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1

Texas. Statewide Health Coordinating Council. Regionalization of specialized medical services: Task force report. [Austin]: Texas Statewide Health Coordinating Council, 1986.

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2

Services, Massachusetts Dept of Social. P.A.C.T. : parents and children together: A specialized foster care pilot project. Mass: The Dept., 1986.

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3

Spiritual care for children living in specialized settings: Breathing underwater. New York: Haworth Pastoral Press, 2000.

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4

Shelton, Terri L. Family-centered care for children needing specialized health and developmental services. 3rd ed. Bethesda, Md: Association for the Care of Children's Health, 1994.

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5

Knowles, Caroline. Psychiatric care in non-specialized community settings: A study of ethnicity and social marginality. [Québec: Quebecois de la recherche social?, 1998.

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6

Hakala, Pirjo. Learning by caring: A follow-up study of participants in a specialized training program in pastoral care and counseling. Helsinki: Suomen Tiedeseura, 2001.

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7

Audits, California Bureau of State. Department of Managed Health Care: Assessments for specialized and full-service HMO's do not reflect its workload and have disparate financial impacts. Sacramento, Calif: Bureau of State Audits, 2002.

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8

Needs, Joint Task Force for the Management of Children with Special Health. Guidelines for the delineation of roles and responsibilities for the safe delivery of specialized health care in the educational setting. Reston, VA: Council for Exceptional Children, 1990.

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9

Niagara District Health Council (Ont.). Developing Niagara-based specialized health services for the elderly: Report of the Regional Geriatric Medical and Geriatric Psychiatry Services Steering Committee. Fonthill, Ont: Niagara District Health Council, 1997.

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10

United States. Congress. House. A bill to amend title XVIII of the Social Security Act to promote the coverage of frail elderly Medicare beneficiaries permanently residing in nursing facilities in specialized health insurance programs for the frail elderly. Washington, D.C: United States Government Printing Office, 1999.

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11

Health, United States Congress House Committee on Veterans' Affairs Subcommittee on. Review the provision of specialized services at the Department of Veterans Affairs: Hearing before the Subcommittee on Health of the Committee on Veterans' Affairs, House of Representatives, One Hundred Fifth Congress, second session, July 23, 1998. Washington: U.S. G.P.O., 1999.

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12

Forde, Elizabeth. Children in specialised care: changes in behavioural and emotional disturbance. (s.l: The Author), 2003.

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13

H, Coons Dorothy, ed. Specialized dementia care units. Baltimore: Johns Hopkins University Press, 1990.

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14

Clark, Kathleen Mary. SPECIALIZED NURSING RESOURCES: THE OCCUPATIONAL CHOICE OF INTENSIVE CARE NURSES (SPECIALIZED NURSING). 1990.

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15

Chambers, Leila, and Robyn Hayes. Specialized Operating Procerdures for Primary Care Physicians. Medical Communication Unlimited, 1998.

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16

New York State Council on Children and Families., ed. Specialized family care for children: An innovative alternative to congregate care. Albany, NY: New York State Council on Children and Families, 1989.

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17

Evans, Charlotte, Anne Creaton, Marcus Kennedy, and Terry Martin, eds. Specialized retrieval systems. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198722168.003.0020.

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Civilian and military retrieval services commonly respond to mass casualty events and international disasters. It is necessary to adapt usual practices to achieve the most for many. The structures, systems, language, and discipline take on a military flavour in civilian disaster response. This brings some order to the chaos and facilitates multiagency cooperation. Triage, treatment, and transport must occur in unfavourable environments. This is exemplified in military scenarios where there is ongoing risk to casualties and retrieval teams. Medical care provided by retrieval teams will depend on risk and resources. Staged retrieval may be required. This is also the case with civilian international retrieval where the patient may be transferred to an intermediate destination facility for immediate care, before being repatriated to their country of origin. Also included, is a section on medical emergency response teams which provide a critical care response to deteriorating patients in a hospital ward setting.
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18

Clark, Kathleen Mary *. Specialized nursing resources: the occupational choice of intensive care nurses. 1990.

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19

Frieson, Michael F. Spiritual Care for Children Living in Specialized Settings: Breathing Underwater. Haworth Pastoral Press, 2000.

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20

Frieson, Michael F. Spiritual Care for Children Living in Specialized Settings: Breathing Underwater. Haworth Press, 2000.

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21

Mancino, Douglas M. Taxation of hospitals and health care organizations (Taxation of specialized industries). Warren, Gorham & Lamont, 2000.

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22

Shelton, Terri. Family Centered Care for Children Needing Specialized Health and Developmental Services. Assn for the Care of Childrens, 1994.

