Suchergebnisse

Cover -- Imprint -- Dedication -- Contents -- Foreword -- Who is this handbook written for? -- Acknowledgements -- Introduction -- Chapter 1: Defining a strengths approach -- Chapter 2: Values-based practice -- Chapter 3: Strengths-based principles -- Chapter 4: Personalisation -- Chapter 5: Recovery and a strengths approach -- Chapter 6: Positive theory and positive practice -- Chapter 7: Reviewing the evidence base -- Chapter 8: Strengths assessment -- Chapter 9: Strengths-based support planning -- Chapter 10: Care and support planning guidance -- Chapter 11: Supporting staff innovation -- Chapter 12: Team development -- Chapter 13: Funky Mental Health -- Chapter 14: Management and leadership -- Appendix 1: Working with strengths checklist -- Appendix 2: A 'strengths' leadership development programme -- Additional resources.

The voices of prisoners are seldom heard as contributors to the evaluation of imprisonment. Official discourse is hostile to their accounts. Prisoner autobiography is a small but established genre in prison writing. The article presents a critical introduction to the study of these texts. Two groups of authors are identified in a sample of post‐war British autobiographies. Several key themes are identified and it is argued that, although problematic, prisoner autobiography should receive more systematic attention as a contribution to the penological archive.

Canadians spend hundreds of millions of dollars per year on pharmaceutical research and development (R&D) through governments, charitable organizations,and private investment. While the pharmaceutical industry accounts for only 2% of the Canadian economy, it is responsible for more than 10% of all Canadian R&D; and although research in other sectors has decreased in recent years, pharmaceutical R&D continues to rise. From a public policy perspective, the hope is that this R&D will spur pharmaceutical innovation with benefits to population health and the economy. The degree to which these goals are both being realized, however, is the subject of increasing debate. This paper investigates the drivers of pharmaceutical R&D and re-examines how "innovations" from this sector are defined and promoted. Our aim is to reframe these issues and stimulate a new, balanced debate on pharmaceutical innovation. ; Medicine, Faculty of ; Population and Public Health (SPPH), School of ; Unreviewed ; Faculty ; Researcher

The Art of Co-ordinating Care offers a fresh approach to service delivery and co-ordinating care. The handbook encourages workers to think creatively and to apply this in their work with service users, particularly in delivering the Care Programme Approach (CPA). It is both a reference and resource, with practical tips and exercises for personal and team-working development. This is fundamentally a practical workbook, which has discussions about how to go about engagement, assessment and care or support planning and review, within a context of value-based and person-centred care and support

"Canadian governments, employers, unions, and patients currently spend more money on prescription drugs (about $20 billion in 2007) than is spent on all services provided by physicians in Canada. At the same time, prescription drug spending per capita varies by over 50% across provinces. Surprisingly little information is systematically collected to determine which drugs account for most of the spending in Canada, what factors drive interprovincial variations in spending, and whether population age is an important cause of spending variations across provinces and trends over time. The 2nd edition of The Canadian Rx Atlas significantly enhances our understanding of medicine use by providing the first-ever portrait of age-specific patterns of prescription drug use and costs across provinces. It breaks down nearly $20 billion in prescription drug spending (private and public) and provides a comprehensive portrait of the factors that drive trends over time and variations across provinces." -CHSPR website ; Applied Science, Faculty of ; Community and Regional Planning (SCARP), School of ; Non UBC ; Medicine, Faculty of ; Population and Public Health (SPPH), School of ; Unreviewed ; Faculty ; Researcher ; Graduate

