Case Management Procedures Research Articles

Legal basis and main technologies of socio-psychological work with vulnerable categories of the population in the community

The war in Ukraine has led to an increase in the need for social assistance among vulnerable populations, which requires strengthening the capacity of social services to respond to new challenges. The purpose of this study is to examine the legal and technological framework for wartime assistance and to demonstrate the effectiveness of modern methods through theoretical and empirical analysis. Data collection and analysis were conducted in compliance with ethical and legal standards for social research. Currently, Ukrainian policy makes it possible to support models such as the proposed Integrated Social Services approach. However, the findings of the study indicate a potential need for legal/regulatory reforms to further strengthen the capacity to respond to crisis situations. The results confirm that the implemented interventions successfully address the problems of displaced persons, veterans, most-at-risk families, etc. Individual case management and group social and psychological trainings contribute to capacity development, and the model of integrated services allows for quick resolution of acute problems. Comparative evaluations show that the integrated system is superior to individual methods in quickly addressing crisis situations. However, new groups that fall outside the scope of current legislation, such as victims of domestic violence, may require mandatory expansion of eligibility criteria. Laws could also include standards for interagency coordination to address fragmentation. This urgent relevance highlights how robust legal/ethical foundations uphold assistance models in turmoil. It was also concluded that the implementation of legal reforms that would create a unified system of cooperation could mitigate these problems. In particular, legislation could formalise requirements such as data and information sharing between service providers, common case management procedures, common reporting standards and interdisciplinary partnerships. The practical significance of the study lies in the possibility of using the results of the problem analysis to create accessible mechanisms to improve the quality of support for vulnerable demographic groups. Enshrining access to care as an inalienable guarantee creates an ecosystem that is resilient to modern threats

Treating an Epidemic During a Pandemic: Experience Treating Opioid Use Disorder at the Baltimore Convention Center Field Hospital.

During the COVID-19 pandemic, access to addiction treatment has plummeted. At the same time, patients with opioid use disorder are at higher risk of COVID-19 infection and experience worse outcomes. The Baltimore Convention Center Field Hospital (BCCFH), a state-run COVID-19 disaster hospital operated by Johns Hopkins Medicine and the University of Maryland Medical System, continues to operate 14 months into the pandemic to serve as an overflow unit for the state's hospitals. BCCFH staff observed the demand for opioid use disorder care and developed admission criteria, a pharmacy formulary, and case management procedures to meet this need. This article describes generalized lessons from the BCCFH experience treating substance use disorder during a pandemic.

Кейс-менеджмент и участие детей, находящихся под альтернативной опекой, в процессе принятия решений

The article discusses the technology of case management on the example of the Children’s Villages — SOS project. The charity Children’s Villages — SOS unites several areas of activity in assisting orphans including alternative care for children left without parental care. Case management is widely used in accompanying the inclusion of a child in a foster family. This approach includes several stages: receiving a child, conducting an in-depth assessment of his/her individual needs, planning for individual development, implementing an individual development plan, reviewing progress, and completing support. The main principle of case management is the child’s direct involvement in all procedures where the child acts as the main expert on his/her life. Such direct inclusion in decision-making regarding one’s own life shows the child the points of interaction, determines the loci of their life’s goals and interests, emphasizes that the child is important for him- or herself and others. Case management is a popular modern practice in social work with orphans proved by international cooperation experience. Children’s villages are located in the north-western part of Russia, and they have functioned there for over 10 years. The study is based on the analysis of the child’s participation at all stages of case management; the potential of this approach to accompanying an orphan and the practical experience of the organization’s staff are evaluated. Expert opinions about case management coordinators and psychologists — the employees of children’s villages in Tomilino, Kandalaksha, Pskov, and Pushkin were also studied. Children aged 10–17 years who live in the villages were interviewed. Methodological developments on the implementation of alternative guardianship in the villages based of international experience, and basic principles of case management were also studied. The paper offers recommendations to those planning to introduce or already implementing case management procedures in organizations working with orphans and individuals acting as foster parents.

