and Review

    PubMed Central

    Ajith, Sreedevi D; Shetty, Smitha; Hussain, Huma; Nagaraj, Tejavathy; Srinath, M

    2014-01-01

    Interdisciplinary care for the management of impacted teeth provides a holistic method of treating patients. Careful planning is necessary to reach the desired treatment goals. This article attempts to highlight the importance of diagnosis and adequate treatment planning for successful eruption of impacted teeth. The concept of forced eruption to improve the bone morphology of the impacted teeth has been used to treat a case of multiple impacted teeth. This paper reviews the diagnosis and management of impacted teeth. A case report of multiple impacted maxillary anterior teeth of a 13-year-old female patient has been presented. How to cite the article: Ajith SD, Shetty S, Hussain H, Nagaraj T, Srinath M. Management of multiple impacted teeth: A case report and review. J Int Oral Health 2014;6(3):93-8. PMID:25083041

  11. Case Studies for Management Development in Bangladesh.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    Eight case studies appropriate for use in a course in management development were prepared and are provided in this document. The typical case describes a real business situation in which a real manager had to reach a decision. The case gives quantitative and qualitative information that is, or may be, relevant to that decision. Questions for…

  12. Study on Case Teaching of Financial Management

    ERIC Educational Resources Information Center

    Che, Zhenghong; Che, Zhengmei

    2011-01-01

    Case teaching is an efficient teaching method of management. It plays an important role to enhance the students' ability to practice the theory. However, case teaching of financial management has not achieved the expected results. The paper aims to study the importance, characteristics and corresponding methods of case teaching method of financial…

  13. Pre-Service Teachers' Attempts at Debating Contemporary Issues in Science Education: A Case Study from Botswana

    ERIC Educational Resources Information Center

    Koosimile, Anthony T.; Suping, Shanah M.

    2011-01-01

    This paper constitutes an attempt to explore trends, issues and challenges that emerge when three different cohorts of pre-service teachers debate contemporary issues in science education at the University of Botswana. Apart from the author's experience of teaching the course, the impetus for this study also comes from a growing interest in the…

  14. Reviewing case management in community psychiatric care.

    PubMed

    Bush, Tony

    Case management is a process of psychiatric care provision that uses a structured and focused approach to effectively assess individual patient's needs. The aim of this article is to examine the current status of case management in NHS community mental health care in terms of therapeutic impact and relevance. PMID:16209396

  15. Iowa Case Management for Rural Drug Abuse

    ERIC Educational Resources Information Center

    Hall, James A.; Vaughan Sarrazin, Mary S.; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin

    2009-01-01

    Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual…

  16. NASW Standards for Social Work Case Management.

    ERIC Educational Resources Information Center

    National Association of Social Workers, Washington, DC.

    This document presents the standards for social work case management created by the National Association of Social Workers (NASW). Social work case management is defined as "a method of providing services whereby a professional social worker assesses the needs of the client and the client's family, when appropriate, and arranges, coordinates,…

  17. Considering Patients' Mental Capacity When Giving Them Bad News May Help Their Well-Being: A Case of Suicide Attempt after Being Informed of Lung Cancer Diagnosis

    PubMed Central

    Kato, Satoshi; Takeuchi, Mitsuo

    2014-01-01

    Mental capacity is a central determinant of patients' ability to make autonomous decisions about their care and deal with bad news. Physicians should be cognizant of this when giving patients bad news in efforts to help them to cope with the illness and to avoid a deterioration of their mental well-being. To show the importance of this concept, a case of suicide attempt with lung cancer is exemplified. A 76-year-old woman attempted suicide after receiving a diagnosis of lung cancer. Her recent life had been emotionally turbulent and she did not have sufficient mental capacity to accept and cope with this truth. She developed depression before attempting suicide. PMID:24963431

  18. Rapid improvement of depressive symptoms in suicide attempters following treatment with milnacipran and tricyclic antidepressants - a case series.

    PubMed

    Kirino, Eiji; Gitoh, Masao

    2011-01-01

    Suicide is a serious social problem in many countries, including Japan. The majority of people who commit suicide suffer from depression. Suicide attempt patients suffering from serious physical injuries are initially treated in hospital emergency departments. The present post hoc analysis examined data from patients admitted to an emergency hospital for treatment of physical injuries, resulting from a suicide attempt, and initial psychiatric treatment for depression and prevention of future suicide attempts. The effects on depressive symptoms were studied in two groups of patients using the 17-item Hamilton depression scale (HAMD). One group (n = 6) had received intravenous tricyclic antidepressants (TCA) (amitriptyline or clomipramine) while the other group (n = 7) had been treated orally with milnacipran, a serotonin and norepinephrine reuptake inhibitor antidepressant. Prior to treatment the four highest scoring items on the HAMD scale were the same in both groups namely, item 1 (depressed mood), item 3 (suicidality), item 7 (interest in work and activities), and item 10 (psychic anxiety). After 1 week of treatment, mean global HAMD scores were significantly reduced in both groups. Treatment resulted in a significant reduction of five HAMD items in the TCA group, whereas in the milnacipran group 12 HAMD items were significantly reduced. Suicidality (item 3) was significantly improved by 1 week treatment with milnacipran, but not by TCAs. Milnacipran rapidly improved a wide range of depressive symptoms, including suicidality within the first week. The improvement with milnacipran would appear to be, at least, equivalent to that achieved with TCAs, possibly affecting a wider range of symptoms. Since milnacipran has been shown in comparative studies to be better tolerated than TCAs, this antidepressant offers an interesting option for the treatment of suicidal patients in an emergency setting. PMID:22247614

  19. Suicide Attempt Characteristics, Diagnoses, and Future Attempts: Comparing Multiple Attempters to Single Attempters and Ideators

    ERIC Educational Resources Information Center

    Miranda, Regina; Scott, Michelle; Hicks, Roger; Wilcox, Holly C.; Munfakh, Jimmie Lou Harris; Shaffer, David

    2008-01-01

    The study compares psychiatric diagnoses and future suicide attempt outcomes of multiple attempters (MAs), single attempters (SAs) and ideators. The results conclude that MAs strongly predict later suicide attempts and diagnosis than SAs and ideators.

  20. RESULTS OF A DATING ATTEMPT -CHEMICAL AND PHYSICAL MEASUREMENTS RELEVANT TO THE CASE OF THE CRETACEOUS TERTIARY EXTINCTIONS

    SciTech Connect

    Asaro, Frank; Michel, Helen V.; Alvarez, Luis W.; Alvarez, Walter

    1980-09-01

    In Gubbio, Italy, a l em layer of clay between extensive limestone formations marks the boundary between the Cretaceous and Tertiary Periods. This clay layer was known to have been deposited about 65 million years ago when many life forms became extinct, but the length of time associated with the deposition was not known. In an attempt to measure this time with normally deposited meteoritic material as a clock, extensive measurements of iridium abundances (and those of many other elements) were made on the Gubbio rocks. Neutron activation analysis was the principal tool used in these studies. About 50 elements are searched for in materials like the earth's crust, about 40 are detected and about 30 are measured with useful precision. We were not able to determine exactly how long the clay deposition took. Instead the laboratory studies on the chemical and physical nature of the Cretaceous-Tertiary boundary led to the theory that an asteroid collision with the earth was responsible for the extinction of many forms of life including the dinosaurs.

  1. Managing severe peripartum hyponatraemia: A case report

    PubMed Central

    Lim, Jerry; Laing, Christopher M; MacCallum, Niall S; Brealey, David A

    2014-01-01

    We present a case of severe peripartum hyponatraemia that occurred following a major obstetric haemorrhage causing both an ischaemic stroke and Sheehan's syndrome and outline the investigations and management strategy required.

  2. Multimedia case management system implemented in Java

    NASA Astrophysics Data System (ADS)

    Stewart, Howard D.; Davis, Midge L.; Handy, Dale L.; Kvarfordt, Kent B.; Ford, Glenn

    1999-01-01

    Managing the timely access of information is a major challenge facing law enforcement agencies. One of the areas of greatest need is that of the case management process. During the course of FY98, the Office of National Drug Control Policy (ONDCP), the Counterdrug Technology Assessment Center (CTAC), the Idaho National Engineering and Environmental Laboratory (INEEL), and the Criminal Investigative Bureau (CIB) of the state of Idaho, created a Northwest testbed to develop and integrate a multimedia case management system. A system was developed to assist investigators in tracking and maintaining investigative cases and improving access to internal and external data resources. In this paper, we discuss the results of our case management system development and the ability to present state and federal information incorporating object oriented and multimedia techniques. We then outline our plans for future research and development.

  3. Case Studies in Managing Psychological Depth.

    ERIC Educational Resources Information Center

    Ringer, Martin; Gillis, H. L.

    This paper outlines a model for assessing and managing psychological depth in outdoor and experiential group work, and presents two case studies of the complexity of such management in real life. The model contains eight levels of emotional risk and presents four criteria for assessing the level to which a particular event or discussion may lead…

  4. Prolonged Apnea During Modified Electroconvulsive Therapy in a Patient of Suicidal Attempt by Organophosphorus Poisoning: A Case Report.

    PubMed

    Dhakne, Rajesh; Mishra, Kshirod K; Kumar, Vinay; Khairkar, Praveen

    2016-06-01

    Organophosphorus (OP) pesticides are commonly used in agricultural fields to control pests in India. However, exposure to it can cause poisoning in humans and animals, or it can be taken intentionally as poison to commit suicide. We present a case of a 35-year-old suicidal man who developed prolonged apnea for almost 4 hours on day 13 of OP poisoning after brief general anesthesia induced by propofol and 1 mg/kg of suxamethonium, during the first session of the third cycle of modified electroconvulsive therapy, despite all due precautions. Such prolonged apnea secondary to complex interactions has been reported very rarely in literature. This case therefore, highlights the importance of careful evaluation and monitoring while giving anesthesia to OP-poisoning patients. PMID:26595234

  5. Recognizing and managing boundary issues in case management.

    PubMed

    Walsh, J

    2000-01-01

    Much of the literature on worker-client boundaries in clinical practice is based on assumptions that the relationship between the two parties is structured and formal. These assumptions do not always apply in community-based case management practice, where the worker and client interact in a wide variety of settings and circumstances. The relative informality of case management makes the establishment of appropriate worker-client boundaries both critical and difficult. In this article key principles for recognizing and managing boundary issues are presented and discussed. PMID:11107659

  6. Outage management: A case study

    SciTech Connect

    Haber, S.B.; Barriere, M.T. ); Roberts, K.H. . Walter A. Haas School of Business)

    1992-01-01

    Outage management issues identified from a field study conducted at a two-unit commercial pressurized water reactor (PWR), when one unit was in a refueling outage and the other unit was at full power operation, are the focus of this paper. The study was conduced as part of the US Nuclear Regulatory Commission's (NRC) organizational factors research program, and therefore the issues to be addressed are from an organizational perspective. Topics discussed refer to areas identified by the NRC as critical for safety during shutdown operations, including outage planning and control, personnel stress, and improvements in training and procedures. Specifically, issues in communication, management attention, involvement and oversight, administrative processes, organizational culture, and human resources relevant to each of the areas are highlighted by example from field data collection. Insights regarding future guidance in these areas are presented based upon additional data collection subsequent to the original study.

  7. Outage management: A case study

    SciTech Connect

    Haber, S.B.; Barriere, M.T.; Roberts, K.H.

    1992-09-01

    Outage management issues identified from a field study conducted at a two-unit commercial pressurized water reactor (PWR), when one unit was in a refueling outage and the other unit was at full power operation, are the focus of this paper. The study was conduced as part of the US Nuclear Regulatory Commission`s (NRC) organizational factors research program, and therefore the issues to be addressed are from an organizational perspective. Topics discussed refer to areas identified by the NRC as critical for safety during shutdown operations, including outage planning and control, personnel stress, and improvements in training and procedures. Specifically, issues in communication, management attention, involvement and oversight, administrative processes, organizational culture, and human resources relevant to each of the areas are highlighted by example from field data collection. Insights regarding future guidance in these areas are presented based upon additional data collection subsequent to the original study.

  8. [An attempt at developing coherent recommendations for jurisdiction in the case of psychoorganic syndrome in which intellectual deficit is revealed].

    PubMed

    Zyss, Tomasz; Hese, Robert T; Zieba, Andrzej; Boroń, Joanna

    2007-01-01

    Traditionally, we distinguish three forms of psychoorganic syndrome: 1) oligophrenic, 2) characteropathic, and 3) dementive. According to ICD-10 classification, these disorders should be defined by more modern terms: 1) mental impairment (F7x), 2) personality disorders and behaviors caused by brain injury or brain malfunction (F07), and 3) various forms of dementia (from F00 to F04), respectively. To assess the level of intellectual aptitude, i.e., to confirm the existence of possible intellectual deficits, we can use various neuro-psychological instruments. The most important instrument here is the Wechsler scale, whose results allow for distinguishing six intellectual levels below mental norms. To assess the judicial importance of particular intellectual deficits, the experts should refer to the former Government Ordinance on the rights to earlier retirement benefits of employees having children who require constant care, of May 15, 1989. According to the above mentioned Ordinance, it is only at least moderate mental impairment that may be the sole basis for deciding about the former second disability group (now: complete inability to work). In the case of slight impairment - such a decision may be issued only if the impairment occurs together with other serious disorders severely impairing organism functioning. In other words, slight mental impairment can justify the certification of mere partial inability to work. Following this line of thought, we must say that lesser intellectual deficits, such as borderline cases or intelligence below average, should not be formally the premises of judicial value. It seems sensible to issue similar guidelines also in the case of dementive syndromes, that is, secondary intellectual deficits occurring at mature or old age. PMID:17571522

  9. Case managers' roles and functions: Commission for Case Manager Certification's 2004 Research, Part I.

    PubMed

    Tahan, Hussein A; Huber, Diane L; Downey, William T

    2006-01-01

    The Commission for Case Manager Certification (CCMC) conducted its third case managers' role and functions study in 2004. The purpose of this research was to validate the currency and relevancy of the certified case manager examination. The results of this study are shared in 2 parts of an article. Part I discusses the process the CCMC used for the development of the Case Manager's Role and Functions Survey Instrument (CMRFSI). The research leads to the identification of 6 new essential functions and 6 new knowledge areas, which describe case management practice. These findings were based on the survey of a large national sample of practicing case managers. Part II continues the analysis of the survey results and focuses on identifying the empirical activity and knowledge domains of case management practice, using factor analysis. It also discusses the similarities and differences found among various subgroups of case managers who were compared on the basis of certain demographic variables. In addition, it summarizes future changes in the field of case management as perceived by those who participated in the study. PMID:16444117

  10. Case managers' roles and functions: Commission for Case Manager Certification's 2004 research, part II.

    PubMed

    Tahan, Hussein A; Downey, William T; Huber, Diane L

    2006-01-01

    The Commission for Case Manager Certification (CCMC) conducted its third case managers' role and functions study in 2004 for the purpose of validating the currency and relevancy of the certified case manager examination. The results of this study are shared in an article of 2 parts. Part I, which was published in the previous issue of this journal, discussed the process the CCMC used for the development of the Case Managers' Role and Functions Survey Instrument and the identification of new 6 essential functions and 6 knowledge areas that describe case management practice. These findings were based on the survey of a large national sample of practicing case managers. Part II continues the analysis of the results and focuses on identifying the empirical (statistically derived) activity and knowledge domains of case management practice, using exploratory factor analysis. It discusses the similarities and differences found among various subgroups of case managers who were compared on the basis of certain demographic variables. In addition, Part II summarizes future changes in the field of case management as perceived by those who participated in the study. PMID:16582699

  11. [Attempt to standardize clinical tests for the purpose of quality management in the field of clinical studies and clinical trials].

    PubMed

    Ishibashi, Midori; Komiyama, Yasushi; Furuta, Koh

    2011-10-01

    The purpose of this study was to contribute to the quality management in the fields of clinical studies and clinical trials. To accomplish this purpose we tried to make guidelines for nationwide standardization of clinical tests. This study was performed by multidisciplinary personnel such as medical doctors, medical technologist, CRC, and representatives of pharmaceutical companies and/or clinical laboratory testing companies. The study was also focused on two fields of clinical tests such as pre-analytical and post-analytical phase. Each member shared various incidents and tried to make solutions. In post-analytical area in particular, further discussion concerning CDISC and SS-MIX was done. Based on these efforts, a tentative guideline was made. PMID:22184881

  12. Self-injection of household cleaning detergents into a ventriculoperitoneal shunt reservoir during a suicide attempt: a case report and literature review.

    PubMed

    Signorelli, Jason W; Osbun, Joshua W; Arias, Eric J; Reynolds, Lauren C; Chyatte, Douglas; Reynolds, Matthew R

    2016-09-01

    Self-injection of household cleaning detergents (more specifically, commercial toilet bowl cleaner) into the reservoir of a ventriculoperitoneal shunt (VPS) has never been reported in the neurosurgical literature. A right-handed 41-year-old female with a past medical history significant for bipolar depression (with multiple prior hospital admissions for suicide attempts) and pseudotumor cerebri (status-post VPS placement from a right frontal approach) successfully injected ∼5 ml of toilet bowl cleaner into her ventricular shunt reservoir during a suicide attempt. She was found unresponsive by a family member 48 h after this event and presented to our hospital in moribund neurological condition (bilaterally fixed and dilated pupils with decerebrate posturing). Head computed tomography (CT) demonstrated marked ventriculomegaly. She was taken emergently to the operating room for placement of a left frontal ventriculostomy. Cerebrospinal fluid (CSF) sampled intraoperatively showed numerous Gram-positive cocci (later determined to be Staphylococcus epidermidis). For this reason, her right-sided shunt system was also removed in its entirety. She was treated with broad-spectrum intravenous and intraventricular antibiotics for her bacterial ventriculitis and her CSF was aggressively drained to treat her hydrocephalus. Once her infection had resolved, the shunt was replaced (using a right parietal approach) and she went on to make an excellent neurological recovery. Here, the authors present the case of a patient who self-injected household cleaning detergents into her VPS reservoir-and, likely, the ventricular system-during a suicide attempt and subsequently developed hydrocephalus and ventriculitis. Following this infrequent clinical scenario, consideration should be given to temporary ventriculostomy placement and shunt removal. Moreover, in patients with a known history of psychiatric co-morbidities-and particularly those patients with prior suicide attempts

  13. Negative Life Events and Attempted Suicide in Rural China

    PubMed Central

    Zhang, Wen-Chao; Jia, Cun-Xian; Zhang, Ji-Yu; Wang, Lin-Lin; Liu, Xian-Chen

    2015-01-01

    Objective This study aimed to examine the association between negative life events (NLEs) and attempted suicide in rural China. Methods Six rural counties were selected from disease surveillance points in Shandong province, China. A total of 409 suicide attempters in rural areas between October 1, 2009, and March 31, 2011, and an equal number of matched controls were interviewed. We compared negative life events experienced within 1 month, 1–3 months, 3–6months, and 6–2 months prior to attempted suicide for cases and prior to interview for controls. We used multivariate logistic regression to examine the association between NLEs and attempted suicide. Results Suicide attempters experienced more NLEs within the last year prior to suicide attempt than controls prior to interview (83.1% vs. 33.5%). There was a significant dose-response relationship between NLEs experienced within the last year and increased risk of attempted suicide. Timing of NLEs analysis showed that NLEs experienced in the last month and 6–12 months prior to suicide attempt were significantly associated with elevated risk of attempted suicide, even after adjusting for mental disorders and demographic factors. Of NLEs, quarrelling with spouse, quarrelling with other family members, conflicting with friends or neighbors, family financial difficulty, and serious illness were independently related to attempted suicide. Conclusion NLEs are significantly associated with increased risk for attempted suicide in rural China. Stress management and intervention may be important to prevent suicidal behavior in rural China. PMID:25611854

  14. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    .... (2) Not use case management (including targeted case management) services to restrict an individual's access to other services under the plan. (3) Not compel an individual to receive case management services... services (including targeted case management services), as defined in § 440.169 of this chapter, the...

