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Sample records for home based management

  1. Alert management for home healthcare based on home automation analysis.

    PubMed

    Truong, T T; de Lamotte, F; Diguet, J-Ph; Said-Hocine, F

    2010-01-01

    Rising healthcare for elder and disabled people can be controlled by offering people autonomy at home by means of information technology. In this paper, we present an original and sensorless alert management solution which performs multimedia and home automation service discrimination and extracts highly regular home activities as sensors for alert management. The results of simulation data, based on real context, allow us to evaluate our approach before application to real data. PMID:21096576

  2. Home-Based Contingency Management Programs that Teachers Can Use.

    ERIC Educational Resources Information Center

    Taylor, Vincent L.; And Others

    1984-01-01

    Offers three guidelines to aid teachers in selecting effective contingency management programs, based on degree of positiveness, effectiveness, and costs to teachers and parents. Describes how to use a simple home-based program, which resulted in successful reduction of mild classroom disruptive behavior. (JAC)

  3. Risk management and clinical governance for complex home-based health care.

    PubMed

    Lewis, Mary; Noyes, Jane

    2007-07-01

    Healthcare professionals have an obligation to enable children with complex needs to lead 'ordinary lives' at home but the views of professionals and family members often diverge in relation to the management of risks. Nurses are increasingly taking on the clinical responsibility for children with complex needs within a multidisciplinary, multi-agency team, yet have little training or experience in adapting risk management and clinical governance frameworks to home-based settings. Risk management frameworks for home-based care for children with complex health and social care needs are introduced in this article. Best practice guidance and resources for adapting risk management frameworks are presented to meet this identified gap in knowledge and experience. Children, young people and their parents have increasing expectations relating to the type and quality of home-based support they receive. Developing and applying clinical governance and risk management frameworks are part of improving outcomes for children with complex needs and their families. PMID:17694890

  4. Mobile Phone Based System Opportunities to Home-based Managing of Chemotherapy Side Effects

    PubMed Central

    Davoodi, Somayeh; Mohammadzadeh, Zeinab; Safdari, Reza

    2016-01-01

    Objective: Applying mobile base systems in cancer care especially in chemotherapy management have remarkable growing in recent decades. Because chemotherapy side effects have significant influences on patient’s lives, therefore it is necessary to take ways to control them. This research has studied some experiences of using mobile phone based systems to home-based monitor of chemotherapy side effects in cancer. Methods: In this literature review study, search was conducted with keywords like cancer, chemotherapy, mobile phone, information technology, side effects and self managing, in Science Direct, Google Scholar and Pub Med databases since 2005. Results: Today, because of the growing trend of the cancer, we need methods and innovations such as information technology to manage and control it. Mobile phone based systems are the solutions that help to provide quick access to monitor chemotherapy side effects for cancer patients at home. Investigated studies demonstrate that using of mobile phones in chemotherapy management have positive results and led to patients and clinicians satisfactions. Conclusion: This study shows that the mobile phone system for home-based monitoring chemotherapy side effects works well. In result, knowledge of cancer self-management and the rate of patient’s effective participation in care process improved. PMID:27482134

  5. Home-based asthma self-management education for inner city children.

    PubMed

    Butz, Arlene M; Syron, Laura; Johnson, Betty; Spaulding, Joanne; Walker, Melissa; Bollinger, Mary Elizabeth

    2005-01-01

    Optimal home self-management in young children with asthma includes accurate symptom identification followed by timely and appropriate treatment. The objective of this study was to evaluate a home-based asthma educational intervention targeting symptom identification for parents of children with asthma. Two hundred twenty-one children with asthma were enrolled into an ongoing home-based clinical trial and randomized into either a standard asthma education (SAE) or a symptom/nebulizer education intervention (SNEI). Data included home visit records and parent's self-report on questionnaires. Symptom identification and self-management skills significantly improved from preintervention to postintervention for parents in both groups with the exception of checking medications for expiration dates and the frequency of cleaning nebulizer device and equipment. However, significantly more parents of children in the SNEI group reported treating cough symptoms as compared with the SAE group (p = 0.05). Of concern is that only 38% of all parents reported having an asthma action plan in the home. A targeted home-based asthma education intervention can be effective for improving symptom identification and appropriate use of medications in children with asthma. Home asthma educational programs should address accurate symptom identification and a demonstration of asthma medication delivery devices. PMID:15982192

  6. Characteristics Associated with Home- and Community-Based Service Utilization for Medicare Managed Care Consumers

    ERIC Educational Resources Information Center

    Alkema, Gretchen E.; Reyes, Judy Y.; Wilber, Kathleen H.

    2006-01-01

    Purpose: We identified the types of home-and community-based services (HCBS) that high-risk older adults in Medicare managed care used, and we examined participant characteristics associated with service use in six areas: overall service use, four specific categories of HCBS, and referrals to insured medical services. Design and Methods: We used…

  7. Nursing Home Staff Adherence to Evidence-Based Pain Management Practices

    PubMed Central

    Jablonski, Anita; Ersek, Mary

    2010-01-01

    The purpose of this study was to determine the extent to which nursing home staff adhere to current evidence-based guidelines to assess and manage persistent pain experienced by elderly residents. A retrospective audit was conducted of the medical records of 291 residents of 14 long-term care facilities in western Washington State. Data revealed a gap between actual practice and current best practice. Assessment of persistent pain was limited primarily to intensity and location. Although prescribing practices were more in line with evidence-based guidelines, a significant number of residents did not obtain adequate pain relief. Nonpharmacological pain management methods were rarely implemented. Nursing home staff and administrators must critically examine both system and individual staff reasons for failure to comply with best pain management practices. Research is needed to determine factors that contribute to less-than-optimal adherence to evidence-based guidelines for pain management, as well as the best methods for implementing practice change. PMID:19650621

  8. Exploring limits to market-based reform: managed competition and rehabilitation home care services in Ontario.

    PubMed

    Randall, Glen E; Williams, A Paul

    2006-04-01

    The rise of neo-liberalism, which suggests that only markets can deliver maximum economic efficiency, has been a driving force behind the trend towards using market-based solutions to correct health care problems. However, the broad application of market-based reforms has tended to assume the presence of fully functioning markets. When there are barriers to markets functioning effectively, such as the absence of adequate competition, recourse to market-based solutions can be expected to produce less than satisfactory, if not paradoxical results. One such case is rehabilitation homecare in Ontario, Canada. In 1996, a "managed competition" model was introduced as part of a province-wide reform of home care in an attempt to encourage high quality at competitive prices. However, in the case of rehabilitation home care services, significant obstacles to achieving effective competition existed. Notably, there were few private provider agencies to bid on contracts due to the low volume and specialized nature of services. There were also structural barriers such as the presence of unionized employees and obstacles to the entry of new providers. This paper evaluates the impact of Ontario's managed competition reform on community-based rehabilitation services. It draws on data obtained through 49 in-depth key informant interviews and a telephone survey of home care coordinating agencies and private rehabilitation provider agencies. Instead of reducing costs and improving quality, as the political rhetoric promised, the analysis suggests that providing rehabilitation homecare services under managed competition resulted in higher per-visit costs and reduced access to services. These findings support the contention that there are limits to market-based reforms. PMID:16198035

  9. An Evaluation and Implementation of Rule-Based Home Energy Management System Using the Rete Algorithm

    PubMed Central

    Fujita, Naotaka; Yoshihisa, Tomoki; Tsukamoto, Masahiko

    2014-01-01

    In recent years, sensors become popular and Home Energy Management System (HEMS) takes an important role in saving energy without decrease in QoL (Quality of Life). Currently, many rule-based HEMSs have been proposed and almost all of them assume “IF-THEN” rules. The Rete algorithm is a typical pattern matching algorithm for IF-THEN rules. Currently, we have proposed a rule-based Home Energy Management System (HEMS) using the Rete algorithm. In the proposed system, rules for managing energy are processed by smart taps in network, and the loads for processing rules and collecting data are distributed to smart taps. In addition, the number of processes and collecting data are reduced by processing rules based on the Rete algorithm. In this paper, we evaluated the proposed system by simulation. In the simulation environment, rules are processed by a smart tap that relates to the action part of each rule. In addition, we implemented the proposed system as HEMS using smart taps. PMID:25136672

  10. An evaluation and implementation of rule-based Home Energy Management System using the Rete algorithm.

    PubMed

    Kawakami, Tomoya; Fujita, Naotaka; Yoshihisa, Tomoki; Tsukamoto, Masahiko

    2014-01-01

    In recent years, sensors become popular and Home Energy Management System (HEMS) takes an important role in saving energy without decrease in QoL (Quality of Life). Currently, many rule-based HEMSs have been proposed and almost all of them assume "IF-THEN" rules. The Rete algorithm is a typical pattern matching algorithm for IF-THEN rules. Currently, we have proposed a rule-based Home Energy Management System (HEMS) using the Rete algorithm. In the proposed system, rules for managing energy are processed by smart taps in network, and the loads for processing rules and collecting data are distributed to smart taps. In addition, the number of processes and collecting data are reduced by processing rules based on the Rete algorithm. In this paper, we evaluated the proposed system by simulation. In the simulation environment, rules are processed by a smart tap that relates to the action part of each rule. In addition, we implemented the proposed system as HEMS using smart taps. PMID:25136672

  11. A cloud-based home management system for patients with a left ventricular assist device: a case report.

    PubMed

    Nomoto, Shinichi; Utsumi, Momoe; Minakata, Kenji

    2016-07-01

    Since implantable left ventricular assist devices (LVAD) with smaller configurations became available for bridge-to-transplant or even destination therapy in patients with end-stage heart failure, an increasing number of patients with these devices are receiving home medical management. However, these patients may be anxious about potential complications such as pump failure, thromboembolism, and infections that may occur during home management. To provide a sense of security during home management of patients with LVAD and to establish an ideal shared-care system, we developed a patient-centered cloud-based home management system for patients with LVAD. In this case report, we describe this system and report a trial of it in a 64-year-old patient with an LVAD. PMID:27312433

  12. Transition from NICU to Home: Are the Parents Ready to Manage Any Emergency? An Evidence-Based Project.

    PubMed

    Murray, Chantel H; Joseph, Rachel A

    2016-01-01

    Transitioning the care of a previously critically ill infant to home poses many challenges for the parents. Prior to the infant's discharge, the parents undergo rigorous training to continue the care of their infants at home. Even after training, parents may feel overwhelmed by the thought of managing an emergency at home. This evidence-based practice project aims to provide parents with additional hands-on practice of cardiopulmonary resuscitation (CPR) prior to their infant's discharge. Based on this project, a program of teaching CPR regularly is established currently in the NICU at Nemours Alfred I. duPont Hospital for Children. PMID:27194609

  13. Factors affecting home care patients' acceptance of a web-based interactive self-management technology

    PubMed Central

    Karsh, Ben-Tzion; Severtson, Dolores J; Burke, Laura J; Brown, Roger L; Brennan, Patricia Flatley

    2010-01-01

    Objective With the advent of personal health records and other patient-focused health technologies, there is a growing need to better understand factors that contribute to acceptance and use of such innovations. In this study, we employed the Unified Theory of Acceptance and Use of Technology as the basis for determining what predicts patients' acceptance (measured by behavioral intention) and perceived effective use of a web-based, interactive self-management innovation among home care patients. Design Cross-sectional secondary analysis of data from a randomized field study evaluating a technology-assisted home care nursing practice with adults with chronic cardiac disease. Measurement and analysis A questionnaire was designed based on validated measurement scales from prior research and was completed by 101 participants for measuring the acceptance constructs as part of the parent study protocol. Latent variable modeling with item parceling guided assessment of patients' acceptance. Results Perceived usefulness accounted for 53.9% of the variability in behavioral intention, the measure of acceptance. Together, perceived usefulness, health care knowledge, and behavioral intention accounted for 68.5% of the variance in perceived effective use. Perceived ease of use and subjective norm indirectly influenced behavioral intention, through perceived usefulness. Perceived ease of use and subjective norm explained 48% of the total variance in perceived usefulness. Conclusion The study demonstrates that perceived usefulness, perceived ease of use, subjective norm, and healthcare knowledge together predict most of the variance in patients' acceptance and self-reported use of the web-based self-management technology. PMID:21131605

  14. Managing migraines at home

    MedlinePlus

    ... Philadelphia, PA: Elsevier Saunders; 2013:chap 58. Silberstein SD. Headache management. In: Benzon HT, Rathmell JP, Wu ... Philadelphia, PA: Elsevier Mosby; 2014:chap 30. Silberstein SD, Holland S, Freitag F, et al. Evidence-based guideline ...

  15. A Feasibility Study of Home-Based Contingency Management with Adolescent Smokers of Rural Appalachia

    PubMed Central

    Reynolds, Brady; Harris, Millie; Slone, Stacey A.; Shelton, Brent J.; Dallery, Jesse; Stoops, William; Lewis, Russell

    2015-01-01

    Cigarette smoking among adolescents remains a significant public health concern. This problem is compounded in regions such as rural Appalachia where rates of smoking are consistently higher than national averages and access to treatments is limited. The current research evaluated a home-based contingency management program completed over the Internet with adolescent smokers recruited from rural Appalachia. Participants (N = 62) submitted three video recordings per day showing their breath carbon monoxide (CO) levels using a handheld CO monitor. Participants were assigned to either an active treatment condition (AT: n = 31) in which reductions in breath CO were reinforced or a control treatment condition (CT: n = 31) in which providing timely video recordings were reinforced with no requirement to reduce breath CO. Results revealed that participants in the AT condition reduced their breath CO levels significantly more so during treatment than participants in the CT condition. Within-group comparisons revealed that participants in both conditions significantly reduced their breath CO, self-reported smoking, and nicotine dependence ratings during treatment. However, only participants in the AT condition significantly reduced urinary cotinine levels during treatment, and only participants in this condition maintained all reductions until six-week post treatment. Participants in the CT condition only maintained self-reported smoking reductions until post-treatment assessments. These results support the feasibility and initial efficacy of this incentive-based approach to smoking cessation with adolescent smokers living in rural locations. PMID:26280592

  16. A feasibility study of home-based contingency management with adolescent smokers of rural Appalachia.

    PubMed

    Reynolds, Brady; Harris, Millie; Slone, Stacey A; Shelton, Brent J; Dallery, Jesse; Stoops, William; Lewis, Russell

    2015-12-01

    Cigarette smoking among adolescents remains a significant public health concern. This problem is compounded in regions such as rural Appalachia where rates of smoking are consistently higher than national averages and access to treatments is limited. The current research evaluated a home-based contingency management program completed over the Internet with adolescent smokers recruited from rural Appalachia. Participants (N = 62) submitted 3 video recordings per day showing their breath carbon monoxide (CO) levels using a handheld CO monitor. Participants were assigned to either an active treatment condition (AT; n = 31) in which reductions in breath CO were reinforced or a control treatment condition (CT; n = 31) in which providing timely video recordings were reinforced with no requirement to reduce breath CO. Results revealed that participants in the AT condition reduced their breath CO levels significantly more so during treatment than participants in the CT condition. Within-group comparisons revealed that participants in both conditions significantly reduced their breath CO, self-reported smoking, and nicotine dependence ratings during treatment. However, only participants in the AT condition significantly reduced urinary cotinine levels during treatment, and only participants in this condition maintained all reductions until 6-week post treatment. Participants in the CT condition only maintained self-reported smoking reductions until posttreatment assessments. These results support the feasibility and initial efficacy of this incentive-based approach to smoking cessation with adolescent smokers living in rural locations. PMID:26280592

  17. Home-based renal dialysis.

    PubMed

    Goodenough, G K; Lutz, L J; Gregory, M C

    1988-02-01

    About 20 percent of chronic dialysis patients receive treatment in their homes. An increasing number of these patients choose peritoneal dialysis. Physicians should be aware of the techniques and possible complications of home-based dialysis so that they can assist patients in choosing a form of dialysis and can help manage problems if they arise. An understanding of the technical and psychosocial problems is also necessary. PMID:3344646

  18. An international randomized study of a home-based self-management program for severe COPD: the COMET

    PubMed Central

    Bourbeau, Jean; Casan, Pere; Tognella, Silvia; Haidl, Peter; Texereau, Joëlle B; Kessler, Romain

    2016-01-01

    Introduction Most hospitalizations and costs related to COPD are due to exacerbations and insufficient disease management. The COPD patient Management European Trial (COMET) is investigating a home-based multicomponent COPD self-management program designed to reduce exacerbations and hospital admissions. Design Multicenter parallel randomized controlled, open-label superiority trial. Setting Thirty-three hospitals in four European countries. Participants A total of 345 patients with Global initiative for chronic Obstructive Lung Disease III/IV COPD. Intervention The program includes extensive patient coaching by health care professionals to improve self-management (eg, develop skills to better manage their disease), an e-health platform for reporting frequent health status updates, rapid intervention when necessary, and oxygen therapy monitoring. Comparator is the usual management as per the center’s routine practice. Main outcome measures Yearly number of hospital days for acute care, exacerbation number, quality of life, deaths, and costs. PMID:27418817

  19. Home audit program: management manual

    SciTech Connect

    Not Available

    1980-09-01

    Many public power systems have initiated home energy audit programs in response to the requests of their consumers. The manual provides smaller public power systems with the information and specific skills needed to design and develop a program of residential energy audits. The program is based on the following precepts: locally owned public systems are the best, and in many cases the only agencies available to organize and coordinate energy conservation programs in many smaller communities; consumers' rights to energy conservation information and assistance should not hinge on the size of the utility that serves them; in the short run, public power systems of all sizes should offer residential energy conservation assistance to their consumers, because such assistance is desirable, necessary, and in the public interest; and in the long run, such programs will complement national energy goals and will produce economic benefits for both consumers and the public power system. A detailed description of home audit program planning, organization, and management are given. (MCW)

  20. Home-based diabetes symptom self-management education for Mexican Americans with type 2 diabetes.

    PubMed

    García, Alexandra A; Brown, Sharon A; Horner, Sharon D; Zuñiga, Julie; Arheart, Kristopher L

    2015-06-01

    This pilot study evaluated an innovative diabetes symptom awareness and self-management educational program for Mexican Americans, a fast growing minority population experiencing a diabetes epidemic. Patients with diabetes need assistance interpreting and managing symptoms, which are often annoying and potentially life-threatening. A repeated measures randomized controlled trial was conducted with 72 Mexican Americans aged 25-75 years with type 2 diabetes. Experimental condition participants received eight weekly, in-home, one-on-one educational and behavior modification sessions with a registered nurse focusing on symptom awareness, glucose self-testing and appropriate treatments, followed by eight biweekly support telephone sessions. Wait-listed control condition participants served as comparisons at three time points. Hierarchical linear modeling was used to evaluate the effects of the intervention between- and within groups on psychosocial, behavioral and clinical outcomes. Participants were predominantly female, middle-aged, moderately acculturated and in poor glycemic control. Experimental group participants (n = 39) significantly improved glycemic control, blood pressure, symptoms, knowledge, self-efficacy, empowerment and quality of life. Post intervention focus groups reported satisfaction with the symptom focus. Addressing symptoms led to clinical and psychosocial improvements. Symptoms seem to be an important motivator and a useful prompt to engage patients in diabetes self-management behaviors to relieve symptoms and prevent complications. PMID:25953971

  1. Making the relationship work. Management of a hospital-based home health agency and hospital for-profit home health aide service.