Procedural Economy at the International Court of Justice

Abstract In April 2016, the International Court of Justice held a colloquium to commemorate the 70th anniversary of its establishment. One of the principal themes of this event was the potential adoption of improvements to the procedures and working practices of the Court. Responses to a Counsel Survey revealed a general interest in procedural reform at the Court, particularly with respect to the areas of evidence and procedural efficiency. The purpose of this article is to set out a case for procedural reform at the ICJ, presenting multiple options, with supplementary reference to the ITLOS. Whereas the work of the Committee also addresses procedural integrity or “the sound administration of justice”, this contribution will focus upon the Court’s case management procedures to call for their reform in order to enhance procedural economy. This would enable the Court to improve its “throughput” to be able to cope with an expanded caseload.

An Analysis of the Top-cited Articles in Anesthesiology Education Literature

In the same way that impact factor is calculated for journals, the number of citations an article receives can indicate its influence or value to a particular field. This study was designed to identify the most frequently cited articles in anesthesiology education to yield insight into which articles have been most useful for researchers in ongoing research and publication. The Web of Science database was searched to capture the top-cited articles in anesthesiology education both in anesthesiology and nonanesthesiology journals. Results were sorted by the most frequently cited. The top 40 cited articles were identified. Articles were included if they (1) related to anesthesiology or included anesthesiologists as subjects and (2) were related to the education of current or future anesthesiologists. The full text was analyzed, and themes were identified. There was a total of 2923 citations of articles in anesthesiology journals and 924 citations of articles in nonanesthesiology journals. Thirty-two of 40 articles (80%) were research studies. Twenty-four of 40 (60%) were about teaching methods. Twenty-five of 40 (63%) focused on simulation, and 31 of 40 (78%) had residents as the subjects. Twenty-eight of 40 (70%) articles were about either case management (15) or learning procedures (13). This study identifies the most widely cited articles in anesthesiology education. Common themes included procedural learning, interventional research study designs, simulation, and studies involving residents as subjects. This article may be a resource to anesthesiology education researchers to identify what articles are widely cited by other researchers.

Practice Patterns of Speech-Language Pathologists in Pediatric Vocal Health.

The purpose of this study was to investigate current practices of speech-language pathologists (SLPs) in the management of pediatric vocal health, with specific analysis of the influence of clinical specialty and workplace setting on management approaches. American Speech-Language-Hearing Association-certified clinicians providing services within the United States (1%-100% voice caseload) completed an anonymous online survey detailing clinician demographics; employment location and service delivery models; approaches to continuing professional development; and specifics of case management, including assessment, treatment, and discharge procedures. Current practice patterns were analyzed for 100 SLPs (0-42 years of experience; 77 self-identifying as voice specialists) providing services in 34 U.S. states across a range of metropolitan and nonmetropolitan workplace settings. In general, SLPs favored a multidisciplinary approach to management; included perceptual, instrumental, and quality of life measures during evaluation; and tailored intervention to the individual using a combination of therapy approaches. In contrast with current practice guidelines, only half reported requiring an otolaryngology evaluation prior to initiating treatment. Both clinical specialty and workplace setting were found to affect practice patterns. SLPs in school settings were significantly less likely to consider themselves voice specialists compared with all other work environments. Those SLPs who considered themselves voice specialists were significantly more likely to utilize voice-specific assessment and treatment approaches. SLP practice largely mirrors current professional practice guidelines; however, potential exists to further enhance client care. To ensure that SLPs are best able to support children in successful communication, further research, education, and advocacy are required.

Risk assessment matters, but only when implemented well: A multisite study in juvenile probation.

