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In this section, feature-length articles bring you up close to common and rare clinical areas. With a focus on disease states, workers' compensation, disease management, long-term care and more, these resources will broaden your clinical base and enhance your delivery of care. Begin with the topical articles below, or start by exploring the five clinical categories to the left.
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Disease Management
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Written by Beth Wilkes, RD/LD
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Friday, 26 February 2010 14:25 |
 A Health Plan’s Active Measures to Curb the Disease
Overweight and obesity affect all of us, whether it is a personal struggle or trying to support family and friends. Despite evidence that obesity rates in children continue to rise, many clinicians and payers are not equipped to address this issue with their patients and members. This article will explore the financial and individual health costs of obesity and explore an innovative approach one Medicaid health plan is using to impact this condition.
National data from the 2003 Survey of Children’s Health shows that 31 percent of children are overweight or obese. More alarming, 40 percent of children on public insurance are overweight or obese. The numbers are worse for adults: 65 percent of American adults are overweight or obese (NHANES 1999-2002).
Defining overweight and obesity is different for adults and children. For adults, body mass index (BMI) determines their weight category. However, for children (2-20 years old) BMI, gender, and age are considered when determining their weight category. This information is plotted on a growth chart to determine their BMI percentile. (See Chart 1 on the next page.)
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Disease Management
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 Glimpses of Hope
Dear Readers,
To complement our cover story in the December 2009 issue of Case In Point—A League of Survivors: Cancer Care Update 2010—we present an inspiring, online-exclusive series on cancer survivors who have written about their own experiences in facing a diagnosis, preparing for their journey and attempting to come to grips with survivorship.
In reading each story, it becomes apparent that surviving cancer is all about attitude. You must commit to the fight, and you will almost inevitably need a team to help you when your willpower starts to fail.
We all know—or will know—someone who has cancer. If you find this series of stories insightful and helpful, please feel free to share the website with those who you think may benefit.
Here are the sad, heartfelt and ultimately rousing stories of individuals facing the test of a lifetime:
In closing, I would like to thank to everyone who contributed. Each of you is an inspiration.
Anne Llewellyn, RN-BC, MS, BHSA, CCM, CRRN
Editor in Chief
Case Management Products
Dorland Health, a division of Access Intelligence
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Disease Management
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Written by Carmen Castillo, RN, BSN
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Wednesday, 16 December 2009 16:10 |
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 With rising health care costs and greater longevity of people living with chronic diseases, case managers must provide services that are cost-effective and that improve a patient’s quality of life. As a nurse case manager at Memorial Sloan-Kettering Cancer Center, I work with patients with systemic AL amyloidosis.
Amyloid is a group of diseases in which abnormal proteins deposit into one or more organ systems, most commonly involving the heart and kidneys. Patients diagnosed with amyloidosis involving the heart have a median survival of 13.2 months. Common presenting symptoms are suggestive of congestive heart failure—shortness of breath, fluid overload and hypotension. Amyloid patients have frequent clinic and emergency department visits as well as hospital admissions due to complications. In addition, patients may be required to attend clinic solely for the purpose of monitoring vital signs and weight. Patient compliance with self-monitoring of fluid status, orthostatic vital signs, weight and salt-restriction is also critical to improving performance and medical status.
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