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The purpose of this paper is to consider mental health issues in children and adolescents with chronic illness or health conditions, including their treatment, and issues related to delivery of services.

A selective review of the literature was conducted to highlight significant mental health issues and their treatment in youth with various types of chronic illness.

A significant portion of youth experience mental health problems related to their chronic health conditions. While evidence-based treatments are available to address these problems, significant barriers exist that impede the delivery of psychological and behavioral interventions for many youth.

More controlled studies are needed to demonstrate the effectiveness and cost offset of delivering psychological and behavioral interventions for the population of youth with various types of chronic health conditions, particularly in clinical and community settings.

Policy reform can ensure that mental health issues are effectively addressed for children with chronic illness. Policy is needed that promotes integrated health care, whereby psychological and behavioral interventions are delivered in health care settings along with medical interventions to reduce barriers to care.

Significant numbers of children and adolescents have chronic health conditions and many experience mental health problems related to their conditions. While evidence-based treatments are available to address these problems, significant barriers impede the delivery of psychological and behavioral interventions for many youth. Health care policy promoting integrated health care to deliver psychological and behavioral interventions in health care settings along with medical interventions should reduce barriers to care and improve both physical and mental health outcomes for youth.

This research provides empirically‐based, detailed information on race as a determinant of the relationship between chronic illness/disability and assistive device use by elderly persons. The database is the 1994 wave of the National Long Term Care Survey. The important findings are: whites are more likely to use home modification devices and blacks are more likely to use portable devices; chronic conditions vary in their influence on the use of assistive devices; the joint presence of diabetes, heart conditions or hypertension with ADLs and IADLs motivates greater assistive device use; the relationships between chronic health conditions and assistive device use vary by race; for blacks, income has the largest impact on assistive device purchases; half of the racial differences in the probability of using assistive devices is explained by differences in sociodemographic characteristics and the rest is explained, in part, by discrimination.

To compare chronic health status, utilization of healthcare services and life satisfaction among immigrant women and their Canadian counterparts.

A secondary analysis of national data from the Canadian Community Health Survey (CCHS), 2015–2016 was conducted. The survey data included 109,659 cases. Given the research question, only female cases were selected, which resulted in a final sample of 52,560 cases. Data analysis was conducted using multiple methods, including logistic regression and linear regression.

Recent and established immigrant women were healthier than native-born Canadian women. While the Healthy Immigrant Effect (HIE) was evident among immigrant women, some characteristics related to ethnic origin and/or unhealthy dietary habits may deteriorate immigrant women's health in the long term. Immigrant women and non-immigrant women with chronic illnesses were both more likely to increase their use of the healthcare system. Notably, the present study did not find evidence that immigrant women under-utilized Canada's healthcare system. However, the findings showed that chronic health issues were more likely to decrease women's life satisfaction.

This analysis contributes to the understanding of immigrant women's acculturation by comparing types of chronic illnesses, healthcare visits, and life satisfaction between immigrant women and their Canadian counterparts.