There is a strong movement toward juvenile justice agencies' use of risk assessment and risk-need-responsivity approaches to improve case management decisions for young offenders. However, little is known about whether adoption of risk assessment actually effectuates any changes in the way young offenders are handled. This was a multisite study of the impact on case processing of implementation of the Structured Assessment of Violence Risk in Youth (SAVRY) or Youth Level of Service/Case Management Inventory in 6 juvenile probation offices using a prepost design and 1,694 propensity score-matched young offenders. Consistent with the risk principle, there were significant changes to at least some areas of case processing in all but 1 site, most notably with respect to decreases in the amount of supervision youth received and in rates of out-of-home placement. The nature and extent of the impact varied as a function of sites' characteristics and implementation quality, not as a function of the risk assessment used. No increases in recidivism were observed in any site, and there was a significant reduction in recidivism in 1 site. The key benefits of implementation of valid risk assessment and case management procedures were improved resource allocation and fewer instances of inappropriate interference in youths' lives without an apparent increased risk to public safety. (PsycINFO Database Record

Responding to the Increased Needs of College Students: A Case Study of Case Management

ABSTRACTThe psychological needs of college students lead to overwhelming demand on college counseling centers’ resources. In this article, we review models of case management in Higher Education including the administrative, behavioral intervention, and counseling center models. We also present a case study of the 3-year development of a counseling center case management service. Initial data suggest that expanding the role of a counseling center case manager to allow for frequent appointments/follow-up and standardizing counseling center case management procedures led to improved appointment attendance and increased communication with students following referral. A vignette and suggestions for other centers are also presented.

Psychologists' Perspectives on Therapy Termination and the Use of Therapy Engagement/Retention Strategies.

Therapists tend to underestimate the number of clients who make unilateral decisions to end treatment in their own practices. Therapists are unlikely to take steps to engage and retain clients in treatment unless they believe that unilateral termination is a significant problem. Clients who unilaterally end treatment are often experiencing problems with the process of therapy (e.g., dissatisfaction, lack of fit, feeling as though therapy is going nowhere), whereas therapists often attribute failed therapy to clients. It is important to be aware of this tendency and look for other explanations. It is worthwhile to actively solicit clients' barriers in an effort to mitigate them. The empirical literature provides ample evidence that it is helpful for therapists to deliberately employ strategies to engage and retain clients in therapy. All therapists would benefit from considering which strategies fit with their practices. Although almost all therapists emphasize building the early working alliance, and this is essential to good outcome, other evidence-based methods of engaging clients in therapy are largely underutilized, such as systematically monitoring client progress and barriers, placing time limits on treatment, using appointment reminders, and case management.

A research-based strategy for managing housing adaptations: study protocol for a quasi-experimental trial.

BackgroundThe primary aim of this paper is to describe the design of a project evaluating the effects of using a research-based strategy for managing housing adaptations (HAs). The evaluation targets clients’ perspectives in terms of activity, participation, usability, fear of falling, fall incidence, use of mobility devices, and health-related quality of life, and determines the societal effects of HAs in terms of costs. Additional aims of the project are to explore and describe this strategy in relation to experiences and expectations (a) among clients and cohabitants and (b) occupational therapists in ordinary practice.Methods/designThis study is a quasi-experimental trial applying a multiphase design, combining quantitative and qualitative data. At the experimental sites, the occupational therapists (OTs) apply the intervention, i.e. a standardized research-based strategy for HA case management. At the control site, the occupational therapists are following their regular routine in relation to HA. Three municipalities in south Sweden will be included based on their population, their geographical dispersion, and their similar organizational structures for HA administration. Identical data on outcomes is being collected at all the sites at the same four time points: before the HA and then 3, 6, and 12 months after the HA. The data-collection methods are semi-structured qualitative interviews, observations, clinical assessments, and certificates related to each client’s HA.Primary outcomes are the usability of the home and the client’s independence in daily activities (ADL). Cross-sectional and longitudinal data analyses will be conducted as well as statistical analyses, health-economic analyses, and qualitative analyses. Qualitative and quantitative data will be sequentially analyzed, and case studies will be developed.DiscussionThe intervention in this study has been developed and tested through many years of research and in collaboration with practitioners. This process includes methodological development and testing research aimed at identifying the most important outcomes and research targeting current HA case-management procedures in Swedish municipalities. When the study is completed, the results will be used for further optimization of the practice strategy for HA, in close collaboration with the data-collecting OTs.Trial registrationNo: NCT01960582.