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23

Kwon, Oh-Jung. Physical aspects of specialized units for Alzheimer patients in long term care facilities. 1988.

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24

Obstetrics in remote settings: Practical guide for non-specialized health care professionals. Paris: Médecins sans Frontières, 2007.

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25

Guidelines and Procedures for Meeting the Specialized Physical Health Care Needs of Pupils. California Dept of Education, 1990.

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26

Winnie, Bachmann, Lundin Janet, and California. State Dept. of Education., eds. Guidelines and procedures for meeting the specialized physical health care needs of pupils. Sacramento: California State Dept. of Education, 1990.

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27

Careers in Specialized Consulting: Health Care, Human Resources, and Information Technology (WetFeet Insider Guide). 2nd ed. WetFeet, Inc., 2006.

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28

Specialized Newborn Care - PCEP Book III: Perinatal Continuing Education Program (Pcep Perinatal Continuting Education Program). American Academy of Pediatrics, 2007.

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29

Clinician's Guide to the Assessment Checklist Series: Specialized Mental Health Measures for Children in Care. Taylor & Francis Group, 2013.

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30

Specialized Consulting Careers: Health Care, Human Resources & Information Technology: WetFeet Insider Guide (Wetfeet Insider Guide). 2nd ed. WetFeet, Inc., 2005.

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31

Kahn, Jeremy M. Long-term weaning centres in critical care. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0384.

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Successfully weaning patients from prolonged mechanical ventilation requires the varied expertise of a dedicated multidisciplinary care team. Traditionally, this care was provided in acute care hospitals, increasingly these patients are transferred to specialized weaning centres. These may improve patient outcomes by concentrating weaning expertise in a low-acuity environment and implementing protocols for liberation from mechanical ventilation. However, these centres might also worsen patient outcomes because they typically offer less intense nurse and physician staffing compared with traditional intensive care units. Generally, the clinical evidence is mixed, with the best studies suggesting that weaning centres offer similar outcomes as acute care hospitals, but at lower costs. Health systems also might stand to gain from dedicated weaning centres, because they can release intensive care unit beds for more acutely-ill patients. Many gaps remain in our understanding of which patients should be transferred to dedicated weaning centres, the optimal timing of transfer, and the best approach to care for patients in this highly specialized setting.
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32

Guidelines for the Delineation of Roles and Responsibilities for the Safe Delivery of Specialized Health Care. Council for Exceptional Children, 1990.

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33

Payne, Sheila, and Tom Lynch. International progress in creating palliative medicine as a specialized discipline and the development of palliative care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0001.

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This chapter provides an overview of the development of palliative medicine as a specialized discipline, and seeks to trace the development of international initiatives that have promoted and facilitated the growth of palliative care services. The focus is on palliative care services for adults with life-limiting conditions and advanced disease. A chronological narrative is traced from the first hospices developed in Dublin, Ireland, to the emergence of the modern hospices in the United Kingdom in the 1960s. The global spread of the principles of palliative care is traced in the formation of national and regional organizations. The chapter offers evidence on the progress of educational initiatives, both within medicine and for other members of the multidisciplinary team, at undergraduate and post-qualification level. The proposal for ten core common interdisciplinary competencies defines the essential foundations of palliative care. Finally, the chapter considers what areas of palliative medicine require further development.
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34

Sherman, Deborah Witt, and David C. Free. Nursing and palliative care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0043.

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Nurses, who are educated in palliative care nursing, facilitate the caring process through a combination of science, presence, openness, compassion, mindful attention to detail, and teamwork. As members of the interdisciplinary palliative care team, nurses bring specialized competence and expertise gained through education, credentialing, and experience. With close to 19.4 million nurses globally, nurses have a tremendous potential to reform health care and ensure quality care for seriously ill patients and their families. Through the integration of empirical, aesthetic, personal, and ethical knowledge at the generalist or advance practice levels, nurses reshape societal perspectives regarding illness, dying, and death. By virtue of their numbers, experience, education, time spent at the bedside, and insight into the lived experiences of patients and families, nurses have the potential to play a prominent role in as public health advocates for palliative care at the local, national, and global level.
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35

Whitehead, Phyllis B. Palliative Care of the Geriatric Patient. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190204709.003.0015.

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More than 50% of all deaths occur in medical and surgical units where the focus is on active, curative treatment, not on managing symptoms and establishing realistic goals of care. Many of these patients are older adults and are vulnerable to many condition. Often they develop end-stage renal disease dementia, hip fractures, and pulmonary conditions and their associated sequelae. Seriously ill, hospitalized patients represent a specialized patient population that greatly benefits from the expanded skills and knowledge of palliative advanced practice registered nurses (APRNs). This chapter reviews renal failure, dementia, pulmonary conditions, and hip fractures and their management for the geriatric patient.
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36

Barr, Jane Ellen. Stoma therapy in palliative care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0412.