Only 55% of patients receive recommended care, with little difference found between care recommended for prevention, to address acute episodes, or to treat chronic conditions (McGlynn et al, 2003). The lag time between the discovery of more effective forms of medical treatment and their incorporation into routine patient care averages seventeen (17) years (IOM). Computerized provider order entry (CPOE) has been widely documented as a necessary tool to reduce preventable medication and other related errors but only 7.4% of acute care hospitals in the United States utilize CPOE with appropriate rules and evidence (HIMSS Analytics). The most fundamental building block for CPOE is the evidence based order set, but complexities associated with creating, managing and updating order sets have introduced major obstacles to CPOE implementation efforts. Chronic conditions such as heart disease, diabetes or arthritis affect more than 130 million Americans directly, and account for 7 in 10 deaths. Further, these chronic conditions consume 75% of all healthcare spending, and account for nearly two-thirds of the growth in health spending over the past 20 years -costing the U. S. economy $1 trillion annually (Almanac of Chronic Conditions, 2008 Edition). Estimates suggest the average patient upon hospitalization has 2.75 diagnoses - meaning "appropriate care" must span and synthesize multiple morbidity-specific best practices to effectively administer care to that "average" patient. The traditional approach to treating patients with evidence based protocols requires a physician to perform an ad hoc exercise of "mental merging" - reconciling duplicate candidate orders across multiple order sets to treat a patient with co-morbidities (today's norm). A more clinically effective, productive, and patient safety-centric alternative is to employ a proprietary software merging algorithm. These advanced algorithms remove duplicate orders, resolve conflicts, completes validation of the appropriate medical evidence and organizes the resulting merged order set so the physician can succinctly address the patients' often complicated treatment by focusing on the unique combination of labs, medications, etc. appropriate for the specific presenting conditions. This article describes a patent-pending propriety method of algorithmically merging multiple independent order sets for patients with co-morbid and chronic conditions into a single, maintenance free and evidence-based order set that can be immediately implemented into physician workflow to satisfy "Meaningful Use" guidelines for incremental provider reimbursement based on the American Recovery and Reinvestment Act (ARRA) legislation.

The decision to disclose an illness is a difficult choice for many individuals. Despite national laws such Americans with Disabilities Act that protect workers with disabilities from discrimination in the workplace, the stigmas around certain illnesses, fears of being judged by others using different standards, and concerns about a lack of support regardless of legal requirements are all reasons why someone may hesitate to disclose a health condition in the workplace.

Using experimentally manipulated vignettes and a combination of theories on attribution and incivility, this study explores the dangers of not disclosing a disability/condition that can lead to behaviors that will engender judgments by coworkers.

The results of the study make clear that there are social benefits to disclosing a health condition rather than concealing. The findings clearly demonstrate that attributing an individual's negative behavior to their disposition will lead to more judgments of responsibility, and less sympathy and more anger compared to behaviors that can be explained by any health reason. Furthermore, more punishment, feelings of revenge and social distancing await individuals whose negative behavior cannot be explained by health issues.

This study combines issues of health, attributions, incivility in an experimental studies that illuminates issues surround disclosing a workplace disability that go beyond the typical focus of legal questions.

Several trends such as improved access to health care information via the internet, the growth of self‐help groups and expenditure on alternative medicine signals consumers are taking an active role in their own health management. Chronic illnesses such as diabetes and asthma require a significant amount of self‐management and thus call for a collaborative patient‐physician relationship. This study explores whether empowering patient‐physician consultations measured through three patient empowerment dimensions (patient control, patient participation, physician support) enhance patients trust in and commitment to their physician.

A comprehensive mail survey of adults registered with one of four different chronic illness associations in Australia was conducted to collect the data.

The structural equation modelling results show that patients are more trusting of and committed to physicians who adopt an empowering communication style with them.

This study focuses on the Australian healthcare context. Thus, future multinational studies should explore suitable strategies to empower healthcare consumers that build on the constraints placed by diverse healthcare systems.

In a managed health care and cost cutting climate where patient trust is deteriorating, these findings suggest that empowering patients presents a means to improve the patient‐physician relationship.

Whilst numerous marketing scholars have researched the empowerment of staff, there is a shortage of studies that address the meaning and outcomes of consumer empowerment. This study proposes a unique communication based consumer empowerment construct which is shown to impact on consumer‐service provider relationships.

This is a report on a recent development of an innovative coordinated care solution named the Care Coordination Centre (CCC), which targets coordinated care arrangements for a populations expected to benefit the most. The purpose of this paper is to identify the patients who might comprise this group, and to assess the best ways to meet their health, community, and social care needs before and after introducing the coordinated care solution across care settings.

This is a summary of the author’s experience in the design and development of a care coordination business model for US providers and UK Clinical Commissioning Groups (CCGs) using coordinated care not only as a cost-cutting tool, but as a mechanism for creating a flexible and responsive patient-centered care. The author makes an assessment of the economic benefits of coordinated care resulting from: the shift to less costly interventions; reduction in readmissions; reduced unplanned admissions; increased time allocation efficiency of healthcare staff; and the overall reduction in per-patient costs.