    PubMed

    Scharf, J H; Lindner, M K; Gordon, J; Albers, J H

    1990-04-01

    In 1984, Overlook Hospital added a for-profit home health agency to its already established hospital-based home health agency. While the rationale for the development of two distinct organizations was sound, there were special legal, financial, and quality assurance issues and problems to consider. PMID:10104803

  2. Cardiac status assessment with a multi-signal device for improved home-based congestive heart failure management.

    PubMed

    Muehlsteff, Jens; Carvalho, Paulo; Henriques, Jorge; Paiva, Rui P; Reiter, Harald

    2011-01-01

    State-of-the-Art disease management for Congestive Heart Failure (CHF) patients is still based on easy-to-acquire measures such as heart rate (HR), weight and blood pressure (BP). However, these measures respond late to changes of the patient health status and provide limited information to personalize and adapt medication therapy. This paper describes our concept called "Cardiac Status Assessment" we have been investigating within the European project "HeartCycle" towards next-generation home-based disease management of CHF. In our concept we analyze non-invasive surrogate measures of the cardio-vascular function in particular systolic time intervals and pulse wave characteristics to estimate Cardiac Output (CO) and Systemic Vascular Resistance (SVR) both are established clinical measures. We discuss the underlying concept, a developed measurement system and first results. PMID:22254450

  3. Home-Based Supervisor's Guide.

    ERIC Educational Resources Information Center

    Research Assessment Management, Inc., Silver Spring, MD.

    The Head Start home-based supervisor provides guidance, support, direction, and continuing staff development opportunities while attempting to maintain and improve quality of services to Head Start children and families. This guide is designed to help the home-based supervisor in carrying out responsibilities while supporting the home visitor, who…

  4. Home Management House: Reflections of Alumnae

    ERIC Educational Resources Information Center

    Tifft, Kathleen; Fletcher, Janice; Junk, Virginia W.

    2011-01-01

    Historically, curriculum for home economics included experiences in home management residences. In this qualitative study, nine alumnae and one advisor who lived in a home management house between 1939 and 1959 were interviewed about how their experiences influenced the quality of their lives in the 40-60 subsequent years. Alumnae of the residence…

  5. 66 FR 46273 - Community Based In-Home Asthma Environmental Education and Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2001-09-04

    ... Radiation and Indoor Air. Section 103(a)(1) of the Clean Air Act authorizes the Administrator to conduct and...: Asthma and Indoor Air Exposures'' ( http://books.nap.edu/catalog/9610.html ). (1-5 points) (7) Applicant... and adults with asthma), results of existing in-home education efforts and/or existing indoor...

  6. Home-based nursing interventions improve knowledge of disease and management in patients with heart failure 1

    PubMed Central

    Azzolin, Karina de Oliveira; Lemos, Dayanna Machado; Lucena, Amália de Fátima; Rabelo-Silva, Eneida Rejane

    2015-01-01

    OBJECTIVE: to assess patient knowledge of heart failure by home-based measurement of two NOC Nursing Outcomes over a six-month period and correlate mean outcome indicator scores with mean scores of a heart failure Knowledge Questionnaire. METHODS: in this before-and-after study, patients with heart failure received four home visits over a six-month period after hospital discharge. At each home visit, nursing interventions were implemented, NOC outcomes were assessed, and the Knowledge Questionnaire was administered. RESULTS: overall, 23 patients received home visits. Mean indicator scores for the outcome Knowledge: Medication were 2.27±0.14 at home visit 1 and 3.55±0.16 at home visit 4 (P<0.001); and, for the outcome Knowledge: Treatment Regimen, 2.33±0.13 at home visit 1 and 3.59±0.14 at home visit 4 (P<0.001). The correlation between the Knowledge Questionnaire and the Nursing Outcomes Classification scores was strong at home visit 1 (r=0.7, P<0.01), but weak and non significant at visit 4. CONCLUSION: the results show improved patient knowledge of heart failure and a strong correlation between Nursing Outcomes Classification indicator scores and Knowledge Questionnaire scores. The NOC Nursing Outcomes proved effective as knowledge assessment measures when compared with the validated instrument. PMID:25806630

  7. [Quality insurance system establishment in the management of home-based chemotherapy: example of hospital at home "Assistance publique-Hôpitaux de Paris"].

    PubMed

    Benizri, F; Balladur, E; Darse, J; Guérin, J; Boudy, V; Echard, M; Brodin, M; Hagenmüller, J B; Prognon, P; Bonan, B

    2010-09-01

    While home-based chemotherapy improves comfort and quality of life of patients, quality and safety conditions must be equivalent to hospital settings. In addition, organization is much more complex. At the hospital at home "Assistance publique-Hôpitaux de Paris", prescribers are potentially spread across 21 health facilities. The administration of chemotherapy is performed by about 300 nurses at the patient's home in Paris and its suburbs. Centralized preparations of chemotherapy began in September 2009 by the pharmacy department of Georges-Pompidou European hospital, with a progressive increase of the activity. This article describes the quality insurance system established with this new organization to meet the specific challenges of home therapy: choice of eligible anticancer drugs, computerized information systems and networking with other heath facilities, secure transport conditions, traceability from the prescription to the administration, security of administration. This experience can offer an important support for other centres in their approach of quality insurance for home chemotherapy. PMID:20807693

  8. Home-Based Diabetes Symptom Self-Management Education for Mexican Americans with Type 2 Diabetes

    ERIC Educational Resources Information Center

    García, Alexandra A.; Brown, Sharon A.; Horner, Sharon D.; Zuñiga, Julie; Arheart, Kristopher L.

    2015-01-01

    This pilot study evaluated an innovative diabetes symptom awareness and self-management educational program for Mexican Americans, a fast growing minority population experiencing a diabetes epidemic. Patients with diabetes need assistance interpreting and managing symptoms, which are often annoying and potentially life-threatening. A repeated…

  9. Home Health Management Aide. Final Report.

    ERIC Educational Resources Information Center

    Mincemoyer, Betty Jane

    The report describes a demonstration project to provide a course of study at the senior high level in home health management for the academically handicapped. The course consisted of practice in nursing skills, home management and laboratory work in food preparation techniques, the family, and child care. Activities included field trips,…

  10. [Useful wound management at home].

    PubMed

    Mizuhara, Akihiro; Taguchi, Akemi; Sato, Mikako; Shindo, Kazuko

    2014-12-01

    In wound care, close observation of the quantity and nature of exudate from a wound, and selection of appropriate dressing and/or medication are crucial. Care should be taken to prevent wounds with excessive exudate from becoming too moist. Furthermore, wound care at home must be easy, which is achievable through the use of readily available materials and medications. 1 ) A wound with little to moderate exudate should be treated using wrap therapy with perforated polyethylene sheets. This therapy can be used to treat pressure ulcers, wounds, wounds with slough, and burns. 2 ) An 18-gauge needle can be used to perforate wounds with little exudate, such as mild pressure ulcers or wounds with slough, and polyurethane film can then be applied. 3 ) Polyurethane film should be applied to blisters, pressure ulcers, or similar skin injuries with little exudate. 4 ) A hydrocolloid dressing should be used on wounds with light exudate. 5 ) An ointment containing steroids should be applied to critically colonized wounds. 6 ) Melolin dressings, Moiskin Pads, or a disposable diaper should be used to manage wounds with heavy exudate. PMID:25595088

  11. Home Management Textbooks and the "Ideal" Family.

    ERIC Educational Resources Information Center

    Williams, Sue W.; Nickols, Sharon Y.

    1981-01-01

    Content analysis of systematically selected paragraphs of the three major textbooks used in teaching college-level home management courses was used to examine the hypothesis that they portray, and implicitly endorse, an ideal family type. Implications of the findings for home economists and family practitioners are discussed. (Author/CT)

  12. Home Care Nursing Improves Cancer Symptom Management

    Cancer.gov

    Home care nursing (HCN) improves the management of symptoms in breast and colorectal cancer patients who take the oral chemotherapy drug capecitabine, according to a study published online November 16 in the Journal of Clinical Oncology.

  13. Energy. Nebraska Home Economics Energy Management Guide.

    ERIC Educational Resources Information Center

    Nickisch, Marge Hill

    The Nebraska Home Economics Energy Management Guide is composed of 25 individual lessons in 5 units plus a resource section. The introductory unit discusses basic principles in decision-making, the historical development of energy sources and use, and the rationale for energy management. The next four units focus on energy management in housing,…

  14. Relative costs and effectiveness of treating uncomplicated malaria in two rural districts in Zambia: implications for nationwide scale-up of home-based management

    PubMed Central

    2011-01-01

    Background Malaria case management is one of the key strategies to control malaria. Various studies have demonstrated the feasibility of home management of malaria (HMM). However, data on the costs and effectiveness of artemisinin-based combination therapy (ACT) and rapid diagnostic tests via HMM is limited. Method Cost-effectiveness of home management versus health facility-based management of uncomplicated malaria in two rural districts in Zambia was analysed from a providers' perspective. The sample included 16 community health workers (CHWs) and 15 health facilities. The outcome measure was the cost per case appropriately diagnosed and treated. Costs of scaling-up HMM nationwide were estimated based on the CHW utilisation rates observed in the study. Results HMM was more cost effective than facility-based management of uncomplicated malaria. The cost per case correctly diagnosed and treated was USD 4.22 for HMM and USD 6.12 for facility level. Utilization and adherence to diagnostic and treatment guidelines was higher in HMM than at a health facility. Conclusion HMM using ACT and RDTs was more efficient at appropriately diagnosing and treating malaria than the health facility level. Scaling up this intervention requires significant investments. PMID:21651828

  15. Fuzzy-Logic Subsumption Controller for Home Energy Management Systems

    SciTech Connect

    Ainsworth, Nathan; Johnson, Brian; Lundstrom, Blake

    2015-10-06

    Home Energy Management Systems (HEMS) are controllers that manage and coordinate the generation, storage, and loads in a home. These controllers are increasingly necessary to ensure that increasing penetrations of distributed energy resources are used effectively and do not disrupt the operation of the grid. In this paper, we propose a novel approach to HEMS design based on behavioral control methods, which do not require accurate models or predictions and are very responsive to changing conditions. We develop a proof-of-concept behavioral HEMS controller and show by simulation on an example home energy system that it capable of making context-dependent tradeoffs between goals under challenging conditions.

  16. Feasibility and acceptability of artemisinin-based combination therapy for the home management of malaria in four African sites

    PubMed Central

    Ajayi, Ikeoluwapo O; Browne, Edmund N; Garshong, Bertha; Bateganya, Fred; Yusuf, Bidemi; Agyei-Baffour, Peter; Doamekpor, Leticia; Balyeku, Andrew; Munguti, Kaendi; Cousens, Simon; Pagnoni, Franco

    2008-01-01

    Background The Home Management of Malaria (HMM) strategy was developed using chloroquine, a now obsolete drug, which has been replaced by artemisinin-based combination therapy (ACT) in health facility settings. Incorporation of ACT in HMM would greatly expand access to effective antimalarial therapy by the populations living in underserved areas in malaria endemic countries. The feasibility and acceptability of incorporating ACT in HMM needs to be evaluated. Methods A multi-country study was performed in four district-size sites in Ghana (two sites), Nigeria and Uganda, with populations ranging between 38,000 and 60,000. Community medicine distributors (CMDs) were trained in each village to dispense pre-packaged ACT to febrile children aged 6–59 months, after exclusion of danger signs. A community mobilization campaign accompanied the programme. Artesunate-amodiaquine (AA) was used in Ghana and artemether-lumefantrine (AL) in Nigeria and Uganda. Harmonized qualitative and quantitative data collection methods were used to evaluate CMD performance, caregiver adherence and treatment coverage of febrile children with ACTs obtained from CMDs. Results Some 20,000 fever episodes in young children were treated with ACT by CMDs across the four study sites. Cross-sectional surveys identified 2,190 children with fever in the two preceding weeks, of whom 1,289 (59%) were reported to have received ACT from a CMD. Coverage varied from 52% in Nigeria to 75% in Ho District, Ghana. Coverage rates did not appear to vary greatly with the age of the child or with the educational level of the caregiver. A very high proportion of children were reported to have received the first dose on the day of onset or the next day in all four sites (range 86–97%, average 90%). The proportion of children correctly treated in terms of dose and duration was also high (range 74–97%, average 85%). Overall, the proportion of febrile children who received prompt treatment and the correct dose for

  17. Home media server content management

    NASA Astrophysics Data System (ADS)

    Tokmakoff, Andrew A.; van Vliet, Harry

    2001-07-01

    With the advent of set-top boxes, the convergence of TV (broadcasting) and PC (Internet) is set to enter the home environment. Currently, a great deal of activity is occurring in developing standards (TV-Anytime Forum) and devices (TiVo) for local storage on Home Media Servers (HMS). These devices lie at the heart of convergence of the triad: communications/networks - content/media - computing/software. Besides massive storage capacity and being a communications 'gateway', the home media server is characterised by the ability to handle metadata and software that provides an easy to use on-screen interface and intelligent search/content handling facilities. In this paper, we describe a research prototype HMS that is being developed within the GigaCE project at the Telematica Instituut . Our prototype demonstrates advanced search and retrieval (video browsing), adaptive user profiling and an innovative 3D component of the Electronic Program Guide (EPG) which represents online presence. We discuss the use of MPEG-7 for representing metadata, the use of MPEG-21 working draft standards for content identification, description and rights expression, and the use of HMS peer-to-peer content distribution approaches. Finally, we outline explorative user behaviour experiments that aim to investigate the effectiveness of the prototype HMS during development.

  18. Research of home networking system based on XML/BACnet

    NASA Astrophysics Data System (ADS)

    Wang, Zhongming

    2008-11-01

    To standardize home networking information and simplify its management, this paper form a universal information module of various devices in home networking by adopting XML technology and BACnet protocol(XML/BACnet). Then, a software architecture of home networking based on this module is designed, having the function like auto management and maintenance, safety, real-time and remote controlling. Consequently, a home networking system based on this architecture is completed. Tested and evaluated, this system is one easy-using, easy-realizing, nice real-time system with strong heterogeneity and stable safety system.

  19. Patient Preferences and Willingness-To-Pay for a Home or Clinic Based Program of Chronic Heart Failure Management: Findings from the Which? Trial

    PubMed Central

    Whitty, Jennifer A.; Stewart, Simon; Carrington, Melinda J.; Calderone, Alicia; Marwick, Thomas; Horowitz, John D.; Krum, Henry; Davidson, Patricia M.; Macdonald, Peter S.; Reid, Christopher; Scuffham, Paul A.

    2013-01-01

    Background Beyond examining their overall cost-effectiveness and mechanisms of effect, it is important to understand patient preferences for the delivery of different modes of chronic heart failure management programs (CHF-MPs). We elicited patient preferences around the characteristics and willingness-to-pay (WTP) for a clinic or home-based CHF-MP. Methodology/Principal Findings A Discrete Choice Experiment was completed by a sub-set of patients (n = 91) enrolled in the WHICH? trial comparing home versus clinic-based CHF-MP. Participants provided 5 choices between hypothetical clinic and home-based programs varying by frequency of nurse consultations, nurse continuity, patient costs, and availability of telephone or education support. Participants (aged 71±13 yrs, 72.5% male, 25.3% NYHA class III/IV) displayed two distinct preference classes. A latent class model of the choice data indicated 56% of participants preferred clinic delivery, access to group CHF education classes, and lower cost programs (p<0.05). The remainder preferred home-based CHF-MPs, monthly rather than weekly visits, and access to a phone advice service (p<0.05). Continuity of nurse contact was consistently important. No significant association was observed between program preference and participant allocation in the parent trial. WTP was estimated from the model and a dichotomous bidding technique. For those preferring clinic, estimated WTP was ≈AU$9-20 per visit; however for those preferring home-based programs, WTP varied widely (AU$15-105). Conclusions/Significance Patient preferences for CHF-MPs were dichotomised between a home-based model which is more likely to suit older patients, those who live alone, and those with a lower household income; and a clinic-based model which is more likely to suit those who are more socially active and wealthier. To optimise the delivery of CHF-MPs, health care services should consider their patients’ preferences when designing CHF-MPs. PMID

  20. Managing latex allergies at home

    MedlinePlus

    ... Allergy Association; American College of Allergy, Asthma and Immunology. Latex Cross-reactive Foods Fact Sheet. Updated October ... Allergy Association; American College of Allergy, Asthma and Immunology. Guidelines for the Management of Latex Allergies. Updated ...

  1. [MATCHE: Management Approach to Teaching Consumer and Homemaking Education.] Occupational Strand: Management. Module II-F-1: Occupational Opportunities Related to Home Management and Supporting Services.

    ERIC Educational Resources Information Center

    Karikka, Katherine

    This competency-based preservice home economics teacher education module on occupational opportunities related to home management and supporting services is the first in a set of two modules on occupational programs related to home management. (This set is part of a larger set of sixty-seven modules on the Management Approach to Teaching Consumer…

  2. Energy Management Checklist for the Home.

    ERIC Educational Resources Information Center

    Pifer, Glenda

    This booklet contains a checklist of equipment and activities for the individual's use in home energy management. The categories covered include: (1) insulation; (2) windows; (3) temperature control; (4) lighting; (5) heating water; (6) laundry; (7) cleaning and maintenance; (8) cooking; (9) refrigeration; (10) dishwashing; (11) recreation; and…

  3. Developing a cost-effective home care management support system for small nursing homes in Taiwan.

    PubMed

    Tu, Ming-Hsiang; Chang, Polun

    2009-01-01

    Home care is important in Taiwan but most of the institutes are small and cannot afford computerization. We develop a support system based on InterRAI case management system using Excel VBA which is the most "free" application in institutes. The prototype system shows promising. PMID:19592932

  4. Managing Everyday Life: A Qualitative Study of Patients’ Experiences of a Web-Based Ulcer Record for Home-Based Treatment

    PubMed Central

    Trondsen, Marianne V.

    2014-01-01

    Chronic skin ulcers are a significant challenge for patients and health service resources, and ulcer treatment often requires the competence of a specialist. Although e-health interventions are increasingly valued for ulcer care by giving access to specialists at a distance, there is limited research on patients’ use of e-health services for home-based ulcer treatment. This article reports an exploratory qualitative study of the first Norwegian web-based counselling service for home-based ulcer treatment, established in 2011 by the University Hospital of North Norway (UNN). Community nurses, general practitioners (GPs) and patients are offered access to a web-based record system to optimize ulcer care. The web-based ulcer record enables the exchange and storage of digital photos and clinical information, by the use of which, an ulcer team at UNN, consisting of specialized nurses and dermatologists, is accessible within 24 h. This article explores patients’ experiences of using the web-based record for their home-based ulcer treatment without assistance from community nurses. Semi-structured interviews were conducted with a total of four patients who had used the record. The main outcomes identified were: autonomy and flexibility; safety and trust; involvement and control; and motivation and hope. These aspects improved the patients’ everyday life during long-term ulcer care and can be understood as stimulating patient empowerment.

  5. The Seattle–King County Healthy Homes II Project: A Randomized Controlled Trial of Asthma Self-management Support Comparing Clinic-Based Nurses and In-Home Community Health Workers

    PubMed Central

    Krieger, James; Takaro, Tim K.; Song, Lin; Beaudet, Nancy; Edwards, Kristine

    2009-01-01

    Objective To compare the marginal benefit of in-home asthma self-management support provided by community health workers (CHWs) with standard asthma education from clinic-based nurses. Design Randomized controlled trial. Setting Community and public health clinics and homes. Participants Three hundred nine children aged 3 to 13 years with asthma living in low-income households. Interventions All participants received nurse-provided asthma education and referrals to community resources. Some participants also received CHW-provided home environmental assessments, asthma education, social support, and asthma-control resources. Outcome Measures Asthma symptom–free days, Pediatric Asthma Caretaker Quality of Life Scale score, and use of urgent health services. Results Both groups showed significant increases in caretaker quality of life (nurse-only group: 0.4 points; 95% confidence interval [CI], 0.3–0.6; nurse + CHW group: 0.6 points; 95% CI, 0.4–0.8) and number of symptom-free days (nurse only: 1.3 days; 95% CI, 0.5–2.1; nurse + CHW: 1.9 days; 95% CI, 1.1–2.8), and absolute decreases in the proportion of children who used urgent health services in the prior 3 months (nurse only: 17.6%; 95% CI, 8.1%–27.2%; nurse + CHW: 23.1%; 95% CI, 13.6%–32.6%). Quality of life improved by 0.22 more points in the nurse + CHW group (95% CI, 0.00–0.44; P=.049). The number of symptom-free days increased by 0.94 days per 2 weeks (95% CI, 0.02–1.86; P = .046), or 24.4 days per year, in the nurse + CHW group. While use of urgent health services decreased more in the nurse + CHW group, the difference between groups was not significant. Conclusion The addition of CHW home visits to clinic-based asthma education yielded a clinically important increase in symptom-free days and a modest improvement in caretaker quality of life. PMID:19188646

  6. Home and Community-Based Services in Seven States

    PubMed Central

    Wiener, Joshua M.; Tilly, Jane; Alecxih, Lisa Maria B.

