Americans are increasingly turning to hospice services to provide them with medical care, pain management, and emotional support at the end of life. The increase in the rates of hospice utilization is explained by a number of factors including a "hospice movement" dating to the 1970s which emphasized hospice as a tool to promote dignity for the terminally ill; coverage of hospice services by Me...

BACKGROUND As a result of the ageing population, there is an urgent need for innovation in community health-care in order to achieve sustainability. Reablement is implemented in primary care in some Western countries to help meet these challenges. However, evidence to support the use of such home-based rehabilitation is limited. Reablement focuses on early, time-intensive, multidisciplinary, mu...

CONTEXT Emergency department utilization by chronically ill older adults may be an important sentinel event signifying a breakdown in care coordination. A primary care group visit (i.e., several patients meeting together with the provider at the same time) may reduce fragmentation of care and subsequent emergency department utilization. OBJECTIVE To determine whether primary care group visits...

STUDY OBJECTIVE The aim of the study was to investigate the relationship between the state of health in childhood and ill health in early adult life. DESIGN The study used data collected as part of the National Child Development Study and related health at 7 years of age to that at 23. A wide range of information on child health in the cohort was available, which was used to construct a broad...

The 2008 presidential election in the United States has again elevated the issue of health care reform to center stage. Reform proposals are proliferating in the states as well as nationally. Virtually all candidates – both Republican and Democratic – running for President have outlined their plans for reforming health care. The renewed interest in health care reform reflects the fact that seve...

Providing continuing patient care when healthcare infrastructure has been damaged or destroyed requires careful advanced planning. Substantial numbers of patients will seek medical care during a disaster, including those injured during the acute phase of the disaster, those injured in recovery and evacuation attempts, and the chronically ill who have been displaced and do not have access to the...

Many people who struggle with psychotic disorder often refuse offers of help, including housing, extended by mental health services. This article uses the ethnographic method to examine the reasons for such refusal among women who are homeless and psychiatrically ill in the institutional circuit in an urban area of Chicago. It concludes that such refusals arise not only from a lack of insight b...

Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeles...

Helping patients to change behaviour concemed with eating, drinking, smoking, exercise, or taking medication is a common task in medical consultations. In both hospital and primary care the care of chronically ill people often entails encouraging them to change behaviour. With the emphasis now placed on health promotion in primary care this activity has been given high priority.' 2 Yet health c...

BACKGROUND The Groningen Protocol aims at providing guidance in end-of-life decision-making for severely impaired newborns. Since its publication in 2005 many bioethicists and health care professionals have written articles in response. However, only very little is known about the opinion among the general population on this subject. The aim of this study was to present the general attitude tow...