Psychoanalysis in a closed ward: The psychoanalytic act in psychosis and case management in a “mental health” institution

Clinical work and diagnostic procedures in mental health institutions are mainly psychiatrically–biologically oriented and the basic requirements from clinicians include case management and support over various aspects of the patient’s daily life, his/her rehabilitation and relations with his family. The role of psychotherapeutic work in general, and in particular psychoanalytically oriented work, is not clear and is often neglected. This article represents a Lacanian Psychoanalytic approach for clinicians in mental health institutions and argues that it is applicable and beneficial for patients even when the institutional orientation is markedly different. It is based on the Lacanian emphasis on the differentiation between two main personality organizations, a neurotic and a psychotic, together with an emphasis on a non interpretative, non authoritative approach to treating patients with psychotic personality organization. The author argues that a position referred to as “the secretary” is beneficial in helping patients improve their life situations and adjust better to the hospitalization and other demands. It also helps the clinician’s practice in case management and rehabilitation procedures.

Designing Policy to Serve Children With Special Medical Needs in Child Welfare: Lessons From New York City

Despite the heightened vulnerability of children with special medical needs (CSMN), few child welfare systems have explicit policies, training, or case management procedures designed to ensure their identification and monitor their safety. This study highlights an innovative approach in New York City that aims to enhance staff's ability to work more effectively with CSMN families. The results of these efforts are compelling, and include targeted training of child protective staff, the development of a comprehensive policy for working with CSMN families, and practice changes designed to ensure staff access to medical expertise. Drawing on interviews and focus groups with staff and experts in the field of CSMN, the study describes the challenges that all child welfare agencies face in their efforts to serve CSMN, and provides recommendations for how agencies can design viable policies to address those challenges.

Outpatient treatment of children with severe pneumonia with oral amoxicillin in four countries: the MASS study

A recent randomized clinical trial demonstrated home-based treatment of WHO-defined severe pneumonia with oral amoxicillin was equivalent to hospital-based therapy and parenteral antibiotics. We aimed to determine whether this finding is generalizable across four countries. Multicentre observational study in Bangladesh, Egypt, Ghana and Vietnam between November 2005 and May 2008. Children aged 3-59 months with WHO-defined severe pneumonia were enrolled at participating health centres and managed at home with oral amoxicillin (80-90 mg/kg per day) for 5 days. Children were followed up at home on days 1, 2, 3 and 6 and at a facility on day 14 to look for cumulative treatment failure through day 6 and relapse between days 6 and 14. Of 6582 children screened, 873 were included, of whom 823 had an outcome ascertained. There was substantial variation in presenting characteristics by site. Bangladesh and Ghana had fever (97%) as a more common symptom than Egypt (74%) and Vietnam (66%), while in Vietnam, audible wheeze was more common (49%) than at other sites (range 2-16%). Treatment failure by day 6 was 9.2% (95% CI: 7.3-11.2%) across all sites, varying from 6.4% (95% CI: 3.1-9.8%) in Ghana to 13.2% (95% CI: 8.4-18.0%) in Vietnam; 2.7% (95% CI: 1.5-3.9%) of the 733 children well on day 6 relapsed by day 14. The most common causes of treatment failure were persistence of lower chest wall indrawing (LCI) at day 6 (3.8%; 95% CI: 2.6-5.2%), abnormally sleepy or difficult to wake (1.3%; 95% CI: 0.7-2.3%) and central cyanosis (1.3%; 95% CI: 0.7-2.3%). All children survived and only one adverse drug reaction occurred. Treatment failure was more frequent in young infants and those presenting with rapid respiratory rates. Clinical treatment failure and adverse event rates among children with severe pneumonia treated at home with oral amoxicillin did not substantially differ across geographic areas. Thus, home-based therapy of severe pneumonia can be applied to a wide variety of settings.