    2002-01-01

    As part of a CMS-funded study, case studies were conducted in Alabama, Indiana, Washington, Wisconsin, Maryland, Michigan, and Kentucky to assess the major features of the home and community-based services system for older people and younger adults with physical disabilities in each State. The case studies analyzed the financing of services; administrative systems; eligibility, assessment, and case management structures; the services provided, including consumer-directed home care and group residential care; cost-containment efforts; and quality assurance. The role that Medicaid plays in home and community-based services is a major focus of the study. PMID:12500351

  7. A multi-method review of home-based chemotherapy.

    PubMed

    Evans, J M; Qiu, M; MacKinnon, M; Green, E; Peterson, K; Kaizer, L

    2016-09-01

    This study summarises research- and practice-based evidence on home-based chemotherapy, and explores existing delivery models. A three-pronged investigation was conducted consisting of a literature review and synthesis of 54 papers, a review of seven home-based chemotherapy programmes spanning four countries, and two case studies within the Canadian province of Ontario. The results support the provision of home-based chemotherapy as a safe and patient-centred alternative to hospital- and outpatient-based service. This paper consolidates information on home-based chemotherapy programmes including services and drugs offered, patient eligibility criteria, patient views and experiences, delivery structures and processes, and common challenges. Fourteen recommendations are also provided for improving the delivery of chemotherapy in patients' homes by prioritising patient-centredness, provider training and teamwork, safety and quality of care, and programme management. The results of this study can be used to inform the development of an evidence-informed model for the delivery of chemotherapy and related care, such as symptom management, in patients' homes. PMID:26545409

  8. Extension and Home-Based Businesses.

    ERIC Educational Resources Information Center

    Loker, Suzanne; And Others

    1990-01-01

    Includes "Building Home Businesses in Rural Communities" (Loker et al.); "Home-Based Business...A Means to Economic Growth in Rural Areas" (Bastow-Shoop et al.); "Business Not As Usual" (Millar, Mallilo); and "Economic Options for Farm Families" (Williams). (SK)

  9. Management of agitation in nursing home patients.

    PubMed

    Billig, N

    1996-08-01

    Agitation in demented nursing home residents is a major clinical problem with which patients, families and staff are required to cope. Agitation may be secondary to a variety of psychiatric, environmental and medical problems, and thus attempts must be made to [correction of be] clarify aetiological issues before initiating a treatment plan. Treatments for agitation are imperfect, and clinicians should be prepared to work through several to find the best for a given patient and clinical situation. Cognitive/behavioural/environmental treatments have the advantage of few or no adverse effects and no drug-drug interactions. Some of these define rather basic nursing management techniques for coping with agitated older adults, while others attempt to diminish specific behaviours. The use of pharmacological interventions should be reserved for those patients in whom other measures have been unsuccessful. While the range of medications that have been used to treat various kinds of agitated behaviours is large, there are few double-blind, placebo-controlled trials in this area and fewer still in nursing home populations. No one class and no one medication has been identified as a treatment of choice. While we work to find the aetiological mechanisms of irreversible forms of dementia, and the possible treatments for the underlying disorders, the challenge to develop more effective medications with better adverse effect profiles is before us. PMID:8820795

  10. Actualizing Concepts in Home Management: Proceedings of a National Conference.

    ERIC Educational Resources Information Center

    American Home Economics Association, Washington, DC.

    The booklet prints the following papers delivered at a national conference: Actualizing Concepts in Home Management: Decision Making, Dorothy Z. Price; Innovations in Teaching: Ergonomics, Fern E. Hunt; Relevant Concepts of Home Management: Innovations in Teaching, Kay P. Edwards; Standards in a Managerial Context, Florence S. Walker; Organizing:…

  11. Top Management Team Characteristics and Innovation in Nursing Homes.

    ERIC Educational Resources Information Center

    Castle, Nicholas G.; Banaszak-Holl, Jane

    1997-01-01

    Examines how demographic characteristics of the top management team in 236 nursing homes can affect the adoption of innovations. Results indicate that managers of non-chain nursing homes showed a greater association between demographic factors and innovation. Job tenure, educational background, and professional involvement were important…

  12. Engineering for reliability in at-home chronic disease management

    PubMed Central

    Kendall, Logan; Eschler, Jordan; Lozano, Paula; McClure, Jennifer B.; Vizer, Lisa M.; Ralston, James D.; Pratt, Wanda

    2014-01-01

    Individuals with chronic conditions face challenges with maintaining lifelong adherence to self-management activities. Although reminders can help support the cognitive demands of managing daily and future health tasks, we understand little of how they fit into people’s daily lives. Utilizing a maximum variation sampling method, we interviewed and compared the experiences of 20 older adults with diabetes and 19 mothers of children with asthma to understand reminder use for at-home chronic disease management. Based on our participants’ experiences, we contend that many self-management failures should be viewed as systems failures, rather than individual failures and non-compliance. Furthermore, we identify key principles from reliability engineering that both explain current behavior and suggest strategies to improve patient reminder systems. PMID:25954384

  13. Quality Assurance Strategy for Existing Homes. Final Quality Management Primer for High Performing Homes

    SciTech Connect

    Del Bianco, M.; Taggart, J.; Sikora, J.; Wood, A.

    2012-12-01

    This guide is designed to help Building America (BA) teams understand quality management and its role in transitioning from conventional to high performance home building and remodeling. It explains what quality means, the value of quality management systems, the unique need for QMS when building high performing homes, and the first steps to a implementing a comprehensive QMS. This document provides a framework and context for BA teams when they encounter builders and remodelers.

  14. Quality Assurance Strategy for Existing Homes: Final Quality Management Primer for High Performing Homes

    SciTech Connect

    Del Bianco, M.; Taggart, J.; Sikora, J.; Wood, A.

    2012-12-01

    This guide is designed to help Building America (BA) Teams understand quality management and its role in transitioning from conventional to high performance home building and remodeling. It explains what quality means, the value of quality management systems, the unique need for QMS when building high performing homes, and the first steps to a implementing a comprehensive QMS. This document provides a framework and context for BA teams when they encounter builders and remodelers.

  15. Managing congestive heart failure using home telehealth.

    PubMed

    Schneider, Nina M

    2004-10-01

    Congestive heart failure (CHF) is the leading cause of rehospitalization and loss of revenue for home care agencies and hospitals. This article outlines how an agency used telehealth to provide CHF patients quality care and improved outcomes while decreasing the number of skilled home nursing visits and reducing rehospitalization rates to 1.2%. PMID:15486513

  16. Managed care. An opportunity for home care agencies.

    PubMed

    Dee-Kelly, P A; Heller, S; Sibley, M

    1994-09-01

    It is clear, even in the future of health care reform, that home care is a growing component of the health care industry. For many years, fee for service was the model reimbursement method. Today we are in a changing health care system that requires a greater emphasis on home care cost containment. New methods of reimbursement are a part of the change. Progressive home care agencies see this as an opportunity to become leaders. This approach does not come without certain risks, however. In taking the risks, it is imperative to minimize the chances for problems, obstacles, and compromising the quality of patient care. It requires that the agency develop a strategy, set a course, and then devote the resources necessary to meet these challenges. Resources may mean investing in upgraded information systems, hiring clinical specialists to develop care plans and protocols, or developing in-house case management staff to allow the agency to monitor use and quality. One thing is clear--the old way of doing business, cost-based fee for service, has a limited life span, and agencies need to embrace these changes, not ignore them. PMID:8090642

  17. Monitors Enable Medication Management in Patients' Homes

    NASA Technical Reports Server (NTRS)

    2014-01-01

    Glenn Research Center awarded SBIR funding to ZIN Technologies to develop a platform that could incorporate sensors quantifying an astronaut’s health status and then communicate with the ground. ZIN created a device, developed the system further, and then formed Cleveland-based FlexLife Health to commercialize the technology. Today it is part of an anti-coagulation management system for people with cardiovascular disease.

  18. Employees’ views on home-based, after-hours telephone triage by Dutch GP cooperatives

    PubMed Central

    2013-01-01

    Background Dutch out-of-hours (OOH) centers find it difficult to attract sufficient triage staff. They regard home-based triage as an option that might attract employees. Specially trained nurses are supposed to conduct triage by telephone from home for after-hours medical care. The central aim of this research is to investigate the views of employees of OOH centers in The Netherlands on home-based telephone triage in after-hours care. Methods The study is a Q methodology study. Triage nurses, general practitioners (GPs) and managers of OOH centers ranked 36 opinion statements on home-based triage. We interviewed 10 participants to help develop and validate the statements for the Q sort, and 77 participants did the Q sort. Results We identified four views on home-based telephone triage. Two generally favor home-based triage, one highlights some concerns and conditions, and one opposes it out of concern for quality. The four views perceive different sources of credibility for nurse triagists working from home. Conclusion Home-based telephone triage is a controversial issue among triage nurses, GPs and managers of OOH centers. By identifying consensus and dissension among GPs, triagists, managers and regulators, this study generates four perspectives on home-based triage. In addition, it reveals the conditions considered important for home-based triage. PMID:24188407

  19. Home Fruit, Juice and Vegetable Pantry Management and Availability Scales

    PubMed Central

    Baranowski, Tom; Missaghian, Mariam; Watson, Kathy; Broadfoot, Alison; Cullen, Karen; Nicklas, Theresa; Fisher, Jennifer; O’Donnell, Sharon

    2008-01-01

    Home fruit, 100% juice and vegetable (FJV) availability is related to increased FJV consumption by children. While FJV must be purchased for use in the home, no scales have been reported on home FJV pantry management practices. A scale for home FJV pantry management practices was generated from focus group discussions with diverse food shoppers. A commonly used scale of home FJV availability was also assessed. A grocery store intercept survey recruited 171 food shoppers with children in front of supermarkets and grocery stores. Survey instruments were administered twice, separated by 6 weeks. Single dimensionality was observed for each scale. Item Response Theory parameter estimates revealed easily interpreted patterns in the sequence of items by difficulty of response. These scales are available to help better understand influences on family FJV purchase decisions. PMID:17959271

  20. The challenges of a home-based nursing consultation business.

    PubMed

    Schulmeister, L

    1999-03-01

    The transition from working in a traditional setting to working at home alone can be challenging for new nurse consultants. Home-based consultants can use a variety of strategies to stay focused and connected, such as having a designated work area, limiting distractions, and networking. Nurse consultants can obtain information about business management from community resources, and computer on-line services offer a means of contacting other small-business owners. Ongoing business evaluations, which include professional accomplishments as well as an examination of income and expenses, help in planning. Home-based nurse consultants can increase the likelihood of business success by setting objectives, working diligently, and networking with others in the business community. PMID:10382409

  1. Family Caregivers Define and Manage the Nursing Home Placement Process.

    PubMed

    Koplow, Sarah M; Gallo, Agatha M; Knafl, Kathleen A; Vincent, Catherine; Paun, Olimpia; Gruss, Valerie

    2015-08-01

    The nursing home placement process is complex and difficult for family caregivers. This qualitative descriptive study examines the experiences of caregivers involved in the management of care and placement of an older family member using the Family Management Style Framework. Ten caregivers were recruited from four nursing homes in the Midwest. The caregivers were interviewed shortly after placement and again 3 months post-placement. Results provide a unique understanding of care management and the nursing home placement process from the perspective of the primary family caregiver. Overall, there were similarities across the same types of caregiving dyads, for example, spousal and adult-children caregivers. Caregivers expressed the need to maintain the identity of their older family member, a familial responsibility for caregiving, and change in their family relationship over time. Appreciating caregivers' challenges and needs gives health care professionals a better understanding for how to provide assistance for a smoother nursing home transition. PMID:25691220

  2. A Handbook for Home-Based Services.

    ERIC Educational Resources Information Center

    Kenney, Maggie

    The manual discusses home based approaches to support families of developmentally disabled children. The first section presents in question and answer format the rationale for such support services. Succeeding sections address the following aspects: respite care, sitter/companion services; parent counseling, education, and training; in home…

  3. Effective Treatment in Home-Based Services.

    ERIC Educational Resources Information Center

    Simboli, Tim; Darou, Wes G.

    The use of home-based treatment programs has become increasingly popular over the last few years. Such a program is offered by the Youth Services Bureau of Ottawa-Carleton through its Detached Worker Program. This program uses paraprofessionals who employ an eclectic combination of behavioral, client-centered, family and reality therapies. Two…

  4. Sickle cell disease pain management and the medical home.

    PubMed

    Raphael, Jean L; Oyeku, Suzette O

    2013-01-01

    Pain is the most common cause for hospitalization and acute morbidity in sickle cell disease (SCD). The consequences of SCD-related pain are substantial, affecting both the individual and the health care system. The emergence of the patient-centered medical home (PCMH) provides new opportunities to align efforts to improve SCD management with innovative and potentially cost-effective models of patient-centered care. The Department of Health and Human Services has designated SCD as a priority area with emphasis on creating PCMHs for affected patients. The question for patients, clinicians, scientists, and policy-makers is how the PCMH can be designed to address pain, the hallmark feature of SCD. This article provides a framework of pain management within the PCMH model. We present an overview of pain and pain management in SCD, gaps in pain management, and current care models used by patients and discuss core PCMH concepts and multidisciplinary team-based PCMH care strategies for SCD pain management. PMID:24319216

  5. Feasibility of home management using ACT for childhood malaria episodes in an urban setting

    PubMed Central

    Nsagha, Dickson S; Elat, Jean-Bosco N; Ndong, Proper AB; Tata, Peter N; Tayong, Maureen-Nill N; Pokem, Francois F; Wankah, Christian C

    2012-01-01

    Background Over 90% of malaria cases occur in Sub-Saharan Africa, where a child under the age of 5 years dies from this illness every 30 seconds. The majority of families in Sub- Saharan Africa treat malaria at home, but therapy is often incomplete, hence the World Health Organization has adopted the strategy of home management of malaria to solve the problem. The purpose of this study was to determine community perception and the treatment response to episodes of childhood malaria in an urban setting prior to implementation of home management using artemisinin-based combination therapy (ACT). Methods This qualitative exploratory study on the home management of malaria in urban children under 5 years of age used 15 focus group discussions and 20 in-depth interviews in various categories of caregivers of children under 5 years. One hundred and eighteen people participated in the focus group discussions and 20 in the in-depth interviews. The study explored beliefs and knowledge about malaria, mothers’ perception of home management of the disease, health-seeking behavior, prepackaged treatment of malaria using ACT and a rapid diagnostic test, preferred channels for home management of uncomplicated malaria, communication, the role of the community in home management of malaria, and the motivation of drug distributors in the community. Results The mothers’ perception of malaria was the outcome of events other than mosquito bites. Home treatment is very common and is guided by the way mothers perceive signs and symptoms of malaria. Frequent change of malarial drugs by the national health policy and financial difficulties were the main problems mothers faced in treating febrile children. Rapid diagnostic testing and prepackaged ACT for simple malaria in children under 5 years would be accepted if it was offered at an affordable price. Tribalism and religious beliefs might hinder the delivery of home management of malaria. The availability of rapid diagnostic testing

  6. Home Furnishings and Equipment. Money Management.

    ERIC Educational Resources Information Center

    Baran, Nancy H., Ed.

    This booklet provides guidelines for buying major home appliances from ranges and refrigerators to washers and dryers, as well as wood and upholstered furniture, and bedding and floor coverings, with helpful charts to make selection easier. It begins with suggestions on how to furnish within one's means. Next, information on equipping the home…

  7. Home and Family Management. A Bibliography.

    ERIC Educational Resources Information Center

    Florida State Univ., Tallahassee. Center for Instructional Development and Services.

    This bibliography describes 133 materials available for use in home economics classes. The materials include books, pamphlets and brochures, films curriculum guides, study guides, and workbooks. A few are suited for use with special needs students. Materials for inclusion in the bibliography were located through the Florida Educational Information…

  8. Home Based Care: Direction for the 80s.

    ERIC Educational Resources Information Center

    Bryce, Marvin E.

    Home based family centered (HBFC) service programs have been developed as alternatives to out-of-home placement. These programs have reported relatively high service success rates at costs signficantly lower than foster home and institutional care while, at the same time, avoiding the social and psychological risks of out-of-home placement.…

  9. Memory Management of Multimedia Services in Smart Homes

    NASA Astrophysics Data System (ADS)

    Kamel, Ibrahim; Muhaureq, Sanaa A.

    Nowadays there is a wide spectrum of applications that run in smart home environments. Consequently, home gateway, which is a central component in the smart home, must manage many applications despite limited memory resources. OSGi is a middleware standard for home gateways. OSGi models services as dependent components. Moreover, these applications might differ in their importance. Services collaborate and complement each other to achieve the required results. This paper addresses the following problem: given a home gateway that hosts several applications with different priorities and arbitrary dependencies among them. When the gateway runs out of memory, which application or service will be stopped or kicked out of memory to start a new service. Note that stopping a given service means that all the services that depend on it will be stopped too. Because of the service dependencies, traditional memory management techniques, in the operating system literatures might not be efficient. Our goal is to stop the least important and the least number of services. The paper presents a novel algorithm for home gateway memory management. The proposed algorithm takes into consideration the priority of the application and dependencies between different services, in addition to the amount of memory occupied by each service. We implement the proposed algorithm and performed many experiments to evaluate its performance and execution time. The proposed algorithm is implemented as a part of the OSGi framework (Open Service Gateway initiative). We used best fit and worst fit as yardstick to show the effectiveness of the proposed algorithm.

  10. Lessons Learned from Home Visiting with Home-Based Child Care Providers

    ERIC Educational Resources Information Center

    McCabe, Lisa A.; Peterson, Shira M.; Baker, Amy C.; Dumka, Marsha; Brach, Mary Jo; Webb, Diana

    2011-01-01

    Caring for Quality and Partners in Family Child Care are home visiting programs designed to improve the quality of home-based child care. This article describes the experiences of two different home visitors to demonstrate how programs such as these can help providers improve the overall quality of care, increase children's development, and lead…

  11. Diabetes Self-Management Education in the Home

    PubMed Central

    Zeitoun, Joanah; Stern, Marianne; Butkiewicz, Elise; Wegner, Elfie; Reinisch, Courtney

    2016-01-01

    Purpose Diabetes self-management education and home visits have been found to improve clinical outcomes in individuals living with diabetes. The purpose of this pilot project was to evaluate the feasibility and effectiveness of conducting self-management education in patients' homes. Methods Baseline biometric data was collected from a cohort of adult patients with diabetes. Home visits to 19 patients were conducted by doctoral students from Rutgers University School of Nursing. The visits included knowledge assessment, review of foods in the home, diabetes self-management education, and teaching the proper use of monitoring tools such as the glucometer and blood pressure monitor. Biomarkers were obtained post-intervention and were compared to baseline biomarkers. Descriptive lifestyle data was collected and opportunities for customized patient education were provided. Results The biomarkers improved overall during the four months after the education intervention. The mean A1C reduced 12% (p=0.0107), the mean glucose reduced 12% (p=0.0994), the mean BMI reduced 2% (p=0.1490), the systolic pressure reduced 1% (p=0.4196), and the diastolic pressure remained stable. Specific goal setting further increased the improvement in the area the individual planned to address.  Conclusions This project supports prior studies that found that in-home educational programs can improve the self-management of diabetes and lead to improvement in health indicators. The benefits of the study included personal attention in ensuring the correct use of home health monitoring devices, building self-management confidence, and identifying treatment barriers that may not be easily discerned in a clinic setting. PMID:27588231

  12. DECENTRALIZED STORMWATER MANAGEMENT: RETROFITTING HOMES, RESTORING WATERSHEDS

    EPA Science Inventory

    Stormwater runoff from impervious surfaces in urban and suburban areas has led to human safety risks and widespread stream ecosystem impairment. While centralized stormwater management can minimize large fluctuations in stream flows and flooding risk to urban areas, this approac...