  15. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    .... (2) Not use case management (including targeted case management) services to restrict an individual's access to other services under the plan. (3) Not compel an individual to receive case management services... services (including targeted case management services), as defined in § 440.169 of this chapter, the...

  16. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    .... (2) Not use case management (including targeted case management) services to restrict an individual's access to other services under the plan. (3) Not compel an individual to receive case management services... services (including targeted case management services), as defined in § 440.169 of this chapter, the...

  17. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Primary care case management services. 440.168... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.168 Primary care case management services. (a) Primary care case management services means case management...

  18. Case Management of Adolescents with Chronic Disease.

    ERIC Educational Resources Information Center

    Lankard, Bettina A.

    This training guide presents a model for optimum delivery of the primary duties, tasks, and steps required in the comprehensive case management of adolescents with chronic disease. Using a team approach to coordinated health care, the guide involves the patient and family as key members of the care team along with the physician, nurse, dietitian,…

  19. Case management: entry-level practice for occupational therapists?

    PubMed

    Baldwin, Tina M; Fisher, Thomas

    2005-01-01

    As American businesses have sought means to control employee health benefits, managed care has evolved. This evolution has brought greater demand for case management. Case management is not a profession but a practice area within one's own profession. Case managers come from a variety of disciplines and work in a variety of practice settings, which include medical, psychosocial, educational, vocational, and rehabilitation. PMID:16061158

  20. The Science Manager's Guide to Case Studies

    SciTech Connect

    Branch, Kristi M.; Peffers, Melissa S.; Ruegg, Rosalie T.; Vallario, Robert W.

    2001-09-24

    This guide takes the science manager through the steps of planning, implementing, validating, communicating, and using case studies. It outlines the major methods of analysis, describing their relative merits and applicability while providing relevant examples and sources of additional information. Well-designed case studies can provide a combination of rich qualitative and quantitative information, offering valuable insights into the nature, outputs, and longer-term impacts of the research. An objective, systematic, and credible approach to the evaluation of U.S. Department of Energy Office of Science programs adds value to the research process and is the subject of this guide.

  1. Critical path case management: the headache clinic.

    PubMed

    Sobkowski, D A; Maquera, V

    1996-01-01

    A practical application of a neurology case management healthcare delivery mode results in increased access to specialty providers, shorter follow-up periods, and improved continuity of medical care. The program described in the following sections was developed at a naval hospital for the ongoing evaluation of therapeutic schemes to optimize headache therapy and, 1 year after implementation, shows improvement in patient outcomes and resource use. PMID:9192570

  2. Increased deep sleep in a medication-free, detoxified female offender with schizophrenia, alcoholism and a history of attempted homicide: Case report

    PubMed Central

    Lindberg, Nina; Tani, Pekka; Takala, Pirjo; Sailas, Eila; Putkonen, Hanna; Eronen, Markku; Virkkunen, Matti

    2004-01-01

    Background Psychiatric sleep research has attempted to identify diagnostically sensitive and specific sleep patterns associated with particular disorders. Both schizophrenia and alcoholism are typically characterized by a severe sleep disturbance associated with decreased amounts of slow wave sleep, the physiologically significant, refreshing part of the sleep. Antisocial behaviour with severe aggression, on the contrary, has been reported to associate with increased deep sleep reflecting either specific brain pathology or a delay in the normal development of sleep patterns. The authors are not aware of previous sleep studies in patients with both schizophrenia and antisocial personality disorder. Case presentation The aim of the present case-study was to characterize the sleep architecture of a violent, medication-free and detoxified female offender with schizophrenia, alcoholism and features of antisocial personality disorder using polysomnography. The controls consisted of three healthy, age-matched women with no history of physical violence. The offender's sleep architecture was otherwise very typical for patients with schizophrenia and/or alcoholism, but an extremely high amount of deep sleep was observed in her sleep recording. Conclusions The finding strengthens the view that severe aggression is related to an abnormal sleep pattern with increased deep sleep. The authors were able to observe this phenomenon in an antisocially behaving, violent female offender with schizophrenia and alcohol dependence, the latter disorders previously reported to be associated with low levels of slow wave sleep. New studies are, however, needed to confirm and explain this preliminary finding. PMID:15507139

  3. Case managers reorganize to challenge claims denials.

    PubMed

    1999-08-01

    A combination of diminished reimbursement, decreased funding for residency programs, an epidemic of claims denials, and the skilled nursing crisis has imperiled teaching hospitals across the country. Increasingly, these hospitals are looking to case management departments as potential saviors. In the short term, that could mean more staff and a beefier budget, but if your department can't produce, cuts later on could be drastic. The University of Pennsylvania Health System in Philadelphia lost $90 million in FY1998 and responded by cutting 1,100 positions--9% of its work force. The case management department lost eight positions and is trying to take up the slack with a massive reorganization of its care delivery system and a rigorous education program designed to reduce claims denials. At Georgetown University Medical Center in Washington, DC, however, case management staff and resources have been increased for now. The department is using its new-found prosperity to thoroughly screen all incoming patients for appropriateness of admission, upgrade its discharge planning capabilities, and hire a full-time employee to appeal denied claims. PMID:10557727

  4. Case management: planning and coordinating strategies.

    PubMed

    Walden, T; Hammer, K; Kurland, C H

    1990-01-01

    In summary, planning a case management system involves moving through sequenced stages; namely, (1) a developmental stage; (2) a phase-in stage; and (3) an operational stage. During the developmental stage, before processes have been formalized, attention is given to the political realities, the formation of a representative planning group, formulating goals and objectives, obtaining administrative support, information gathering, assessment of needs, resource procurement, program structure and design, selection of a case management model, participatory decision making, determining organizational fit, and beginning networking. During the phase-in or early implementation state, the formal stage of system introduction, attention is given to the establishment of interorganizational relationships, contracting for services, job descriptions, work assignments, training, problem solving, and conflict resolution. During the operational or full implementation stage, a period when the system should become more stabilized, attention needs to be given to managing movement of the client through the system, the flow of information, program updating, quality assurance, recordkeeping, resource management, evaluating, and system refurbishing. In practice, these stages will interact and overlap. Closure, if the system is to remain viable and open to change, should never occur. PMID:10110505

  5. Forest Planning in an Oregon Case Study: Defining the Problem and Attempting to Meet Goals with a Spatial-Analysis Technique

    PubMed

    Bettinger; Johnson; Sessions

    1996-07-01

    Five major management goals were identified for the upper Grande Ronde River Basin on the Wallowa-Whitman National Forest in northeastern Oregon: to produce high-quality fish habitat, to maintain elk habitat, to restore and maintain forest conditions within the natural range of viability, and to contribute to community economic stability. From the broad goals, specific goals for stream temperature, habitat effectiveness index (HEI), habitat corridors, maintenance of land in late or old seral stages, and a nondeclining even flow of timber were selected. A case study was undertaken in a small watershed that is under typical societal constraints to determine whether one decision-support tool, SNAP II+, could evaluate the selected goals in a single planning exercise. Three riparian management strategies and two forest road scenarios were used. The exclusion of harvest and road-building from riparian zones in order to increase habitat protection decreased harvest levels and net present value but maintained preactivity stream temperatures. Other resources were generally maintained within prescribed management levels. Although the technique has limitations (e.g., it does not account for riparian zones in calculations of forage and cover for HEI, and it can use the maximum but not minimum acreage goal for some resources), it shows promise for evaluating management tradeoffs in watershed analysis. PMID:8661622

  6. Forest planning in an Oregon case study: Defining the problem and attempting to meet goals with a spatial-analysis technique

    NASA Astrophysics Data System (ADS)

    Bettinger, Pete; Johnson, K. Norman; Sessions, John

    1996-07-01

    Five major management goals were identified for the upper Grande Ronde River Basin on the Wallowa-Whitman National Forest in northeastern Oregon: to produce high-quality fish habitat, to maintain elk habitat, to restore and maintain forest conditions within the natural range of viability, and to contribute to community economic stability. From the broad goals, specific goals for stream temperature, habitat effectiveness index (HEI), habitat corridors, maintenance of land in late or old seral stages, and a nondeclining even flow of timber were selected. A case study was undertaken in a small watershed that is under typical societal constraints to determine whether one decisionsupport tool, SNAP II+, could evaluate the selected goals in a single planning exercise. Three riparian management strategies and two forest road scenarios were used. The exclusion of harvest and road-building from riparian zones in order to increase habitat protection decreased harvest levels and net present value but maintained preactivity stream temperatures. Other resources were generally maintained within prescribed management levels. Although the technique has limitations (e.g., it does not account for riparian zones in calculations of forage and cover for HEI, and it can use the maximum but not minimum acreage goal for some resources), it shows promise for evaluating management tradeoffs in watershed analysis.

  7. Attempted homicide by electrocution.

    PubMed

    Pfeiffer, H; Karger, B

    1998-01-01

    Attempted homicide by the application of a high-voltage, low-amperage current is reported in an elderly male. An electrician constructed an apparatus and applied the current to wet towels placed on the abdomen of the victim sleeping next door. The attempt was unsuccessful and resulted in burns only. The victim was hospitalised and died 3 weeks later. A causal connection could not be established between the attempted electrocution and the demise of the victim. PMID:9826095

  8. Case management's value is finally recognized. What happens now? .

    PubMed

    2015-10-01

    In recent years, case management has been recognized as a key in improving healthcare quality and reducing costs, but while hospitals are giving case managers more responsibilities, many administrators are not approving an increase in staff to handle the extra work. Case managers can help their hospital succeed with the Centers for Medicare & Medicaid Services' Value-based Purchasing program, the readmission reduction program, and bundled payments. Case management directors should make sure the hospital's senior leadership understands the roles and responsibilities of case managers and how their interventions can affect outcomes and the bottom line. The number of caseloads depends on the case management model, the responsibilities of case managers, and whether they have assistants or case management extenders who can take over some tasks and allow the licensed staff to work at the top of their licenses. Don't let technology replace communication and patient-centered interactions. PMID:26427224

  9. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... case management providers; or (iii) The methodology under which case management providers will be paid..., including for foster care programs, services such as, but not limited to, the following: (1)...

  10. Case Management in Community Corrections: Current Status and Future Directions

    ERIC Educational Resources Information Center

    Day, Andrew; Hardcastle, Lesley; Birgden, Astrid

    2012-01-01

    Case management is commonly regarded as the foundation of effective service provision across a wide range of human service settings. This article considers the case management that is offered to clients of community corrections, identifying the distinctive features of case management in this particular setting, and reviewing the empirical evidence…

  11. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... chapter. (b) Targeted case management services means case management services furnished without regard to....240 (related to comparability). Targeted case management services may be offered to individuals in any defined location of the State or to individuals within targeted groups specified in the State plan. (c)...

  12. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... chapter. (b) Targeted case management services means case management services furnished without regard to....240 (related to comparability). Targeted case management services may be offered to individuals in any defined location of the State or to individuals within targeted groups specified in the State plan. (c)...

  13. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Case management services. 440.169 Section 440.169 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.169 Case management services. (a) Case management services...

  14. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.169 Case management services. (a) Case management services means services furnished to assist individuals, eligible under the... 42 Public Health 4 2011-10-01 2011-10-01 false Case management services. 440.169 Section...

  15. Case Management Takes Hold in Long-Term Care.

    ERIC Educational Resources Information Center

    Rose, Stephen M.; And Others

    1992-01-01

    Includes "Empowering Case Management Clients" (Rose); "Case Management in Rural Japan" (Maeda, Takahashi); "Coordinated-Care Teams" (Brodsky, Sobol); "Comparing Practice in the United States and the United Kingdom" (Sturges); "Business of Case Management Flourishing in the U.S." (Cress); and "Community Options Bring Change to Long-Term Care in…

  16. Intelsat VI Capture Attempt

    NASA Technical Reports Server (NTRS)

    1992-01-01

    The first single crewmember EVA capture attempt of the Intelsat VI as seen from Endeavour's aft flight deck windows. EVA Mission Specialist Pierre Thuot standing on the Remote Manipulator System (RMS) end effector platform, with the satellite capture bar attempting to attach it to the free floating communications satellite.

  17. Young People's Risk of Suicide Attempts after Contact with a Psychiatric Department--A Nested Case-Control Design Using Danish Register Data

    ERIC Educational Resources Information Center

    Christiansen, Erik; Larsen, Kim Juul

    2012-01-01

    Background: There seems to be an increased risk of children and adolescents committing or attempting suicide after contact with a psychiatric department. Children and adolescents living in families with low socio-economic status (SES) might have an especially increased suicide attempt risk. Methods: A complete extraction of Danish register data…

  18. Management case study: Tampa Bay, Florida

    USGS Publications Warehouse

    Morrison, Gerold; Greening, Holly; Yates, Kimberly K.

    2011-01-01

    Tampa Bay, Florida, USA, is a shallow, subtropical estuary that experienced severe cultural eutrophication between the 1940s and 1980s, a period when the human population of its watershed quadrupled. In response, citizen action led to the formation of a public- and private-sector partnership (the Tampa Bay Estuary Program), which adopted a number of management objectives to support the restoration and protection of the bay’s living resources. These included numeric chlorophyll a and water-clarity targets, as well as long-term goals addressing the spatial extent of seagrasses and other selected habitat types, to support estuarine-dependent faunal guilds. Over the past three decades, nitrogen controls involving sources such as wastewater treatment plants, stormwater conveyance systems, fertilizer manufacturing and shipping operations, and power plants have been undertaken to meet these and other management objectives. Cumulatively, these controls have resulted in a 60% reduction in annual total nitrogen (TN) loads relative to earlier worse-case (latter 1970s) conditions. As a result, annual water-clarity and chlorophyll a targets are currently met in most years, and seagrass cover measured in 2008 was the highest recorded since 1950. Factors that have contributed to the observed improvements in Tampa Bay over the past several decades include the following: (1) Development of numeric, science-based water-quality targets to meet a long-term goal of restoring seagrass acreage to 1950s levels. Empirical and mechanistic models found that annual average chlorophyll a concentrations were a primary manageable factor affecting light attenuation. The models also quantified relationships between TN loads, chlorophyll a concentrations, light attenuation, and fluctuations in seagrass cover. The availability of long-term monitoring data, and a systematic process for using the data to evaluate the effectiveness of management actions, has allowed managers to track progress and

  19. Diversity in case management modalities: the Summit model.

    PubMed

    Peterson, G A; Drone, I D; Munetz, M R

    1997-06-01

    Though ubiquitous in community mental health agencies, case management suffers from a lack of consensus regarding its definition, essential components, and appropriate application. Meaningful comparisons of various case management models await such a consensus. Global assessments of case management must be replaced by empirical studies of specific interventions with respect to the needs of specific populations. The authors describe a highly differentiated and prescriptive system of case management involving the application of more than one model of service delivery. Such a diversified and targeted system offers an opportunity to study the technology of case management in a more meaningful manner. PMID:9211044

  20. Quick management of accidental tritium exposure cases.

    PubMed

    Singh, Vishwanath P; Badiger, N M; Managanvi, S S; Bhat, H R

    2012-07-01

    Removal half-life (RHL) of tritium is one of the best means for optimising medical treatment, reduction of committed effective dose (CED) and quick/easy handling of a large group of workers for medical treatment reference. The removal of tritium from the body depends on age, temperature, relative humidity and daily rainfall; so tritium removal rate, its follow-up and proper data analysis and recording are the best techniques for management of accidental acute tritium exposed cases. The decision of referring for medical treatment or medical intervention (MI) would be based on workers' tritium RHL history taken from their bodies at the facilities. The workers with tritium intake up to 1 ALI shall not be considered for medical treatment as it is a derived limit of annual total effective dose. The short-term MI may be considered for tritium intake of 1-10 ALI; however, if the results show intake ≥100 ALI, extended strong medical/therapeutic intervention may be recommended based on the severity of exposure for maximum CED reduction requirements and annual total effective dose limit. The methodology is very useful for pressurized heavy water reactors (PHWRs) which are mainly operated by Canada and India and future fusion reactor technologies. Proper management will optimise the cases for medical treatment and enhance public acceptance of nuclear fission and fusion reactor technologies. PMID:22349318

  1. Socio-Demographic, Clinical and Behavioral Characteristics Associated with a History of Suicide Attempts among Psychiatric Outpatients: A Case Control Study in a Northern Mexican City

    PubMed Central

    Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis Francisco; Arnaud-Gil, Carlos Alberto; Hernández-Tinoco, Jesús; Molina-Espinoza, Luis Fernando; Rábago-Sánchez, Elizabeth

    2014-01-01

    Background: Little is known about the epidemiology of suicide attempts among psychiatric outpatients in Mexico. This study was aimed to determine the socio-demographic, clinical and behavioral characteristics associated with suicide attempts in psychiatric outpatients in two public hospitals in Durango, Mexico. Methods: Two hundred seventy six psychiatric outpatients (154 suicide attempters and 122 patients without suicide attempt history) attended the two public hospitals in Durango City, Mexico were included in this study. Socio-demographic, clinical and behavioral characteristics were obtained retrospectively from all outpatients and compared in relation to the presence or absence of suicide attempt history. Results: Increased prevalence of suicide attempts was associated with mental and behavioral disorders due to psychoactive substance use (F10-19) (P=0.01), schizophrenia, schizotypal and delusional disorders (F20-29) (P=0.02), mood (affective) disorders (F30-39) (P<0.001), and disorders of adult personality and behavior (F60-69) (P<0.001). Multivariate analysis showed that suicide attempts were associated with young age (OR=1.21, 95% CI: 1.06-1.39; P=0.003), female gender (OR=2.98, 95% CI: 1.55-5.73; P=0.001), urban residence (OR=2.31, 95% CI: 1.17-4.57; P=0.01), memory impairment (OR=1.91, 95% CI: 1.07-3.40; P=0.02), alcohol consumption (OR=2.39, 95% CI: 1.21-4.70; P=0.01), and sexual promiscuity (OR=3.90, 95% CI: 1.74-8.77; P<0.001). Conclusions: We report the association of suicide attempts with socio-demographic, clinical and behavioral characteristics in psychiatric outpatients in Mexico. Results may be useful for an optimal planning of preventive measures against suicide attempts in psychiatric outpatients. PMID:24711751

  2. Applying e-health to case management.

    PubMed

    Adams, J M

    2000-01-01

    The healthcare industry is only beginning to understand e-health. E-health can be defined as the use of technology to directly improve healthcare delivery-affording patients the opportunity to participate in their own healthcare management, provider, and institution. The market is changing rapidly, and innovations, partnerships, and mergers are taking place daily. For healthcare institutions, setting a long-term, yet adaptable e-health strategy is of vital importance for the continued success of the organization. For clinicians, an understanding of and familiarity with technologies can significantly improve workflow, organization, and patient interaction. For the patient, technology can be leveraged as a means to take initiative and responsibility for his/her own health. This article defines e-health and explains the implications and benefits of e-health to nurses and their patients. The article also identifies unique opportunities e-health/e-commerce can provide case managers in promoting patient connectivity, care management, and economy in cost of care. PMID:16397993