Background: In 2003, the government of British Columbia, Canada introduced a universal drug benefit plan to cover drug costs that are high relative to household income. Residents were required to register in order to be eligible for the income-based benefits. Given past research suggesting that registration processes may pose an access barrier to certain subpopulations, we aimed to determine whether registration rates varied across small geographic areas that differed in ethnic composition. Methods: Using linked population-based administrative databases and census data, we conducted multivariate logistic regression analyses to determine whether the probability of registration for the public drug plan varied across areas of differing ethnic composition, controlling for household-level predisposing, enabling and needs factors. Results: The adjusted odds of registration did not differ across regions characterized by high concentrations (greater than 30%) of residents identifying as North American, British, French or other European. Households located in areas with concentrations of residents identifying as an Asian ethnicity had the highest odds of program registration: Chinese (OR = 1.21, CI: 1.19-1.23) and South Asian (OR = 1.19, CI: 1.16-1.22). Despite this positive finding, households residing in areas with relatively high concentrations of recent immigrants had slightly lower adjusted odds of registering for the program (OR = 0.97, CI: 0.95-0.98). Conclusions: This study identified ethnic variation in registration for a new public drug benefit program in British Columbia. However, unlike previous studies, the variation observed did not indicate that areas with high concentrations of certain ethnicities experienced disadvantages. Potential explanations are discussed. ; Nursing, School of ; Medicine, Faculty of ; Population and Public Health (SPPH), School of ; Applied Science, Faculty of ; Reviewed ; Faculty

Abstract Background In 2003, the government of British Columbia, Canada introduced a universal drug benefit plan to cover drug costs that are high relative to household income. Residents were required to register in order to be eligible for the income-based benefits. Given past research suggesting that registration processes may pose an access barrier to certain subpopulations, we aimed to determine whether registration rates varied across small geographic areas that differed in ethnic composition. Methods Using linked population-based administrative databases and census data, we conducted multivariate logistic regression analyses to determine whether the probability of registration for the public drug plan varied across areas of differing ethnic composition, controlling for household-level predisposing, enabling and needs factors. Results The adjusted odds of registration did not differ across regions characterized by high concentrations (greater than 30%) of residents identifying as North American, British, French or other European. Households located in areas with concentrations of residents identifying as an Asian ethnicity had the highest odds of program registration: Chinese (OR = 1.21, CI: 1.19-1.23) and South Asian (OR = 1.19, CI: 1.16-1.22). Despite this positive finding, households residing in areas with relatively high concentrations of recent immigrants had slightly lower adjusted odds of registering for the program (OR = 0.97, CI: 0.95-0.98). Conclusions This study identified ethnic variation in registration for a new public drug benefit program in British Columbia. However, unlike previous studies, the variation observed did not indicate that areas with high concentrations of certain ethnicities experienced disadvantages. Potential explanations are discussed.

IntroductionIdentifying strategies to prevent hospital readmissions remains elusive since the reasons for returning to hospital can include a number of interlinked patient, health provider and system level factors. The impact of patient medications are of significant interest since a large proportion of re-admissions are related to adverse drug events.
Objectives and ApproachThe objective was to determine which factors are associated with non-adherence to in-hospital medications and the impact of non-adherence on re-hospitalization, emergency department visits and death in the 30-days post discharge for patients admitted at two tertiary care academic hospitals in Montreal, Quebec between October 2014 and May 2016. Non-adherence to in-hospital changes was measured by comparing patient discharge prescriptions (patient chart) to medications filled in community 30-days post-discharge (dispensing data) and included i) community medications stopped in-hospital and filled post-discharge, ii) community medications modified in-hospital but not filled at the modified daily-dose, and iii) new medications not filled post-discharge.
ResultsAmong 2,895 included patients, mean age was 70 (SD 15) and 58% were males. A median of 4 in-hospital medication changes were made (IQR:3-6) and 54% of patients were non-adherent to at least one change. Multivariable Poisson models suggested that the most important factor associated with the number of new medications not filled post discharge was out of pocket cost; for each additional $10 increase in costs there was a 20% increase in the number of new medications not filled. Multivariable time-varying Cox models suggested that in patients who filled medications post-discharge, selective non-adherence to new and discontinued medications reduced the risk adverse health outcomes in 30-days, while not filling any medications post discharge more than doubled the risk of an adverse event in 30-days.
Conclusion/ImplicationsNot only did the majority of patients not follow all medication changes that were made during hospitalization, the extent to which this occurred significantly impacted the risk of hospital re-admissions and ED visits. Policy and patient level interventions should be developed specifically targeting barriers for adherence to medication changes.