  13. Dementia Home Care Resources: How Are We Managing?

    PubMed Central

    Ward-Griffin, Catherine; Hall, Jodi; DeForge, Ryan; St-Amant, Oona; McWilliam, Carol; Oudshoorn, Abram; Forbes, Dorothy; Klosek, Marita

    2012-01-01

    With the number of people living with dementia expected to more than double within the next 25 years, the demand for dementia home care services will increase. In this critical ethnographic study, we drew upon interview and participant data with persons with dementia, family caregivers, in-home providers, and case managers in nine dementia care networks to examine the management of dementia home care resources. Three interrelated, dialectical themes were identified: (1) finite formal care-inexhaustible familial care, (2) accessible resources rhetoric-Iinaccessible resources reality, and (3) diminishing care resources-increasing care needs. The development of policies and practices that provide available, accessible, and appropriate resources, ensuring equitable, not necessarily equal, distribution of dementia care resources is required if we are to meet the goal of aging in place now and in the future. PMID:22132332

  14. An Analysis of a Computerized System for Managing Curriculum Decisions and Tracking Student Progress in a Home-Based Pre-School Education Project.

    ERIC Educational Resources Information Center

    Lutz, John E.; And Others

    The degree of success of the computerized Child-Based Information System (CBIS) was analyzed in two areas--presenting, delivering, and managing a developmental curriculum; and recording, filing, and monitoring child tracking data, including requirements for Individualized Education Plans (IEP's). Preschool handicapped and high-risk children and…

  15. Home Management Curriculum Guide. Energy and the Family.

    ERIC Educational Resources Information Center

    Davidson, Jane S.; Morris, Carol

    This curriculum guide on home management, covering one of the five content areas of the Energy and Family Curriculum Guide, has been designed to provide learning experiences and identify resources that can be used to develop units of study related to energy usage and conservation. The guide is intended for use in comprehensive courses of home…

  16. Home fruit, juice, and vegetable pantry management and availability scales: A validation

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Home fruit, 100% juice, and vegetables (FJV) availability is related to increased FJV consumption by children. While FJV must be purchased for use in the home, no scales have been reported on home FJV pantry management practices. A scale for home FJV pantry management practices was generated from fo...

  17. Skill-Based Management Training: The Teaching Family Model Revisisted.

    ERIC Educational Resources Information Center

    Baron, Richard L.; And Others

    This paper provides a description of the Program Manager Workshop, a skill-based management training workshop for managers of group homes. The workshop is an extension of the Teaching-Family Model of Community Based Care, a model used in residential treatment homes for persons experiencing problems such as delinquency, retardation, mental illness,…

  18. "Making Do" Decisions: How Home Healthcare Personnel Manage Their Exposure to Home Hazards.

    PubMed

    Wills, Celia E; Polivka, Barbara J; Darragh, Amy; Lavender, Steven; Sommerich, Carolyn; Stredney, Donald

    2016-04-01

    This study describes the decision-making processes home healthcare personnel (HHP) use to manage their personal health and safety when managing hazards in client homes. A professionally diverse national sample of 68 HHP participated in individual semi-structured interviews and focus group discussions, and described their decision making and strategies for hazard management in their work environments. HHP described 353 hazard management dilemmas within 394 specifically identified hazards, which were clustered within three broader categories: electrical/fire, slip/trip/lift, and environmental exposures. HHP described multiple types of "making do" decisions for hazard management solutions in which perceived and actual resource limitations constrained response options. A majority of hazard management decisions in the broader hazards categories (72.5%, 68.5%, and 63.5%, respectively) were classifiable as less than optimal. These findings stress the need for more support of HHPs, including comprehensive training, to improve HHP decision making and hazard management strategies, especially in context of resource constraints. PMID:26669605

  19. “Making Do” Decisions: How Home Healthcare Personnel Manage Their Exposure to Home Hazards

    PubMed Central

    Wills, Celia E.; Polivka, Barbara J.; Darragh, Amy; Lavender, Steven; Sommerich, Carolyn; Stredney, Donald

    2016-01-01

    This study describes the decision-making processes home healthcare personnel (HHP) use to manage their personal health and safety when managing hazards in client homes. A professionally diverse national sample of 68 HHP participated in individual semi-structured interviews and focus group discussions, and described their decision making and strategies for hazard management in their work environments. HHP described 353 hazard management dilemmas within 394 specifically identified hazards, which were clustered within three broader categories: electrical/fire, slip/trip/lift, and environmental exposures. HHP described multiple types of “making do” decisions for hazard management solutions in which perceived and actual resource limitations constrained response options. A majority of hazard management decisions in the broader hazards categories (72.5%, 68.5%, and 63.5%, respectively) were classifiable as less than optimal. These findings stress the need for more support of HHPs, including comprehensive training, to improve HHP decision making and hazard management strategies, especially in context of resource constraints. PMID:26669605

  20. A Fuzzy-Logic Subsumption Controller for Home Energy Management Systems

    SciTech Connect

    Ainstworth, Nathan; Johnson, Brian; Lundstrom, Blake

    2015-10-05

    Presentation for NAPS 2015 associated with conference publication CP-64392. Home Energy Management Systems (HEMS) are controllers that manage and coordinate the generation, storage, and loads in a home. These controllers are increasingly necessary to ensure that increasing penetrations of distributed energy resources are used effectively and do not disrupt the operation of the grid. In this paper, we propose a novel approach to HEMS design based on behavioral control methods, which do not require accurate models or predictions and are very responsive to changing conditions.

  1. Home-based radiology transcription and a productivity pay plan.

    PubMed

    Kerr, K

    1997-01-01

    Shands Hospital in Gainesville, Fla., decided to evaluate the way it provided transcription services in its radiology department. It identified four goals: increased productivity, decreased operating expense, finding much needed space in the radiology department and increasing employee morale. The department performs 165,000 procedures annually, with 66 radiologists, 29 faculty, and 37 residents and fellows on staff. Six FTEs comprised the transcription pool in the radiology department, with transcription their only duty. Transcriptionists were paid an hourly rate based on their years of service, not their productivity. Evaluation and measurement studies were undertaken by the hospital's management systems engineering department. The transcriptionists' hours were then changed to provide coverage during the periods of heaviest dictation. The productivity level of the transcription staff was also measured and various methods of measurement reviewed. The goal was a pure incentive pay plan that would reward employees for every increase in productivity. The incentive pay plan was phased in over a three-month period. Transcriptionists were paid for work performed, with no base pay beyond minimum wage. The move to home-based transcription was planned. The necessary equipment was identified and various issues specific to working at home were addressed. Approximately six months later, the transcriptionists were set up to work at home. The astounding results achieved are presented: 28% increase in productivity, operational cost savings exceeding $25,000 and a space savings of 238 square feet. PMID:10164979

  2. The safety at home study: an evidence base for policy and practice change.

    PubMed

    Doran, Diane; Blais, Régis; Baker, G Ross; Harrison, Margaret B; Lang, Ariella; Macdonald, Marilyn; McShane, Julie; Killackey, Tieghan

    2014-01-01

    This paper explores the policies and practices that are needed to improve the safety of home care in light of the most recent evidence about home care safety in Canada. Four areas for policy and practice change are addressed: 1) the promotion of effective communication processes in home care through cross-sector collaboration, case management and technology innovations; 2) screening for safety risk factors; 3) standardizing care processes, packaging and equipment; and 4) supporting family/caregivers and strengthening clients' ability to engage in therapeutic self-care. Evidence-based strategies for change are presented within the context of the evidence about home care safety issues. PMID:25591609

  3. Managing Home and Work Responsibilities. Secondary Learning Guide 9. Project Connect. Linking Self-Family-Work.

    ERIC Educational Resources Information Center

    Emily Hall Tremaine Foundation, Inc., Hartford, CT.

    This competency-based secondary learning guide on managing home and work responsibilities is part of a series that are adaptations of guides developed for adult consumer and homemaking education programs. The guides provide students with experiences that help them learn to do the following: make decisions; use creative approaches to solve…

  4. Home Health Care (HHC) Managers Perceptions About Challenges and Obstacles that Hinder HHC Services in Jordan

    PubMed Central

    Ajlouni, Musa T.; Dawani, Hania; Diab, Salah M.

    2015-01-01

    Home care aims at supporting people with various degrees of dependency to remain at home rather than use residential, long-term, or institutional-based nursing care. Demographic, epidemiological, social, and cultural trends in Jordan as in other countries are changing the traditional patterns of care with growing emphasis on home care. The purpose of this study is to highlight the most common challenges related to home health care (HHC) services in Jordan as perceived by the managers of HHC agencies. Methods: a descriptive qualitative design that depends on focus group discussions has been used to collect data from a sample of 18 managers who met the selection criteria and who are willing to participate, the study found that, the main challenges of HHC services as perceived by managers were: shortage of female staff, lack of governance and regulation, poor management, unethical practices, lack of referral systems, and low accessibility of the poor and less privileged as HHC services are not included in health insurance schemes, it concludes also that the home health care industry in Jordan is facing many challenges and problems that may have negative effects on the effectiveness, efficiency, equity and quality of services and should be addressed by health policy makers. PMID:25946949

  5. Innovative leadership and management in a nursing home.

    PubMed

    Jeong, Sarah Yeun-Sim; Keatinge, Diana

    2004-11-01

    The Australian Aged Care Reform Package, implemented from October 1997, has led radical changes in nursing practice in residential aged care facilities. Apart from anecdotal evidence, however, little is known about the impact of the Reform Package on nursing staff and their practice in nursing home facilities. In an attempt to explore these issues a qualitative explorative research study was conducted in one nursing home during 2000-2001. The study found that the impact of policy change on nursing staff and their practice depended on the management's leadership in interpreted the new policy and implemented innovative strategies in order to meet its requirements. The findings of the study highlight management's 'no them vs. us' and 'holistic' approach that considered both nursing staff and residents as whole beings. Integral to this approach was management's recognition that in order to facilitate teamwork, appropriate standards of nursing practice and resident care, and staff job satisfaction four resource elements must be provided. These elements comprise material, environmental, psychosocial and psychological resources. Management's provision of each of these resources ensured that nurses considered this nursing home 'a nice place to work'. PMID:15509274

  6. vizHOME--A context-based home assessment: Preliminary implications for informatics.

    PubMed

    Casper, Gail R; Flatley Brennan, Patricia; Perreault, Jesse O; Marvin, Alex G

    2015-01-01

    The rapid migration of health care from the institution to the home presents a plethora of consumer health technology options.. The fit of these technologies to the users' actual task performance and environment remains to be explored. In the vizHOME study, we set out to conduct in-depth analyses of health information management tasks conducted by individuals residing in 20 homes in the Midwestern United States who self-reported with diabetes. This paper will explore early results from five of the 13 assessments we have performed to-date. Early observations are described and implications for informatics are posited. PMID:26262170

  7. Home-based system for stroke rehabilitation.

    PubMed

    Durfee, William; Deng, Huiqiong; Nuckley, David; Rheude, Brandon; Severson, Amy; Skluzacek, Katie; Spindler, Kristen; Davey, Cynthia; Carey, James

    2011-01-01

    A system was developed for home-based stroke motor rehabilitation of the ankle. A study was conducted to test the hypothesis that moving while concentrating will lead to greater recovery than movement alone. Sixteen post-stroke subjects participated, one half in a tracking training group and the other have in a move group. The tracking training group tracked a target waveform by moving their ankle to control the tracking cursor while the move group moved their ankle approximately the same amount but without target following. Over four weeks subjects completed 3600 trials. The results showed that the Tracking group had more improvement in ankle dorsiflexion compared to the Move group. The remaining assessment criteria showed no significant differences between the groups. PMID:22254683

  8. Remote access to medical specialists: home care interactive patient management system

    NASA Astrophysics Data System (ADS)

    Martin, Peter J.; Draghic, Nicole; Wiesmann, William P.

    1999-07-01

    Diabetes management involves constant care and rigorous compliance. Glucose control is often difficult to maintain and onset of complications further compound health care needs. Status can be further hampered by geographic isolation from immediate medical infrastructures. The Home Care Interactive Patient Management System is an experimental telemedicine program that could improve chronic illness management through Internet-based applications. The goal of the system is to provide a customized, integrated approach to diabetes management to supplement and coordinate physician protocol while supporting routine patient activity, by supplying a set of customized automated services including health data collection, transmission, analysis and decision support.

  9. Safety culture of nursing homes: opinions of top managers

    PubMed Central

    Castle, Nicholas G.; Wagner, Laura M.; Ferguson, Jamie C.; Handler, Steven M.

    2016-01-01

    Background Examining the perception of the patient safety culture (PSC) of top managers in healthcare settings is important because their orientation to PSC can have a large influence on the facility. Purposes In this research, the perception of the PSC of Nursing Home Administrators (NHAs) and Directors of Nursing (DONs) is examined. Methodology/Approach Primary data were collected to examine the opinions of the PSC from NHAs and DONs. Information was collected from a large nationally representative sample of 4,000 nursing homes. The Nursing Home Survey on Patient Safety Culture (NHSPSC) survey instrument was used as a measure of PSC. This has 12 domains and 38 items. Bias indexes, intraclass correlation coefficients, and Pearson’s product-moment correlation coefficients of the differences between NHA and DON item scores were examined. Findings Using a 0–100 scale, most scores fell into the 55–80 range. Higher scores represent a higher (more favorable) PSC. Agreement between the NHA and DON was excellent for 10 items, good in 15 items, moderate in 4 items, and poor in 8 items. Of the 4 largest differences in scores, the NHA scores were higher than the DON scores for one item and DON scores were higher than the NHA scores for 3 items. Implications The overall perception from both NHAs and DONs, would appear to represent a somewhat “positive” outlook from these top managers on their institution’s PSC. However, NHAs in general report higher scores than DONs. The areas of divergence between these top managers are further discussed, with a view towards directing future patient safety investigations and initiatives in nursing homes. PMID:21317661

  10. Home-based versus centre-based cardiac rehabilitation

    PubMed Central

    Taylor, Rod S; Dalal, Hayes; Jolly, Kate; Moxham, Tiffany; Zawada, Anna

    2014-01-01

    Background The burden of cardiovascular disease world-wide is one of great concern to patients and health care agencies alike. Traditionally centre-based cardiac rehabilitation (CR) programmes are offered to individuals after cardiac events to aid recovery and prevent further cardiac illness. Home-based cardiac rehabilitation programmes have been introduced in an attempt to widen access and participation. Objectives To determine the effectiveness of home-based cardiac rehabilitation programmes compared with supervised centre-based cardiac rehabilitation on mortality and morbidity, health-related quality of life and modifiable cardiac risk factors in patients with coronary heart disease. Search methods We updated the search of a previous review by searching the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2007, Issue 4), MEDLINE, EMBASE and CINAHL from 2001 to January 2008. We checked reference lists and sought advice from experts. No language restrictions were applied. Selection criteria Randomised controlled trials (RCTs) that compared centre-based cardiac rehabilitation (e.g. hospital, gymnasium, sports centre) with home-based programmes, in adults with myocardial infarction, angina, heart failure or who had undergone revascularisation. Data collection and analysis Studies were selected independently by two reviewers, and data extracted by a single reviewer and checked by a second one. Authors were contacted where possible to obtain missing information. Main results Twelve studies (1,938 participants) met the inclusion criteria. The majority of studies recruited a lower risk patient following an acute myocardial infarction (MI) and revascularisation. There was no difference in outcomes of home- versus centre-based cardiac rehabilitation in mortality risk ratio (RR) was 1.31 (95% confidence interval (C) 0.65 to 2.66), cardiac events, exercise capacity standardised mean difference (SMD) −0.11 (95% CI −0.35 to 0.13), as well

  11. Nursing Home Staff Characteristics and Knowledge Gain from a Didactic Workshop on Depression and Behavior Management

    ERIC Educational Resources Information Center

    Meeks, Suzanne; Burton, Elizabeth G.

    2004-01-01

    Depression is a prevalent and serious problem among nursing home residents. Nursing home staff members are gatekeepers for mental health treatment for residents, but may know little about depression and its management. We evaluated a didactic workshop for nursing home staff on depressive symptoms and management. Results for 58 staff participants…

  12. Impact of human resource management practices on nursing home performance.

    PubMed

    Rondeau, K V; Wagar, T H

    2001-08-01

    Management scholars and practitioners alike have become increasingly interested in learning more about the ability of certain 'progressive' or 'high-performance' human resource management (HRM) practices to enhance organizational effectiveness. There is growing evidence to suggest that the contribution of various HRM practices to impact firm performance may be synergistic in effect yet contingent on a number of contextual factors, including workplace climate. A contingency theory perspective suggests that in order to be effective, HMR policies and practices must be consistent with other aspects of the organization, including its environment. This paper reports on empirical findings from research that examines the relationship between HRM practices, workplace climate and perceptions of organizational performance, in a large sample of Canadian nursing homes. Data from 283 nursing homes were collected by means of a mail survey that included questions on HRM practices, programmes, and policies, on human resource aspects of workplace climate, as well as a variety of indicators that include employee, customer/resident and facility measures of organizational performance. Results derived from ordered probit analysis suggest that nursing homes in our sample which had implemented more 'progressive' HRM practices and which reported a workplace climate that strongly values employee participation, empowerment and accountability tended to be perceived to generally perform better on a number of valued organizational outcomes. Nursing homes in our sample that performed best overall were found to be more likely to not only have implemented more of these HRM practices, but also to report having a workplace climate that reflects the seminal value that it places on its human resources. This finding is consistent with the conclusion that simply introducing HRM practices or programmes, in the absence of an appropriately supportive workplace climate, will be insufficient to attain

  13. Home-Based Resistance Training: Predictors of Participation and Adherence.

    ERIC Educational Resources Information Center

    Jette, Alan M.; Rooks, Dan; Lachman, Margie; Lin, Ting H.; Levenson, Claudia; Heislein, Diane; Giorgetti, Marie M.; Harris, B. A.