  3. Ensuring the quality of asthma case management.

    PubMed

    Aït-Khaled, N; Enarson, D A

    2006-07-01

    An evaluation based on recording the number of patients and evaluating their treatment outcomes provides the information necessary to plan the provision of care, determine the analysis of the situation and revise practice if the results are not satisfactory. The standardised tools proposed for this evaluation are: a district register for new persistent asthma patients, quarterly reports of case finding and an annual report of cohort patient follow-up. The main indicators of quality of care based on register information given by the cohort analysis are the percentage of defaulters and the percentage of patients whose asthma is controlled or well controlled after 1 year of follow-up. The services involved in asthma management should be adapted to the local situation in each country. In particular, the health service structure and national guidelines must be respected, and services involved in asthma management should be implemented in stages. Operational research within the services is essential to ensure that the services provided are appropriate. This type of research involves the health personnel responsible for patient management, provides them with new knowledge and helps them to resolve problems they are confronted with on a regular basis. It also inspires critical thinking, which is crucial to both research and practice. PMID:16848332

  4. Reconceptualizing case management in theory and practice: a frontline perspective.

    PubMed

    Yarmo Roberts, Deborah

    2002-08-01

    'Case management' in the health and social service sector is controversial, highly political and saturated with conflicting agendas among stakeholders. Research was conducted recently to explore the role of case managers in three evolving, Australian-based, long-term care, case management models. The findings have relevance to countries worldwide that contend with delivering quality care that is cost effective. The research captures the perspectives of 51 open-ended interviews with front-line case managers who have first-hand knowledge of the models' effect on their clients and on their own roles. Contrary to the rhetoric that case management is client-centred, case management is concluded to be 'system centred' based on a unilateral approach taken by each of the three models. Case managers had a limited ability to attain necessary services for clients. Success was dependent on the range of case managers' skills and experience, relationship with the client, degree of job satisfaction, level of influence in the health and social system and ability to collaborate with relevant professionals. The relationship between the three primary influences (system, model, client) affecting case managers' pursuit of achieving appropriate client services was also reviewed. A reconceptualized multidimensional approach, or 'neo-process-centred' case management, is proposed. The revised approach can be applied to existing and new models and has direct implications for policy makers, management and practitioners aspiring to improve client care within existing constraints. PMID:12184835

  5. Attempted Suicide Triggers in Thai Adolescent Perspectives.

    PubMed

    Sukhawaha, Supattra; Arunpongpaisal, Suwanna; Rungreangkulkij, Somporn

    2016-06-01

    The study goal was to describe attempted suicide triggers in Thai adolescents. A descriptive exploratory qualitative study approach was used utilizing in-depth interviews with twelve adolescents who had attempted suicide and six of their parents. Content analysis was conducted. Attempted suicide triggers were (1) severe verbal criticisms and expulsion to die by a significant family member, (2) disappointed and unwanted by boyfriend in first serious relationship, (3) unwanted pregnancy, and (4) mental illness leading to intense emotions and irresistible impulses. These attempted suicide triggers should be of concern and brought into suicide prevention management programs such as emotional management, effective communication for adolescents and family. PMID:27256938

  6. Management of infratentorial subdural hygroma complicating foramen magnum decompression: a report of three cases.

    PubMed

    Bahl, Anuj; Murphy, Mary; Thomas, Nicholas; Gullan, Richard

    2011-05-01

    Decompression of the foramen magnum for symptomatic Chiari malformation attends a small but significant risk of infratentorial subdural extra-arachnoid hygroma when an arachnoid-sparing procedure is attempted. We present three cases whereby an arachnoid-sparing procedure was carried out and resulted in infratentorial subdural hygroma and hydrocephalus. The complication was managed by re-exploration of the posterior fossa and wide arachnoidotomy. In cases whereby the decision has been made to open the dura, we recommend routine arachnoidotomy in foramen magnum decompression, avoiding the risks of infratentorial subdural hygroma. In cases where arachnoid-sparing procedures have been attempted and subdural hygroma subsequently develops, we advocate re-exploration of the posterior fossa rather than cerebrospinal fluid diversion. PMID:21258949

  7. Case management insider. The 2-midnight rule--a game-changer for case management.

    PubMed

    Cesta, Toni

    2014-04-01

    As a case manager or case management leader, it is important for you to stay in touch with how CMS continues to roll out the two-midnight rules as well as the manner of auditing on a go-forward basis. It is also important that your department continue to have a close working relationship with the billing department in your hospital to ensure that the hospital remains compliant with this new rule. Finally, it is also critical that your emergency department and its physicians are kept up to date on the rule and its implications for hospital admissions. Having a case management presence in the emergency department will help to ensure a sound review process at this important route of entry to the hospital. A working team should be created to review the cases that fall outside of the rule, and these cases should also be presented to the utilization review committee so that the hospital can continue to learn and move forward. Finally, listen to the CMS National Provider Calls (www.cms. gov/NPC) to gain additional and updated information as it becomes available! For additional information on the two-midnight rule go to www.cms.gov and search for CMS-1599-F. PMID:24697139

  8. Case management: a management system for quality and cost effective outcomes.

    PubMed

    Dees, J P; Anderson, N L

    1996-08-01

    1. Case management is an effective strategy for occupational health nurses to use to reduce corporate health insurance, workers' compensation, and disability expenditures. 2. Case management has evolved from a reactive to a proactive strategy useful in many arenas. While there are differences among group health, workers' compensation, and disability, the basic case management process is the same. 3. Early intervention and comprehensive assessment are the foundation of a successful case management process. 4. Occupational health nurses have extensive clinical, interpersonal, and management skills enabling them to excel as case managers. PMID:8852236

  9. Management of a rare case of arrhythmogenic right ventricular dysplasia in pregnancy: a case report.

    PubMed

    Anouar, Jarraya; Mohamed, Smaoui; Kamel, Kolsi

    2014-01-01

    Arrhythmogenic right ventricular dysplasia is a rare but not exceptional inherited cardiomyopathy characterized by fibrofatty replacement of the myocardium of the right ventricular which could lead to serious arrhythmia and sudden death. Only a few cases of pregnancies with ARVD have been reported. The aim of this case presentation is to describe the clinical characteristics and anesthetics specificities in management of this disease in pregnancy and in delivery. We report the case of a young woman aged 28 years old with a past history of ARVD treated by medical treatment with radiofrequency ablation. This patient was pregnant and it was scheduled for cesarean section delivery. Preoperative evaluation showed a well tolerated pregnancy inspite of the severity of the ARVD. It was a severe form of ARVD because of RV dilation, the spread of the disease to LV and the history of ventricular tachycardia during an attempted of ablation by radio frequency. The treatment received by the patient was kept until the day of surgery. The act took place under general anesthesia. The postoperative period was uneventful and morphine titration was used for pain relief. The patient exits the hospital 3 days after delivery and breastfeeding was forbidden. We should pay attention on this disease witch is not yet well known and witch is highly risky in the peri-partum period. Even if pregnancy may be tolerated in moderate forms of ARVD, conception and delivery sould be discouraged especially in severe forms. PMID:25852789

  10. Case management in the social health maintenance organization demonstrations

    PubMed Central

    Yordi, Cathleen L.

    1988-01-01

    In this article, case management departments and roles during the early years of the social health maintenance organization (S/HMO) demonstrations are compared. These organizations provide acute and chronic care services under a prepaid plan for the elderly. Eligibility criteria for case management and chronic care services at each site are compared, followed by a description of the resultant case mix of members receiving chronic care benefits. Case managers principal activities are described, and a preliminary assessment is made about the strength of the linkages that have been developed between the case management component of these plans and the larger health care system. PMID:10312977

  11. Repeated suicide attempts.

    PubMed

    Mynatt, S

    2000-12-01

    Attempted suicide is an act associated with childhood sexual abuse, depression, bipolar illness, substance abuse, and other diagnoses, as documented in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) (American Psychiatric Association [APA], 1994). Three women, who attended a group to decrease their depression and increase their self-esteem and who had histories of multiple suicide attempts, agreed to participate in interviews designed to determine the common factors associated with their suicide attempts and to examine the assertion that their suicide attempts were an addiction, similar to their addictions to alcohol and drugs. The common factors found were depression, substance use disorders with early abuse and risky behaviors, history of sexual abuse, faulty relationships, alteration of mood with a suicide plan, and distorted and illogical thinking and motivation. The similarities to addiction also were described. Based on the complexity of factors that emerged and the addictive nature of the suicide attempts, treatment for similar patients needs to be multidimensional and ongoing to allow sufficient time to monitor progress and address the numerous factors involved. PMID:11131404

  12. Case Studies for Management Development in Bangladesh. Second Book.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    These 15 case studies developed by faculty at institutions in Bangladesh are appropriate for use in a course in management development. The typical case describes a real business situation in which a real manager had to reach a decision. The case gives quantitative and qualitative information that is, or may be, relevant to that decision.…

  13. 75 FR 23582 - Annular Casing Pressure Management for Offshore Wells

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-04

    ... published the proposed rule Annular Casing Pressure Management for Offshore Wells (74 FR 38147). The comment... the published proposed rule 1010-AD47 Annular Casing Pressure Management for Offshore Wells (74 FR... subsea wellhead. (3) hybrid well, a riser or the production casing pressure is greater than 100...

  14. Implementation of Network Leader Sponsored Supply Chain Management Systems: A Case Study of Supplier IT Business Value

    ERIC Educational Resources Information Center

    Miller, Mark S.

    2010-01-01

    This qualitative multiple-case study was conducted to explore and understand how the implementation of required relationship-specific supply chain management system (SCMS) dictated by the network leader within a supplier network affects a supplier organization. The study, on a very broad sense, attempted to research the current validity of how the…

  15. Assessing the Risk of Re-Offending for Juvenile Offenders Using the Youth Level of Service/Case Management Inventory

    ERIC Educational Resources Information Center

    Bechtel, Kristin; Lowenkamp, Christopher T.; Latessa, Edward

    2007-01-01

    The purpose of the Youth Level of Service Case Management Inventory (YLS/CMI) is to assess, classify, and assist agencies with developing treatment and service plans according to the offender's criminogenic risk factors. Given the limited research in the predictive validity for this instrument, the current study attempts to examine this issue on a…

  16. Intensive case management for severe mental illness

    PubMed Central

    Dieterich, Marina; Irving, Claire B; Park, Bert; Marshall, Max

    2014-01-01

    Background Intensive Case Management (ICM) is a community based package of care, aiming to provide long term care for severely mentally ill people who do not require immediate admission. ICM evolved from two original community models of care, Assertive Community Treatment (ACT) and Case Management (CM), where ICM emphasises the importance of small caseload (less than 20) and high intensity input. Objectives To assess the effects of Intensive Case Management (caseload <20) in comparison with non-Intensive Case Management (caseload > 20) and with standard community care in people with severe mental illness. To evaluate whether the effect of ICM on hospitalisation depends on its fidelity to the ACT model and on the setting. Search methods For the current update of this review we searched the Cochrane Schizophrenia Group Trials Register (February 2009), which is compiled by systematic searches of major databases, hand searches and conference proceedings. Selection criteria All relevant randomised clinical trials focusing on people with severe mental illness, aged 18 to 65 years and treated in the community-care setting, where Intensive Case Management, non-Intensive Case Management or standard care were compared. Outcomes such as service use, adverse effects, global state, social functioning, mental state, behaviour, quality of life, satisfaction and costs were sought. Data collection and analysis We extracted data independently. For binary outcomes we calculated relative risk (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data we estimated mean difference (MD) between groups and its 95% confidence interval (CI). We employed a random-effects model for analyses. We performed a random-effects meta-regression analysis to examine the association of the intervention’s fidelity to the ACT model and the rate of hospital use in the setting where the trial was conducted with the treatment effect. Main results We included 38 trials

  17. Examining End-of-Life Case Management: Systematic Review

    PubMed Central

    Thomas, Roger E.; Wilson, Donna M.; Birch, Stephen

    2014-01-01

    Case management was initiated in the 1970s to reduce care discontinuity. A literature review focused on end-of-life (EOL) case management identified 17 research articles, with content analysis revealing two themes: (a) seeking to determine or establish the value of EOL case management and (b) identifying ways to improve EOL case management. The evidence, although limited, suggests that EOL case management is helpful to dying individuals and their families. Research is needed to more clearly illustrate its usefulness or outcomes and the extent of need for it and actual availability. Among other benefits, EOL case management may help reduce hospital utilization, a major concern with the high cost of hospital-based care and the increased desire for home-based EOL care. PMID:24999433

  18. [Attempted suicide and depression].

    PubMed

    Stenager, E N; Christensen, L L; Jepsen, I M; Krarup, G; Petersen, P; Rasmussen, G T; Benjaminsen, S

    1991-03-18

    The frequency of depressive illness was investigated in 195 patients who had been referred consecutively after attempted suicide during the period 15. February 1989-15, October 1989. A total of 130 of these patients were admitted to hospital while the remainder were treated in the psychiatric emergency room or admission department. Registration of depressive symptoms on admission revealed that 85% had depressed mood and other depressive symptoms. According to the criteria established by Feighner et al. 51% suffered from definite depressive disease on admission. According to Zung's Depression Scale, 60% were depressed. On the basis of observations during hospitalization, 25% suffered from depressive disease according to the criteria established by Feighner et al. 19% of these patients suffered from endogenic depression according to the Newcastle I scale which corresponds to 5% of all the hospitalized patients with attempted suicide. Approximately 10% were treated with antidepressives. Only 8% were discharged with the diagnoses of endogenic or reactive psychoses (ICD-8). It is concluded that depressive symptoms occur in the majority of patients with attempted suicide but that slight non-endogenic depressive states are most commonly concerned and that many of these improve rapidly during hospitalization without medicinal treatment. Restraint should be observed in prescription of antidepressive medicine to patients with attempted suicide until the diagnosis of depressive disease is verified. PMID:2014567

  19. Knowledge Management Analysis: A Case Study

    ERIC Educational Resources Information Center

    Mecha, Ezi I.; Desai, Mayur S.; Richards, Thomas C.

    2009-01-01

    It is imperative for businesses to manage knowledge and stay competitive in the marketplace. Knowledge management is critical and is a key to prevent organizations from duplicating their efforts with a subsequent improvement in their efficiency. This study focuses on overview of knowledge management, analyzes the current knowledge management in…

  20. A Case of Telecommunications (Mis)Management; [and] A Case of Telecommunications (Mis)Management: Case Analysis.

    ERIC Educational Resources Information Center

    Fin, T. Andrew; Rogers, Priscilla S.; Taylor, James R.

    1999-01-01

    Presents a series of analyses of a case involving implementing a new voice-mail system, noting a newly appointed manager's failure to obtain feedback about the planned transition and evaluate user needs; successful introduction of any new technology is variable and suggests a degree of incrementalism; and four major issues arising in similar cases…

  1. Alcohol Consumption and Nearly Lethal Suicide Attempts.

    ERIC Educational Resources Information Center

    Powell, Kenneth E.; Kresnow, Marcie-jo; Mercy, James A.; Potter, Lloyd B.; Swann, Alan C.; Frankowski, Ralph F.; Lee, Roberta K.; Bayer, Timothy L.

    2002-01-01

    Presents a case-control study of the association between nearly lethal suicide attempts and facets of alcohol consumption; namely, drinking frequency, drinking quantity, binge drinking, alcoholism, drinking within 3 hours of suicide attempt, and age began drinking. In bivariate analyses, all measures were associated with nearly lethal suicide…

  2. Case Management: Effects of Improved Risk and Value Information

    ERIC Educational Resources Information Center

    Weissert, William G.; Hirth, Richard A.; Chernew, Michael E.; Diwan, Sadhna; Kim, Jinkyung

    2003-01-01

    Purpose: The purpose of this study was to determine the impact on resource use of providing case managers with information on the potential for patients to benefit from home care services. Design and Methods: Twenty-four case managers working in the Arizona Long Term Care System (ALTCS) were randomized into treatment and control groups. Members of…

  3. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Primary care case management services. 440.168 Section 440.168 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.168 Primary care case management services. (a)...

  4. Identifying costs for capitation in psychiatric case management.

    PubMed

    Baker, J J; Chiverton, P; Hines, V

    1998-01-01

    This article presents an example of how one hospital identified costs for capitation in psychiatric case management. An 18-month postacute case management pilot project collected data on a nurse-specific and patient-specific basis. Costs were identified using activity-based costing methodology. PMID:9502055

  5. 34 CFR 303.23 - Service coordination (case management).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., the system of payments for services in the State, and other pertinent information. (Authority: 20 U.S... 34 Education 2 2011-07-01 2010-07-01 true Service coordination (case management). 303.23 Section... Service coordination (case management). (a) General. (1) As used in this part, except in §...

  6. Effective Case Study Methodologies in the Management of IT Courses.

    ERIC Educational Resources Information Center

    Buffington, James R.; Harper, Jeffrey S.

    Many Association to Advance Collegiate Schools of Business (AACSB) accredited schools require undergraduate Management Information Systems (MIS) majors to take a course in the management of information technology. Over half of these schools utilize case studies in the teaching of this course. Case studies are an important vehicle for teaching…

  7. Laparoscopic management of recurrent pheochromocytoma: A case report.

    PubMed

    Garg, Harshit; Uppal, Manpreet; Sreedharan, Sreesanth Kelu; Aggarwal, Sandeep

    2016-01-01

    Recurrence of pheochromocytoma after a total adrenalectomy is uncommon. Such recurrent tumours are mostly managed by the open technique, with very few studies reporting laparoscopic management. We hereby report a case of successful laparoscopic management of a recurrent pheochromocytoma after total adrenalectomy for left adrenal pheochromocytoma. PMID:27279402

  8. Laparoscopic management of recurrent pheochromocytoma: A case report

    PubMed Central

    Garg, Harshit; Uppal, Manpreet; Sreedharan, Sreesanth Kelu; Aggarwal, Sandeep

    2016-01-01

    Recurrence of pheochromocytoma after a total adrenalectomy is uncommon. Such recurrent tumours are mostly managed by the open technique, with very few studies reporting laparoscopic management. We hereby report a case of successful laparoscopic management of a recurrent pheochromocytoma after total adrenalectomy for left adrenal pheochromocytoma. PMID:27279402

  9. 38 CFR 62.31 - Supportive service: Case management services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... management services. 62.31 Section 62.31 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... management services. Grantees must provide case management services that include, at a minimum: (a... appointments for participants) to help participants obtain needed supportive services, such as medical,...

  10. Our Attempts in Astronomy

    NASA Astrophysics Data System (ADS)

    Vanichai, Yupa

    During the last decade of twentieth century astronomical articles in Thai scientific magazines were out of date. Interacting galaxies blackholes and other celestial objects beyond solar system were hardly found. While a pocket book for deep space was purposefully written by a lecturer a website of astronomy for Thais was planned by the cooperation of two computer programmers. An obseravatory with 600-mm reflector was the first attempt by a Thai engineer. The product of the first 150-mm reflector Dosonian made in Thailand is sold in low price. Future optical programs are now being planned to be made by Thais. These people have recently worked together to develope astronomy in Thailand.

  11. An Action Research in Young Children (3-5) with Activities on Solid Waste Management in Greece: An Attempt for Assessment.

