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Kaiser Permanente Project Proves Electronic Health Information And Care Coordination Improve Chronic Disease Management
Specialty care physicians can improve the health of high-risk patients by reviewing electronic health records and proactively providing e-consultations and treatment plan recommendations with primary care physicians, according to a Kaiser Permanente paper published online in the British Medical Journal.
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Spike In Australian H1N1 Cases Could Lead WHO To Declare Pandemic
The H1N1 (swine flu) outbreak could soon be declared the first flu pandemic in 41 years after a recent jump in the number of confirmed cases in Australia, WHO officials said Tuesday, the AP/Google.com reports (Jordans, AP/Google.com, 6/9).
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NYT Editorial Urges Gov. Paterson To Sign Bill Prohibiting Shackling Of Female Prisoners During Labor
New York Gov. David Paterson (D) should sign a bill prohibiting the "barbaric and medically hazardous practice of shackling female prisoners during labor," a New York Times editorial states. Along with "further frightening these vulnerable women, the practice of chaining their legs, wrists and even their abdomens" during labor "makes treatment and delivery more difficult and places mother and child at greater risk of harm," according to the Times. It adds that five states have similar policies in place. The American College of Obstetricians and Gynecologists several years ago called for an end to shackling during labor, and the Federal Bureau of Prisons last fall "ended the routine use of restraints for women in labor and limited shackling to cases in which a woman presents a danger to herself, the baby or the staff," the editorial states.The New York measure, which is "[m]odeled on federal prison policy and laws in other states, … would prohibit women from being shackled while being taken to the hospital for a delivery," although an inmate "could be cuffed by one wrist in cases in which she presented a danger to herself, hospital staff or corrections workers," the editorial states. However, "it seems highly unlikely that a woman doubled over in labor pains would be able to attempt an escape or overcome corrections officers," it notes.The bill "has caused a debate about how many pregnant women are actually shackled in New York," but "recent interviews of female inmates by the Correctional Association of New York … sugges[t] that the practice may be more common than corrections officials know," the editorial continues. "In any case, the bill would put an end to it, by establishing clear guidelines that carry the authority of law," according to the editorial. It adds that Paterson "should make it clear whether he thinks the measure needs minor changes or clarifications." The editorial concludes, "Otherwise, he should sign the bill into law" and "bring New York into line" with the federal government and other states "that have wisely acted to protect pregnant inmates and their children during labor" (New York Times, 7/21).
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Support Grows For New Home Based Service For Challenging Mental Patients

A new national service which will provide comprehensive care and support for challenging mental health patients in their own homes following discharge from hospital is being welcomed by lead clinicians and patient advocates. Vicky Wadsworth, head of the mental health department at Roebucks solicitors in Blackburn, which acts on behalf of hundreds of patients, said: "There is a huge gap in care provision that this service can help fill. Health service outreach teams are desperately overstretched and cannot provide the sustained intensive treatment and rehabilitation support that many patients require. In some cases, this means that patients can"t be moved on into the community and so remain confined in secure facilities unnecessarily." Dr Christopher Findlay, a leading community psychiatrist working in Runcorn, said: "There are limits to what Community Mental Health Teams can provide. There are also limited in-patient beds. Any service that offers to work alongside established NHS services to provide intensive safe alternatives to in-patient care is to be welcomed, particularly those that are individually tailored and committed to improved outcomes and the safe social inclusion of patients with mental health difficulties. Working alongside and not replacing existing services is an advantage for responsible clinicians who hope to establish a long term relationship through the journey towards recovery." The service from Gray Healthcare provides sustained support for people who may or may not have been sectioned under the Mental Health Act but who typically have a history of admission, medication and treatment, discharge and re-admission. The service is designed to build self esteem and independence. Patients will be helped to obtain their own tenancy and will then benefit from appropriate support provided by a multidisciplinary team including psychiatric nursing, occupational therapy and psychological services. The majority of patients being referred to the new service are those being considered for discharge from hospital by their responsible clinician under a Community Treatment Order (CTO). This means that the Gray Healthcare clinical team will work closely with NHS staff to create a bespoke care, support and treatment package, tailored to meet the needs and safety of the individual. Jonathan Gray, Chief Executive of Gray Healthcare says: "The Mental Health Act requires us to care for people in the least restrictive environment that is possible and our aim is to help those who have suffered mental illness move from a secure hospital/rehabilitation setting into their own homes with the full range of support necessary to do this safely and successfully. Our goal is a safe and sustainable return to living in the community." Gray Healthcare


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