    1998-01-01

    Identifies factors associated with exercise participation and adherence in a sample of sedentary, functionally limited, community-dwelling adults ages 60 to 94 who participated in a home-based resistance training program (N=102). Results show that psychological factors were most important to adherence to the home-based program. (Author/MKA)

  14. Perceptions of health and risk management among home care workers in Sweden

    PubMed Central

    Larsson, A; Karlqvist, L; Westerberg, M; Gard, G

    2013-01-01

    Background: Municipal home care workers provide high-quality services to an increasing proportion of elderly people living in private homes. The work environments and working conditions of these workers vary to a great extent, implying rapid priority-making among both employers and employees to ensure that the work can be performed in a safe way. Objectives: This study aims to examine home care workers’ perceptions of health, risks, working conditions, and risk management within their organization. Method: The study was based on cross-sectional data collected from home care service staff in a municipality in the north of Sweden. Nursing assistants and care aides (n = 133) replied to a self-administered questionnaire. Descriptive statistics and between-group differences were analysed. Results: Home care work was perceived to require high levels of professional skill and ingenuity, a good psychosocial work situation, but required a high physical workload. The general health, the capacity and self-efficacy of the staff in relation to work were good. Difficulty in performing risk assessments and following safety regulations due to lack of time, equipment, and information were identified. Conclusion: There is a need to increase participation in risk assessments among the staff, improve management support, structures, and cooperation with other divisions of the social services and the medical care organizations. PMID:24078781

  15. Home medical monitoring network based on embedded technology

    NASA Astrophysics Data System (ADS)

    Liu, Guozhong; Deng, Wenyi; Yan, Bixi; Lv, Naiguang

    2006-11-01

    Remote medical monitoring network for long-term monitoring of physiological variables would be helpful for recovery of patients as people are monitored at more comfortable conditions. Furthermore, long-term monitoring would be beneficial to investigate slowly developing deterioration in wellness status of a subject and provide medical treatment as soon as possible. The home monitor runs on an embedded microcomputer Rabbit3000 and interfaces with different medical monitoring module through serial ports. The network based on asymmetric digital subscriber line (ADSL) or local area network (LAN) is established and a client - server model, each embedded home medical monitor is client and the monitoring center is the server, is applied to the system design. The client is able to provide its information to the server when client's request of connection to the server is permitted. The monitoring center focuses on the management of the communications, the acquisition of medical data, and the visualization and analysis of the data, etc. Diagnosing model of sleep apnea syndrome is built basing on ECG, heart rate, respiration wave, blood pressure, oxygen saturation, air temperature of mouth cavity or nasal cavity, so sleep status can be analyzed by physiological data acquired as people in sleep. Remote medical monitoring network based on embedded micro Internetworking technology have advantages of lower price, convenience and feasibility, which have been tested by the prototype.

  16. Strategy Guideline: Quality Management in Existing Homes; Cantilever Floor Example

    SciTech Connect

    Taggart, J.; Sikora, J.; Wiehagen, J.; Wood, A.

    2011-12-01

    This guideline is designed to highlight the QA process that can be applied to any residential building retrofit activity. The cantilevered floor retrofit detailed in this guideline is included only to provide an actual retrofit example to better illustrate the QA activities being presented. The goal of existing home high performing remodeling quality management systems (HPR-QMS) is to establish practices and processes that can be used throughout any remodeling project. The research presented in this document provides a comparison of a selected retrofit activity as typically done versus that same retrofit activity approached from an integrated high performance remodeling and quality management perspective. It highlights some key quality management tools and approaches that can be adopted incrementally by a high performance remodeler for this or any high performance retrofit. This example is intended as a template and establishes a methodology that can be used to develop a portfolio of high performance remodeling strategies.

  17. Managing resident to resident elder mistreatment (R-REM) in nursing homes: the SEARCH approach

    PubMed Central

    Ellis, Julie; Teresi, Jeanne A.; Ramirez, Mildred; Silver, Stephanie; Boratgis, Gabriel; Kong, Jian; Eimicke, Joseph P.; Sukha, Gail; Lachs, Mark S.; Pillemer, Karl A.

    2014-01-01

    This article describes an educational program to inform nursing and care staff in the management of resident-to-resident elder mistreatment (R-REM) in nursing homes, using the SEARCH approach. Although relatively little research has been conducted on this form of abuse, there is mounting interest in R-REM, as such aggression has been found to be extensive and can have both physical and psychological consequences for residents and staff. The aim of the SEARCH approach is to support staff in the identification and recognition of R-REM, and suggesting recommendations for management. The education program and the SEARCH approach are described. Three case studies from the research project are presented, illustrating how the SEARCH approach can be used by nurses and care staff to manage R-REM in nursing homes. Resident- and staff safety and well-being can be enhanced by the use of the evidence-based SEARCH approach. PMID:24548656

  18. A staff management system for maintaining improvements in continence with elderly nursing home residents.

    PubMed Central

    Burgio, L D; Engel, B T; Hawkins, A; McCormick, K; Scheve, A; Jones, L T

    1990-01-01

    We developed a staff management system for maintaining treatment gains achieved on a specialized continence unit located in a geriatric nursing home. Geriatric assistants learned to use a prompted voiding procedure to maintain improved dryness for 4 elderly residents. The staff management system included self-monitoring and recording of prompted voiding activities and supervisory monitoring and feedback based on group performance of these activities. Results show that the system was effective in maintaining prompted voiding activities with corresponding maintenance of improved patient continence. However, a gradual decline in staff performance was noted 4 to 5 months after the initiation of the system. During a subsequent phase of the study, provision of individual feedback restored staff performance to previous levels. Results are discussed in relation to the practicality of prompted voiding interventions in nursing home environments and the applicability of staff management systems in this setting. PMID:2335482

  19. Current Sensor Based Home Appliance and State of Appliance Recognition

    NASA Astrophysics Data System (ADS)

    Saitoh, Takeshi; Osaki, Tomoyuki; Konishi, Ryosuke; Sugahara, Kazunori

    This paper presents a current sensor-based home appliance and its state recognition method for intelligent outlets. Our system has three main functions: remote control, monitoring, and power supply schedule management. This research focuses particular on the monitoring function. To recognize the appliance and the state of the appliance, we extract ten features based on a measured current signal. In the experiment, we gather a number of signals with various appliances, and find that three features Irms, Iavg, and Ipeak yield valid recognition results of 84.3%, 86.4%, and 90.3% for classifying the state of the appliance into three categories. Moreover, sufficient recognition rates of 97.4%, 97.7%, and 99.0% are obtained by consideration of three candidates.

  20. Back disorders and lumbar load in nursing staff in geriatric care: a comparison of home-based care and nursing homes

    PubMed Central

    2009-01-01

    Background Back pain is one of the most frequent complaints in the nursing profession. Thus, the 12-month prevalence of pain in the lumbar spine in nursing staff is as high as 76%. Only a few representative studies have assessed the prevalence rates of back pain and its risk factors among nursing staff in nursing homes in comparison to staff in home-based care facilities. The present study accordingly investigates the prevalence in the lumbar and cervical spine and determines the physical workload to lifting and caring in geriatric care. Methods 1390 health care workers in nursing homes and home care participated in this cross sectional survey. The nursing staff members were examined by occupational physicians according to the principals of the multistep diagnosis of musculoskeletal disorders. Occupational exposure to daily care activities with patient transfers was measured by a standardised questionnaire. The lumbar load was calculated with the Mainz-Dortmund dose model. Information on ergonomic conditions were recorded from the management of the nursing homes. Comparisons of all outcome variables were made between both care settings. Results Complete documentation, including the findings from the occupational physicians and the questionnaire, was available for 41%. Staff in nursing homes had more often positive orthopaedic findings than staff in home care. At the same time the values calculated for lumbar load were found to be significant higher in staff in nursing homes than in home-based care: 45% vs. 6% were above the reference value. Nursing homes were well equipped with technical lifting aids, though their provision with assistive advices is unsatisfactory. Situation in home care seems worse, especially as the staff often has to get by without assistance. Conclusions Future interventions should focus on counteracting work-related lumbar load among staff in nursing homes. Equipment and training in handling of assistive devices should be improved especially

  1. Managing Opioid-Tolerant Patients in the Perioperative Surgical Home.

    PubMed

    Wenzel, John T; Schwenk, Eric S; Baratta, Jaime L; Viscusi, Eugene R

    2016-06-01

    Management of acute postoperative pain is important to decrease perioperative morbidity and improve patient satisfaction. Opioids are associated with potential adverse events that may lead to significant risk. Uncontrolled pain is a risk factor in the transformation of acute pain to chronic pain. Balancing these issues can be especially challenging in opioid-tolerant patients undergoing surgery, for whom rapidly escalating opioid doses in an effort to control pain can be associated with increased complications. In the perioperative surgical home model, anesthesiologists are positioned to coordinate a comprehensive perioperative analgesic plan that begins with the preoperative assessment and continues through discharge. PMID:27208711

  2. Practice Leadership at the Front Line in Supporting People with Intellectual Disabilities and Challenging Behaviour: A Qualitative Study of Registered Managers of Community-Based, Staffed Group Homes

    ERIC Educational Resources Information Center

    Deveau, Roy; McGill, Peter

    2016-01-01

    Background: The front-line management role in services for people with intellectual disabilities remains rather under-researched. The aim of this study was to examine the experiences of registered managers in services for adults with intellectual disability who exhibit challenging behaviour. Method: Interviews, primarily focussed upon staff…

  3. [Role of the community pharmacist in the management of drug related problems in home care patients].

    PubMed

    Van de Putte, M; Appels, S; Boone, T; Collienne, S; Daems, T; De Lepeleire, J; Foulon, V

    2012-09-01

    Medication management in home care is an error prone process. In a small pilot project in Flanders, community pharmacists collaborated with physicians and home care nurses through a shared electronic care plan, to optimize the medication management of their home care patients. The pilot project shows that GPs and nurses are positive about the possible contribution of the pharmacist in medication management of home care patients. A larger follow up study is necessary to further identify possible roles of pharmacists in home care and to show related health benefits. PMID:23697093

  4. Home management of the adult patient with leukemia.

    PubMed

    Dwyer, J E; Held, D M

    1982-12-01

    The many changes that have occurred within the medical profession and among the public are taking long-term care out of the hospital and placing it back into the home. Attitudes toward cancer have altered, as seen by the rapid growth of the oncology specialty as well as the willingness of the community to allow those with cancer to return to a viable status. Even the individual who must face end-stage disease can now rest comfortably in the privacy of his or her own home, surrounded by loved ones. Improved nutritional efforts during periods of active therapy are reducing the side effects and improving the tolerance of highly cytotoxic drugs. Thus, acute episodes of treatment are shortened, allowing for earlier discharge. Individuals are demanding accurate information regarding their disease and its treatment. Patients are catalysts for their own recovery as they become more active participants in their care. Some are even choosing not to undergo suggested therapies and are returning home to put their lives in order and let disease processes take their natural course, even until death. As for leukemia, more supportive measures such as blood component therapy and evaluative work-ups are being offered on an outpatient basis. Patients are learning self-care measures to counteract or minimize side effects to chemotherapy or radiation therapy. Thus, overwhelming infection is of less risk and hospitalization is shortened. Infection, especially from Staphylococcus aureus, still remains a major cause of death of patients with leukemia. However, one must consider how prevalent this organism is in the hospital environment. Home care management is improving; care can be as comprehensive as one might need or receive in the hospital setting. PMID:6924785

  5. Extension and Home-Based Business: A Collaborative Approach.

    ERIC Educational Resources Information Center

    Burns, Marilyn; Biers, Karen

    1991-01-01

    The Center for Home-Based Entrepreneurship at Oklahoma State University developed from collaborative efforts of extension, government agencies, business associations, and the vo-tech system. It provides education, directories, information services, and other assistance to people interested in establishing businesses in their homes. (SK)

  6. Novel pervasive scenarios for home management: the Butlers architecture.

    PubMed

    Denti, Enrico

    2014-01-01

    Many efforts today aim to energy saving, promoting the user's awareness and virtuous behavior in a sustainability perspective. Our houses, appliances, energy meters and devices are becoming smarter and connected, domotics is increasing possibilities in house automation and control, and ambient intelligence and assisted living are bringing attention onto people's needs from different viewpoints. Our assumption is that considering these aspects together allows for novel intriguing possibilities. To this end, in this paper we combine home energy management with domotics, coordination technologies, intelligent agents, ambient intelligence, ubiquitous technologies and gamification to devise novel scenarios, where energy monitoring and management is just the basic brick of a much wider and comprehensive home management system. The aim is to control home appliances well beyond energy consumption, combining home comfort, appliance scheduling, safety constraints, etc. with dynamically-changeable users' preferences, goals and priorities. At the same time, usability and attractiveness are seen as key success factors: so, the intriguing technologies available in most houses and smart devices are exploited to make the system configuration and use simpler, entertaining and attractive for users. These aspects are also integrated with ubiquitous and pervasive technologies, geo-localization, social networks and communities to provide enhanced functionalities and support smarter application scenarios, hereby further strengthening technology acceptation and diffusion. Accordingly, we first analyse the system requirements and define a reference multi-layer architectural model - the Butlers architecture - that specifies seven layers of functionalities, correlating the requirements, the corresponding technologies and the consequent value-added for users in each layer. Then, we outline a set of notable scenarios of increasing functionalities and complexity, discuss the structure of the

  7. Managing chronic illness: physician practices increased the use of care management and medical home processes.

    PubMed

    Wiley, James A; Rittenhouse, Diane R; Shortell, Stephen M; Casalino, Lawrence P; Ramsay, Patricia P; Bibi, Salma; Ryan, Andrew M; Copeland, Kennon R; Alexander, Jeffrey A

    2015-01-01

    The effective management of patients with chronic illnesses is critical to bending the curve of health care spending in the United States and is a crucial test for health care reform. In this article we used data from three national surveys of physician practices between 2006 and 2013 to determine the extent to which practices of all sizes have increased their use of evidence-based care management processes associated with patient-centered medical homes for patients with asthma, congestive heart failure, depression, and diabetes. We found relatively large increases over time in the overall use of these processes for small and medium-size practices as well as for large practices. However, the large practices used fewer than half of the recommended processes, on average. We also identified the individual processes whose use increased the most and show that greater use of care management processes is positively associated with public reporting of patient experience and clinical quality and with pay-for-performance. PMID:25561647

  8. Between ideals and reality in home-based rehabilitation

    PubMed Central

    Steihaug, Sissel; Lippestad, Jan-W.; Werner, Anne

    2016-01-01

    Setting and objective The growing elderly population and the rising number of people with chronic diseases indicate an increasing need for rehabilitation. Norwegian municipalities are required by law to offer rehabilitation. The aim of this study was to investigate how rehabilitation work is perceived and carried out by first-line service providers compared with the guidelines issued by Norway’s health authorities. Design and subjects In this action research project, qualitative data were collected through 24 individual interviews and seven group interviews with employees – service providers and managers – in the home-based service of two boroughs in Oslo, Norway. The data were analysed using a systematic text-condensation method. Results The results show that rehabilitation receives little attention in the boroughs and that patients are seldom rehabilitated at home. There is disagreement among professional staff as to what rehabilitation is and should be. The purchaser–provider organization, high speed of service delivery, and scarcity of resources are reported to hamper rehabilitation work. Conclusion and implications A discrepancy exists between the high level of ambitious goals of Norwegian health authorities and the possibilities that practitioners have to achieve them. This situation results in healthcare staff being squeezed by the increasing expectations and demands of the population and the promises and statutory rights coming from politicians and administrators. For the employees in the municipalities to place rehabilitation on the agenda, it is a requirement that authorities understand the clinical aspect of rehabilitation and provide the municipalities with adequate framework conditions for successful rehabilitation work. Key pointsHome-based rehabilitation is documented to be effective, and access to rehabilitation has been established in Norwegian law.The purchaser–provider organization, high rate of speed, and a scarcity of resources in

  9. In-Home Care for Optimizing Chronic Disease Management in the Community

    PubMed Central

    2013-01-01

    Background The emerging attention on in-home care in Canada assumes that chronic disease management will be optimized if it takes place in the community as opposed to the health care setting. Both the patient and the health care system will benefit, the latter in terms of cost savings. Objectives To compare the effectiveness of care delivered in the home (i.e., in-home care) with no home care or with usual care/care received outside of the home (e.g., health care setting). Data Sources A literature search was performed on January 25, 2012, using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published from January 1, 2006, until January 25, 2012. Review Methods An evidence-based analysis examined whether there is a difference in mortality, hospital utilization, health-related quality of life (HRQOL), functional status, and disease-specific clinical measures for in-home care compared with no home care for heart failure, atrial fibrillation, coronary artery disease, stroke, chronic obstructive pulmonary disease, diabetes, chronic wounds, and chronic disease / multimorbidity. Data was abstracted and analyzed in a pooled analysis using Review Manager. When needed, subgroup analysis was performed to address heterogeneity. The quality of evidence was assessed by GRADE. Results The systematic literature search identified 1,277 citations from which 12 randomized controlled trials met the study criteria. Based on these, a 12% reduced risk for in-home care was shown for the outcome measure of combined events including all-cause mortality and hospitalizations (relative risk [RR]: 0.88; 95% CI: 0.80–0.97). Patients receiving in-home care had an average of 1 less unplanned hospitalization (mean difference [MD]: –1.03; 95% CI: –1.53 to –0.53) and an average of 1 less

  10. Closing the Loop: Integrated Waste Management Activities for School & Home. K-12 Edition. A School-Based Waste Minimization and Education Program.

    ERIC Educational Resources Information Center

    Institute for Environmental Education, Chagrin Falls, OH.

    Increased human population has led to more frequent interactions with the environment. The results of those interactions have affected the Earth's ecosystem. This manual contains hands-on, problem-centered activities to help students develop an environmental ethic and stewardship regarding waste management. The activities are grouped under three…

  11. Home Computer Based Learning Systems (HCBLS).

    ERIC Educational Resources Information Center

    Ross, Jeremy

    The rebirth of the home as workshop, studio, and laboratory, due in large part to the advent of the microcomputer, will accelerate the spread of alternative modes of education and the process of "deschooling" society. Formal education as we know it developed as a result of social, historical, and economic factors that are no longer applicable. As…

  12. Parents' Perspectives: An Evaluation of Case Management Interventions in Home Visiting Programs for Young Children

    ERIC Educational Resources Information Center

    Allen, Susan F.

    2007-01-01

    In home visiting programs for children younger than age three, home visitors work with parents to enhance the child's environment. This study examined how the home visitor-parent relationship, amount of contact, and level of need affected the intensity of case management interventions received. Researchers interviewed 90 mothers to measure the…

  13. Pragmatic diabetes management in nursing homes: individual care plan.

    PubMed

    Benetos, Athanase; Novella, Jean-Luc; Guerci, Bruno; Blickle, Jean-Frederic; Boivin, Jean-Marc; Cuny, Pierre; Delemer, Brigitte; Gabreau, Thierry; Jan, Philippe; Louis, Jacques; Passadori, Yves; Petit, Jean-Michel; Weryha, Georges

    2013-11-01

    Although the management of diabetes as a simple entity has been extensively developed, there is a dearth of evidence in elderly, frail patients with multiple comorbidities and polymedication. This population represents a large proportion of the residents of nursing homes (NHs). As a multidisciplinary group of French experts (geriatricians, endocrinologists, diabetologists, and general practitioners) with practical experience in this area, which is growing in magnitude throughout the world, we convened to compile pragmatic, simple advice on the management of elderly, frail diabetic patients. Given demands on NH personnel (manager, medical coordinator, nurses, and, at the front line of care provision, the undertrained and overworked carers), coupled with the quasiconstant of high staff turnover, the foundation stone of a patient's diabetes management is an Individual Care Plan (ICP) expressed in layman's language. This document that is opened on the patient's admission aims to make sure that the prescriptions established at admission are followed, notably to ensure correct treatment and adapted, regular monitoring with dates and times when examinations and tests are due. This includes monitoring of the diabetes control (HbA1c and, if necessary, blood and urine glucose) and its complications (cardiovascular disease, hypoglycemia, ocular problems, foot disorders, malnutrition, peripheral neuropathy, kidney failure). A necessary corollary is the training of staff to understand the specificities of caring for a frail patient with diabetes, on what to do in a potential emergency, and how to keep the ICP up to date for consultation by doctors and nurses. PMID:24113629

  14. Final Scientific/Technical Report: Context-Aware Smart Home Energy Manager (CASHEM)

    SciTech Connect

    Foslien, Wendy K; Curtner, Keith L

    2013-01-15

    Because of growing energy demands and shortages, residential home owners are turning to energy conservation measures and smart home energy management devices to help them reduce energy costs and live more sustainably. In this context, the Honeywell team researched, developed, and tested the Context Aware Smart Home Energy Manager (CASHEM) as a trusted advisor for home energy management. The project focused on connecting multiple devices in a home through a uniform user interface. The design of the user interface was an important feature of the project because it provided a single place for the homeowner to control all devices and was also where they received coaching. CASHEM then used data collected from homes to identify the contexts that affect operation of home appliances. CASHEM's goal was to reduce energy consumption while keeping the user's key needs satisfied. Thus, CASHEM was intended to find the opportunities to minimize energy consumption in a way that fit the user's lifestyle.