The health and social care systems in the USA and the UK are facing the biggest challenges in their history. Payers, providers, governments, and communities need to work to build better coordination and integration mechanisms to manage the increasing demand on health and social care in a period of stagnant health and social care budgets. New innovative models of coordinated care have been developed in both countries, at the local economy level, as the health service systems are undergoing crucial transformation from a supply to a demand-based model. In the UK, the Trafford CCG has commissioned a new CCC, responsible for the delivery of high-quality coordinated care. The CCC is designed to function at clinical, service, and community levels across multiple providers to cover, among other tasks, chronic condition patient case management, risk stratification of preventative, elective, and unscheduled care for the whole region.

Insights from the work with Trafford CCG would be of considerable methodological and practical interest to researchers, policy makers, commissioners, healthcare professionals, and innovators.

The purpose of this paper is to outline a conceptual plan for innovative, integrated care designed for people living with long-term conditions (LTCs).

The conceptual plan delivers a partnership between the health system, the person with LTCs (chronic), their family, and the community. The partnership aims to support people at home with access to effective treatment, consistent with the New Zealand Government Health Strategy. This concept of people-owned care is provided by nurses with advanced practice skills, who coordinate care across services, locations and multiple LTCs.

With the global increase in numbers of people with multiple chronic conditions, health services are challenged to deliver good outcomes and experience. This model aims to demonstrate the effective use of healthcare resources by supporting people living with a chronic condition, to increase their self-efficacy and resilience in accordance with personal, cultural and social circumstance. The aim is to have a model of care that is replicable and transferable across a range of health services.

People living with chronic conditions can be empowered to manage their health and well-being, whilst having access to nurse-led care appropriate to individual needs.

Although there are examples of case management and nurse-led coordination, this model is novel in that it combines a liaison nursing role that works in partnership with patients, whilst ensuring that care across a number of primary and secondary care services is truly integrated and not simply interfaced.

Despite having inadequate resources, highly impoverished patients tend to seek and share health information over social media groups to improve each other’s well-being. This study aims to focus on access to health-care information for such patients and aims to provide an understanding of how online health-care communities (OHCs), as transformative service mediators, can be platforms for patients with chronic and nonchronic health conditions to share their experiences in a base-of-the-pyramid (BOP) context.

A large-scale survey among 658 respondents was conducted in a very low-income country. Structural equation modeling was used to test the hypotheses.

A model of patients’ experience sharing (PES), motivations and consequences for health-care services are introduced and tested. The result supports the PES model for patients with chronic health conditions, showing that utilitarian, hedonic and social value dimensions directly influence PES and indirectly influence patients’ continuance intention with OHCs and patient efforts. However, a mediating effect of PES was found only between the value dimensions and patients’ efforts. A negative moderation effect of medical mistrust was found in the relationship between utilitarian value and PES for both chronic and nonchronic patient groups.

This study is a pioneering attempt to develop and test a PES model in a BOP market.

Engaging people from lower socio‐economic backgrounds in self‐management of their chronic disease(s) presents particular challenges (Walker & Peterson, 2003). A demonstration project (HealthPartners) targeting such clients with diabetes and/or cardiovascular disease, plus one or more co‐existing conditions and aged 50 years or older, has recently been co‐ordinated by the Canning Division of General Practice in Western Australia. Six new interventions for clients were developed, including one‐to‐one facilitation. Where the latter occurred, a key aspect of client management and commitment adopted by HealthPartners was joint preparation of action plans by client and facilitator. Such action plans covered issues identified, stage of change, goals, actions and progress (the extent to which actions specified in a previous plan had been carried out by the time the plan was revisited). The paper provides an overview of the action‐planning process and its outcomes, and the results of an impact assessment of the programme as a whole. To be effective in changing behaviour, it appears important for many clients to participate in a group with peers in a relevant activity.