Stable Clients Research Articles

A comparison of a hospital-based and two home-based rehabilitation programmes

Purpose. This paper compares the service models of three different types of rehabilitation programmes provided in Victoria, Australia: One hospital-based and two types of rehabilitation in the home (RITH).Method. Nine focus group interviews were conducted with multidisciplinary staff working in rehabilitation teams in one hospital-based and eight RITH programmes. Additional data were collected for 164 clients and 75 carers from eight of these programmes at admission, discharge and three months post discharge. Interviews were conducted with 32 clients and 14 carers.Results. The criteria for admission and model of rehabilitation adopted in the three programmes were similar. There were differences in programme aims, characteristics of the clients admitted and the type and level of therapy clients received, both between hospital and home-based programmes and between the three programmes. In general, staff and clients saw the home as providing a relevant context that enabled individualized, goal directed therapy for medically stable rehabilitation clients. The hospital offered an opportunity to socialize with others and specialized equipment.Conclusions. Results of this study suggest clients and carers require a mix of hospital and home-based rehabilitation that is able to respond to their needs and preferences at each phase of the rehabilitation continuum.

PMSS 시스템에서 서버/클라이언트 간 서비스 모델의 성능분석

본 논문은 단일 주문형 비디오 환경에서의 서버/클라이언트 미디어 서비스 모델을 분석하고 이를 병렬 주문형 비디오 환경에 적용함으로써 보다 나른 사용자 QoS(Quality of Service)를 제공하고자 한다. 미디어 서비스 모델로는 클라이언트가 데이터를 요청하고 서버가 전달해주는 Client Pull 모델과 서버 측에서 일방적으로 데이터를 전달해 주는 Server Push 모델 그리고 두 모델을 통합한 IPP(Interleaving Pull & Push) 서비스 모델로 크게 나뉜다. 병렬 주문형 비디오 환경을 위해 병렬형 미디어 스트리밍 서비스, 즉 단일 클라이언트를 위해 다수의 서버들이 동시에 서버에 참여하는 PMSS(Parallel Media Streaming Service) 시스템을 구축하였으며, 단일/병렬 주문형 비디오 환경에서 네트워크상 전달지연과 클라이언트 버퍼 내 데이터 잔여량 인자를 통하여 각 서비스 모델간 성능을 비교 분석하였다. 실험을 통해 병렬 주문형 비디오 환경에서 IPP 서비스 모델이 가장 적은 전달지연과 안정적인 클라이언트 버퍼를 유지함을 알 수 있었다. 이를 통해 사용자에게 보다 나은 서비스를 제공할 수 있음을 확인하였다 This paper provides the higher user QoS(Quality of Service) by analyzing media service model between server and client in single VoD(Video on Demand) environment and applying it to parallel VoD environment. Media service model is divided into the Client Pull, Server Push, and IPP(Interleaving Pull & Push) model. A server sends data based on client's request in the Client Pull Model. A server one-sidedly sends data without client's request in the Server Pull model. And the WP model unites above two models. For a parallel VoD environment, We built the PMSS system which provides the parallel media streaming services that one client is simultaneously served by several servers. In the single and parallel VoD environment, We compare and analyze the performance of service models with respect to network delay and data size in buffer. In this experiment, we found that IPP service model keeps the least network delay and stable client buffer in the parallel VoD environment. This result shows that PMSS can provide the more quality of service.

The Canadian Occupational Performance Measure: Is it a Reliable Measure in Clients with Chronic Obstructive Pulmonary Disease?

The Canadian Occupational Performance Measure (COPM) is now a widely used and accepted outcome measure for clients with chronic conditions. The aim of this study was to examine the reproducibility of the COPM in clients with chronic obstructive pulmonary disease (COPD). Test-retest reliability of the performance and satisfaction scores has yet to be established in this population. The reasons for examining reliability are discussed. Fifteen clinically stable clients (eight men and seven women, mean age 67.1 years) were interviewed by an occupational therapist and their COPM performance and satisfaction scores recorded. A reassessment of the performance and satisfaction scores then took place about 7 days later. The scores were analysed using the mean difference, 95% confidence intervals and correlation coefficients. The results were as follows: performance score 1 and performance score 2: mean difference = 0.14 (95% CI: −0.39 to 0.68); and satisfaction score 1 and satisfaction score 2: mean difference = 0.42 (95% CI: −0.18 to 1.01). The intraclass correlation coefficients between test 1 and test 2 were high (r = 0.92 for performance and r = 0.90 for satisfaction). This study indicates that the COPM is a reliable tool in clients with COPD.

An innovative approach to reducing cannabis use in a subset of methadone maintenance clients

Cannabis use rates among methadone maintenance clients are high. We attempted to decrease cannabis use in our most stable clients by adding a requirement to the take home dose policy that clients provide cannabis free urines to achieve twice a week pick up status (2×/week). The urine records and take home status of all clients were monitored for the 6 months prior to implementation of the policy change and 1 year following. A total of four of eight clients (50%) on 2×/week status who were using cannabis discontinued their use in order to maintain 2×/week status or to return to 2×/week status if it had been lost.

'Free to be' peer group supports patients with MPD/DD.

1. During the last decade, dissociative identity disorder increasingly has been recognized as a relatively common post-traumatic syndrome. 2. Individuals with MPD/DD often are estranged from abusive families and have difficulty with social connection; an urgent therapeutic task is the re-creation of a sense of human interdependency and community. 3. Group therapy can be a useful and successful adjunct to individual psychotherapy for relatively stable clients with MPD/DD; the group's focus should be here-and-now, supportive, and psychoeducative in nature.

Analysis of an addictions treatment system

A treatment system consisting of an assessment/referral service, a detox, a mission, a hospital recovery unit, and three recovery homes was examined using a retrospective client-tracking approach over 1 year. There were 4,187 admissions to the system accounted for by 1,522 individuals; system users tended to be males, unmarried, unemployed, and in their 30s and 40s. The best predictor of readmission to the system after treatment was prior system use. Use patterns and referral data indicated that perceived gatekeepers (i.e., detoxication and assessment services) were not consistently coordinating the system and that more socially stable clients appeared to be more likely to be involved with non-addiction specific services (i.e., medical, general counselling).