  15. Long-term evaluation of home-based pulmonary rehabilitation in patients with COPD

    PubMed Central

    Grosbois, Jean Marie; Gicquello, Alice; Langlois, Carole; Le Rouzic, Olivier; Bart, Frédéric; Wallaert, Benoit; Chenivesse, Cécile

    2015-01-01

    Introduction Personalized, global pulmonary rehabilitation (PR) management of patients with COPD is effective, regardless of the place in which this rehabilitation is provided. The objective of this retrospective observational study was to study the long-term outcome of exercise capacity and quality of life during management of patients with COPD treated by home-based PR. Methods Home-based PR was administered to 211 patients with COPD (mean age, 62.3±11.1 years; mean forced expiratory volume in 1 second, 41.5%±17.7%). Home-based PR was chosen because of the distance of the patient’s home from the PR center and the patient’s preference. Each patient was individually managed by a team member once a week for 8 weeks with unsupervised continuation of physical exercises on the other days of the week according to an individual action plan. Exercise conditioning, therapeutic patient education, and self-management were included in the PR program. The home assessment comprised evaluation of the patient’s exercise capacity by a 6-minute stepper test, Timed Up and Go test, ten times sit-to-stand test, Hospital Anxiety and Depression score, and quality of life (Visual Simplified Respiratory Questionnaire, VQ11, Maugeri Respiratory Failure 28). Results No incidents or accidents were observed during the course of home-based PR. The 6-minute stepper test was significantly improved after completion of the program, at 6 months and 12 months, whereas the Timed Up and Go and ten times sit-to-stand test were improved after PR and at 6 months but not at 12 months. Hospital Anxiety and Depression and quality of life scores improved after PR, and this improvement persisted at 6 months and 12 months. Conclusion Home-based PR for unselected patients with COPD is effective in the short term, and this effectiveness is maintained in the medium term (6 months) and long term (12 months). Home-based PR is an alternative to outpatient management provided all activities, such as exercise

  16. An Evaluation of Migrant Head Start Programs. Preliminary Report on Home Base Findings.

    ERIC Educational Resources Information Center

    Reyes (J.A.) Associates, Inc., Washington, DC.

    The report provides Indian and Migrant Program Division managers and specialists in each of the 5 Head Start component areas with a comprehensive picture of the 43 home base learning centers operating between October 1978 and May 1979, with a total enrollment of 3,108 migrant children. Using data collected from the Head Start and center directors,…

  17. Small and Home-Based Businesses: Measures of Success and the Contribution of Local Development Services

    ERIC Educational Resources Information Center

    Brooks, Lara; Whitacre, Brian; Shideler, Dave; Muske, Glenn; Woods, Mike

    2012-01-01

    Small and home-based businesses have long been identified by Extension educators as an important component of economic development, particularly in rural areas. The services available to these businesses can take many forms, including management training, accessibility of local funding, providing incubation facilities, or setting up mentoring…

  18. [Quality of care and risk management in hospital at home services].

    PubMed

    Franzin-Garrec, Martine; Hoden, Romy

    2016-04-01

    Hospital at home structures are healthcare institutions in their own right, with the same obligations in terms of governance with regard to quality of care and risk management. However, hospital at home services are characterised by the remote management of the activity and the nursing staff, with specific constraints. PMID:27085929

  19. 75 FR 41994 - Federal Management Regulation; Home-to-Work Transportation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-20

    ... Register on September 12, 2000 (65 FR 54966) to establish policy regarding home-to-work transportation... 3090-AJ05 Federal Management Regulation; Home-to-Work Transportation AGENCY: Office of Governmentwide... Administration is amending the Federal Management Regulation (FMR) to clarify existing...

  20. A disease management program for heart failure: collaboration between a home care agency and a care management organization.

    PubMed

    Gorski, Lisa A; Johnson, Kathy

    2003-01-01

    This article describes a collaborative approach to manage patients with heart failure between a home care agency and a care management agency. The resulting disease management program used a combination of home visits and phone contact. Care management plans emphasized patient education on increasing adherence to medical and diet regimens, and recognizing early symptoms of exacerbation that could lead to rehospitalization. Clinician activities and patient outcomes are described. PMID:14646784

  1. Home Start: How a Home-Based Preschool Program Raised Black Achievements.

    ERIC Educational Resources Information Center

    Scott, Ralph

    This presentation discusses longitudinal results of a home-based program for low SES black and white children whose parents received weekly visits designed to chart children's individualized enrichment when they were from 2 to 5 years of age. The program drew upon school and community resource personnel when appropriate, to provide parents with…

  2. Geographic Concentration Of Home-Based Medical Care Providers.

    PubMed

    Yao, Nengliang; Ritchie, Christine; Camacho, Fabian; Leff, Bruce

    2016-08-01

    The United States faces a shortage of providers who care for homebound patients. About 5,000 primary care providers made 1.7 million home visits to Medicare fee-for-service beneficiaries in 2013, accounting for 70 percent of all home-based medical visits. Nine percent of these providers performed 44 percent of visits. However, most homebound people live more than thirty miles from a high-volume provider. PMID:27503964

  3. A randomized clinical trial of care for women with preterm labour: home management versus hospital management

    PubMed Central

    Goulet, Céline; Gévry, Hélène; Lemay, Michel; Gauthier, Robert J.; Lepage, Linda; Fraser, William; Polomeno, Viola

    2001-01-01

    Background Preterm labour occurs in about 10% of all pregnancies and is the most important cause of premature birth. Women with preterm labour are admitted to hospital to have the contractions stopped. Thereafter, many women remain in hospital until delivery. We conducted a randomized clinical trial to compare hospital care with home care of women who had been admitted to hospital for preterm labour. Methods After they had received treatment for an acute episode of premature labour, women at 2 regional perinatal centres associated with teaching hospitals were randomly assigned to home care or hospital care. Eligible women (n = 250) were aged 18 years or older, lived within 50 km of the hospital, had a gestational age between 20 and 35 weeks, had no prior preterm delivery and were experiencing their first episode of preterm labour and first admission to hospital for preterm labour. Analysis was by intention to treat. Results There were no significant differences between the 2 groups in mean gestational age at delivery (home: 37.52 weeks, hospital: 37.50 weeks) or in mean birth weight (home: 2974 g, hospital: 3020 g). There were no significant differences between the 2 groups with respect to the proportions of babies born before term or the mean duration of neonatal hospital stay, neonatal intensive care unit stay and intermediate care nursery stay. The mean duration of the first stay in hospital for the women in the home group (3.8 days) was significantly shorter than the mean duration for women in the hospital group (6.1 days). In addition, the mean duration of all maternal stays in hospital was significantly shorter for the women in the home group (3.7 days) than in the hospital group (5.0 days). Interpretation Home care management is an efficient and acceptable alternative to hospital care for women experiencing preterm labour. PMID:11314452

  4. A web-based care-requiring client and Home Helper mutual support system.

    PubMed

    Ogawa, Hidekuni; Yonezawa, Yoshiharu; Maki, Hiromichi; Hahn, Allen W; Caldwell, W Morton

    2005-01-01

    For the improved efficiency of home care of the elderly, a web-based system has been developed to enable faster communications between care-requiring clients, their Home Helper and the care manager. Changes to care items, such as cooking, bathing, washing, cleaning and shopping are usually requested by the elderly client over the telephone. However, the care central office often requires 24 hours to process and respond to such spoken requests. The system we have developed consists of Internet client computers with liquid crystal input tablets, wireless Internet Java enabled mobile phones and a central office server that yields almost instant communication. The care clients enter requests on the liquid crystal tablet at their home and then their computer sends these requests to the server at the Home Helper central office. The server automatically creates a new file of the requested items, and then immediately transfers them to the care manager and Home Helper's mobile phone. With this non-vocal and paperless system, the care-requiring clients, who can easily operate the liquid crystal tablet, can very quickly communicate their needed care change requests to their Home Helper. PMID:15850098

  5. A Novel Robot Visual Homing Method Based on SIFT Features

    PubMed Central

    Zhu, Qidan; Liu, Chuanjia; Cai, Chengtao

    2015-01-01

    Warping is an effective visual homing method for robot local navigation. However, the performance of the warping method can be greatly influenced by the changes of the environment in a real scene, thus resulting in lower accuracy. In order to solve the above problem and to get higher homing precision, a novel robot visual homing algorithm is proposed by combining SIFT (scale-invariant feature transform) features with the warping method. The algorithm is novel in using SIFT features as landmarks instead of the pixels in the horizon region of the panoramic image. In addition, to further improve the matching accuracy of landmarks in the homing algorithm, a novel mismatching elimination algorithm, based on the distribution characteristics of landmarks in the catadioptric panoramic image, is proposed. Experiments on image databases and on a real scene confirm the effectiveness of the proposed method. PMID:26473880

  6. Home-based care, technology, and the maintenance of selves.

    PubMed

    Parks, Jennifer A

    2015-06-01

    In this paper, I will argue that there is a deep connection between home-based care, technology, and the self. Providing the means for persons (especially older persons) to receive care at home is not merely a kindness that respects their preference to be at home: it is an important means of extending their selfhood and respecting the unique selves that they are. Home-based technologies like telemedicine and robotic care may certainly be useful tools in providing care for persons at home, but they also have important implications for sustaining selfhood in ways that are of value to individuals and those who care for them. I will argue, by appealing to Hilde Lindemann's notion of "holding" persons' identities in place, that technological interventions are not only useful tools for improving and sustaining health and good care at home, but that they may also help to extend our personal identities and relational capacities in ways that are practically and ethically good. Because of these important goods, I will claim that there is a prima facie moral duty to do this "holding" work and that it is best done by family members and loved ones who are well suited to the job because of their history and relationship with the individual that needs to be "held" in place. PMID:25787720

  7. [MATCHE: Management Approach to Teaching Consumer and Homemaking Education.] Occupational Strand: Human Development. Module II-E-4: Convalescent Home Aide.

    ERIC Educational Resources Information Center

    Boogaert, John

    This competency-based preservice home economics teacher education module on convalescent home aide is the fourth in a set of four modules on establishing occupational programs for human development. (This set is part of a larger set of sixty-seven modules on the Management Approach to Teaching Consumer and Homemaking Education [MATCHE]--see CE 019…

  8. The prevalence, impact and management of musculoskeletal disorders in older people living in care homes: a systematic review.

    PubMed

    Smith, Toby O; Purdy, Rachel; Latham, Sarah K; Kingsbury, Sarah R; Mulley, Graham; Conaghan, Philip G

    2016-01-01

    The aim was to systematically review the literature describing the prevalence, impact and current management of musculoskeletal pain in older people living in care homes. Published literature (AMED, CINAHL, EMBASE, psycINFO, MEDLINE, Cochrane Library) and unpublished literature (OpenGrey, the WHO International Clinical Trials Registry Platform, Current Controlled Trials, UK National Research Register Archive) were searched on 1 March 2015. All studies assessing the prevalence, impact and management of musculoskeletal disorders in older people living in care homes were included. Literature was appraised using the CASP cohort and qualitative critical appraisal tools. Data were analysed using descriptive statistical approaches, meta-analysis and meta-ethnography techniques. Twenty-four papers reporting the results of 263,775 care home residents in 12 countries were identified. The evidence base was moderate in quality. Prevalence of musculoskeletal pain for people in care homes was 30.2 % (95 % confidence intervals 29.9-30.5 %; n = 105,463). Care home residents reported that musculoskeletal pain had a significant impact on their perceived independence and overall ability to participate in everyday activities of daily living. Three papers which presented data on interventions demonstrated that whilst multi-component assessment and management packages did not significantly change clinical outcomes, these empowered care home staff to feel more confident in managing these patients. Musculoskeletal pain is a common problem in care homes worldwide, and residents report significant impact on their lives. However, there is uncertainty regarding how to assess and manage such pain. PROSPERO Registration Number: CRD42014009824. PMID:26245357

  9. A context management system for a cost-efficient smart home platform

    NASA Astrophysics Data System (ADS)

    Schneider, J.; Klein, A.; Mannweiler, C.; Schotten, H. D.

    2012-09-01

    This paper presents an overview of state-of-the-art architectures for integrating wireless sensor and actuators networks into the Future Internet. Furthermore, we will address advantages and disadvantages of the different architectures. With respect to these criteria, we develop a new architecture overcoming these weaknesses. Our system, called Smart Home Context Management System, will be used for intelligent home utilities, appliances, and electronics and includes physical, logical as well as network context sources within one concept. It considers important aspects and requirements of modern context management systems for smart X applications: plug and play as well as plug and trust capabilities, scalability, extensibility, security, and adaptability. As such, it is able to control roller blinds, heating systems as well as learn, for example, the user's taste w.r.t. to home entertainment (music, videos, etc.). Moreover, Smart Grid applications and Ambient Assisted Living (AAL) functions are applicable. With respect to AAL, we included an Emergency Handling function. It assures that emergency calls (police, ambulance or fire department) are processed appropriately. Our concept is based on a centralized Context Broker architecture, enhanced by a distributed Context Broker system. The goal of this concept is to develop a simple, low-priced, multi-functional, and save architecture affordable for everybody. Individual components of the architecture are well tested. Implementation and testing of the architecture as a whole is in progress.

  10. Home Management and Consumer Education in Rural Development Programmes: Latin America. Nutrition Information Documents Series No. 5.

    ERIC Educational Resources Information Center

    United Nations Food and Agriculture Organization, Rome (Italy).

    The report represents a preliminary study of a three-month consultantship intended to review field experiences in selected Latin American countries for teaching rural families home management/consumer education concepts and to collect materials based on experiences. A detailed account is presented of the projects visited in Mexico, Argentina, and…

  11. Performance-based contracting in home-care work in The Netherlands: professionalism under pressure?

    PubMed

    Oomkens, Rosanne; Hoogenboom, Marcel; Knijn, Trudie

    2016-07-01

    Our aim was to improve the understanding of the relationships between performance-based contracting, management supportiveness and professionalism in home care. Using path analysis, this article explores the relationships between home-care workers' perceptions of management support, implementation of performance-based contracting (i.e. use of strict time registration rules and cost-efficiency measures) and autonomy and intrinsic job satisfaction. We hypothesised that: use of strict time registration rules and cost-efficiency measures relates to lower levels of autonomy and intrinsic job satisfaction (H1); there is an indirect relationship between use of strict time registration rules and use of cost-efficiency measures and intrinsic job satisfaction via autonomy (H2); higher levels of management support relate to the use of looser time registration rules and less use of cost-efficiency measures (H3); and higher levels of management support relate to higher levels of autonomy and intrinsic job satisfaction (H4). We used data from a cross-sectional survey conducted in 2010 of a sample of Dutch home-care workers (N = 156, response rate = 34%). Overall, our study suggests that the consequences of performance-based contracting for professionalism are ambiguous. More specifically, using strict time registration rules is related to lower levels of autonomy, whereas using cost-efficiency measures does not seem to affect autonomy (H1). Performance-based contracting has no consequences for the level of fulfilment home-care workers find in their job, as neither of the two contracting dimensions measured was directly or indirectly related to intrinsic job satisfaction (H1, H2). The role of managers must be taken into account when studying performance-based contracting, because perceived higher management support is related to managers' less frequent use of both strict time registration rules and of cost-efficiency measures (H3). The insight we gained into the importance of

  12. The Home Environment and Family Asthma Management Among Ethnically Diverse Urban Youth with Asthma

    PubMed Central

    Sato, Amy F.; Kopel, Sheryl J.; McQuaid, Elizabeth L.; Seifer, Ronald; Esteban, Cynthia; Coutinho, Maria Teresa; Klein, Robert; Fritz, Gregory K.; Koinis-Mitchell, Daphne

    2013-01-01

    While the pediatric psychology literature underscores the importance of illness related aspects of the home environment for optimal family asthma management, little is known about the contribution of more global aspects of the home environment (e.g., family routines/schedule, quality of stimulation provided to child) to asthma management in ethnic minority and urban families. The goals of this study were to: 1) explore ethnic/racial group differences in global and specific dimensions of home environment quality among Latino, non-Latino white (NLW), and African American urban children with asthma; and 2) examine associations between the quality and quantity of support and stimulation within the home environment, as measured by the HOME Inventory, and family asthma management in this sample. Urban, low-income children (N=131) between the ages of 6 and 13 with asthma and a primary caregiver participated in a multi-modal assessment including an in home observation and semi structured interviews to assess aspects of home environment quality and family asthma management practices. While controlling for poverty, no ethnic group differences were found in the global home environment; however, there were significant differences in specific dimensions (e.g. Family Participation in Developmentally Stimulating Experiences, and Aspects of the Physical Environment) of home environment quality. Across the whole sample, home environment quality predicted family asthma management. When examining this association for specific ethnic groups, this finding did not hold for the Latino subsample. The results highlight the need to consider ethnic group differences in non-illness specific aspects of the home environment when addressing families’ asthma management strategies. PMID:23795627

  13. Home- versus office-based buprenorphine inductions for opioid-dependent patients

    PubMed Central

    Sohler, Nancy L.; Li, Xuan; Kunins, Hillary V.; Sacajiu, Galit; Giovanniello, Angela; Whitley, Susan; Cunningham, Chinazo O.

    2010-01-01

    Recent legislation permits the treatment of opioid-dependent patients with buprenorphine in the primary care setting, opening doors for the development of new treatment models for opioid dependence. We modified national buprenorphine treatment guidelines to emphasize patient self-management by giving patients the opportunity to choose to have buprenorphine inductions at home or the physician’s office. We examined whether patients who had home-based inductions achieved greater 30-day retention than patients who had traditional office-based inductions in a study of 115 opioid-dependent patients treated in an inner-city health center. Retention was similar in both groups: 50 (78.1%) in office-based group versus 40 (78.4%) in home-based group, p = .97. Several patient characteristics were associated with choosing office- versus home-based inductions, which likely influenced these results. We conclude that opioid dependence can be successfully managed in the primary care setting. Approaches that encourage patient involvement in treatment for opioid dependence can be beneficial. PMID:19801178

  14. A Hybrid Process Fidelity Assessment in a Home-based Randomized Clinical Trial

    PubMed Central

    WILDE, MARY H.; LIEBEL, DIANNE; FAIRBANKS, EILEEN; WILSON, PAULA; LASH, MARGARET; SHAH, SHIVANI; McDONALD, MARGARET V.; BRASCH, JUDITH; ZHANG, FENG; SCHEID, EILEEN; McMAHON, JAMES M.

    2016-01-01

    A process fidelity assessment was conducted as a nested study within a home-based randomized clinical trial teaching self-management to 101 long-term indwelling urinary catheter users in the treatment group. Our hybrid model combined external assessments (outside observations and tape recordings) with internal evaluation methods (through study nurse forms and notes) for a comprehensive process fidelity assessment. Barriers, patient-related issues, and nurse perspectives were identified demonstrating the complexity in home care intervention research. The complementary and synergistic approaches provided in depth information about the context of the delivery and the impact of the intervention on study outcomes. PMID:25894688

  15. Community Service Program in Foster Home Management and Creative Arts.

    ERIC Educational Resources Information Center

    Rhode Island Univ., Kingston.