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Patients with ostomies, wounds, or incontinence in the setting of a serious or life-threatening illness experience numerous challenges, including distress related to pain and other symptoms, psychological disturbances, and family concerns. Expert management of these conditions and their many complications is an essential part of a comprehensive palliative plan of care. In many countries, nurse specialists with advanced training in the management of ostomies, wounds, or incontinence are available as consultants or as members of a specialist palliative care team. These professionals can improve health care and quality of life for selected patients across venues of care that include hospital, home, long-term care, hospice, and specialized settings. If a stoma nurse specialist is available, he or she may have a key role in directing decision-making and care management related to these problems, evaluating and controlling symptoms that cause patients and families suffering, and providing psychosocial and spiritual support.
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37

Wijdicks, Eelco F. M., William D. Freeman, James Y. Findlay, and Ayan Sen, eds. Mayo Clinic Critical and Neurocritical Care Board Review. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190862923.001.0001.

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Physicians have cared for acutely ill patients throughout history; after the devastating poliomyelitis epidemics of the 1950s, a new specialty emerged. Initially, respiratory care units were created for these severely affected patients, but soon they were transformed into intensive care units (ICUs). Trauma units and transplant units soon followed. Specialized care for patients with acute neurologic and neurosurgical disease occurred in parallel with these developments, but many of the early neuroscience ICUs were redesigned wards for neurosurgical or neurologic patients. Specialized physicians and nursing staff delivered multidisciplinary care, recognizing that no one group could function well alone. It was inevitable that critical care for the sickest patient was the only option to give them a fighting chance to survive. Currently, neurocritical care board examination combines neurocritical care with general intensive care, and questions are equally divided between the two. It is therefore appropriate to combine both areas of expertise in one single volume. The chapters correspond with the key disorders suggested by UCNS to assist in preparation for the examination. As expected, this book is not only detailed in basic pathophysiology but also presents major disorders and syndromes and their management. Because it has unprecedented full coverage of acute neurology, this book is equally useful as a preparation for the critical care medicine board examination.
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38

Minnesota. Dept. of Health. and Minnesota. Dept. of Human Services., eds. The Distribution and scope of specialized health care for children: The role of children's hospitals in the context of health care reform : report to the Legislature. [St. Paul, Minn.?]: Minnesota Dept. of Health, 1995.

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39

E, Frye Judith, and Wisconsin. Legislature. Legislative Audit Bureau., eds. An evaluation of specialized medical vehicle transportation, Department of Health and Social Services. Madison, WI: State of Wisconsin, Legislative Audit Bureau, 1994.

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40

Romero, Margarita Sánchez. Care and Socialization of Children in the European Bronze Age. Edited by Sally Crawford, Dawn M. Hadley, and Gillian Shepherd. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780199670697.013.18.

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Care and socialization are practices included in what have been called maintenance activities, a set of works that entangle very specific and characteristic relations and identities. These activities involve the quotidian maintenance of human groups through care, socialization, provision, food processing, and cooking or the organization and maintenance of the living area. Such practices are vital for the reproduction, cohesion, and wellbeing of communities and involve a significant amount of specialized knowledge, experience, and technology. This chapter examines evidence from the European Bronze Age for care and socialization practices, offering new challenges and questions on issues such as children’s agency and identity and involvement in the processes of daily life.
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41

Casaer, Michael P., and Greet Van den Berghe. Nutrition support in acute cardiac care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0032.

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Malnutrition in cardiac and critical illness is associated with a compromised clinical outcome. The aim of nutrition therapy is to prevent these complications and particularly to attenuate lean tissue wasting and the loss of muscle force and of physical function. During the last decade, several well-powered randomized controlled nutrition trials have been performed. Their results challenge the existing nutrition practices in critically ill patients. Enhancing the nutritional intake and the administration of specialized formulations failed to evoke clinical benefit. Some interventions even provoked an increased mortality or a delayed recovery. These unexpected new findings might be, in part, caused by an important leap forward in the methodological quality in the recent trials. Perhaps reversing early catabolism in the critically ill patient by nutrition or anabolic interventions is impossible or even inappropriate. Nutrients effectively suppress the catabolic intracellular autophagy pathway. But autophagy is crucial for cellular integrity and function during metabolic stress, and consequently its inhibition early in critical illness might be deleterious. Evidence from large nutrition trials, particularly in acute cardiac illness, is scarce. Nutrition therapy is therefore focused on avoiding iatrogenic harm. Some enteral nutrition is administered if possible and eventually temporary hypocaloric feeding is tolerated. Above all, the refeeding syndrome and other nutrition-related complications should be prevented. There is no indication for early parenteral nutrition, increased protein doses, specific amino acids, or modified lipids in critical illness.
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42

Casaer, Michael P., and Greet Van den Berghe. Nutrition support in acute cardiac care. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0032_update_001.

