The need for primary medical care in the home will increase with a growing elderly and disabled population. The effectiveness of the service must be assessed in light of its relatively high costs. The aim of this study was to evaluate VNA HouseCalls of Greater Cleveland, Ohio during its first year of operations. The program targets high-risk older adults using teams of advanced practice nurses and physicians. The pilot evaluation focused on the attainment of identified program goals. Data collection techniques included clinical record review (N = 139), mailed referral source satisfaction survey, and both mailed and telephone interview patient satisfaction surveys. The results showed that the typical patient served by VNA HouseCalls was a homebound woman in advanced old age with regular family contact and both physical and mental disorders. When asked, the typical patient indicated that without the program she would not have received the care that she needed.VNA HouseCalls helped in preventing functional decline and reducing hospitalization. It received high satisfaction ratings from both referral sources and patients. Study findings suggest that primary care in the home bears further examination for addressing community need and affecting positive patient outcomes for high risk older adults.
Climate change and the future of energy has been a divisive, polarizing topic of conversation within Canada, but no more so than within Alberta. The Alberta Narratives Project (ANP) sought to address this challenge. Using intimate roundtable discussions, the ANP engaged with various Alberta stakeholder groups, including oil and gas workers, environmentalists, conservative voters, business leaders, and youth. The ANP undertook to understand and engage with participants’ values in order to facilitate open conversation among roundtable participants with the goal of finding effective narratives with which to discuss climate change within the various demographics as well as the broader community. At MacEwan University, researchers hosted a roundtable discussion for youth ages 18 to 28 to answer the question: how do youth in Alberta engage with the topic of climate change? Researchers found the youth group was receptive to government regulation, while being sceptical of absolutes and slogans. Youth valued government and corporate accountability along with the opinions of scientists on subjects like climate change. These findings are significant because they grant us insight into how we might approach climate change communication with this demographic in the future.
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