    ERIC Educational Resources Information Center

    Apanomeritaki, Olga

    This action research project sought to increase the waste management and recycling knowledge among 20 children age 4 and 5 years enrolled in a preschool program in Thessaloniki, Greece. A structured interview was developed to assess the children's pre-intervention knowledge of waste management and recycling. It indicated that most children knew…

  12. An attempt to extend the Habitat Harshness Hypothesis to tidal flats: A case study of Anomalocardia brasiliana (Bivalvia: Veneridae) reproductive biology

    NASA Astrophysics Data System (ADS)

    Corte, Guilherme Nascimento; Yokoyama, Leonardo Querobim; Amaral, A. Cecília Z.

    2014-10-01

    The Habitat Harshness Hypothesis (HHH) predicts that populations inhabiting the intertidal area of a dissipative beach should produce more gametes and have a longer reproductive cycle than those inhabiting an intermediate or reflective beach. This hypothesis was proposed for the exposed morphodynamic continuum between the reflective and dissipative states; however, no attempt has been made thus far to verify whether the HHH is valid for tidal flats. In this study, we analysed the reproductive cycle of Anomalocardia brasiliana in an intermediate beach and in a tidal flat and compared the results to determine whether the reproductive cycles of A. brasiliana were in agreement with the predictions of the HHH and to examine the possibility of extending this hypothesis to tidal flats. A continuous spawning season and synchrony between sexes were observed at both sites, although the reproductive effort was higher in the intermediate beach. The results of this first attempt did not support the extension of the HHH to tidal flats. It is possible that hypotheses that take into account only physical variables may not be the most adequate for describing environments with such a high species richness and high abundance as tidal flats. Nevertheless, other studies are necessary to confidently expand or refute the HHH with regard to tidal flats, and this topic should be considered as a priority in future investigations in sandy beach ecology.

  13. Public Management of Science Case Studies.

    ERIC Educational Resources Information Center

    American Univ., Washington, DC. Coll. of Public Affairs.

    Presented are six papers pertaining to the management of science, research, and development by federal agencies. The papers were prepared by students in a management of science course offered at the American University, Washington, D.C. Federal agencies reviewed include: National Aeronautics and Space Administration (NASA); Department of…

  14. Privileged Emotion Managers: The Case of Actors

    ERIC Educational Resources Information Center

    Orzechowicz, David

    2008-01-01

    Theatre provides a unique set of conditions for the management of emotions. Drawing on participant observation from one repertory theater, three university productions, and interviews with stage actors, directors, and acting instructors, I conceptualize actors as privileged emotion managers. Actors access structural resources that enable their…

  15. Interdependency Management in Universities: A Case Study

    ERIC Educational Resources Information Center

    Braun, Dietmar; Benninghoff, Martin; Ramuz, Raphaël; Gorga, Adriana

    2015-01-01

    There remains uncertainty in scientific discussions regarding the governance of universities in new public management regimes in terms of who actually "rules" in the university. Apparently, a strengthened management leadership is confronted with continuing elements of academic self-regulation and professional autonomy in knowledge…

  16. Critical factors in case management: practical lessons from a cardiac case management program.

    PubMed

    Stafford, Randall S; Berra, Kathy

    2007-08-01

    Case management (CM) is an important strategy for chronic disease care. By utilizing non-physician providers for conditions requiring ongoing care and follow-up, CM can facilitate guideline-concordant care, patient empowerment, and improvement in quality of life. We identify a series of critical factors required for successful CM implementation. Heart to Heart is a clinical trial evaluating CM for coronary heart disease (CHD) risk reduction in a multiethnic, low-income population. Patients at elevated cardiac risk were randomized to CM plus primary care (212 patients) or to primary care alone (207). Over a mean follow-up of 17 months, patients received face-to-face nurse and dietitian visits. Mean contact time was 14 hours provided at an estimated cost of $1250 per patient for the 341 (81%) patients completing follow-up. Visits emphasized behavior change, risk-factor monitoring, self-management skills, and guideline-based pharmacotherapy. A statistically significant reduction in mean Framingham risk probability occurred in CM plus primary care relative to primary care alone (1.6% decrease in 10-year CHD risk, p = 0.007). Favorable changes were noted across individual risk factors. Our findings suggest that successful CM implementation relies on choosing appropriate case managers and investing in training, integrating CM into existing care systems, delineating the scope and appropriate levels of clinical decision making, using information systems, and monitoring outcomes and costs. While our population, setting, and intervention model are unique, these insights are broadly relevant. If implemented with attention to critical factors, CM has great potential to improve the process and outcomes of chronic disease care. PMID:17718658

  17. Dacryomeniscometry: an early attempt

    NASA Astrophysics Data System (ADS)

    Ho, Arthur; Papas, Eric B.; Keshavarzi, Kaykhosrow; Lum, Edward; Ehrmann, Klaus

    2000-06-01

    The pre-corneal tear layer provides an important optical as well as physiological function. Hence, the ability to assess the quality and behavior of tears, especially in dry-eye, marginal dry-eye and contact lens patients is important. While a large range of clinical tests exists for assessing tear quality, many are subjective and show poor repeatability. Since the tear meniscus is dependent on factors such as volume, viscosity and 'wettability,' we attempted to develop an optical system for imaging the tear meniscus. A basic prototype to test feasibility has been constructed. An algorithm for computing the profile of the meniscus was also developed. The methodology is described together with some examples of tear menisci imaged and analyzed.

  18. Pediatric Emergency Department Suicidal Patients: Two-Site Evaluation of Suicide Ideators, Single Attempters, and Repeat Attempters

    ERIC Educational Resources Information Center

    Asarnow, Joan Rosenbaum; Baraff, Larry J.; Berk, Michele; Grob, Charles; Devich-Navarro, Mona; Suddath, Robert; Piacentini, John; Tang, Lingqi

    2008-01-01

    The study examines ideators, single attempters, and repeats attempters of suicide to clarify optimal strategies for emergency department management and risk assessment to help them in reducing youth suicide and suicide attempts. Depression was found to be a strong predictor of suicide/suicide attempts along with substance use, externalizing…

  19. An Attempt at Quantifying Factors that Affect Efficiency in the Management of Solid Waste Produced by Commercial Businesses in the City of Tshwane, South Africa

    PubMed Central

    Worku, Yohannes; Muchie, Mammo

    2012-01-01

    Objective. The objective was to investigate factors that affect the efficient management of solid waste produced by commercial businesses operating in the city of Pretoria, South Africa. Methods. Data was gathered from 1,034 businesses. Efficiency in solid waste management was assessed by using a structural time-based model designed for evaluating efficiency as a function of the length of time required to manage waste. Data analysis was performed using statistical procedures such as frequency tables, Pearson's chi-square tests of association, and binary logistic regression analysis. Odds ratios estimated from logistic regression analysis were used for identifying key factors that affect efficiency in the proper disposal of waste. Results. The study showed that 857 of the 1,034 businesses selected for the study (83%) were found to be efficient enough with regards to the proper collection and disposal of solid waste. Based on odds ratios estimated from binary logistic regression analysis, efficiency in the proper management of solid waste was significantly influenced by 4 predictor variables. These 4 influential predictor variables are lack of adherence to waste management regulations, wrong perception, failure to provide customers with enough trash cans, and operation of businesses by employed managers, in a decreasing order of importance. PMID:23209483

  20. Myocardial Injury without Electrocardiographic Changes after a Suicide Attempt by an Overdose of Glimepiride and Zolpidem: A Case Report and Literature Review.

    PubMed

    Chou, Shengpu; Ayabe, Seiji; Sekine, Nobuo

    2015-01-01

    A 40-year-old diabetic man was admitted to our hospital for poor glycemic control. During hospitalization, he took 42 mg glimepiride and 50 mg zolpidem as a suicide attempt. The following day, the creatine kinase-MB fraction and troponin I levels were elevated to 112 IU/L and 8.77 ng/mL, respectively, without any electrocardiographic abnormalities. The patient recovered completely without any complications. Four weeks later, coronary computed tomography angiography and myocardial perfusion scintigraphy revealed moderate one-vessel coronary disease without the evidence of myocardial ischemia or old infarction. Cardiac-specific markers must be considered in sulfonylurea-induced hypoglycemic patients, particularly when the patient is unconscious and does not exhibit any clinical manifestations. PMID:26521901

  1. Embracing case management for computerization of care pathways.

    PubMed

    Mei, Jing; Li, Jing; Yu, Yiqin; Li, Xiang; Liu, Haifeng; Xie, Guotong

    2014-01-01

    The computerization of care pathways (CPs) has drawn considerable attention, for improving quality of health care and reducing costs. A well-known big challenge of implementing CPs is their flexibility and ad hoc variations in execution of clinical tasks. We observe that case management suits well to address this problem, and this paper proposes a CMMN-based CP model, where CMMN (Case Management Model and Notation) is becoming an industry standard. Via an experimental experience on modelling CHF (congestive heart failure) ambulatory CP, we illustrate that the usage of case management paves the way to popularize CPs, particularly for its quick deployment and execution in industrial products. PMID:25160134

  2. Nursing case management for children with failure to thrive.

    PubMed

    MacPhee, M; Hoffenberg, E

    1996-01-01

    The case management approach is described for children with nonorganic failure to thrive in the pediatric tertiary care setting. An advanced practice nurse facilitated the organization of a planning committee, the construction of a care path, and the evaluation of the case management model. A 4-day care path is presented to show staff nursing functions in the nurse case manager role. Special issues are discussed for developing care paths for organic-based failure to thrive where parent reports can help guide health care interventions. PMID:8847607

  3. Walking a tightrope: case management services and outpatient commitment.

    PubMed

    Sullivan, W Patrick; Carpenter, Jenneth; Floyd, Destinee F

    2014-01-01

    Effective case managers in community mental health are successful at forging a working alliance with recipients. This article explores one key aspect of case management practice, serving involuntary clients, specifically those on outpatient commitment orders. In 19 intensive interviews, a subset of a larger study, case managers shared their perceptions of the utility of outpatient commitment with a focus on how such orders impacted the professional relationship. We argue that the use of advance psychiatric directives and shared decision-making processes can reduce the need for coercive practice. PMID:25222837

  4. Media Management Education and the Case Method.

    ERIC Educational Resources Information Center

    Hoag, Anne; Brickley, Dale J.; Cawley, Joanne M.

    2001-01-01

    Traces the development and pedagogical theory of the case study method. Offers an overview of current discourse on its effectiveness. Presents results from a quasi-experiment. Finds that students exposed to the case method improved their problem solving skills measurably and significantly over a 15-week semester, outperforming the control group…

  5. Is your staffing ratio appropriate for your case management model?

    PubMed

    2015-03-01

    Case managers may be working longer hours and have more responsibilities to help their hospital comply with health care reform initiatives, but before rushing to the C-suite to ask for more staff, case management directors should take a hard look at the roles and responsibilities of the department, experts say. They recommend: Look at your staffing ratio and determine if it is appropriate for your case management model and if it is in line with staffing ratios at similar hospitals with similar models. Make a list of all the tasks that case managers are asked to do and break out those that don't affect outcomes or cost of care and those that don't require licensure. Get these assigned to other employees. Before you approach management to ask for more staff, do your homework and have hard data to back up your request. Consider hiring case management extenders to take over clerical tasks and free up case managers to work at the top of their licenses. PMID:25730955

  6. Human Error in Throat Pack Management: Report of Two Cases.

    PubMed

    Baranger, Violaine; Bon Mardion, Nicolas; Dureuil, Bertrand; Compère, Vincent

    2016-06-15

    Throat packs are frequently used after tracheal intubation during ear, nose, and throat surgery. We report 2 cases of complications related to throat packs retained at the end of surgery. Miscommunication between anesthesiology and surgery teams on throat pack management led to an upper gastrointestinal endoscopy examination under general anesthesia in the first case and to severe respiratory distress requiring tracheal reintubation in the second case. Our 2 case reports highlight the importance of good communication between anesthesiology and surgery teams and of standardized procedures and checklists for the management of throat packs to ensure patient safety. PMID:27301056

  7. Surviving a Suicide Attempt

    PubMed Central

    Al-Harrasi, Ahmed; Al Maqbali, Mandhar; Al-Sinawi, Hamed

    2016-01-01

    Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for suicide including mental illness, stressful life situations, loss of social support, and general despair. The association of suicide with Islam has not been extensively studied. The common impression from clinical practice is that being a practicing Muslim reduces the risk of suicide. Another factor associated with suicide is starting a patient on antidepressants. However, this has been questioned recently. This report describes a middle-aged man with depression and multiple social stressors who survived a serious suicide attempt. The discussion will focus on the factors that lead him to want to end his life and the impact of the assumed protective factors such as religious belief and family support on this act of self-harm. Such patients can be on the edge when there is an imbalance between risk factors (such as depression, insomnia, and psychosocial stressors) and protective factors (like religious affiliation and family support). All physicians are advised to assess the suicide risk thoroughly in patients with depression regardless of any presumed protective factor. PMID:27602193

  8. Surviving a Suicide Attempt.

    PubMed

    Al-Harrasi, Ahmed; Al Maqbali, Mandhar; Al-Sinawi, Hamed

    2016-09-01

    Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for suicide including mental illness, stressful life situations, loss of social support, and general despair. The association of suicide with Islam has not been extensively studied. The common impression from clinical practice is that being a practicing Muslim reduces the risk of suicide. Another factor associated with suicide is starting a patient on antidepressants. However, this has been questioned recently. This report describes a middle-aged man with depression and multiple social stressors who survived a serious suicide attempt. The discussion will focus on the factors that lead him to want to end his life and the impact of the assumed protective factors such as religious belief and family support on this act of self-harm. Such patients can be on the edge when there is an imbalance between risk factors (such as depression, insomnia, and psychosocial stressors) and protective factors (like religious affiliation and family support). All physicians are advised to assess the suicide risk thoroughly in patients with depression regardless of any presumed protective factor. PMID:27602193

  9. Case III: Managing Conflict--The Case of the Faculty Stuck in the Middle.

    ERIC Educational Resources Information Center

    Trombly, Robert M.; Comer, Robert W.; Villamil, Juanita E.

    2002-01-01

    Explores techniques of conflict management as well as the positive and negative factors that may exert progressive or detrimental influences. Presents a case scenario, drawn from a faculty development workshop, involving a dental school faculty member, and highlights central issues of the case and relevant management concepts. (EV)

  10. Preparing health care organizations for successful case management programs.

    PubMed

    Bonvissuto, C A; Kastens, J M; Atwell, S R

    1997-01-01

    This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program. PMID:9335724

  11. Effectiveness of Case Management for Homeless Persons: A Systematic Review

    PubMed Central

    de Vet, Renée; van Luijtelaar, Maurice J. A.; Brilleslijper-Kater, Sonja N.; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D.

    2013-01-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309

  12. ED case managers save $4.5 million.

    PubMed

    2011-08-01

    Emergency department case managers at Lee Memorial Health System in Fort Myers, FL saved more than $4.5 million by ensuring that patients were in the right status and transferring patients who did not meet admission criteria to a more appropriate level of care. Case managers and social workers cover the emergency department at peak hours, seven days a week. Case managers screen patients for admission criteria and make sure admission orders are complete and correct. Case managers and social workers coordinate community services and placement for patients who don't meet admission criteria. Social workers intervene when there are concerns about abuse and neglect, and they facilitate placement to other acute care facilities. PMID:21789904

  13. Effectiveness of case management for homeless persons: a systematic review.

    PubMed

    de Vet, Renée; van Luijtelaar, Maurice J A; Brilleslijper-Kater, Sonja N; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D; Wolf, Judith R L M

    2013-10-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309

  14. Nurse's Breakout Session Injury/Illness Case Management

    NASA Technical Reports Server (NTRS)

    Hesselgesser, Connie

    2001-01-01

    An overview of the work related injury and illness case management model developed at the Johnson Space Center was presented. The major accomplishments and the challenges of implementation were discussed.

  15. The employer's case for health management.

    PubMed

    Coulter, Christopher H

    2006-01-01

    Employers' past solutions to rising health benefit costs--adopting managed care strategies, cost shifting to employees and reducing benefits-are no longer effectively controlling costs and are depressing the value of health benefits for employee recruitment and retention. An alternative strategy is to implement health management approaches that improve the health status of employees. These programs reduce medical costs and have a documented positive impact on workers' compensation, disability costs, absenteeism and productivity. Further, this approach is complementary to health care consumerism as a strategy for health improvement and benefit cost reduction and results in improved employee health, outlook and satisfaction. PMID:16792389

  16. Development, optimization, and characterization of polymeric electrospun nanofiber: a new attempt in sublingual delivery of nicorandil for the management of angina pectoris.

    PubMed

    Singh, Baljeet; Garg, Tarun; Goyal, Amit K; Rath, Goutam

    2016-09-01

    The objective of the current investigation was to develop a novel biocomposite polymeric nanofiber for sublingual delivery of nicorandil in an attempt to reduce mucosal ulceration and to improve drug bioavailability. Polymeric nanofibers were achieved using vitamin B12 and a blend of hyaluronic acid and polyvinyl alcohol as polymeric constituents. The electrospinning method was used to prepare drug (nicorandil)-loaded nanofibers. The resulting nanofibers were characterized for morphology, drug loading, XRD, DSC, in vitro drug release, degree of swelling, and pharmacokinetic behavior. The prepared nanofibers were found to be uniform, non-beaded, and non-woven, with fiber diameter ranging from 200-450 nm. In vitro drug release substantiated the controlled release behavior of the developed formulation. Histopathology studies demonstrated no evidence of mucosal ulceration at the site of application. Pharmacokinetic studies established the preclinical safety and showed the maintenance of an effective therapeutic level for a prolonged period. The present investigation gives inputs showing that the biocomposite nanofiber assists as a perfect carrier system for sublingual delivery of anti-anginal drugs. PMID:26134924

  17. The DiaS trial: dialectical behavior therapy versus collaborative assessment and management of suicidality on self-harm in patients with a recent suicide attempt and borderline personality disorder traits - study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background In Denmark 8,000 to 10,000 people will attempt suicide each year. The Centre of Excellence in Suicide Prevention in the Capital Region of Denmark is treating patients with suicidal behavior, and a recent survey has shown that 30% of the patients are suffering from borderline personality disorder. The majority of patients (70% to 75%) with borderline personality disorder have a history of deliberate self-harm and 10% have a lifetime risk to die by suicide. The DiaS trial is comparing dialectical behavior therapy with collaborative assessment and management of suicidality-informed supportive psychotherapy, for the risk of repetition of deliberate self-harm in patients with a recent suicide attempt and personality traits within the spectrum of borderline personality disorder. Both treatments have previously shown effects in this group of patients on suicide ideation and self-harm compared with treatment as usual. Methods/Design The trial is designed as a single-center, two-armed, parallel-group observer-blinded randomized clinical superiority trial. We will recruit 160 participants with a recent suicide attempt and at least two traits of the borderline personality disorder from the Centre of Excellence in Suicide Prevention, Capital Region of Denmark. Randomization will be performed though a centralized and computer-generated approach that conceals the randomization sequence. The interventions that are offered are a modified version of a dialectical behavior therapy program lasting 16 weeks versus collaborative assessment and management of suicidality-informed supportive psychotherapy, where the duration treatment will vary in accordance with established methods up to 16 weeks. The primary outcome measure is the ratio of deliberate self-harming acts including suicide attempts measured at week 28. Other exploratory outcomes are included such as severity of symptoms, suicide intention and ideation, depression, hopelessness, self-esteem, impulsivity, anger

  18. Draugen HSE-case - occupational health risk management

    SciTech Connect

    Glas, J.J.P.; Kjaer, E.