    A training program for prospective foster home operators and volunteer workers with creative arts was held in the fall of 1968 and again in the spring of 1969 under the joint sponsorship of the Program in Gerontology of the University of Rhode Island, the Cooperative Extension Service, and the Rhode Island Medical Center. The foster homes under…

  16. Enabling affordable and efficiently deployed location based smart home systems.

    PubMed

    Kelly, Damian; McLoone, Sean; Dishongh, Terry

    2009-01-01

    With the obvious eldercare capabilities of smart environments it is a question of "when", rather than "if", these technologies will be routinely integrated into the design of future houses. In the meantime, health monitoring applications must be integrated into already complete home environments. However, there is significant effort involved in installing the hardware necessary to monitor the movements of an elder throughout an environment. Our work seeks to address the high infrastructure requirements of traditional location-based smart home systems by developing an extremely low infrastructure localisation technique. A study of the most efficient method of obtaining calibration data for an environment is conducted and different mobile devices are compared for localisation accuracy and cost trade-off. It is believed that these developments will contribute towards more efficiently deployed location-based smart home systems. PMID:19641259

  17. Data base management study

    NASA Technical Reports Server (NTRS)

    1976-01-01

    Data base management techniques and applicable equipment are described. Recommendations which will assist potential NASA data users in selecting and using appropriate data base management tools and techniques are presented. Classes of currently available data processing equipment ranging from basic terminals to large minicomputer systems were surveyed as they apply to the needs of potential SEASAT data users. Cost and capabilities projections for this equipment through 1985 were presented. A test of a typical data base management system was described, as well as the results of this test and recommendations to assist potential users in determining when such a system is appropriate for their needs. The representative system tested was UNIVAC's DMS 1100.

  18. An Economic Evaluation of Home Versus Laboratory-Based Diagnosis of Obstructive Sleep Apnea

    PubMed Central

    Kim, Richard D.; Kapur, Vishesh K.; Redline-Bruch, Julie; Rueschman, Michael; Auckley, Dennis H.; Benca, Ruth M.; Foldvary-Schafer, Nancy R.; Iber, Conrad; Zee, Phyllis C.; Rosen, Carol L.; Redline, Susan; Ramsey, Scott D.

    2015-01-01

    Study Objectives: We conducted an economic analysis of the HomePAP study, a multicenter randomized clinical trial that compared home-based versus laboratory-based testing for the diagnosis and management of obstructive sleep apnea (OSA). Design: A cost-minimization analysis from the payer and provider perspectives was performed, given that 3-mo clinical outcomes were equivalent. Setting: Seven academic sleep centers. Participants: There were 373 subjects at high risk for moderate to severe OSA. Interventions: Subjects were randomized to either home-based limited channel portable monitoring followed by unattended autotitration with continuous positive airway pressure (CPAP), versus a traditional pathway of in-laboratory sleep study and CPAP titration. Measurements and Results: From the payer perspective, per subject costs for the laboratory-based pathway were $1,840 (95% confidence interval [CI] $1,660, $2,015) compared to $1,575 (95% CI $1,439, $1,716) for the home-based pathway under the base case. Costs were $264 (95% CI $39, $496, P = 0.02) in favor of the home arm. From the provider perspective, per subject costs for the laboratory arm were $1,697 (95% CI $1,566, $1,826) compared to $1,736 (95% CI $1,621, $1,857) in the home arm, for a difference of $40 (95% CI −$213, $142, P = 0.66) in favor of the laboratory arm under the base case. The provider operating margin was $142 (95% CI $85, $202,P < 0.01) in the laboratory arm, compared to a loss of −$161 (95% CI −$202, −$120, P < 0.01) in the home arm. Conclusions: For payers, a home-based diagnostic pathway for obstructive sleep apnea with robust patient support incurs fewer costs than a laboratory-based pathway. For providers, costs are comparable if not higher, resulting in a negative operating margin. Clinicaltrials.gov Identifier: NCT00642486. Citation: Kim RD, Kapur VK, Redline-Bruch J, Rueschman M, Auckley DH, Benca RM, Foldvary-Schafer NR, Iber C, Zee PC, Rosen CL, Redline S, Ramsey SD. An economic

  19. THE ROLE OF THE CONSEQUENCE MANAGEMENT HOME TEAM IN THE FUKUSHIMA DAIICHI RESPONSE

    SciTech Connect

    Pemberton, Wendy; Mena, RaJah; Beal, William

    2012-05-01

    The Consequence Management Home Team is a U.S. Department of Energy/National Nuclear Security Administration asset. It assists a variety of response organizations with modeling; radiological operations planning; field monitoring techniques; and the analysis, interpretation, and distribution of radiological data. These reach-back capabilities are activated quickly to support public safety and minimize the social and economic impact of a nuclear or radiological incident. In the Fukushima Daiichi response, the Consequence Management Home Team grew to include a more broad range of support than was historically planned. From the early days of the response to the continuing involvement in supporting late phase efforts, each stage of the Consequence Management Home Team support had distinct characteristics in terms of management of incoming data streams as well as creation of products. Regardless of stage, the Consequence Management Home Team played a critical role in the Fukushima Daiichi response effort.

  20. Outcomes in a Nursing Home Transition Case-Management Program Targeting New Admissions

    ERIC Educational Resources Information Center

    Newcomber, Robert; Kang, Taewoon; Graham, Carrie

    2006-01-01

    Purpose: The Providing Assistance to Caregivers in Transition (PACT) program offers nursing home discharge planning and case management for individuals in the transitional period following a return to the community. The PACT program targeted individuals newly admitted to nursing homes and worked with a family caregiver to develop and implement a…

  1. Role for a Labor-Management Partnership in Nursing Home Person-Centered Care

    ERIC Educational Resources Information Center

    Leutz, Walter; Bishop, Christine E.; Dodson, Lisa

    2010-01-01

    Purpose: To investigate how a partnership between labor and management works to change the organization and focus of nursing home frontline work, supporting a transition toward person-centered care (PCC) in participating nursing homes. Design and Methods: Using a participatory research approach, we conducted case studies of 2 nursing homes…

  2. Visual homing with a pan-tilt based stereo camera

    NASA Astrophysics Data System (ADS)

    Nirmal, Paramesh; Lyons, Damian M.

    2013-01-01

    Visual homing is a navigation method based on comparing a stored image of the goal location and the current image (current view) to determine how to navigate to the goal location. It is theorized that insects, such as ants and bees, employ visual homing methods to return to their nest. Visual homing has been applied to autonomous robot platforms using two main approaches: holistic and feature-based. Both methods aim at determining distance and direction to the goal location. Navigational algorithms using Scale Invariant Feature Transforms (SIFT) have gained great popularity in the recent years due to the robustness of the feature operator. Churchill and Vardy have developed a visual homing method using scale change information (Homing in Scale Space, HiSS) from SIFT. HiSS uses SIFT feature scale change information to determine distance between the robot and the goal location. Since the scale component is discrete with a small range of values, the result is a rough measurement with limited accuracy. We have developed a method that uses stereo data, resulting in better homing performance. Our approach utilizes a pan-tilt based stereo camera, which is used to build composite wide-field images. We use the wide-field images combined with stereo-data obtained from the stereo camera to extend the keypoint vector described in to include a new parameter, depth (z). Using this info, our algorithm determines the distance and orientation from the robot to the goal location. We compare our method with HiSS in a set of indoor trials using a Pioneer 3-AT robot equipped with a BumbleBee2 stereo camera. We evaluate the performance of both methods using a set of performance measures described in this paper.

  3. Survey-based Indices for Nursing Home Quality Incentive Reimbursement

    PubMed Central

    Willemain, Thomas R.

    1983-01-01

    Incentive payments are a theoretically appealing complement to nursing home quality assurance systems that rely on regulatory enforcement. However, the practical aspects of incentive program design are not yet well understood. After reviewing the rationale for incentive approaches and recent State and. Federal initiatives, the article considers a basic program design issue: creating an index of nursing home quality. It focuses on indices constructed from routine licensure and certification survey results because State initiatives have relied heavily on these readily accessible data. It also suggests a procedure for creating a survey-based index and discusses a sampling of Implementation issues. PMID:10309858

  4. Predictors of Home Based Long-Term Care Services.

    ERIC Educational Resources Information Center

    Luppens, Jean; And Others

    An attempt was made to determine predictors of service need, use, and outcome among chronically impaired adults and aged who were living in the community and using the home-based, long term care services of the Chronic Illness Center (CIC) of the Cuyahoga County Hospitals (Ohio). Randomly selected consumer service records (N=200) were coded for…

  5. Medicaid Home and Community-Based Services. Disability Statistics Report.

    ERIC Educational Resources Information Center

    Harrington, Charlene; LeBlanc, Allen J.

    Federal Medicaid long-term care regulations do not require states to offer home and community-based service (HCBS) alternatives; rather, they are offered at the discretion of each state. The two most significant Medicaid HCBS programs are the Medicaid 1915(c) HCBS waiver programs and the Medicaid Title XIX personal care services (PCS) optional…

  6. Energy Conservation in the Home. Performance Based Lesson Plans.

    ERIC Educational Resources Information Center

    Alabama State Dept. of Education, Montgomery. Home Economics Service.

    These ten performance-based lesson plans concentrate on tasks related to energy conservation in the home. They are (1) caulk cracks, holes, and joints; (2) apply weatherstripping to doors and windows; (3) add plastic/solar screen window covering; (4) arrange furniture for saving energy; (5) set heating/cooling thermostat; (6) replace faucet…

  7. 45 CFR 1306.33 - Home-based program option.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... specified in 45 CFR 1304.23(b)(2) and provide appropriate snacks and meals to the children during group... 45 Public Welfare 4 2011-10-01 2011-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33...

  8. 45 CFR 1306.33 - Home-based program option.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... specified in 45 CFR 1304.23(b)(2) and provide appropriate snacks and meals to the children during group... 45 Public Welfare 4 2010-10-01 2010-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33...

  9. Home-Based Crisis Therapy: A Comparative Outcome Study.

    ERIC Educational Resources Information Center

    Rowland, Charity; And Others

    Substitute care for a child at risk has been been associated with psychological distress in the child and his family and a drain on public finances. To investigate the cost effectiveness and ultimate influence on family intactness of home-based family crisis intervention, 77 low income, inner city families with an adolescent child at risk of…

  10. 45 CFR 1306.33 - Home-based program option.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... specified in 45 CFR 1304.23(b)(2) and provide appropriate snacks and meals to the children during group... 45 Public Welfare 4 2013-10-01 2013-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33...

  11. 45 CFR 1306.33 - Home-based program option.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... specified in 45 CFR 1304.23(b)(2) and provide appropriate snacks and meals to the children during group... 45 Public Welfare 4 2014-10-01 2014-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33...

  12. 45 CFR 1306.33 - Home-based program option.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... specified in 45 CFR 1304.23(b)(2) and provide appropriate snacks and meals to the children during group... 45 Public Welfare 4 2012-10-01 2012-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33...

  13. Home-Based Educational Curricula for Mothers and Infants.

    ERIC Educational Resources Information Center

    Apfel, Nancy; Brion, LaRue

    This package contains five home-based intervention curricula for families with children between 12 and 30 months of age. Three independent curricula (each emphasizing children's language, play or social development) enlist the mother's aid as observer, teacher and researcher, and promote a three-way interaction among mother, child, and…

  14. An Evaluation of Home-Based Respite Care.

    ERIC Educational Resources Information Center

    Upshur, Carole C.

    1982-01-01

    Findings of an evaluation of a pilot home-based respite care program designed to serve 35 severely mentally retarded and disabled persons were reported. Results indicated that respite care services had never been previously received by 51.8% of the families. (Author/SB)

  15. Home Management in the Context of Family Studies: Appraisal and Clarification

    ERIC Educational Resources Information Center

    Churaman, Charlotte Vandiver

    1974-01-01

    The background and content of home management is clarified and its contribution to an integrated approach to family studies is elaborated. Problems in bridging the gaps in the broad applied field of family studies are discussed. (Author)

  16. The political economy of a public health case management program's transition into medical homes.

    PubMed

    Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele

    2015-11-01

    Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent. PMID:26460509

  17. Designing of smart home automation system based on Raspberry Pi

    NASA Astrophysics Data System (ADS)

    Saini, Ravi Prakash; Singh, Bhanu Pratap; Sharma, Mahesh Kumar; Wattanawisuth, Nattapol; Leeprechanon, Nopbhorn

    2016-03-01

    Locally networked or remotely controlled home automation system becomes a popular paradigm because of the numerous advantages and is suitable for academic research. This paper proposes a method for an implementation of Raspberry Pi based home automation system presented with an android phone access interface. The power consumption profile across the connected load is measured accurately through programming. Users can access the graph of total power consumption with respect to time worldwide using their Dropbox account. An android application has been developed to channelize the monitoring and controlling operation of home appliances remotely. This application facilitates controlling of operating pins of Raspberry Pi by pressing the corresponding key for turning "on" and "off" of any desired appliance. Systems can range from the simple room lighting control to smart microcontroller based hybrid systems incorporating several other additional features. Smart home automation systems are being adopted to achieve flexibility, scalability, security in the sense of data protection through the cloud-based data storage protocol, reliability, energy efficiency, etc.

  18. Home-based telehealth to deliver evidence-based psychotherapy in veterans with PTSD.

    PubMed

    Strachan, Martha; Gros, Daniel F; Yuen, Erica; Ruggiero, Kenneth J; Foa, Edna B; Acierno, Ron

    2012-03-01

    Although medical service delivery via home-based telehealth technology (HBT) is gaining wider acceptance in managing chronic illnesses such as diabetes or chronic obstructive pulmonary disease, few studies have tested HBT applications of psychotherapy. Clinicians, administrators, and researchers question whether delivering psychotherapeutic services to patients in their homes via video-conferencing technology compromises patient safety, potency of treatment, or data security. Despite these concerns, HBT service delivery may increase access to evidence-based psychotherapies for veterans with posttraumatic stress disorder (PTSD), who may be less willing or less able to receive weekly treatment at a VA medical center or outpatient clinic due to symptom severity or other similar barriers to care. Indeed, although combat-exposed service members endorse high rates of psychiatric disorders, few appear to initiate mental health services or receive an adequate dose of treatment. Thus, using HBT technologies to administer evidence-based therapies remains uncharted territory in both the clinical and research arenas. This manuscript describes an ongoing four year randomized controlled trial comparing in-person Prolonged Exposure (PE) - a specialized evidence-based psychotherapy for PTSD - and PE delivered via HBT, with a particular focus on the selection, application, and strengths/weaknesses of HBT procedures. PMID:22101225

  19. Important features of home-based support services for older Australians and their informal carers.

    PubMed

    McCaffrey, Nikki; Gill, Liz; Kaambwa, Billingsley; Cameron, Ian D; Patterson, Jan; Crotty, Maria; Ratcliffe, Julie

    2015-11-01

    In Australia, newly initiated, publicly subsidised 'Home-Care Packages' designed to assist older people (≥ 65 years of age) living in their own home must now be offered on a 'consumer-directed care' (CDC) basis by service providers. However, CDC models have largely developed in the absence of evidence on users' views and preferences. The aim of this study was to determine what features (attributes) of consumer-directed, home-based support services are important to older people and their informal carers to inform the design of a discrete choice experiment (DCE). Semi-structured, face-to-face interviews were conducted in December 2012-November 2013 with 17 older people receiving home-based support services and 10 informal carers from 5 providers located in South Australia and New South Wales. Salient service characteristics important to participants were determined using thematic and constant comparative analysis and formulated into attributes and attribute levels for presentation within a DCE. Initially, eight broad themes were identified: information and knowledge, choice and control, self-managed continuum, effective co-ordination, effective communication, responsiveness and flexibility, continuity and planning. Attributes were formulated for the DCE by combining overlapping themes such as effective communication and co-ordination, and the self-managed continuum and planning into single attributes. Six salient service features that characterise consumer preferences for the provision of home-based support service models were identified: choice of provider, choice of support worker, flexibility in care activities provided, contact with the service co-ordinator, managing the budget and saving unspent funds. Best practice indicates that qualitative research with individuals who represent the population of interest should guide attribute selection for a DCE and this is the first study to employ such methods in aged care service provision. Further development of

  20. Electric Energy Management in the Smart Home: Perspectives on Enabling Technologies and Consumer Behavior

    SciTech Connect

    Zipperer, A.; Aloise-Young, P. A.; Suryanarayanan, S.; Zimmerle, D.; Roche, R.; Earle, L.; Christensen, D.; Bauleo, P.

    2013-08-01

    Smart homes hold the potential for increasing energy efficiency, decreasing costs of energy use, decreasing the carbon footprint by including renewable resources, and trans-forming the role of the occupant. At the crux of the smart home is an efficient electric energy management system that is enabled by emerging technologies in the electricity grid and consumer electronics. This article presents a discussion of the state-of-the-art in electricity management in smart homes, the various enabling technologies that will accelerate this concept, and topics around consumer behavior with respect to energy usage.

  1. Electric Energy Management in the Smart Home: Perspectives on Enabling Technologies and Consumer Behavior: Preprint

    SciTech Connect

    Zipperer, A.; Aloise-Young, P. A.; Suryanarayanan, S.; Roche, R.; Earle, L.; Christensen, D.; Bauleo, P.; Zimmerle. D.

    2013-08-01

    Smart homes hold the potential for increasing energy efficiency, decreasing costs of energy use, decreasing the carbon footprint by including renewable resources, and transforming the role of the occupant. At the crux of the smart home is an efficient electric energy management system that is enabled by emerging technologies in the electric grid and consumer electronics. This article presents a discussion of the state-of-the-art in electricity management in smart homes, the various enabling technologies that will accelerate this concept, and topics around consumer behavior with respect to energy usage.

  2. Caregiver-Delivered Home-Based Instruction Using Simultaneous Prompting for Teaching Home Skills to Individuals with Developmental Disabilities

    ERIC Educational Resources Information Center

    Batu, Sema

    2008-01-01

    It is very important for individuals with all kinds of developmental disabilities to learn skills in order to be independent at home. The purposes of the study were twofold; (1) to examine the effectiveness of caregiver-delivered home-based instruction using simultaneous prompting to children with moderate developmental disabilities on teaching…

  3. Region based Brain Computer Interface for a home control application.

    PubMed

    Akman Aydin, Eda; Bay, Omer Faruk; Guler, Inan

    2015-08-01

    Environment control is one of the important challenges for disabled people who suffer from neuromuscular diseases. Brain Computer Interface (BCI) provides a communication channel between the human brain and the environment without requiring any muscular activation. The most important expectation for a home control application is high accuracy and reliable control. Region-based paradigm is a stimulus paradigm based on oddball principle and requires selection of a target at two levels. This paper presents an application of region based paradigm for a smart home control application for people with neuromuscular diseases. In this study, a region based stimulus interface containing 49 commands was designed. Five non-disabled subjects were attended to the experiments. Offline analysis results of the experiments yielded 95% accuracy for five flashes. This result showed that region based paradigm can be used to select commands of a smart home control application with high accuracy in the low number of repetitions successfully. Furthermore, a statistically significant difference was not observed between the level accuracies. PMID:26736451

  4. How Technology in Care at Home Affects Patient Self-Care and Self-Management: A Scoping Review

    PubMed Central

    Peeters, José M.; Wiegers, Therese A.; Friele, Roland D.

    2013-01-01

    The use of technology in care at home has potential benefits such as improved quality of care. This includes greater focus on the patients’ role in managing their health and increased patient involvement in the care process. The objective of this scoping review is to analyse the existing evidence for effects of technology in home-based care on patients’ self-care and self-management. Using suitable search terms we searched the databases of Pubmed, Embase, Cochrane Library, Cinahl, Picarta and NIVEL dating from 2002 to 2012. Thirty-three studies (six review studies and twenty-seven individual studies) were selected. Effects were extracted from each study and were classified. In almost all the studies, the concepts self-care and self-management are not clearly defined or operationalized. Therefore, based on a meta-analysis, we made a new classification of outcome measures, with hierarchical levels: (1) competence (2) illness-management (3) independence (social participation, autonomy). In general, patient outcomes appear to be positive or promising, but most studies were pilot studies. We did not find strong evidence that technology in care at home has (a positive) effect on patient self-care and self-management according to the above classification. Future research is needed to clarify how technology can be used to maximize its benefits. PMID:24173139

  5. [Management of the patient with COPD: home case or hospitalization].