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Malnutrition in cardiac and critical illness is associated with a compromised clinical outcome. The aim of nutrition therapy is to prevent these complications and particularly to attenuate lean tissue wasting and the loss of muscle force and of physical function. During the last decade, several well-powered randomized controlled nutrition trials have been performed. Their results challenge the existing nutrition practices in critically ill patients. Enhancing the nutritional intake and the administration of specialized formulations failed to evoke clinical benefit. Some interventions even provoked an increased mortality or a delayed recovery. These unexpected new findings might be, in part, caused by an important leap forward in the methodological quality in the recent trials. Perhaps reversing early catabolism in the critically ill patient by nutrition or anabolic interventions is impossible or even inappropriate. Nutrients effectively suppress the catabolic intracellular autophagy pathway. But autophagy is crucial for cellular integrity and function during metabolic stress, and consequently its inhibition early in critical illness might be deleterious. Evidence from large nutrition trials, particularly in acute cardiac illness, is scarce. Nutrition therapy is therefore focused on avoiding iatrogenic harm. Some enteral nutrition is administered if possible and eventually temporary hypocaloric feeding is tolerated. Above all, the refeeding syndrome and other nutrition-related complications should be prevented. There is no indication for early parenteral nutrition, increased protein doses, specific amino acids, or modified lipids in critical illness.
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43

Casaer, Michael P., and Greet Van den Berghe. Nutrition support in acute cardiac care. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0032_update_002.

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Malnutrition in cardiac and critical illness is associated with a compromised clinical outcome. The aim of nutrition therapy is to prevent these complications and particularly to attenuate lean tissue wasting and the loss of muscle force and of physical function. During the last decade, several well-powered randomized controlled nutrition trials have been performed. Their results challenge the existing nutrition practices in critically ill patients. Enhancing the nutritional intake and the administration of specialized formulations failed to evoke clinical benefit. Some interventions even provoked an increased mortality or a delayed recovery. These unexpected new findings might be, in part, caused by an important leap forward in the methodological quality in the recent trials. Perhaps reversing early catabolism in the critically ill patient by nutrition or anabolic interventions is impossible or even inappropriate. Nutrients effectively suppress the catabolic intracellular autophagy pathway. But autophagy is crucial for cellular integrity and function during metabolic stress, and consequently its inhibition early in critical illness might be deleterious. Evidence from large nutrition trials, particularly in acute cardiac illness, is scarce. Nutrition therapy is therefore focused on avoiding iatrogenic harm. Some enteral nutrition is administered if possible and eventually temporary hypocaloric feeding is tolerated. Above all, the refeeding syndrome and other nutrition-related complications should be prevented. There is no indication for early parenteral nutrition, increased protein doses, specific amino acids, or modified lipids in critical illness.
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44

An E valuation of the effectiveness of a specialized nursing case management model in coordinating supportive cancer care in the community. Hamilton, Ont: Juravinski Cancer Centre, 2004.

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45

Kahn, Jeremy M. The Role of Long-Term Ventilator Hospitals. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199653461.003.0004.

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Long-term ventilator facilities play an increasingly important role in the care of chronically critically ill patients in the recovery phase of their acute illness. These hospitals can take several forms, depending on the country and health system, including �step-down� units within acute care hospitals and dedicated centres that specialize in weaning patients from prolonged mechanical ventilation. These hospitals may improve outcomes through increased clinical experience at applying protocolized weaning approaches and specialized, multidisciplinary, rehabilitation-focused care; they may also worsen outcomes by fragmenting the episode of acute care across multiple hospitals, leading to communication delays and hardship for families. Long-term ventilator facilities may also have important �spillover effects�, in that they free ICU beds in acute care hospitals to be filled with greater numbers of acute critically ill patients. Current evidence suggests that mortality of chronically critically ill patients is equivalent between acute care hospitals and specialized weaning centres; however, mechanical ventilation may be longer and cost of care higher in patients who remain in acute care hospitals. Given the rising incidence of prolonged mechanical ventilation and capacity constraints on acute care ICUs, long-term ventilator hospitals are likely to serve a key function in critical illness recovery.
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46

Chronic Care for Neglected Infectious Diseases: Leprosy/Hansen's Disease, Lymphatic Filariasis, Trachoma, and Chagas Disease. Pan American Health Organization, 2021. http://dx.doi.org/10.37774/9789275122501.