    1996-12-31

    The Draugen HSE-Case serves as a risk management tool. Originally, risk management included only major safety hazards to personnel, environment and assets. Work Environment risks such as ergonomics, psycho-social factors and exposure to chemicals and noise, was not given the same attention. The Draugen HSE-Case addresses this weakness and extends all work environment risks. In order to promote line responsibility and commitment, relevant personnel is involved in the Case development. {open_quotes}THESIS{degrees}, a software application, is used to systematize input and to generate reports. The Draugen HSE-case encompasses: HSE risk analyses related to specific activities; Control of risk related to work environment; Established tolerability criteria; Risk reducing measures; Emergency contingency measures; and Requirements for Competence and Follow-up. The development of Draugen HSE-Case is a continuous process. It will serve to minimize the potential of occupational illnesses, raise general awareness, and make occupational health management more cost-effective.

  19. Managing Change: A Case Study in Evolving Strategic Management.

    ERIC Educational Resources Information Center

    Thor, Linda; Scarafiotti, Carol; Helminski, Laura

    1998-01-01

    Presents Rio Salado College as a case study of an institution that aligns itself with the needs of learners by altering its organizational values and practices. Emphasizes the need for institutions to embrace change and innovation to accommodate the needs of its learners. Contains 11 references. (YKH)

  20. Data management for genomic mapping applications: A case study

    SciTech Connect

    Markowitz, V.M.; Lewis, S.; McCarthy, J.; Olken, F.; Zorn, M.

    1992-05-01

    In this paper we describe a new approach to the construction of data management systems for genomic mapping applications in molecular biology, genetics, and plant breeding. We discuss the architecture of such systems and propose an incremental approach to the development of such systems. We illustrate the proposed approach and architecture with a case study of a prototype data management system for genomic maps.

  1. Essentials of Enrollment Management: Cases in the Field

    ERIC Educational Resources Information Center

    Black, Jim

    2004-01-01

    In AACRAO's new publication Essentials of Enrollment Management: Cases in the Field experts in enrollment management representing all types of institutions reveal the evolution of the enrollment strategies implemented at their institutions, the results, and the lessons learned. The introductory chapter provides an overview of themes and models…

  2. Psychopathology Associated with Suicide Attempts among Rural Adolescents of China

    ERIC Educational Resources Information Center

    Liu, Xianchen; Tein, Jenn-Yun; Sandler, Irwin N.; Zhao, Zhongtang

    2005-01-01

    This case control study examined the relationship between psychopathological profiles and self reported suicide attempts among rural adolescents of China. Cases consisted of 142 adolescents who reported a suicide attempt in the past 6 months in a questionnaire survey (n = 1,365). An equal number of adolescents without reporting a suicide attempt,…

  3. Economic assessment of managing processionary moth in pine forests: a case-study in Portugal.

    PubMed

    Gatto, Paola; Zocca, Alessia; Battisti, Andrea; Barrento, Maria João; Branco, Manuela; Paiva, Maria Rosa

    2009-02-01

    This paper assesses the private and social profitability of current strategies for managing processionary moth (Thaumetopoea pityocampa) in Portuguese pine forests, looking at economic and environmental costs and benefits. Costs include the expenses for forest treatment and the social costs of threats to human health (dermatitis amongst others); benefits are assessed in terms of both revenue and social benefits such as carbon fixation and recreation. The evaluation was done using Cost Benefit Analysis (CBA) as an analytical framework. While this tool is currently applied to forest and environmental assessment and specific applications to pest management strategies are to be found in agricultural economics, rather few attempts have been made in the field of forest pest management. In order to assess and compare with--without options, a case-study was analysed for the Setúbal Peninsula, south of Lisbon, an area where extensive stands of maritime pine (Pinus pinaster) grow. The exercise has shown that CBA can be a valuable tool for assessing the economic and social profitability of pest management. The results demonstrate that the loss of revenues in the no-management option is not sufficient to make pest management profitable for private forest owners in the short-term. Conversely, a social profit is gained as pest management minimizes health risks for humans and avoids possible recreational losses. PMID:18336989

  4. A CASE STUDY OF ENVIRONMENTAL DATA MANAGEMENT

    EPA Science Inventory

    In order to support our ongoing research in watershed ecology and global climate change, we gather and analyze environmental data from several government agencies. This case study demonstrates a researcher’s approach to accessing, organizing, and using intersectoral data. T...

  5. Cost-Effectiveness of Case Management in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Saleh, Shadi S.; Vaughn, Thomas; Levey, Samuel; Fuortes, Laurence; Uden-Holmen, Tanya; Hall, James A.

    2006-01-01

    Objective: The purpose of this study, which is part of a larger clinical trial, was to examine the cost-effectiveness of case management for individuals treated for substance abuse in a residential setting. Method: Clients who agreed to participate were randomly assigned to one of four study groups. Two groups received face-to-face case management…

  6. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Case management services. 441.18 Section 441.18 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES General Provisions § 441.18 Case...

  7. Covert Conditioning: Case Studies in Self-Management.

    ERIC Educational Resources Information Center

    Yager, Geoffrey G.

    The self-management of thoughts and mental images was used in a series of empirical case studies to influence behavior changes. The target behaviors in the cases reported were smoking, overeating, fingernail biting, thinking self-depreciative thoughts, and responding assertively. Self-monitoring, covert positive reinforcement, covert…

  8. School Nurse Case Management: Achieving Health and Educational Outcomes

    ERIC Educational Resources Information Center

    Bonaiuto, Maria M.

    2007-01-01

    Educators and health care professionals alike understand that healthy students are likely to be successful learners. The goal of school nurse case management is to support students so that they are ready to learn. This article describes the outcomes of a 4-year process improvement project designed to show the impact of school nurse case management…

  9. CASE MANAGEMENT INSIDER. Re-Engineering Your Case Management Department: It's Simple, It's Just Not Easy, Part 1.

    PubMed

    Cesta, Toni

    2016-07-01

    This month, we have begun our discussion of the reasons why this is a very good time for hospitals to review and re-engineer their case management models and departments, including the Affordable Care Act and value-based purchasing, among others. Next time, we will discuss the elements you need to review when re-engineering your own case management department. PMID:27434941

  10. Attempting to detect and record brushland in the northeastern United States using MSS data - Schoharie County, N.Y., as a case study

    NASA Technical Reports Server (NTRS)

    Baumann, Paul R.

    1990-01-01

    Before county and local governments will utilize satellite data extensively for landcover inventories, digital image processing techniques must be developed to identify transitional land-use conditions and create large-scale, readable land-cover maps. This study examines a satellite-based land-cover inventory done for Schoharie County, New York and reviews the problems encountered in identifying and mapping brushland - a significant transitional land use - within the county and region. Brushland throughout the Northeast represents a barometer for measuring the shift away from agricultural land use to second-home property. Detecting and locating brushland on a regular basis can greatly assist county and local government officials in planning and managing a county's future.

  11. Integration of case tools for software project management

    SciTech Connect

    Paul, R.; Shinagawa, Y.; Khan, M.F.

    1996-12-31

    Building and maintenance of high quality large software projects is a complex and difficult process. Tools employing software metrics are becoming an effective aid for management of such large projects. In this paper, we briefly trace the evolution of such tools from their beginnings up until the current trends of integrated CASE tools. We present a generic integrated CASE environment incorporating a formal set of software metrics with a suite of advanced analytic techniques. The proposed integrated CASE environment is an enhancement of currently used tools, and can enable more efficient and cost-effective management of large and complex software projects.

  12. Species Conservation and Management: Case Studies

    USGS Publications Warehouse

    Akcakaya, H.R.; Burgman, M.A.; Kindvall, O.; Wood, C.C.; Sjogren-Gulve, P.; Hatfield, J.S.; McCarthy, M.A.

    2004-01-01

    This edited volume is a collection of population and metapopulation models for a wide variety of species, including plants, invertebrates, fishes, amphibians, reptiles, birds, and mammals. Each chapter of the book describes the application of RAMAS GIS 4.0 to one species, with the aim of demonstrating how various life history characteristics of the species are incorporated into the model, and how the results of the model has been or can be used in conservation and management of the species. The book comes with a CD that includes a demo version of the program, and the data files for each species.

  13. Management case study: Tampa Bay, Florida

    USGS Publications Warehouse

    Morrison, G.; Greening, H.S.; Yates, K.K.

    2012-01-01

    Tampa Bay, Florida,USA, is a shallow,subtropical estuary that experienced severe cultural eutrophication between the 1940s and 1980s, a period when the human population of its watershed quadrupled. In response, citizen action led to the formation of a public- and private-sector partnership (the Tampa Bay Estuary Program), which adopted a number of management objectives to support the restoration and protection of the bay’s living resources. These included numeric chlorophyll a and water-clarity targets, as well as long-term goals addressing the spatial extent of sea grasses and other selected habitat types, to support estuarine-dependent faunal guilds.

  14. Attempted Suicide among Iranian Population

    ERIC Educational Resources Information Center

    Sheikholeslami, Homayoun; Kani, Camellia; Ziaee, Amir

    2008-01-01

    Predictors of suicide attempts in Iran, to distinguish any similarities and differences of these predictors between suicide attempts in Iran and other developed and developing countries and to investigate the relation between general psychiatric symptoms and repetition of suicidal attempts were assessed. The validated Farsi version of the General…

  15. Heavy Metal Risk Management: Case Analysis

    PubMed Central

    Kim, Ji Ae; Lee, Seung Ha; Choi, Seung Hyun; Jung, Ki Kyung; Park, Mi Sun; Jeong, Ji Yoon; Hwang, Myung Sil; Yoon, Hae Jung; Choi, Dal Woong

    2012-01-01

    To prepare measures for practical policy utilization and the control of heavy metals, hazard control related institutions by country, present states of control by country, and present states of control by heavy metals were examined. Hazard control cases by heavy metals in various countries were compared and analyzed. In certain countries (e.g., the U.S., the U.K., and Japan), hazardous substances found in foods (e.g., arsenic, lead, cadmium, and mercury) are controlled. In addition, the Joint FAO/WHO Expert Committee on Food Additives (JECFA) recommends calculating the provisional tolerable weekly intake (PTWI) of individual heavy metals instead of the acceptable daily intake (ADI) to compare their pollution levels considering their toxicity accumulated in the human body. In Korea, exposure assessments have been conducted, and in other countries, hazardous substances are controlled by various governing bodies. As such, in Korea and other countries, diverse food heavy metal monitoring and human body exposure assessments are conducted, and reducing measures are prepared accordingly. To reduce the danger of hazardous substances, many countries provide leaflets and guidelines, develop hazardous heavy metal intake recommendations, and take necessary actions. Hazard control case analyses can assist in securing consumer safety by establishing systematic and reliable hazard control methods. PMID:24278603

  16. An Attempt to Describe Frequency-Correlations among kHz QPOs and HBOs by Two-Armed Vertical p-Mode Oscillations: Case of No Magnetic Field

    NASA Astrophysics Data System (ADS)

    Kato, Shoji

    2012-12-01

    The trapping of two-armed (m = 2) vertical p-mode oscillations in relativistic disks is examined. The disks are assumed to be isothermal in the vertical direction, but are truncated at a certain height by the presence of corona. The same issues were examined in a previous paper (Kato 2012a). In this paper, unlike the previous paper, however, we do not use the approximation that the oscillations are nearly vertical, but limit to a simpler case of no magnetic field. As in the previous paper, the results suggest that the two basic oscillation modes [both are the fundamental (n =1) in the vertical direction, but in the horizontal direction one is the fundamental (nr = 0) and the other the first overtone (nr =1)] correspond to the twin kHz QPOs. Second, the oscillation mode, which is the first overtone (n =2) in the vertical direction and the fundamental in the horizontal direction (nr =0), will correspond to the horizontal branch oscillation (HBO) of Z-sources. The latter suggests that the horizontal branch of Z-sources is a sequence of temperature change in disks whose vertical thickness is strongly terminated. The temperature increases leftward along the sequence from the apex between the normal and horizontal branches.

  17. Integrating behavior change theory into geriatric case management practice.

    PubMed

    Enguidanos, S

    2001-01-01

    Case management practices have continued to grow despite a lack of clear evidence of their efficacy. With the expanding segment of the elderly population, there is a critical need to develop and identify programs that will address the many needs of the aging. Geriatric Case Management has been the avenue selected by many health care providers to address these issues, focusing on maintaining health status and improving linkages with medical and community resources. Studies testing the effectiveness of these models have failed to demonstrate their effectiveness in reducing depression, reducing acute care service use, and improving or maintaining health status. The Geriatric Case Management models presented in these lack an evidence-based, theoretical framework that provides definition and direction for case management practice. This article introduces behavior change theories as a method of structuring and delineating the case management intervention. The Transtheoretical Model and the Theory of Planned Behavior are discussed and methods of integrating these theories into practice are discussed. PMID:11878076

  18. Adapters, Strugglers, and Case Managers: A Typology of Spouse Caregivers

    PubMed Central

    Davis, Linda Lindsey; Chestnutt, Deborah; Molloy, Margory; Deshefy-Longhi, Tess; Shim, Bomin; Gilliss, Catherine L.

    2015-01-01

    Although family home care problems are frequently described in the health care literature, the ways in which families and other informal caregivers manage those problems are not often addressed. We conducted a descriptive analysis of interviews in which spouses caring for a partner with Alzheimer’s or Parkinson’s disease were asked to describe difficult home care problems and how they managed those problems. Analysis of these interviews indicated three recurring management styles. Adapters told stories about applying pre-existing skills to manage home care problems. Strugglers told stories of reoccurring home care problems for which they had few or no management strategies. Case Managers’ interview stories focused on the challenges of finding and coordinating home care services. These findings suggest that caregiving burden might be influenced more by the caregiver’s management style than the demands of the care situation. Suggestions for tailoring support programs for the three types of caregivers are proposed. PMID:25189535

  19. MMP3 and TIMP2 gene variants as predisposing factors for Achilles tendon pathologies: Attempted replication study in a British case-control cohort.

    PubMed

    El Khoury, Louis; Ribbans, William J; Raleigh, Stuart M

    2016-09-01

    Variants within the MMP3 (rs679620) and TIMP2 (rs4789932) genes have been associated with the risk of Achilles tendon pathology (ATP) in populations from South Africa and Australia. This study aimed to determine whether these variants were associated with the risk of ATP in British Caucasians. We recruited 118 cases with ATP, including a subset of 25 individuals with Achilles tendon rupture (RUP) and 131 controls. DNA samples were isolated from saliva and genotyped using qPCR. For the TIMP2 rs4789932 variant we found a significant (p = 0.038) difference in the genotype distribution frequency between males with ATP (CC, 39.4%; CT, 43.7%; TT, 16.9%) compared to male controls (CC, 20.7%; CT, 59.8%; TT, 19.5%). We also observed a difference in the TIMP2 rs4789932 genotype distribution between males with rupture compared to male controls (p = 0.038). The MMP3 rs679620 GG genotype was found to be overrepresented in the Achilles tendon rupture (RUP) group (AA, 24.0%; AG, 32.0%; GG, 44.0%) compared to controls (AA, 26.7%; AG, 54.2%; GG, 19.1%). In conclusion, the CT genotype of the TIMP2 rs4789932 variant was associated with lower risk of ATP in males. Furthermore, while we revealed differences for both variants in genotype distribution between the RUP and control groups, the sample size of the RUP group was small and confirmation would be required in additional cohorts. Finally, although both the TIMP2 rs4789932 and MMP3 rs679620 variants tentatively associated with ATP, there were differences in the direction of association compared to earlier work. PMID:27222816

  20. [Managing methotrexate toxicity: a case report].

    PubMed

    Fernández Megía, M J; Alós Almiñana, M; Terol Castera, M J

    2004-01-01

    High-dose methotrexate is included in chemotherapy regimens used to treat a number of malignant neoplasms. Methotrexate plasma concentration is considered the best toxicity predictor. Monitoring methotrexate plasma concentrations is standard practice in the identification of at-risk patients, the titration of folinic acid doses, and the establishment of corrective measures. Methotrexate is a kidney-cleared weak acid, and renal function impairment may retard methotrexate clearance. A case of severe methotrexate-induced toxicity secondary to renal failure is reported in a patient with non-Hodgkin s lymphoma receiving methotrexate at a dose of 1 g/m2. Corrective measures included folinic acid rescue therapy, cholestyramine resin administration, hydration and urine alkalinization, urine pH monitoring, and extracorporeal clearance techniques. PMID:15504095

  1. Case vignette: the vicissitudes of managed care.

    PubMed

    Austad, Carol Shaw; Cummings, Nicholas A; Macklin, Ruth; Newman, Russ

    1992-01-01

    Lee Wilson, age 26, was referred to Dr. Jackson for psychotherapy 5 weeks ago by a friend. Lee has been feeling increasingly depressed about longstanding family issues and the recent breakup of a 2-year relationship with a live-in companion. Over the course of the once-per-week sessions, Dr. Jackson notes persistent suicidal ideation, with vague plans to act if, as Lee puts it, "things get any worse." Just before the sixth session, Dr. Jackson is contacted by a reviewer for the managed care health insurance program covering Lee's therapy. The reviewer informs Dr. Jackson that the company will not authorize payment for further psychotherapeutic care. Dr. Jackson knows that Lee is in need of continued treatment and fears that terminating therapy at this time could result in increased suicide risk. Lee's income could cover only a small portion of Dr. Jackson's usual fee. Dr. Jackson does not wish to abandon Lee, but he already provides a significant amount of reduced-fee service to other clients. Is the health insurance carrier's stance ethical? Should Dr. Jackson be expected to treat Lee for the foreseeable future at a greatly reduced fee? How should Dr. Jackson handle this situation? PMID:11651366

  2. Management of maxillofacial injuries in bear mauling cases: a review of 20 cases

    PubMed Central

    2016-01-01

    Objectives As the craniofacial and neck regions are prime areas of injury in bear attacks, the careful management of soft and hard tissue injuries and selection of reconstructive options is of the utmost importance. This study will review the incidence and patterns of bear mauling in eastern India reported to our department and the various modalities used for their treatment over a period of 7 years. It also documents the risks of infection in bear mauling cases and the complications that have occurred. Materials and Methods Twenty cases were treated over the study period. Cases were evaluated for soft and hard tissue injuries including tissue loss and corresponding management in the craniofacial region. Cases were also evaluated for other associated injuries, organ damage and related complications. Results Various modalities of treatment were used for the management of victims, ranging from simple primary repairs to free tissue transfers. Simple primary repairs were done in 75% of cases, while the management of the injured victims required reconstruction by local, regional or distant flaps in 25%. Free tissue transfers were performed in 15% of cases, and no cases of wound infection were detected in the course of treatment. Conclusion Knowledge of various reconstructive techniques is essential for managing maxillofacial injuries in bear mauling cases. Modern reconstructive procedures like free tissue transfer are reliable options for reconstruction with minimal co-morbidity and dramatic improvement in treatment outcomes. PMID:26904490

