Background: The organization of leg ulcer care is poorly defined in the community. This study assessed the overall influence of a specialized community service on management and outcome of chronic leg ulcers, irrespec...
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Background: The organization of leg ulcer care is poorly defined in the community. This study assessed the overall influence of a specialized community service on management and outcome of chronic leg ulcers, irrespective of aetiology. Methods: Assessment and outcome of ulcers were compared in patient samples (n = 200) from East and West Gloucestershire, before and after the introduction of specialized clinics into East Gloucestershire, In clinics, vascular disease was routinely assessed by duplex scanning and determination of the ankle:brachial pressure index. Results: There was no coordinated community structure for the care of patients with leg ulcers before the service was introduced, and 74 and 67 per cent of limbs in East and West Gloucestershire respectively had aetiology undiagnosed. After introduction of the clinics, the 12-week healing rate increased from 12 to 22 per cent in East Gloucestershire (P = 0.05) and to 47 per cent in the specialized East Gloucestershire clinics (P < 0.001). The 12-month recurrence rate decreased from 50 to 41 per cent in East Gloucestershire and to 17 per cent in the East clinics (P < 0.001). The West Gloucestershire control showed no significant changes. Conclusion: A specialized leg ulcer service with defined protocols provides an improved management structure for treating patients with leg ulcers in the community. Accurate diagnosis of chronic leg ulcers and improved outcome may be achieved within this specialized service.
The harmful effects of alcohol and other drug abuse are widespread. Our health care, social service, education and legal systems are strained under the impact of substance abuse, not to mention the economic costs asso...
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The harmful effects of alcohol and other drug abuse are widespread. Our health care, social service, education and legal systems are strained under the impact of substance abuse, not to mention the economic costs associated with substance abuse. Consequently, effective strategies which prevent substance abuse must be identified and replicated. Yet, user-friendly and cost-effective evaluation tools for community-based substance abuse prevention programs are rare, A recently developed tool that has promise to overcome some of the barriers which exist when evaluating prevention programs is 'Results Mapping'. Results Mapping documents and aims to quantify the contributions of a program to future outcomes of its target population with the intention of making data meaningful at the program and funding agency level. This case study was conducted to assess the feasibility of implementing the Results Mapping evaluation tool for community-based prevention programs. The study assessed qualitatively how well Results Mapping worked for one community-based substance abuse prevention program, as well as how much time and funding it took to implement this new tool. Results suggested that Results Mapping may be a valuable documentation, planning and learning tool, but funding agencies should be cautious about using Results Mapping scores to determine funding allocations.
Since 1994, health policy in the UK has focused explicitly on making the NHS 'primary care-led'. However, the meaning of primary is contested by different health professions and by policy-makers. This paper ch...
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Since 1994, health policy in the UK has focused explicitly on making the NHS 'primary care-led'. However, the meaning of primary is contested by different health professions and by policy-makers. This paper charts the major points of debate since the 1960s and suggests that there are limitations as to what general practice can be expected to deliver in respect of primary care. (C) 1998 John Wiley & Sons, Ltd.
Explores the concept of truth and power in relation to the United States' health policy. Information on community-oriented primary care (COPC) and small area analysis (SAA); Emergence of COPC and SAA as attractive...
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Explores the concept of truth and power in relation to the United States' health policy. Information on community-oriented primary care (COPC) and small area analysis (SAA); Emergence of COPC and SAA as attractive methodological solutions to major health problems; Examination of truth and power in COPC and SAA.
In response to concerns about the adequate provision of long term care, the National Long Term Care Channeling Demonstration has been funded by the Department of Health and Human Services. The project is designed to p...
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Bioethical discussion of justice in health care has been much enlivened in recent years by new developments in the theory of rationing and by the emergence of a strong communitarian voice. Unfortunately, these develop...
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Bioethical discussion of justice in health care has been much enlivened in recent years by new developments in the theory of rationing and by the emergence of a strong communitarian voice. Unfortunately, these developments have not enjoyed much in the way of close engagement with feminist-inspired reflections on power, privilege, and justice. I hope here to promote interchange between ''mainstream'' treatments of justice in health care and feminist thought.
ABSTRACT: Professionals concerned with rural health issues sometimes overlook the possibilities that the Cooperative Extension Services (CES) hold for addressing rural health problems. Joint venturing between health c...
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