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In 2016, PAHO's Directing Council, through Resolution CD55.R9, approved the “Plan of Action for Elimination of Neglected Infectious Diseases (NID) and Post-Elimination Actions, 2016-2022.” This Resolution urges Member States to implement a set of interventions to reduce the burden of disease by NID in the Americas by 2022, including “…support promotion of treatment, rehabilitation, and related support services through an approach focused on integrated morbidity management and disability prevention for individuals and families afflicted by those neglected infectious diseases that cause disability and generate stigma.” NIDs can have devastating chronic sequelae for patients, such as disability, visible change or loss in body structure, loss of tissue, and impairment of proper tissue and organ function, among others. All of these can in turn lead to unjustified discrimination, stigmatization, mental health problems, and partial or total incapacity to work, perpetuating the vicious cycle of neglected diseases as both a consequence and a cause of poverty. Patients with chronic conditions caused by NIDs require proper health care in order to prevent further damage and improve their living and social conditions. This should be provided at the primary health care level, as patients suffering from NIDs are often unable to travel to or afford to pay for specialized care services. Care for patients suffering from chronic morbidity caused by NID should be integrated into care for other chronic conditions caused by non-communicable diseases. This manual provides a framework for morbidity management and disability prevention of patients affected by NIDs and gives specific guidance for the proper care of patients suffering from chronic conditions caused by lymphatic filariasis, leprosy, trachoma, and Chagas disease. It is intended to be used mainly by health care workers at the primary health care level, but health workers at more complex and specialized levels may also find it useful.
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47

Griffin, Patricia Lynne. The potential impact of population-based funding in regional models on the planning financing and delivery of specialized health care services: The case of paediatrics. 2000.

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48

Oregon. Senior and Disabled Services Division., ed. Community based care (CBC) provider guide for adult foster homes, residential care facilities, assisted and specialized living facilities / prepared by Program Assistance and Business Servies Sections, Senior and Disabled Services Division, Dept. of Human Resources. Salem, Or: Program Assistance and Business Services Sections, Senior and Disabled Services Division, Dept. of Human Resources, 1991.

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49

Nuwer, Marc R., Ronald G. Emerson, and Cecil D. Hahn. Principles and Techniques for Long-Term EEG Recording (Epilepsy Monitoring Unit, Intensive Care Unit, Ambulatory). Edited by Donald L. Schomer and Fernando H. Lopes da Silva. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228484.003.0031.

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Long-term monitoring is a set of methods for recording electroencephalographic (EEG) signals over a period of 24 hours or longer. Patient video recording is often synchronized to the EEG. Interpretation aids help physicians to identify events, which include automated spike and seizure detection and various trending displays of frequency EEG content. These techniques are used in epilepsy monitoring units for presurgical evaluations and differential diagnosis of seizures versus nonepileptic events. They are used in intensive care units to identify nonconvulsive seizures, to measure the effectiveness of therapy, to assess depth and prognosis in coma, and other applications. The patient can be monitored at home with ambulatory monitoring equipment. Specialized training is needed for competent interpretation of long-term monitoring EEGs. Problems include false-positive events flagged by automated spike and seizure detection software, and muscle and movement artifact contamination during seizures.
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50

Giuseffi, Jennifer, John McPherson, Chad Wagner, and E. Wesley Ely. Acute cognitive disorders: recognition and management of delirium in the cardiovascular intensive care unit. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0074.

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Delirium is the most common acute cognitive disorder seen in critically ill patients in the cardiovascular intensive care unit. It is defined as a disturbance of consciousness and cognition that develops suddenly and fluctuates over time. Delirious patients can become hyperactive, hypoactive, or both. The occurrence of delirium during hospitalization is associated with increased in-hospital and long-term morbidity and mortality. The cause of delirium is multifactorial and may include imbalances in neurotransmitters, inflammatory mediators, metabolic disturbances, impaired sleep, and the use of sedatives and analgesics. Patients with advanced age, dementia, chronic illness, extensive vascular disease, and low cardiac output are at particular risk of developing delirium. Specialized bedside assessment tools are now available to rapidly diagnose delirium, even in mechanically ventilated patients. Increased awareness of delirium risk factors, in addition to non-pharmacological and pharmacological treatments for delirium, can be effective in reducing the incidence of delirium in cardiac patients and in minimizing adverse outcomes, once delirium occurs.
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