Outcomes of Case Management for African-American Men in Batterer Counseling

Case management for additional referrals has been recommended especially for African-American men in batterer counseling programs. Additional services addressing “at risk” needs may help to improve batterer program outcomes. To test this expectation, a quasi-experimental evaluation of a case management project was conducted for both “intention-to-treat” and “received-treatment.” The case management included brief assessment at batterer program intake, referral to relevant services, and follow-up calls from batterer program staff. Re-assault and re-arrests during a 12-month follow-up, along with program dropout from the 16 required sessions of the batterer program, were compared for 202 African-American program participants under case management and a sample of 482 African-American participants previously in the batterer program. In both bivariate and confirmatory multivariate analyses, neither the case management nor actual service contact significantly improved outcomes. However, the small portion of men contacting drug and alcohol treatment did tend toward better program outcomes. Poor implementation of the case management procedures may have contributed to the overall weak effects.

Judicial Management of Patent Claim Construction

Patent litigation has gained increased Supreme Court and Congressional attention in recent years. Concern over the Court of Appeals for the Federal Circuit's frequent reversal of district court patent claim constructions has sparked critical commentary and proposed legislation intended to address the high reversal rate. Recently, several groups have issued recommendations for federal district court judges on how best to manage claim construction, minimize the likelihood of reversal, and reduce the costs of litigation. This paper presents the results of a survey of federal district court judges. The survey assessed the case management and claim construction procedures currently used by these judges. We compare the judges' reported practices with the recommendations contained in four recent sources: the Federal Judicial Center's Manual for Complex Litigation (Fourth Edition) (MCL), the Patent Litigation Committee of the American Intellectual Property Law Association's 2004 Report (AIPLA Report), the guidelines issued by the Federal Circuit Bar Association in 2005 (FCBA Report), and the public comment draft of the Report on the Markman Process released by the Sedona Conference in 2006 (Sedona Conference Report). In general, the surveyed judges' reported practices are consistent with these sources' recommendations. When judges' strategies differ from the sources' guidelines, the differences are not extreme. The survey assessed the practices of judges who are both relatively and with patent litigation and claim construction, and judges in these two groups tended to give similar answers. The few times more experienced and less experienced judges' answers differed are noted in the text.

A Pilot Study of a Case Management Program for Patients With Chronic Obstructive Pulmonary Disease (COPD)

The purpose of this study was to develop a case management program for patients with chronic obstructive pulmonary disease (COPD) and to test the effects of the developed program on patient length of stay in the hospital, medical costs, disease knowledge and level of satisfaction with nursing care received. This quasi-experimental study focused on a group of 50 COPD patients (24 in the control group and 26 in the experimental one), all treated in one hospital medical ward in northern Taiwan. The control group received routine care, while those in the experimental group received a COPD case management protocol. Data for the control group was collected between September of 2003 and January 2004. Data for the experimental group was collected between April and December 2004. Data collection instruments included medical records, the COPD Knowledge Measurement scale, and the Patient Satisfaction with Nursing Care Questionnaire. Descriptive and inferential statistical analyses were applied to describe demographics, length of stay, medical cost, patient disease-related knowledge, and patient satisfaction with nursing care. Results indicated that, while the study found no significant difference in length of stay and medical cost between the two groups, the use of case management procedures improved patient disease-related knowledge and satisfaction with nursing care. This conclusion supports the premise that case management improves patient care in these two dimensions and is, thus, an effective approach in the management of patients diagnosed with secondary COPD infections.

Evaluation of Michigan's Foster Care Case Management System

Objective: In 1997, Michigan's Family Independence Agency piloted casemanagement procedures designed to expedite permanency and improve services to children in foster care. Method: A 3-year evaluation examined outcomes in nine pilot and nine comparison counties to determine if children in the pilot counties achieved permanency, either returned home or another permanent arrangement, more rapidly than those in the comparison counties. Preceding implementation, pilot and comparison counties employed the same case management procedures and had similar records of achieving permanency for children entering foster care. Results: After implementation, pilot counties attained permanency for a significantly greater proportion of children entering foster care than did comparison counties. This difference was observed for subgroups defined by child ethnicity, initial placement type, and child age, although the differences were not always significant. Conclusion: Pilot counties were more likely to reunify children postimplementation than were comparison counties, and these children were no more likely to reenter foster care.