  3. Factors associated with adolescent suicidal attempts in Greece.

    PubMed

    Beratis, S

    1990-01-01

    The cultural characteristics of a population may affect the relevant importance of the various factors involved in suicidal attempts. This study investigated the factors which led Greek adolescents to such attempts. Family disruption was significantly greater in the attempters than in the control subjects. However, parental restriction of the youngsters' personal freedom emerged as the major factor resulting in suicidal attempts. It was reported by 55% of the attempters and only by 17% of the control subjects. In 48% of the attempters, restriction of freedom was the reason for quarrels and strained relationship between them and their parents. Psychiatric disorders were significantly more frequent in the attempters (57%) than in the control subjects (3%). Youngsters with multiple attempts (41% of the cases) were more frequently associated with psychiatric disorders than youngsters with one attempt. The findings indicate that suppression of personal freedom by the parents is a major risk factor for suicidal attempts in Greek adolescent girls. PMID:2277824

  4. Building Perinatal Case Manager Capacity Using Quality Improvement

    PubMed Central

    Fitzgerald, Elaine

    2015-01-01

    ABSTRACT Improving breastfeeding rates among Black women is a potential strategy to address disparities in health outcomes that disproportionately impact Black women and children. This quality improvement (QI) initiative aimed to improve perinatal case manager knowledge and self-efficacy to promote breastfeeding among Black, low-income women who use services through Boston Healthy Start Initiative. QI methodology was used to develop and test a two-part strategy for perinatal case managers to promote and support breastfeeding. A positive change was observed in infant feeding knowledge and case manager self-efficacy to promote breastfeeding. Among the 24 mothers participating in this QI initiative, 100% initiated and continued breastfeeding at 1 week postpartum, and 92% were breastfeeding at 2 weeks postpartum. PMID:26937160

  5. Interdisciplinary Management of Gingivitis Artefacta Major: A Case Series

    PubMed Central

    Pattnaik, Naina; Satpathy, Anurag; Mohanty, Rinkee; Nayak, Rashmita; Sahoo, Surjeet

    2015-01-01

    Cases described here discuss interdisciplinary (periodontal and behavioral) approach in the management of rare and difficult to diagnose self-inflicted injuries of gingiva such as gingivitis artefacta major. Self-inflicted injuries to the gingiva are rare and their management by periodontal therapy alone is inadequate. Proper management of this condition requires early detection and effective psychological treatment through behavioral therapy in addition to the treatment of dental lesion. Three male patients in their twenties presented with traumatic injuries of gingiva with history of self-injury and underlying emotional disturbances. Following basic periodontal intervention, their self-inflicting behavior was confirmed on psychiatric consultation. All of them underwent cognitive behavior therapy and were able to successfully curb their self-inflicting behavior prior to any definitive dental procedures. These cases illustrate the essentiality of behavioral intervention in addition to periodontal procedures in the management of such lesions. PMID:26664762

  6. Interdisciplinary Management of Gingivitis Artefacta Major: A Case Series.

    PubMed

    Pattnaik, Naina; Satpathy, Anurag; Mohanty, Rinkee; Nayak, Rashmita; Sahoo, Surjeet

    2015-01-01

    Cases described here discuss interdisciplinary (periodontal and behavioral) approach in the management of rare and difficult to diagnose self-inflicted injuries of gingiva such as gingivitis artefacta major. Self-inflicted injuries to the gingiva are rare and their management by periodontal therapy alone is inadequate. Proper management of this condition requires early detection and effective psychological treatment through behavioral therapy in addition to the treatment of dental lesion. Three male patients in their twenties presented with traumatic injuries of gingiva with history of self-injury and underlying emotional disturbances. Following basic periodontal intervention, their self-inflicting behavior was confirmed on psychiatric consultation. All of them underwent cognitive behavior therapy and were able to successfully curb their self-inflicting behavior prior to any definitive dental procedures. These cases illustrate the essentiality of behavioral intervention in addition to periodontal procedures in the management of such lesions. PMID:26664762

  7. Management of diabetic foot ulcers: evaluation of case studies.

    PubMed

    Torkington-Stokes, Rachel; Metcalf, Daniel; Bowler, Philip

    2016-08-11

    This article explores local barriers to diabetic foot ulcer healing, and describes the use of a dressing designed to manage exudate, infection and biofilm (AQUACEL® Ag+ dressing (AQAg+)) on recalcitrant diabetic foot ulcers. The authors consider four case studies that demonstrate how managing local barriers to wound healing with antimicrobial and anti-biofilm dressings in protocols of care can improve outcomes for patients. PMID:27523769

  8. Case management training needs to support vocational rehabilitation for case managers and general practitioners: a survey study

    PubMed Central

    2014-01-01

    Background The use of the biopsychosocial model of health and case management for effective vocational rehabilitation (VR) has been confirmed for many health conditions. While Case and Condition Managers (CCMPs) use this approach in their everyday work, little is known about their views on training needs. A review of the training curriculum for General Practitioners’ (GPs) revealed little training in VR and the biopsychosocial model of care. This study aims to identify Case and Condition Managers and GPs perceptions of their training needs in relation to employability and VR. Methods 80 Case and Condition Managers and 304 GPs working in NHS Lanarkshire, providing a comparison group, were invited to participate in this study. A self-completion questionnaire was developed and circulated for online completion with a second round of hardcopy questionnaires distributed. Results In total 45 responses were obtained from CCMPs, 5 from occupational health nurses (62% response rate) and 60 from GPs (20% response rate). CCMPs and the nursing group expressed a need for training but to a lesser extent than GP’s. The GP responses demonstrated a need for high levels of training in case/condition management, the biopsychosocial model, legal and ethical issues associated with employment and VR, and management training. Conclusions This survey confirms a need for further training of CCMPs and that respondent GPs in one health board are not fully equipped to deal with patients employability and vocational needs. GPs also reported a lack of understanding about the role of Case and Condition managers. Training for these professional groups and others involved in multidisciplinary VR could improve competencies and mutual understanding among those advising patients on return-to-work. PMID:24884477

  9. Case studies of emergency management of screwworm.

    PubMed

    Reichard, R

    1999-04-01

    Screwworm myiasis, caused by infestation of even minor wounds by the obligative parasitic larval stages of the New World screwworm (NWS) (Cochliomyia hominivorax) or Old World screwworm (OWS) (Chrysomya bezziana) flies, is a major cause of livestock morbidity and mortality in tropical and sub-tropical regions of the world. The two parasites occur in different hemispheres but are remarkably homologous. Animal health emergencies result from the invasion of new territories by the parasites or, in the case of NWS, reinfestation of areas from which the parasite had been eradicated after great effort and expense. The author reviews the biology of the parasites and the effects of screwworm, in addition to prevention of infestation upon the introduction of animals. Examples of three programmes or events are described. The first is the eradication of previously exotic NWS from an epizootic in Libya before the parasite spread to become enzootic in the Mediterranean Basin and eventually other areas of the Eastern Hemisphere. The second example reviews the serious consequences of the extension of the range of OWS into Iraq where conditions at the time were favourable for propagation and unfavourable for control. The third example describes the NWS programme strategy in North and Central America which, for forty years, has been to progressively achieve eradication and then protection of areas from north to south on that continent, employing the sterile insect technique (SIT). Outbreaks in areas where screwworm has already been eradicated divert costly programme resources and slow progress southwards, and are considered emergencies. Some problems encountered and the solutions found during the height of the eradication programme in Mexico are described. Although to date eradication of screwworms has only been accomplished with the application of SIT, this technique alone will not eradicate the pest. The author describes other elements which are required to control or eradicate

  10. [Case management. The nursing business of care or cost].

    PubMed

    Sandhu, B K; Duquette, A; Kérouac, S; Rouillier, L

    1992-01-01

    Less money spent on health services, cost-effectiveness, better productivity and more efficiency are some of the driving forces of contemporary "neo-liberalism" and political trends. How can nursing services and the profession's human values adapt in this difficult context? The authors describe the newest modality of patient care delivery system: nursing case management. They examine the factors and assumptions that led up to its development and point out the validity of asking some serious questions before embarking on the euphoria of case management. PMID:1291932

  11. Managing Bullying and Managing Difference: A Case Study of One Secondary School

    ERIC Educational Resources Information Center

    Dixon, Roz; Smith, Peter; Jenks, Chris

    2004-01-01

    Much work on school bullying focuses on developing our understanding of the various factors that contribute to bullying and its management. This case study focuses on the possible connections between parts and offers a metaperspective of one mainstream secondary school. Demonstrating that bullying and its management is embedded within the network…

  12. Cognitive Distortions and Suicide Attempts.

    PubMed

    Jager-Hyman, Shari; Cunningham, Amy; Wenzel, Amy; Mattei, Stephanie; Brown, Gregory K; Beck, Aaron T

    2014-08-01

    Although theorists have posited that suicidal individuals are more likely than non-suicidal individuals to experience cognitive distortions, little empirical work has examined whether those who recently attempted suicide are more likely to engage in cognitive distortions than those who have not recently attempted suicide. In the present study, 111 participants who attempted suicide in the 30 days prior to participation and 57 psychiatric control participants completed measures of cognitive distortions, depression, and hopelessness. Findings support the hypothesis that individuals who recently attempted suicide are more likely than psychiatric controls to experience cognitive distortions, even when controlling for depression and hopelessness. Fortune telling was the only cognitive distortion uniquely associated with suicide attempt status. However, fortune telling was no longer significantly associated with suicide attempt status when controlling for hopelessness. Findings underscore the importance of directly targeting cognitive distortions when treating individuals at risk for suicide. PMID:25294949

  13. Management of a hypoplastic lower urinary tract: a case report.

    PubMed

    Alagaratnam, Swethan; Sengamalai, Manoharan; Mushtaq, Imran

    2011-06-01

    This case relates to a child with an antenatal diagnosis of severe bilateral hydronephrosis with congenital anomalies of the ureters, bladder, and urethra. We describe the presentation and surgical management, highlighting the complexity of this anomaly and the surgical technique used to reconstruct the lower urinary tract. To our knowledge, there has not been a similar case in the literature and the use of a segment of colon for ureteric substitution in children has not been previously reported in the literature. PMID:21683188

  14. Student Affairs Case Management: Merging Social Work Theory with Student Affairs Practice

    ERIC Educational Resources Information Center

    Adams, Sharrika D.; Hazelwood, Sherry; Hayden, Bruce

    2014-01-01

    Case management is a functional area in higher education and student affairs that emerged after the mass shootings at Virginia Tech in 2007. Although new to higher education, case management emerged from established social work practice. This article compares social work theory and case management standards with a new case management model for…

  15. Case I: Managing People--The Case of the Frustrated Faculty Member.

    ERIC Educational Resources Information Center

    Glickman, Gerald N.; Comer, Robert W.; Filler, Steven J.; Fine, James Burke

    2002-01-01

    Presents an overview of some critical theories in human relations management. Offers a hypothetical case, drawn from a faculty development workshop, involving a dental school faculty member and her dean, for discussion and application of principles. Finally, presents the central issues of the case along with a review of relevant management…

  16. Case III: Managing conflict--the case of the faculty stuck in the middle.

    PubMed

    Trombly, Robert M; Comer, Robert W; Villamil, Juanita E

    2002-04-01

    The need for administrative faculty members to have superior leadership and management skills to handle their increasingly complex responsibilities is well established. As a part of the 2000-01 ADEA Leadership Institute curriculum, fellows were responsible for developing situational case studies for a faculty development workshop to develop participants' leadership and management skills. The case presented here involved managing conflicts in the dental academic setting. The foundation of conflict management centers on communication techniques including transparent communication, open discussion, open confrontation, and active listening. Management options such as avoidance, accommodation, competition, negotiation, and collaboration are potential strategies for the faculty leader. This case study involves a fictitious public dental school, New Horizons University, which has embarked on solutions to address limited resources, but unwittingly has created conflicts between individuals and groups of faculty members. The case discussion analyzes the cause of conflicts, presents the positive and negative potential of the conflicts, reviews techniques of conflict management, and discusses specific management concepts regarding resource allocation and equity theory. PMID:12014569

  17. Case studies illustrating the management of trigeminal neuropathic pain using topical 5% lidocaine plasters

    PubMed Central

    Yilmaz, Zehra; Renton, Tara

    2013-01-01

    Chronic trigeminal pain, with its severe related functional problems, is difficult to treat. Treatment is often empirically based on medications used for other chronic pain conditions. Systemic sodium channel and calcium channel blocking agents may cause a multitude of complications that are often poorly tolerated by the patient. Aim: The aim of this case report was to assess the efficacy of topical 5% lidocaine plasters in reducing pain and reducing adjuvant medication in patients with orofacial neuropathic pain. Method: Fourteen patients with chronic orofacial pain conditions referred to the oral surgery department were instructed to wear 5% lidocaine plasters for 12 hours each day over the painful area. The conditions included post-surgical neuropathy (n = 10), multiple sclerosis-related pain (n = 1), persistent idiopathic facial pain (n = 1), Ramsay Hunt syndrome (post-herpetic neuralgia, n = 1) and trigeminal neuralgia (n = 1). Data were collected on patient demographics, pain levels and medication. Results: Pain levels improved in 12 out of 14 patients. Nine patients had a reduction in adjuvant medication, two of whom completely stopped adjuvant treatment. Conclusion: This case series demonstrates that of the use of 5% lidocaine plasters may play a useful role in the management of chronic trigeminal pain. A suggested novel approach for the management of orofacial pain, for clinicians, is presented. Summary points Management of chronic orofacial pain continues to be a major challenge to the clinician. Patients are often placed on a multitude of medications in an attempt to alleviate pain without success. Topical 5% lidocaine plasters, currently used for the management of post-herpetic neuralgia, offer the option of locally targeting trigeminal pain without the multiple side-effects of systemic medication. This case series demonstrates that lidocaine plasters decrease verbal pain scores in extraoral, trigeminal and neuropathic pain, and reduce the use of other

  18. Cardiovascular collapse with attempted pericardial drain withdrawal

    PubMed Central

    Kraus, Molly B; Spitznagel, Rachel A; Kugler, Jane A

    2016-01-01

    Cardiac tamponade is a rare but serious emergency condition in the pediatric population. As treatment, a pericardial drain is often placed to evacuate the fluid. We present a case of a 4-year-old girl with cardiac tamponade secondary to renal failure. After the tamponade resolved, she suffered cardiovascular collapse upon attempted drain withdrawal. This case highlights an unusual cause for cardiovascular collapse, which occurred on blind removal of a pericardial drain. PMID:27625522

  19. Management of Federally Sponsored Libraries: Case Studies and Analysis.

    ERIC Educational Resources Information Center

    Missar, Charles D., Ed.

    This book provides insight into how managers of federally sponsored libraries view their roles and carry out their duties. Seven federally supported libraries were selected to serve as case studies. These libraries represent a cross-section of various types, and the nine chapters are written by librarians from these facilities. The discussion…

  20. 38 CFR 62.31 - Supportive service: Case management services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Supportive service: Case management services. 62.31 Section 62.31 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) SUPPORTIVE SERVICES FOR VETERAN FAMILIES PROGRAM § 62.31 Supportive service:...

  1. Technology Solutions Case Study: Moisture Management of High-Walls

    SciTech Connect

    2013-12-01

    Moisture management of high-R walls is important to ensure optimal performance. This case study, developed by Building America team Building Science Corporation, focuses on how eight high-R walls handle the three main sources of moisture—construction moisture, air leakage condensation, and bulk water leaks.

  2. Medical Training Skills Curriculum for Case Management Assistants.

    ERIC Educational Resources Information Center

    Family Planning Council of Southeastern Pennsylvania, Philadelphia.

    This manual helps service care providers working with HIV-infected people learn how HIV affects the body's major systems, emphasizing the structure and functions of each system and direct and indirect effects of HIV on each system. The curriculum was developed for case management assistants (CMAs) who work in homes of HIV-infected people. Lessons…

  3. School Asthma Screening and Case Management: Attendance and Learning Outcomes

    ERIC Educational Resources Information Center

    Moricca, Michelle L.; Grasska, Merry A.; BMarthaler, Marcia; Morphew, Tricia; Weismuller, Penny C.; Galant, Stanley P.

    2013-01-01

    Asthma is related to school absenteeism and underperformance in elementary students. This pilot study assessed whether school nurse case management (CM) in children identified with asthma impacts academic performance and school absenteeism in one school. A validated questionnaire was used to identify children at risk for asthma and CM was provided…

  4. Magic from Social Networks that Talk to Management: Four Cases

    ERIC Educational Resources Information Center

    Sugarman, Barry

    2010-01-01

    Purpose: The purpose of this paper is to understand how social networks can help to produce the "magic" of extraordinary results for organizations. Design/methodology/approach: In this exploratory study four cases (from published reports) are compared in order to illustrate different management approaches to utilizing the power of networks.…

  5. Management Science in Higher Education Institutions: Case Studies from Greece

    ERIC Educational Resources Information Center

    Saiti, Anna

    2010-01-01

    Regardless of the source of funding, university quality is based on knowledge, teaching, and research, and hence cannot be run like private enterprises as they are expert organisations that provide solely a public service. The purpose of this paper is to investigate, through the analysis of case studies, whether or not management theory,…

  6. 34 CFR 303.23 - Service coordination (case management).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... be persons who, consistent with § 303.344(g), have demonstrated knowledge and understanding about— (1..., the system of payments for services in the State, and other pertinent information. (Authority: 20 U.S... 34 Education 2 2010-07-01 2010-07-01 false Service coordination (case management). 303.23...

  7. The Management of Training in Multinational Corporations: Comparative Case Studies.

    ERIC Educational Resources Information Center

    Noble, Charles

    1997-01-01

    Case studies of British and Australian multinational corporations in the food and drink industry investigated how training and development are managed. Competency-based education and industry boards are important elements in both countries. Lack of a training culture in the industry and little innovation in training were observed. (SK)

  8. Managing Educational Change: A Case of Two Leadership Approaches

    ERIC Educational Resources Information Center

    Chow, Alice

    2013-01-01

    This article reports a case study that investigated the ways in which heads of subject departments managed the development and application of new assessment strategies in one secondary school in Hong Kong. The data of the study were gathered through participant observation and interviews with 12 teachers who participated in an assessment for…

  9. Impact of School Nurse Case Management on Students with Asthma

    ERIC Educational Resources Information Center

    Taras, Howard; Wright, Sandra; Brennan, Jesse; Campana, Jack; Lofgren, RoseMarie

    2004-01-01

    This project determined asthma prevalence in a large school district, absentee rates, and potential effects of school nurse case management for student asthma over three years. Data were derived from an asthma tracking tool used by nurses in one school district for every student reported as having asthma by their parent. School nurses began…

  10. Case Management and Rehabilitation Counseling: Procedures and Techniques. Fourth Edition

    ERIC Educational Resources Information Center

    Roessler, Richard T.; Rubin, Stanford E.

