using the narrative analysis approach. Results: 17 publications met the inclusion criteria (8 randomized controlled trials, 1 case-controlled trial, 6 qualitative and 2 economic evaluation studies of moderate to high quality), which represented 10 studies. Disease activity was the most common measure of effectiveness with NLC being superior (n= 3) or equal (n= 3) to comparator. Acceptability was assessed in 6 studies; patients were more (n= 4) or equally (n= 1) satisfied with NLC compared to single-provider care and less satisfied compared to team care (n= 1). NLC was found to be safe (n= 2), with no difference in blood tests and disease activity. With regard to efficiency, mixed data on cost of NLC was reported with NLC being equivalent or less costly than traditional models (n= 3). Quantitative measures of accessibility and appropriateness were not found. Although in qualitative studies patients found NLC provided improved continuity of care (n= 3) and education and support (n= 4). ConClusions: NLC for RA patients is effective, acceptable, and safe. More information regarding accessibility, appropriateness and efficiency of this model, including its cost-effectiveness and the impact on patient flow, is needed.
In Germany the assessment of needs for technical aids occurs widely unsystematic and without the possibility to verify the advice process. A systematic assessment of individual needs for technical aids that follows standardised indication criteria so far has not been paid much attention. Compared with this, the advice and supply measures in the Netherlands are increasingly based on a systematic and comprehensible analysis of the individual inquiry. This analysis is called "indication and selection advice" and is usually carried out by therapists. Under Dutch law, consultants can act rather independently of any commercial interest. The basics of the analysis derive from the ICIDH and theoretical models of occupational therapy. Besides an overview of the legislation on the supply with technical aids in the Netherlands, the procedure of needs assessment plus a specific instrument based on occupational therapy knowledge are presented. The realization of advice as a defined part of the supply process required a new definition of tasks for occupational therapists. The resulting changes in the comprehension of professional roles are briefly described, too. The results of this investigation regarding the practice of needs assessment in the Netherlands suggest that changes are also required in the German service delivery system and its legal basis. Because of their specific expert knowledge of indication and selection of suitable technical aids, a more extensive involvement of occupational therapists in this key process of measures of home adaptation and the supply with technical aids is recommended in Germany, too. The development of practicable, standardised instruments to assess individual needs is advisable because it will contribute to increased efficiency of the supply with technical aids.
Geographic Information System for Urban and Regional Planning. — This article describes the different stages in the development of a demonstration of a Geographic Information System (GIS) for urban and regional planning. It describes the background of the project, the problems encountered in the collection of data and the four 'modules' which constitute the demonstrator. The aim of the project was to show to planners the advantages that can be obtained from the utilisation of GIS and also to provide a basic tool for teaching the principles of GIS. The demonstrators were developed for the planning policy section of the Department of the Environment.
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