Prospective Molecular Epidemiological Study on Transmission of Pulmonary Tuberculosis and Migration (MuT Study)

In Western Europe prevalence and incidence of tuberculosis in the indigenous population is declining and TB in migrants from high prevalence countries is becoming a major issue of TB control. Resulting changes in transmission patterns need to be investigated to adapt control strategies. The MuT (Migration and Tuberculosis) study a co-operation among federal and local public health services (ODG), the National Surveillance Center (RKI) and the University has been established in Baden-Wuerttemberg to address these issues. The goal of this ongoing study is to determine the transmission dynamics of TB in Baden-Wuerttemberg. Here, we present the first set of data on TB cases and their contacts and discuss strategies to overcome arising difficulties. Prospective data collection of culture positive pulmonary tuberculosis cases and their contacts. Analysis of (1) routine data, (2) spatial data, (3) social interaction data, (4) molecular typing data, and (5) observational data of the implementation phase. The study demonstrates the capability of the study consortium to identify clusters. It provides valuable insights into current case detection and case management procedures and shows ways to improve. A set of factors has been identified that (a) facilitate and (b) discourage study participation. Collaboration among federal and local public health services (OGD), National Surveillance Center (RKI) and the University is a promising approach to investigate and improve TB control. This model has potentials for other infectious disease control.

Tuberculosis Skin Test Conversion Rates Evaluated at an Overseas Military Hospital

As a result of a perceived increase in purified protein derivative skin test converters, purified protein derivative skin testing of hospital staff and epidemiological evaluation were undertaken. A possible common source of tuberculosis exposure was identified and evaluated. This patient was skin test positive but never provided prophylactic treatment in Spain, and normal case management procedures failed. The Andalusia region, where the naval base is located, has a reported rate of about 15 new tuberculosis cases per 100,000 persons per year, whereas the rate for the entire country of Spain is 22 per 100,000 persons. More than half of the new cases of tuberculosis reported in Spain come from this region. As a result of this work, improved personal prevention programs were instituted and hospital and base orientation regarding the unique risk of tuberculosis in this region was improved.

Analgesia

Critical to reducing patient morbidity as well as heightened ethical awareness, alleviation of pain in animals has become integral to medical case management and surgical procedures. Pharmacotherapy is directed at peripheral nociceptors, primary and secondary spinal neurons, and pain-processing areas in the CNS. Accordingly, three primary pharmacologic strategies have evolved: drugs that bind to and activate opioid receptors, drugs that bind to and activate alpha 2 receptors, and drugs that reduce de novo prostaglandin synthesis. In horses, the two predominant types of pain encountered are musculoskeletal and visceral pain. Several factors must be considered when devising a therapeutic strategy, including the etiology of the painful event, desired duration of therapy (acute vs chronic), desire for sedation, and potential side effects and toxicity. Opioids and alpha 2 agonists are particularly effective for visceral pain associated with colic. Butorphanol remains the only commercially available opioid and provides superior visceral analgesia compared with pentazocine or flunixin meglumine but not compared with the alpha 2 agonists. The behavioral changes such the sedative effects of alpha 2 agonists and the increased locomotion and CNS excitability seen with some opioids are important considerations when these agents are used as analgesics. NSAIDs may be considered for visceral pain therapy also, especially pain associated with an inflammatory component or endotoxemia. In particular, flunixin meglumine and ketoprofen provide prolonged analgesia and suppress the effects of endotoxin. Long-term therapy of musculoskeletal diseases usually necessitates chronic NSAID use. Although many NSAIDs are now available in approved equine formulations, there remain some important differences among NSAIDs for the practitioner to consider when choosing an analgesic. NSAIDs differ in their ability to ameliorate pyrexia, affect platelet function, alleviate pain, and reduce inflammation. For ease of administration, those available for oral use include phenylbutazone, meclofenamic acid, flunixin meglumine, and naproxen. All are potentially ulcerogenic, and poor tolerance to one may necessitate switching to another with a better toleration profile or to drug from a different analgesic class.