    2006-01-01

    "Case Management and Rehabilitation Counseling" discusses procedures that are useful to rehabilitation professionals working in many settings. Specifically, this book reviews the finer points relating to diagnosing, arranging services, monitoring program outcomes, arranging for placement, planning for accommodations, ethical decision making,…

  11. Temperament Characteristics of Suicide Attempters.

    ERIC Educational Resources Information Center

    Mehrabian, Albert; Weinstein, Lisa

    1985-01-01

    In a preliminary study of a single group of suicide attempters, male and female subjects did not differ in temperament characteristics. Data from both sexes indicated that suicide-prone individuals have unpleasant, arousable, and submissive temperaments, with arousability a strong discriminator of suicide attempters relative to the general…

  12. Chiropractic management of chronic idiopathic meralgia paresthetica: a case study

    PubMed Central

    Houle, Sébastien

    2012-01-01

    Objectives This report describes the case of a patient with chronic idiopathic meralgia paresthetica associated with bilateral sacroiliac joint dysfunction who was managed with chiropractic care. Clinical Features A 35-year-old white woman presented to a private chiropractic clinic with a complaint of numbness in the right anterolateral thigh region. Neurological assessment revealed a diminution of sensibility and discrimination on the right lateral femoral cutaneous nerve territory. Pain was rated as 8.5 on a numeric pain scale of 0 to 10. Musculoskeletal examination of the pelvic region disclosed bilateral sacroiliac joint dysfunction. Intervention and Outcomes Chiropractic management included pelvic mobilizations, myofascial therapy, transverse friction massage, and stretching exercises. After 3 visits (2 weeks later), result of neurological evaluation was normal, with no residual numbness over the lateral thigh. Conclusion In the present case, chiropractic management with standard and applied kinesiology techniques resulted in recovery of meralgia paresthetica symptoms for this patient. PMID:22942840

  13. A case study in evidence-based wound management.

    PubMed

    Patten, J

    On the first of July 1998, Frank Dobson, the then Secretary of State for Health, revealed the consultation document 'A First Class Service' (Department of Health (DoH), 1998). This article describes a wound management case study which showed how a first class service was provided for a patient with very severe pressure ulcers and complex medical problems. A multiprofessional approach to her complex and challenging problems was maintained. Evidence-based guidelines for the prevention and management of pressure damage were followed, supported by modern researched-based wound management and pressure relief. In addition, risk management strategies were observed, and provided the basis for planning and evaluating her individualized care. PMID:11235289

  14. "Managing after the Merger": Feedback at BAS Case Analysis. Response to "Managing after the Merger" Case Analysis.

    ERIC Educational Resources Information Center

    DeWine, Sue; Eicholtz, Mary M.; Walker, Juanie N.; Walker, Michael G.

    2000-01-01

    Offers two responses to the case study for management communication classes (presented in this same issue) examining issues of performance appraisals and employee feedback in a company after a recent merger. Outlines advice for coaching the supervisor on the performance appraisal process and in his understanding of cultural mergers. Examines…

  15. Energy management study: A proposed case of government building

    NASA Astrophysics Data System (ADS)

    Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

    2015-05-01

    Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount of energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.

  16. Energy management study: A proposed case of government building

    SciTech Connect

    Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

    2015-05-15

    Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount of energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.

  17. Pathogenesis and Management of Hepatolithiasis: A Report of Two Cases.

    PubMed

    Dey, Biswajit; Kaushal, Gourav; Jacob, Sajini Elizabeth; Barwad, Adarsh; Pottakkat, Biju

    2016-03-01

    Hepatolithiasis or primary intrahepatic stones are prevalent in the Far-East countries such as Korea, Japan and Taiwan. It has been associated with helminthiasis, bacterial infections, environmental and dietary factors. Despite high prevalence of helminthiasis like ascariasis, poor environmental condition and low protein diet, India and Middle-East countries have a low incidence of hepatolithiasis. We report two cases of hepatolithiasis associated with bacterial infections and were surgically managed. The first case is a 45-year-old female presenting with upper abdominal pain and fever. She had multiple calculi in intrahepatic biliary radicles, common bile duct, common hepatic duct and gall bladder. She was managed by cholecystectomy, left lateral liver sectionectomy, choledochoscopy assisted stone clearance of the residual liver and Roux-en-Y hepatico-jejunostomy. The second case is a 60-year-old female presenting with epigastric pain and fever and past history of cholecystectomy for cholelithiasis. She had multiple right and left intrahepatic calculi and managed by left lateral liver sectionectomy with excision of CBD and Roux-en-Y hepatico-jejunostomy. Both the cases showed growth of bacteria in the culture of the intraoperatively collected bile. PMID:27134934

  18. Pathogenesis and Management of Hepatolithiasis: A Report of Two Cases

    PubMed Central

    Kaushal, Gourav; Jacob, Sajini Elizabeth; Barwad, Adarsh; Pottakkat, Biju

    2016-01-01

    Hepatolithiasis or primary intrahepatic stones are prevalent in the Far-East countries such as Korea, Japan and Taiwan. It has been associated with helminthiasis, bacterial infections, environmental and dietary factors. Despite high prevalence of helminthiasis like ascariasis, poor environmental condition and low protein diet, India and Middle-East countries have a low incidence of hepatolithiasis. We report two cases of hepatolithiasis associated with bacterial infections and were surgically managed. The first case is a 45-year-old female presenting with upper abdominal pain and fever. She had multiple calculi in intrahepatic biliary radicles, common bile duct, common hepatic duct and gall bladder. She was managed by cholecystectomy, left lateral liver sectionectomy, choledochoscopy assisted stone clearance of the residual liver and Roux-en-Y hepatico-jejunostomy. The second case is a 60-year-old female presenting with epigastric pain and fever and past history of cholecystectomy for cholelithiasis. She had multiple right and left intrahepatic calculi and managed by left lateral liver sectionectomy with excision of CBD and Roux-en-Y hepatico-jejunostomy. Both the cases showed growth of bacteria in the culture of the intraoperatively collected bile. PMID:27134934

  19. Suicide attempts in a emergency hospital.

    PubMed

    Alves, Verônica de Medeiros; Silva, Amanda Mirlla Santos da; Magalhães, Ana Paula Nogueira de; Andrade, Tiago Gomes de; Faro, Ana Cristina Mancussi e; Nardi, Antonio E

    2014-02-01

    This study aimed to characterize the profiles of suicide attempts that were attended to in the Hospital of Alagoas in the year 2010. Four hundred sixty-one charts and service bulletins were analyzed. Patients attempting suicide were predominately female. There were significant difference for suicide attempts (SAs) among men and women in the age of 10 to 19 years and 60 to 69 years. Women have tried more suicide aged between 10 and 19 years and men between 60 and 69 years. The ingestion of drugs was the most frequent method for women; and poisoning, use of sharp objects and hanging for men. The results of this study may contribute to elaboration, planning and implementation of preventive measures to reduce cases of SAs. PMID:24604366

  20. The Impact of Comprehensive Case Management on HIV Client Outcomes

    PubMed Central

    Rodgers, Leslie; Ernst, Jerome; Wirth, Doug; Morretti, Antonio

    2016-01-01

    In 1990, New York State instituted Comprehensive Medicaid Case Management, also known as Target Case Management (TCM), for people dealing with multiple comorbid conditions, including HIV. The goal of TCM is to assist clients in navigating the health care system to increase care engagement and treatment adherence for individuals with complex needs. HIV-positive individuals engaged in care are more likely to be virally suppressed, improving clinical outcomes and decreasing chances of HIV transmission. The purpose of this study was to understand the impact of TCM management on outcomes for people with HIV. Data were obtained from Amida Care, which operates not-for-profit managed care Medicaid and Medicare Special Needs Plans (SNPs) for HIV clients. Changes in clinical, cost, as well as medical and pharmacy utilization data among TCM clients were examined between January 2011 through September 2012 from the start of case management enrollment through the end of the study period (i.e., up to 6 months after disenrollment). Additionally, CD4 counts were compared between Amida Care TCM clients and non-TCM clients. Notable findings include increased CD4 counts for TCM clients over the one-year study period, achieving parity with non-TCM clients (i.e., Mean CD4 count > 500). When looking exclusively at TCM clients, there were increases in medication costs over time, which were concomitant with increased care engagement. Current findings demonstrate that TCM is able to achieve its goals of improving care engagement and treatment adherence. Subsequent policy changes resulting from the Affordable Care Act and the New York State Medicaid Redesign have made the Health Home the administrator of TCM services. Government entities charged with securing and managing TCM and care coordination for people with HIV should provide thoughtful and reasonable guidance and oversight in order to maintain optimal clinical outcomes for TCM clients and reduce the transmission of HIV. PMID:26849561

  1. The Impact of Comprehensive Case Management on HIV Client Outcomes.

    PubMed

    Brennan-Ing, Mark; Seidel, Liz; Rodgers, Leslie; Ernst, Jerome; Wirth, Doug; Tietz, Daniel; Morretti, Antonio; Karpiak, Stephen E

    2016-01-01

    In 1990, New York State instituted Comprehensive Medicaid Case Management, also known as Target Case Management (TCM), for people dealing with multiple comorbid conditions, including HIV. The goal of TCM is to assist clients in navigating the health care system to increase care engagement and treatment adherence for individuals with complex needs. HIV-positive individuals engaged in care are more likely to be virally suppressed, improving clinical outcomes and decreasing chances of HIV transmission. The purpose of this study was to understand the impact of TCM management on outcomes for people with HIV. Data were obtained from Amida Care, which operates not-for-profit managed care Medicaid and Medicare Special Needs Plans (SNPs) for HIV clients. Changes in clinical, cost, as well as medical and pharmacy utilization data among TCM clients were examined between January 2011 through September 2012 from the start of case management enrollment through the end of the study period (i.e., up to 6 months after disenrollment). Additionally, CD4 counts were compared between Amida Care TCM clients and non-TCM clients. Notable findings include increased CD4 counts for TCM clients over the one-year study period, achieving parity with non-TCM clients (i.e., Mean CD4 count > 500). When looking exclusively at TCM clients, there were increases in medication costs over time, which were concomitant with increased care engagement. Current findings demonstrate that TCM is able to achieve its goals of improving care engagement and treatment adherence. Subsequent policy changes resulting from the Affordable Care Act and the New York State Medicaid Redesign have made the Health Home the administrator of TCM services. Government entities charged with securing and managing TCM and care coordination for people with HIV should provide thoughtful and reasonable guidance and oversight in order to maintain optimal clinical outcomes for TCM clients and reduce the transmission of HIV. PMID:26849561

  2. [Fluctuations and seasonality in suicidal attempts].

    PubMed

    Polewka, Andrzej; Szkolnicka, Beata; Targosz, Dorota; Groszek, Barbara; Kroch, Stanisław; Chrostek Maj, Jan; Zieba, Andrzej

    2004-01-01

    The aim of the study was to analyze seasonality and temporal fluctuations in suicide attempts by persons living in Krakow and hospitalized in the Department of Clinical Toxicology CMUJ in the years 2000-2002. The research focussed on the frequency of suicide attempts in relation to the time of the day, day of the week, and month of the year. Temporal fluctuations in the frequency of suicide attempts have been assessed on the basis of the data from medical documentation concerning 2757 suicide attempts by individuals ranging in age from 14 to 90 years. The group consisted of 1607 females and 1150 males. According to the results of the research, seasonality and temporal fluctuations in the frequency of suicide attempts is different for males and females. In the case of the males examined, no dependence between the frequency of suicide attempts and a particular month or season has been observed. In the case of females, on the contrary, the data indicate the existence of a seasonal pattern with the peak in the spring (or early part of the summer), and in the autumn--in October and November. In males, the peak day for attempted suicide was Monday, whereas in females--Sunday and Monday. As regards the time of the day, both the results of the present research and data collected by WHO/EURO indicate that suicide attempts occurred most frequently in the evening, late in the evening or in the early part the night. In conclusion, it has been emphasized that the majority of suicide attempts, especially by females, occurs late in the evening or early in the night. This finding seems to be of particular importance for suicide prevention--it can contribute to the increase in the effectiveness of the organization of work in the Crisis Intervention Centres and make therapists and patients' families aware of the existence of periods of an increased suicide risk. The research has been conducted owing to the cooperation between the department of Clinical Toxicology, CMUJ and the

  3. Management challenges in a case of gender identity disorder

    PubMed Central

    Rathi, Anubhav; Bhatia, Manjeet Singh

    2014-01-01

    Gender identity disorder (GID) is a complex disorder and can be defined as a group of disorders whose common feature is a strong and persistent preference for living as a person of the other sex. It is associated with significant impairment in social, occupational, interpersonal, and other areas of functioning. We describe the case of an adolescent, biologically male who was brought to our outpatient department primarily with symptoms of adjustment disorder with GID and the management provided. The role of a psychiatrist in the management, ethical and legal issues involved is also discussed. PMID:25788806

  4. A case of severe ectopic ACTH syndrome from an occult primary – diagnostic and management dilemmas

    PubMed Central

    Griffin, Katherine; Amer, Saima

    2015-01-01

    Summary Resection of primary tumour is the management of choice in patients with ectopic ACTH syndrome. However, tumours may remain unidentified or occult in spite of extensive efforts at trying to locate them. This can, therefore, pose a major management issue as uncontrolled hypercortisolaemia can lead to life-threatening infections. We present the case of a 66-year-old gentleman with ectopic ACTH syndrome from an occult primary tumour with multiple significant complications from hypercortisolaemia. Ectopic nature of his ACTH-dependent Cushing's syndrome was confirmed by non-suppression with high-dose dexamethasone suppression test and bilateral inferior petrosal sinus sampling. The primary ectopic source remained unidentified in spite of extensive anatomical and functional imaging studies, including CT scans and Dotatate-PET scan. Medical adrenolytic treatment at maximum tolerated doses failed to control his hypercortisolaemia, which led to recurrent intra-abdominal and pelvic abscesses, requiring multiple surgical interventions. Laparoscopic bilateral adrenalectomy was considered but decided against given concerns of technical difficulties due to recurrent intra-abdominal infections and his moribund state. Eventually, alcohol ablation of adrenal glands by retrograde adrenal vein approach was attempted, which resulted in biochemical remission of Cushing's syndrome. Our case emphasizes the importance of aggressive management of hypercortisolaemia in order to reduce the associated morbidity and mortality and also demonstrates that techniques like percutaneous adrenal ablation using a retrograde venous approach may be extremely helpful in patients who are otherwise unable to undergo bilateral adrenalectomy. Learning points Evaluation and management of patients with ectopic ACTH syndrome from an unidentified primary tumour can be very challenging.Persisting hypercortisolaemia in this setting can lead to debilitating and even life-threatening complications and hence

  5. [Rare side effects in management of hyperthyroidism. Case report].

    PubMed

    Sohár, Gábor; Kovács, Mónika; Györkös, Andrea; Gasztonyi, Beáta

    2016-05-29

    The authors present the case history of a patient suffering from hyperthyroidism. The diagnostic procedures revealed the presence of propylthiouracyl induced vasculitis with renal involvement, that recovered completely after the withdrawal of propylthiouracyl and corticosteroid treatment. Thereafter, the patient was treated with thiamasol, that caused agranulocytosis with fever. After transient litium carbonate therapy a succesful thyreoidectomy was performed. Cumulative serious side effects of antithyroid drugs are rare. This case highlights some of the challenges and complications encountered in the management of hyperthyroidism. PMID:27211356

  6. Postanoxic myoclonus: two case presentations and review of medical management.

    PubMed

    Budhram, Adrian; Lipson, David; Nesathurai, Shanker; Harvey, David; Rathbone, Michel P

    2014-03-01

    Postanoxic myoclonus is a rare manifestation after an anoxic event, with fewer than 150 cases reported in the literature. The condition is characterized by myoclonic jerks, which are worse on action than at rest, and postural lapses, ataxia, and dysarthria. The disability caused by postanoxic myoclonus can be profound, and treatment in the rehabilitation setting is exceptionally challenging. We present 2 patients who suffered from postanoxic myoclonus after an anoxic event, both of whom were successfully treated with a combination of levetiracetam, valproic acid, and clonazepam. These cases act as a framework for discussing the management of postanoxic myoclonus in the clinical setting. PMID:24060492

  7. The chiropractic management of two cases of cervical spondylotic radiculopathy

    PubMed Central

    Dufton, John A.; Giantomaso, Tony

    2003-01-01

    Cervical spondylotic radiculopathy (CSR) is one of the potential sources of radiculopathy, particularly in patients aged 40 to 60 years. The hallmark sign of cervical-brachial pain presents in the majority of the cases, however a definitive clinical diagnosis is often difficult in the absence of reliable and valid diagnostic tests. Two cases of presumed CSR illustrate the usefulness of applying a comprehensive mechanical assessment that guides the patient's rehabilitation regardless of the traditional anatomical diagnosis. A brief overview of the epidemiology, clinical presentation, and management of CSR is also presented.

  8. The created environment for physical assessment by case managers.

    PubMed

    Skillen, D L; Anderson, M C; Knight, C L

    2001-02-01

    Goals of gerontological nursing include maximizing health and confronting functional impairments. The health of older adults is often fragile because of age-related change, complicated by chronic illnesses. Identification of changes in health status permits responsive care and consultation but requires proficiency in physical assessment. In 1995, research was conducted in Alberta, Canada, on registered nurse case managers' reported use of assessment skills. Nineteen continuing-care facilities in 1 of 17 provincial health regions participated (N = 189). After expert review and pilot testing, questionnaires were distributed to two independent groups: nurse administrators/staff development coordinators and case managers (response rate = 73%). Qualitative data were subjected to descriptive, interpretive, and pattern coding. Reported are factors constraining or facilitating physical assessment in continuing care. Neuman's concept of the created environment provided a factor-organizing framework. A holistic view of environment and data source triangulation increased confidence in the comprehensiveness and credibility of results. PMID:11216026

  9. [Importance of compliance in nutritional management. Case report].

    PubMed

    Mikulka, Ilona

    2016-04-10

    Disease-related malnutrition is usually caused by the joint action of the underlying disease itself and dietary deficiency. The consequences of malnutrition, if left untreated, are serious, causing a marked decline in physical and psychological health and function, and an increased rate of complications and decreased effectiveness of the medical treatments. In case a functional gastrointestinal tract is present, the recommended form of nutritional management is the use of oral nutritional supplements. However, just like to any other therapy, compliance to oral nutritional supplements is highly influenced by the consistency, taste, smell, volume consumed, and side effects. The aim of the present case report is to illustrate that nutritional management is a successful and effective treatment option of disease-related malnutrition when the selection of the oral nutritional supplement takes into consideration patient's preferences as well. PMID:27039999

  10. Clinical management of hypohidrotic ectodermal dysplasia with anodontia: case report.

    PubMed

    Paschos, Ekaterini; Huth, Karin Christine; Hickel, Reinhard

    2002-01-01

    Ectodermal dysplasia is a rare hereditary disorder with a characteristic physiognomy. The case of a 5-year-old child with hypohidrotic ectodermal dysplasia and complete anodontia is presented. Because of the anodontia and the need for treatment at an early age, the prosthetic management of such a young child can be difficult. Complete dentures were provided to encourage a normal psychological development and to improve the function of the stomatognathic system. PMID:12413164

  11. Surgical Management of Fractured Orthodontic Mini- Implant- A Case Report

    PubMed Central

    Jain, Anoop; Sumra, Nida

    2015-01-01

    The idea of absolute anchorage has always been an elusive goal for clinicians. Orthodontic mini-implants or temporary anchorage devices allow tooth movements previously thought to be impossible or difficult. Although extensive literature exists on use of temporary anchorage devices, their failures have been hardly focused upon, especially implant fracture. The following case report describes successful management of fractured orthodontic mini-implant. PMID:25738088

  12. Oral bullous lichen planus: Case report and review of management

    PubMed Central

    Patil, Archana; Prasad, Shiva; Ashok, L.; Sujatha, G. P.

    2012-01-01

    A 34-year-old female patient with the chief complaint of burning sensation in the oral cavity associated with generalized pruritis, scalp and skin lesions diagnosed as Bullous lichen planus and treated with systemic prednisolone, levamisole, benzydamine oral rinse. Patient is in follow up since 1 year and free of lesions. Here we report the case and review current modalities in the management of oral lichen planus. PMID:23293497

  13. Surgical Approaches and Management of Panfacial Trauma: A Case Report

    PubMed Central

    Dhanasekaran, Vandana

    2015-01-01

    Patients with multiple fractures involving upper third of the face, the mid-face and the lower third are generally referred to as Pan-facial fractures and managing these cases is extremely complicated. Proximity of the maxillofacial region to the important features or senses such as visual function (diplopia), olfaction, respiration (airway management), chewing or mastication (occlusion), deglutition and aesthetics; makes the scenario a little more complex for the surgeon operating in this particular region than the surgeon operating any other part of the body. Inability to directly visualize and reduce all the components of a pan facial injury along with inadequate stability of the fractured bones leads to persistent deformity. It is challenging to follow an established pattern for repairing the pan facial fractures. Each case with this type of fracture is unique and requires skill and expertise of the surgeon to restore the pre-traumatic anatomy and facial aesthetics. Despite all the aggressive treatment, most of the patient’s with pan facial trauma may have some residual deformity which may require another correction surgery later. This article briefs about the management and simple approaches used to reduce and fix a case of pan facial trauma in a 23-year-old male. PMID:26436064

  14. Prosecuting attempted suicides in London: 1891-1913.

    PubMed

    Lester, David

    2009-12-01

    A study of 30 cases of attempted suicide tried at the Old Bailey criminal court in London (England) from 1891 to 1913 indicated that having made prior attempts was the only predictor of the severity of the sentence. 22 individuals were tried for murdering or attempting to murder their child and also attempting suicide. None of the murderers but half of the attempted murderers were found not guilty, or guilty then released. Mothers used drowning more than did fathers and were more likely to be found not guilty. PMID:20099544

  15. Clinicopathological profile and management of 161 cases of actinic cheilitis*

    PubMed Central

    Lopes, Maria Luiza Diniz de Sousa; da Silva Júnior, Francisco Leonardo; Lima, Kenio Costa; de Oliveira, Patrícia Teixeira; da Silveira, Éricka Janine Dantas

    2015-01-01

    BACKGROUND Actinic cheilitis (AC) is a potentially malignant disorder of the lip caused by chronic exposure to ultraviolet radiation from the sun. OBJECTIVES To evaluate the clinical, demographic, morphological and therapeutic management in AC cases data associating to the histopathological grading. METHODS Demographic, clinical and management data of 161 patients with AC were analyzed. In biopsied cases, two calibrated examiners performed histopathological grading by binary system. RESULTS There was a prevalence of males (79.5%), aged 40 years or older (77.5%), light-skinned (85.7%), experiencing occupational exposure to sunlight (80.3%), with AC presenting clinically as white lesions (33.6%). Conservative treatment was adopted in 78 cases and biopsy in 83 cases (60.2% graded as low-risk AC). There were no significant associations between histopathological grading and gender (p= 0.509), age (p=0.416), ethnicity (p=0.388), occupational exposure to sunlight (p=1.000) or clinical presentation (p=0.803). CONCLUSION This study reinforces the hypothesis that demographic and clinical characteristics of AC are not related to histopathological grading. Advice on protection from sun exposure should be encouraged to avoid progression of AC and invasive therapies. PMID:26375219

  16. Chiropractic management of breast-feeding difficulties: a case report

    PubMed Central

    Holleman, Annique C.; Nee, John; Knaap, Simone F.C.

    2011-01-01

    Objective The purpose of this study is to discuss a chiropractic case of management and resolution of breast-feeding difficulties. Clinical Features The case involves an 8-day-old baby unable to breast-feed since 4 days old. Initial examination revealed cervical, cranial, and sacral restrictions. She was diagnosed with craniocervical syndrome by a doctor of chiropractic. Intervention and Outcome Following history and examination, the infant received gentle chiropractic manipulation based on clinical findings. Immediate improvement and complete resolution of the nursing problems were observed after 3 treatments over 14 days. Conclusion The results of this case suggest that neuromusculoskeletal dysfunction may influence the ability of an infant to suckle successfully and that intervention via chiropractic adjustments may result in improving the infant's ability to suckle efficiently. PMID:22014911

  17. BCG-related renal granulomas managed conservatively: A case series

    PubMed Central

    Al-Qaoud, Talal; Brimo, Fadi; Aprikian, Armen G.; Andonian, Sero

    2015-01-01

    Introduction: The aim of this case series is to present two cases of renal granulomas discovered incidentally post-intravesical Bacillus Calmette-Guerin (BCG) installations and were managed conservatively. Case reports: The first case is a 68-year-old man with bladder and right ureteral orifice carcinoma in situ. After transurethral resection of the right ureteral orifice and bladder tumours, he received 6 + 3 weekly intravesical installations of BCG and then 6 + 3 weekly intravesical installations of BCG with interferon alpha (IFN) in the presence of an indwelling ureteral stent since he had refused cystoprostatectomy. At the 18-month follow-up, his computed tomography scan showed two right renal masses. Biopsy demonstrated non-necrotizing granulomatosis. Serial follow-up with imaging studies showed complete resolution of these masses without anti-tuberculous medications. The second case is a 74-year old man with left renal high-grade papillary urothelial carcinoma. After ureteral meatotomy and insertion of indwelling ureteral stents, he received 6 weekly intravesical installations of BCG followed by 3 weekly installations of BCG and IFN prior to the definitive management with laparoscopic left nephroureterectomy. Final pathology showed pT1 urothelial carcinoma and an incidental finding of BCG-related renal granulamotosis. The patient has been asymptomatic and did not require anti-tuberculous medications. Conclusions: While these two cases demonstrate the ability of intravesical BCG to reach the renal pelvis, patients with a history of intravesical BCG with incidental renal masses may benefit from renal biopsy. These renal granulomas may resolve without anti-tuberculous medications. PMID:26085879

  18. Farmers' use of nutrient management: lessons from watershed case studies.

    PubMed

    Osmond, Deanna L; Hoag, Dana L K; Luloff, Al E; Meals, Donald W; Neas, Kathy

    2015-03-01

    Nutrient enrichment of water resources has degraded coastal waters throughout the world, including in the United States (e.g., Chesapeake Bay, Gulf of Mexico, and Neuse Estuary). Agricultural nonpoint sources have significant impacts on water resources. As a result, nutrient management planning is the primary tool recommended to reduce nutrient losses from agricultural fields. Its effectiveness requires nutrient management plans be used by farmers. There is little literature describing nutrient management decision-making. Here, two case studies are described that address this gap: (i) a synthesis of the National Institute of Food and Agriculture, the Conservation Effects Assessment Project, and (ii) field surveys from three nutrient-impaired river basins/watersheds in North Carolina (Neuse, Tar-Pamlico, and Jordan Lake drainage areas). Results indicate farmers generally did not fully apply nutrient management plans or follow basic soil test recommendations even when they had them. Farmers were found to be hesitant to apply N at university-recommended rates because they did not trust the recommendations, viewed abundant N as insurance, or used recommendations made by fertilizer dealers. Exceptions were noted when watershed education, technical support, and funding resources focused on nutrient management that included easing management demands, actively and consistently working directly with a small group of farmers, and providing significant resource allocations to fund agency personnel and cost-share funds to farmers. Without better dialogue with farmers and meaningful investment in strategies that reward farmers for taking what they perceive as risks relative to nutrient reduction, little progress in true adoption of nutrient management will be made. PMID:26023957

  19. Neurosurgical management of anterior meningo-encephaloceles about 60 cases

    PubMed Central

    Rifi, Loubna; Barkat, Amina; El Khamlichi, Abdeslam; Boulaadas, Malek; El Ouahabi, Abdessamad

    2015-01-01

    Anterior meningo-encephaloceles (AME) are congenital malformations characterized by herniation of brain tissue and meninges through a defect in the cranium, in frontal, orbital, nasal and ethmoidal regions. The management of this complex congenital malformation is controversial according to whether use, an intracranial, extra-cranial or combined approach. This is the first largest series published in Africa, in which we present our experience in the operative management of AME; we share our recommendation in technical consideration for surgical approach with review of the literature. All patients beneficed of neuro-radiological investigations including Plan X rays, Spiral Three dimensional CT scan and MRI. Ophthalmologic and maxillo-facial evaluations were done in all the cases. MEA are surgically approached in various ways, mainly on the basis of its location and type, by cranio-facial approach in one-step, or in two stages by intracranial approach followed by facial approach, only by cranial approach or facial approach. The surgical results were evaluated in the follow up on the basis of disappearance of cranio-facial tumefaction with correction of hypertelorism. 60 children with AME were treated in our department between January 1992 and December 2012. The mean age at time of surgery was 14 months (20 days to 18 years) with slight men predominance (28 females/32 males). Cranio-facial team operated 21 patients, 16 were operated in two stages by intracranial approach followed by facial approach, 20 cases beneficed the neurosurgical approach and three only the facial approach Some post operative complications were observed: 2 cases of post operative hydrocephalus underwent shunt; CSF fistulas in three cases cured by spinal drainage, one death due to per operative hypothermia, 3 cases of recurrence how needed second surgery. After mean follow up for 80 months (1 year to 19 years) theses techniques permitted a good cosmetics results in 42 cases, average cosmetics

  20. Multilingualism among University Staff: A Case Study of Language Management at an Australian University

    ERIC Educational Resources Information Center

    Marriott, Helen

    2013-01-01

    Employing the language management framework, this paper reports on multilingual use among the staff of a major metropolitan university in Melbourne and covers both simple and organised management. It describes a top-down attempt to survey staffs' (academic and general) background in Languages other than English (LOTE), LOTE usage and…

  1. Empowerment and change management in Aboriginal organisations: a case study.

    PubMed

    McEwan, Alexandra B; Tsey, Komla; McCalman, Janya; Travers, Helen J

    2010-08-01

    The social organisation of work, management styles and social relationships in the workplace all matter for health. It is now well recognised that people who have control over their work have better health and that stress in the workplace increases the level of disease. In the context of organisational change, the potential benefits of empowerment strategies are two-fold: a positive impact on the organisation's effectiveness and enhancements in staff health, wellbeing and sense of control. This case study describes the University of Queensland Empowerment Research Program's experience working with the Apunipima Cape York Health Council in a change management process. Participatory action research and empowerment strategies were utilised to facilitate shifts in work culture and group cohesion towards achieving Apunipima's vision of being an effective lead agency for Indigenous health reform in Cape York. As part of the project, staff morale and confidence were monitored using a pictorial tool, Change Curve, which outlined the phases of organisational change. The project findings indicated that organisational change did not follow a clear linear trajectory. In some ways the dynamics mapped over a period of 18 months mirror the type of struggles individuals commonly encounter as a part of personal growth and development. In this case, one of the factors which influenced the program's success was the willingness of executive employees to actively support and participate in the change management process. PMID:20797370

  2. Case management in a DUI lab: effect on drugs reported.

    PubMed

    Tiscione, Nicholas B; Shan, Xiaoqin; Yeatman, Dustin Tate

    2014-10-01

    An evaluation of an internal laboratory decision to implement a protocol for limiting drug testing based on ethanol concentration in laboratory analysis for driving under the influence (DUI) cases is presented. The described case management strategy is supported by known impairment of ethanol at relatively high concentrations, difficulty assigning a level of contributing impairment from drugs in the presence of high ethanol levels and the likelihood that the drug results may be suppressed at trial. Although the results of this study reinforce the assertion that such protocols lead to the under reporting of drugs in DUI cases, for the majority of cases, 95% in this study, the drug analysis results were not significant and did not warrant the time and resources needed for the additional blood drug testing. Furthermore, the study demonstrated that a high drug positivity rate does not necessarily mean that those drug results are legally or pharmacologically meaningful. Additional research should be conducted with quantitative drug results and casework impact of blood drug screen protocols as previous studies only report drug positivity rates and not whether the drug results would be meaningful to the case. PMID:25217546

  3. Adult-onset laryngomalacia: case reports and review of management.

    PubMed

    Hey, Shi Ying; Oozeer, Nashreen Banon; Robertson, Stuart; MacKenzie, Kenneth

    2014-12-01

    Laryngomalacia is a dynamic airway condition characterised by inward collapse of flaccid supraglottic structures during inspiration. Although the most common cause of stridor in the paediatric population, adult-onset laryngomalacia remains a rare entity and its management, challenging. Two cases of adult-onset laryngomalacia are reported. A review of the English literature is performed and additional publications identified by hand-searching relevant papers; 13 case reports/series comprising 28 cases of adult-onset laryngomalacia were identified, divided into two main groups: idiopathic (6/28) and acquired (22/28). The aetiology of the acquired form includes neurological, traumatic and iatrogenic. Reported therapeutic measures used are laser supraglottoplasty, epiglottopexy, partial epiglottidectomy, defunctioning tracheostomy and intubation whilst correcting the underlying cause. The majority of patients only required one therapeutic procedure (follow-up of 2-24 months). A strong index of suspicion is required to diagnose adult-onset laryngomalacia aided by in-office laryngoscopy. The rarity of this condition prevents management-based randomised controlled trials. PMID:24615649

  4. Case Managers' Attitudes toward the Use of Homework for People Diagnosed with a Severe Psychiatric Disability

    ERIC Educational Resources Information Center

    Kelly, Peter J.; Deane, Frank P.; Kazantzis, Nikolaos; Crowe, Trevor P.

    2007-01-01

    The study examined mental health case managers' attitudes toward the use of homework and explored the relationship between clinician attitudes and systematic homework administration practices. A survey examining attitudes toward the use of homework was completed by 122 Australian mental health case managers. Case managers who held more positive…

  5. Child Protective Services Case Management Project. Final Report: Innovations in Protective Services.

    ERIC Educational Resources Information Center

    Texas State Dept. of Human Resources, Austin.

    One of seven reports in the Innovations in Protective Services series, this document reports on the development of a model of case management that clarified what is expected from Child Protective Service (CPS) specialists. By conducting a literature review, studying the role of the CPS case manager, and developing a case management model, the Case…

  6. Suicide attempt with a mix of synthetic cannabinoids and synthetic cathinones: Case report of non-fatal intoxication with AB-CHMINACA, AB-FUBINACA, alpha-PHP, alpha-PVP and 4-CMC.

    PubMed

    Klavž, Janez; Gorenjak, Maksimiljan; Marinšek, Martin

    2016-08-01

    We report on a case of intoxication with a mix of new psychoactive substances. A 38-year-old male was brought to the emergency department (ED) following the ingestion of an unknown drug in a suicide attempt. During the transport, he became progressively more somnolent and unresponsive to painful stimuli. Urine and stomach content were collected on admission to be screened for drugs of abuse and medicinal drugs. After admission, the patient's next of kin presented five small grip seal plastic bags containing different powders/crystals, and they were sent for analysis along with urine and stomach content to the toxicology laboratory. An easy and rapid sample preparation technique was applied for the extraction of urine and stomach content. Samples were extracted with liquid-liquid extraction (LLE) technique and analysed using gas chromatography-mass spectrometry (GC-MS). A small amount of powder material from the bags was diluted in methanol and injected directly into the GC-MS instrument. Obtained spectra (EI) were evaluated against SWGDRUG library. Five different designer drugs were identified in the powder material, including synthetic cannabinoids (AB-CHMINACA, AB-FUBINACA) and synthetic cathinones (alpha-PHP, alpha-PVP and 4-CMC). With the exception of 4-CMC, all of these substances were also detected in the stomach content along with the prescription drugs. This is the first time that a positive identification of these five drugs has been made by a clinical laboratory in Slovenia. PMID:26890319

  7. Laparoscopic Management of Hilar Cholangiocarcinoma: a Case Report.

    PubMed

    Puntambekar, Shailesh; Sharma, Vikrant; Kumar, Sanjay; Mitkare, Sainath; Joshi, Geetanjali; Parikh, Hirav

    2016-02-01

    The only option for cure of Klatskin's tumour is surgical excision. The radicality of the procedure is determined by the extent of the tumour and functional parameters of the patient. Complete laparoscopic resection of hilar cholangiocarcinoma with biliary reconstruction is a challenging procedure. The main aim is to achieve pathological negative margins, complete lymph node retrieval and enterobiliary bypass. We present a case report of a patient with hilar cholangiocarcinoma managed laparoscopically. The nodal yield was nine. On 6-month follow-up, the patient was symptom free. The main aim is to study the feasibility of performing this complex procedure completely laparoscopically. PMID:27186042

  8. Management of Ectopically Erupting Maxillary Incisors: A Case Series

    PubMed Central

    Suresh, Kotumachagi Sangappa; Uma, HL; Nagarathna, J

    2015-01-01

    ABSTRACT Eruption disturbances related to the position include ectopic eruption and transpositions. The occurrence of ectopic eruption is most commonly associated with maxillary incisors. The normal eruption, position and morphology of these teeth are crucial to craniofacial development, facial esthetics as well as phonetics. It is essential that the clinicians have thorough knowledge of the eruption disturbances in order to make an appropriate, as well as timely intervention, as dictated by the complexity of the problem. How to cite this article: Suresh KS, Uma HL, Nagarathna J, Kumar P. Management of Ectopically Erupting Maxillary Incisors: A Case Series. Int J Clin Pediatr Dent 2015;8(3):227-233. PMID:26604543

  9. Management of Ectopically Erupting Maxillary Incisors: A Case Series.

    PubMed

    Suresh, Kotumachagi Sangappa; Uma, H L; Nagarathna, J; Kumar, Pravin

    2015-01-01

    Eruption disturbances related to the position include ectopic eruption and transpositions. The occurrence of ectopic eruption is most commonly associated with maxillary incisors. The normal eruption, position and morphology of these teeth are crucial to craniofacial development, facial esthetics as well as phonetics. It is essential that the clinicians have thorough knowledge of the eruption disturbances in order to make an appropriate, as well as timely intervention, as dictated by the complexity of the problem. How to cite this article: Suresh KS, Uma HL, Nagarathna J, Kumar P. Management of Ectopically Erupting Maxillary Incisors: A Case Series. Int J Clin Pediatr Dent 2015;8(3):227-233. PMID:26604543

  10. A Case of Error Disclosure: A Communication Privacy Management Analysis

    PubMed Central

    Petronio, Sandra; Helft, Paul R.; Child, Jeffrey T.

    2013-01-01

    To better understand the process of disclosing medical errors to patients, this research offers a case analysis using Petronios’s theoretical frame of Communication Privacy Management (CPM). Given the resistance clinicians often feel about error disclosure, insights into the way choices are made by the clinicians in telling patients about the mistake has the potential to address reasons for resistance. Applying the evidenced-based CPM theory, developed over the last 35 years and dedicated to studying disclosure phenomenon, to disclosing medical mistakes potentially has the ability to reshape thinking about the error disclosure process. Using a composite case representing a surgical mistake, analysis based on CPM theory is offered to gain insights into conversational routines and disclosure management choices of revealing a medical error. The results of this analysis show that an underlying assumption of health information ownership by the patient and family can be at odds with the way the clinician tends to control disclosure about the error. In addition, the case analysis illustrates that there are embedded patterns of disclosure that emerge out of conversations the clinician has with the patient and the patient’s family members. These patterns unfold privacy management decisions on the part of the clinician that impact how the patient is told about the error and the way that patients interpret the meaning of the disclosure. These findings suggest the need for a better understanding of how patients manage their private health information in relationship to their expectations for the way they see the clinician caring for or controlling their health information about errors. Significance for public health Much of the mission central to public health sits squarely on the ability to communicate effectively. This case analysis offers an in-depth assessment of how error disclosure is complicated by misunderstandings, assuming ownership and control over information