    PubMed

    Aubert, John-David

    2013-05-01

    Acute exacerbation of COPD is one of the most common causes of hospital admission in patients affected with this disease. In most cases, consideration of differential diagnoses and assessment of important comorbidities will allow to make the decision whether or not the patient needs to be hospitalized. A decision to hospitalize will be based on specific symptoms and signs, as well on the patient's history. Contrary to bronchial asthma, a systematic action plan strategy is lacking for COPD. However, a disease management plan involving all the health care providers may have the potential to improve the patient's well being and to decrease costs related to these exacerbations. PMID:23644245

  6. Social-Interaction Knowledge Translation for In-Home Management of Urinary Incontinence and Chronic Care.

    PubMed

    Jansen, Lynn; McWilliam, Carol L; Forbes, Dorothy; Forchuk, Cheryl

    2013-12-01

    Although urinary incontinence (UI) can be managed conservatively, it is a principal reason for the breakdown of in-home family care. This study explored the social interaction processes of knowledge translation (KT) related to how UI management knowledge might be translated within in-home care. In-depth interview data were collected from a theoretical sample of 23 family caregivers, older home care recipients, and home care providers. Constant comparison and Glaser’s analysis criteria were used to create translating knowledge through relating , a substantive theory with 10 subthemes: living with the problem; building experiential knowledge; developing comfort; easing into a working relationship; nurturing mutuality; facilitating knowledge exchange; building confidence; fi ne-tuning knowledge; putting it all together; and managing in-home care. Findings inform both theory and practice of in-home UI KT, illuminating how intersubjectivity and bi-directional relational interactions are essential to translating in-home chronic care knowledge, which is largely tacit and experiential in nature. PMID:24063503

  7. Evidence-based management.

    PubMed

    Cohen, Frank

    2012-01-01

    It's OK to be lucky when you're lucky, but it's not OK when the issues are critical. Too often, we manage by anecdote, which is OK when you can afford to be wrong, but when finances are tight, or the market is overregulated, or a lot is at stake, making mistakes is not an option. Evidence-based management depends on attention to three components: analytics, decision making, and problem solving. These are skills that should be required of everyone who assumes a management position, no matter how high or low one is on the totem pole. Understanding basic analytical techniques, knowing how to apply these techniques to making good decisions, and learning how to become a skilled problem solver ensure that, when we manage our businesses, we minimize the risk of mistakes and maximize the potential for positive outcomes. PMID:22594062

  8. Home-School Relationships: A School Management Perspective

    ERIC Educational Resources Information Center

    Stringer, Patricia; Hourani, Rida Blaik

    2013-01-01

    Abu Dhabi, United Arab Emirates (UAE) is in the process of initiating major education reform designed to improve schools. Parental involvement in support of student learning ranks high on the reform agenda. This study explores managerial aspects of implementing home-school relationships in seven primary Public Private Partnership (PPP) schools in…

  9. Home Care and Management of the Mentally Retarded Child.

    ERIC Educational Resources Information Center

    Vulpe, Shirley German

    The manual details a behavioral and developmental assessment procedure, treatment techniques and method of planning home training programs for mentally retarded children. Focus is on normal preschool development up through 5 years of age. Aims are to help the child function at maximum level by providing practical suggestions to parents for…

  10. Creating an Ethnodrama to Catalyze Dialogue in Home-Based Dementia Care.

    PubMed

    Speechley, Mark; DeForge, Ryan T; Ward-Griffin, Catherine; Marlatt, Nicole M; Gutmanis, Iris

    2015-11-01

    This article describes the development of a theater script derived from a critical ethnographic study that followed people living with dementia--and their family and professional caregivers--over an 18-month period. Analysis of the ethnographic data yielded four themes that characterized home-based dementia care relationships: managing care resources, making care decisions, evaluating care practices, and reifying care norms. The research team expanded to include a colleague with playwright experience, who used these themes to write a script. A theater director was included to cast and direct the play, and finally, a videography company filmed the actors on a realistic set. To contribute to the qualitative health research and the research-based theater knowledge translation literatures, this article describes and explains the creative decisions taken as part of our effort to disseminate research focused on home-based dementia care in a way that catalyzes and fosters critical (actionable) dialogue. PMID:26468252

  11. Developing Initiatives for Home-Based Child Care: Current Research and Future Directions

    ERIC Educational Resources Information Center

    Porter, Toni; Paulsell, Diane

    2011-01-01

    Home-based child care accounts for a significant share of the child care supply in the United States, especially for infants and toddlers. A synthesis of the home-based care research literature and information about recent home-based care quality initiatives points to a critical need for more systematic efforts to develop and test quality…

  12. 42 CFR 440.180 - Home or community-based services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Home or community-based services. 440.180 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.180 Home or community-based services. (a) Description and requirements for services. “Home or community-based...

  13. 42 CFR 436.217 - Individuals receiving home and community-based services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Individuals receiving home and community-based... receiving home and community-based services. The agency may provide Medicaid to any group or groups of... if institutionalized. (b) In the absence of home and community-based services under a waiver...

  14. 42 CFR 440.180 - Home or community-based services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Home or community-based services. 440.180 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.180 Home or community-based services. (a) Description and requirements for services. “Home or community-based...

  15. 42 CFR 436.217 - Individuals receiving home and community-based services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Individuals receiving home and community-based... receiving home and community-based services. The agency may provide Medicaid to any group or groups of... if institutionalized. (b) In the absence of home and community-based services under a waiver...

  16. 42 CFR 435.217 - Individuals receiving home and community-based services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Individuals receiving home and community-based... receiving home and community-based services. The agency may provide Medicaid to any group or groups of... if institutionalized. (b) In the absence of home and community-based services under a waiver...

  17. 42 CFR 435.217 - Individuals receiving home and community-based services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Individuals receiving home and community-based... receiving home and community-based services. The agency may provide Medicaid to any group or groups of... if institutionalized. (b) In the absence of home and community-based services under a waiver...

  18. 42 CFR 436.217 - Individuals receiving home and community-based services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Individuals receiving home and community-based... receiving home and community-based services. The agency may provide Medicaid to any group or groups of... if institutionalized. (b) In the absence of home and community-based services under a waiver...

  19. 42 CFR 435.217 - Individuals receiving home and community-based services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Individuals receiving home and community-based... receiving home and community-based services. The agency may provide Medicaid to any group or groups of... if institutionalized. (b) In the absence of home and community-based services under a waiver...

  20. 42 CFR 436.217 - Individuals receiving home and community-based services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Individuals receiving home and community-based... receiving home and community-based services. The agency may provide Medicaid to any group or groups of... if institutionalized. (b) In the absence of home and community-based services under a waiver...

  1. 42 CFR 441.530 - Home and Community-Based Setting.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Home and Community-Based Setting. 441.530 Section... SERVICES Home and Community-Based Attendant Services and Supports State Plan Option (Community First Choice) § 441.530 Home and Community-Based Setting. (a) States must make available attendant services...

  2. Treating depression within the HIV "medical home": a guided algorithm for antidepressant management by HIV clinicians.

    PubMed

    Adams, Julie L; Gaynes, Bradley N; McGuinness, Teena; Modi, Riddhi; Willig, James; Pence, Brian W

    2012-11-01

    People living with HIV/AIDS (PLWHA) suffer increased depression prevalence compared to the general population, which negatively impacts antiretroviral (ART) adherence and HIV-related outcomes leading to morbidity and mortality. Yet depression in this population often goes undiagnosed and untreated. The current project sought to design an evidence-based approach to integrate depression care in HIV clinics. The model chosen, measurement-based care (MBC), is based on existing guidelines and the largest randomized trial of depression treatment. MBC was adapted to clinical realities of HIV care for use in a randomized controlled effectiveness trial of depression management at three academic HIV clinics. The adaptation accounts for drug-drug interactions critical to ongoing ART effectiveness and can be delivered by a multidisciplinary team of nonmental health providers. A treatment algorithm was developed that enables clinically supervised, nonphysician depression care managers (DCMs) to track and monitor antidepressant tolerability and treatment response while supporting nonpsychiatric prescribers with antidepressant choice and dosing. Quality of care is ensured through weekly supervision of DCMs by psychiatrists. Key areas of flexibility that have been important in implementation have included flexibility in timing of assessments, accommodation of divergence between algorithm recommendations and provider decisions, and accommodation of delays in implementing treatment plans. This adaptation of the MBC model to HIV care has accounted for critical antidepressant-antiretroviral interactions and facilitated the provision of quality antidepressant management within the HIV medical home. PMID:23134559

  3. A Semantic Approach with Decision Support for Safety Service in Smart Home Management.

    PubMed

    Huang, Xiaoci; Yi, Jianjun; Zhu, Xiaomin; Chen, Shaoli

    2016-01-01

    Research on smart homes (SHs) has increased significantly in recent years because of the convenience provided by having an assisted living environment. The functions of SHs as mentioned in previous studies, particularly safety services, are seldom discussed or mentioned. Thus, this study proposes a semantic approach with decision support for safety service in SH management. The focus of this contribution is to explore a context awareness and reasoning approach for risk recognition in SH that enables the proper decision support for flexible safety service provision. The framework of SH based on a wireless sensor network is described from the perspective of neighbourhood management. This approach is based on the integration of semantic knowledge in which a reasoner can make decisions about risk recognition and safety service. We present a management ontology for a SH and relevant monitoring contextual information, which considers its suitability in a pervasive computing environment and is service-oriented. We also propose a rule-based reasoning method to provide decision support through reasoning techniques and context-awareness. A system prototype is developed to evaluate the feasibility, time response and extendibility of the approach. The evaluation of our approach shows that it is more effective in daily risk event recognition. The decisions for service provision are shown to be accurate. PMID:27527170

  4. A Bibliography of Materials on Behavior Management in the Home and Community.

    ERIC Educational Resources Information Center

    Kupper, Lisa, Ed.

    This brief bibliography lists 26 resource materials for managing behavior problems in the home and community. Suggested resources were published between 1985 and 1993 and cover such topics as general behavior management, self-injury, food and behavior, functional communication training, impulsivity, alternatives to punishment, anger, and…

  5. Responsible Management and Use of a Personal Take-Home Naloxone Supply: A Pilot Project

    ERIC Educational Resources Information Center

    McAuley, Andrew; Lindsay, George; Woods, Maureen; Louttit, Derek

    2010-01-01

    Aims: To assess if Scottish drug users, their family and friends could be trained in critical incident management and the safe and effective administration of naloxone. The project also sought to monitor whether drug users can manage their own personal take-home naloxone (THN) supply and use it appropriately in an emergency opiate overdose…

  6. Individual Perseverance: A Theory of Home Tutors' Management of Schooling in Isolated Settings

    ERIC Educational Resources Information Center

    Tynan, Belinda; O'Neill, Marnie

    2007-01-01

    This article reports a study of parents' management of the education of primary school-aged children in their care in remote and rural locations of Western Australia. It presents a theory of the ways in which these parents, in the role of home tutors, "manage" the schooling of their children in a distance education regime in isolated settings. The…

  7. Top Management Leadership Style and Quality of Care in Nursing Homes

    ERIC Educational Resources Information Center

    Castle, Nicholas G.; Decker, Frederic H.

    2011-01-01

    Purpose: The purpose of this study was to examine the association of Nursing Home Administrator (NHA) leadership style and Director of Nursing (DON) leadership style with quality of care. Design and Methods: Leaders were categorized into 4 groups: consensus managers, consultative autocrats, shareholder managers, or autocrats. This leadership style…

  8. Standardising Home Range Studies for Improved Management of the Critically Endangered Black Rhinoceros

    PubMed Central

    Plotz, Roan D.; Grecian, W. James; Kerley, Graham I.H.; Linklater, Wayne L.

    2016-01-01

    Comparisons of recent estimations of home range sizes for the critically endangered black rhinoceros in Hluhluwe-iMfolozi Park (HiP), South Africa, with historical estimates led reports of a substantial (54%) increase, attributed to over-stocking and habitat deterioration that has far-reaching implications for rhino conservation. Other reports, however, suggest the increase is more likely an artefact caused by applying various home range estimators to non-standardised datasets. We collected 1939 locations of 25 black rhino over six years (2004–2009) to estimate annual home ranges and evaluate the hypothesis that they have increased in size. A minimum of 30 and 25 locations were required for accurate 95% MCP estimation of home range of adult rhinos, during the dry and wet seasons respectively. Forty and 55 locations were required for adult female and male annual MCP home ranges, respectively, and 30 locations were necessary for estimating 90% bivariate kernel home ranges accurately. Average annual 95% bivariate kernel home ranges were 20.4 ± 1.2 km2, 53 ±1.9% larger than 95% MCP ranges (9.8 km2 ± 0.9). When home range techniques used during the late-1960s in HiP were applied to our dataset, estimates were similar, indicating that ranges have not changed substantially in 50 years. Inaccurate, non-standardised, home range estimates and their comparison have the potential to mislead black rhino population management. We recommend that more care be taken to collect adequate numbers of rhino locations within standardized time periods (i.e., season or year) and that the comparison of home ranges estimated using dissimilar procedures be avoided. Home range studies of black rhino have been data deficient and procedurally inconsistent. Standardisation of methods is required. PMID:27028728

  9. Standardising Home Range Studies for Improved Management of the Critically Endangered Black Rhinoceros.

    PubMed

    Plotz, Roan D; Grecian, W James; Kerley, Graham I H; Linklater, Wayne L

    2016-01-01

    Comparisons of recent estimations of home range sizes for the critically endangered black rhinoceros in Hluhluwe-iMfolozi Park (HiP), South Africa, with historical estimates led reports of a substantial (54%) increase, attributed to over-stocking and habitat deterioration that has far-reaching implications for rhino conservation. Other reports, however, suggest the increase is more likely an artefact caused by applying various home range estimators to non-standardised datasets. We collected 1939 locations of 25 black rhino over six years (2004-2009) to estimate annual home ranges and evaluate the hypothesis that they have increased in size. A minimum of 30 and 25 locations were required for accurate 95% MCP estimation of home range of adult rhinos, during the dry and wet seasons respectively. Forty and 55 locations were required for adult female and male annual MCP home ranges, respectively, and 30 locations were necessary for estimating 90% bivariate kernel home ranges accurately. Average annual 95% bivariate kernel home ranges were 20.4 ± 1.2 km(2), 53 ± 1.9% larger than 95% MCP ranges (9.8 km(2) ± 0.9). When home range techniques used during the late-1960s in HiP were applied to our dataset, estimates were similar, indicating that ranges have not changed substantially in 50 years. Inaccurate, non-standardised, home range estimates and their comparison have the potential to mislead black rhino population management. We recommend that more care be taken to collect adequate numbers of rhino locations within standardized time periods (i.e., season or year) and that the comparison of home ranges estimated using dissimilar procedures be avoided. Home range studies of black rhino have been data deficient and procedurally inconsistent. Standardisation of methods is required. PMID:27028728

  10. Management Seminar Series I and II for Nursing Home Administrators, March-July 1969.

    ERIC Educational Resources Information Center

    Peck, Janice R.

    Developed by the University of Maryland for the Maryland-D.C. Nursing Home Association, these two series, each containing 84 hours of instruction in four three-day seminars, were designed to meet nursing home administrators' need for managerial skills and to prepare them for licensing. (Based on experiences with the first series, course materials…

  11. Home assessment and care.

    PubMed Central

    Ferrier, C.; Lysy, P.

    2000-01-01

    OBJECTIVE: To describe the scope of home care and to give practical advice for incorporating home visits into family practice. QUALITY OF EVIDENCE: Most of the literature is based on expert opinion, but there are some randomized trials and well done surveys. MAIN MESSAGE: Although physicians make fewer housecalls than they used to, home visiting is essential to providing good care to certain patients. An approach to evaluating patients and their home environments is presented. Management plans should be formulated in collaboration with home care teams. We offer practical advice for incorporating home visits into practice. CONCLUSION: Home visits can be a valuable and rewarding complement to family practice and are essential for the development of home care. PMID:11072585

  12. Nurse practitioner management of acute in-hours home visit or assessment requests: a pilot study

    PubMed Central

    Edwards, Martin; Bobb, Carol; Robinson, Susan I

    2008-01-01

    Background GPs often perceive home-visit requests as a time-consuming aspect of general practice. The new general medical services contract provides for practices to be relieved of responsibility for home-visits, although there is no model for the transfer of care. One such model could be to employ nurse practitioners to manage such requests. Nurse practitioners can effectively substitute for GPs in managing same-day in-hours emergency care in the surgery, but their role in managing all such requests, including those requiring home visits, has not been assessed. Aim To explore the feasibility and clinical management outcomes of nurse practitioner management of same-day care requests, including those requiring home visits, to inform a proposed randomised controlled trial. Design of study Non-randomised comparative trial. Setting One large general practice (14 600 patients) in south London. Method Nurse practitioner assessment and management of all same-day care requests for 2 days per week was compared with normal GP management on another 2 days, over a 6-month period. Clinical management outcome data were collected from patient records and from data-collection forms completed by a nurse practitioner and GPs. Patient and staff satisfaction was assessed by questionnaire. Results The nurse practitioner was more likely than GPs to assess patients in person, less likely to give advice alone, and more likely to issue a prescription. There was no significant difference between the nurse practitioner and GPs regarding any other clinical management outcomes or patient satisfaction; however, the response rate of the patient satisfaction questionnaire in this pilot study was poor. Conclusion Nurse practitioner management of acute in-hours care requests, including home visits, appears feasible in practice and merits further assessment. PMID:19105910

  13. Posture recognition based on fuzzy logic for home monitoring of the elderly.

    PubMed

    Brulin, Damien; Benezeth, Yannick; Courtial, Estelle

    2012-09-01

    We propose in this paper a computer vision-based posture recognition method for home monitoring of the elderly. The proposed system performs human detection prior to the posture analysis; posture recognition is performed only on a human silhouette. The human detection approach has been designed to be robust to different environmental stimuli. Thus, posture is analyzed with simple and efficient features that are not designed to manage constraints related to the environment but only designed to describe human silhouettes. The posture recognition method, based on fuzzy logic, identifies four static postures and is robust to variation in the distance between the camera and the person, and to the person's morphology. With an accuracy of 74.29% of satisfactory posture recognition, this approach can detect emergency situations such as a fall within a health smart home. PMID:22997188

  14. Web-based home telemedicine system for orthopedics

    NASA Astrophysics Data System (ADS)

    Lau, Christopher; Churchill, Sean; Kim, Janice; Matsen, Frederick A., III; Kim, Yongmin

    2001-05-01

    Traditionally, telemedicine systems have been designed to improve access to care by allowing physicians to consult a specialist about a case without sending the patient to another location, which may be difficult or time-consuming to reach. The cost of the equipment and network bandwidth needed for this consultation has restricted telemedicine use to contact between physicians instead of between patients and physicians. Recently, however, the wide availability of Internet connectivity and client and server software for e- mail, world wide web, and conferencing has made low-cost telemedicine applications feasible. In this work, we present a web-based system for asynchronous multimedia messaging between shoulder replacement surgery patients at home and their surgeons. A web browser plug-in was developed to simplify the process of capturing video and transferring it to a web site. The video capture plug-in can be used as a template to construct a plug-in that captures and transfers any type of data to a web server. For example, readings from home biosensor instruments (e.g., blood glucose meters and spirometers) that can be connected to a computing platform can be transferred to a home telemedicine web site. Both patients and doctors can access this web site to monitor progress longitudinally. The system has been tested with 3 subjects for the past 7 weeks, and we plan to continue testing in the foreseeable future.

  15. An Attachment-Based Home Visiting Program for Distressed Mothers of Young Infants

    ERIC Educational Resources Information Center

    Kaitz, Marsha; Tessler, Naomi; Chriki, Miriam

    2012-01-01

    Mom2Mom is an attachment-based home visiting project for distressed mothers of young infants, based in Israel. Home visitors, who are volunteer mothers from the community, are trained and supervised by professionals. Home visits occur weekly for 1-2 hours and continue until the infant is 1 year old. The project was founded in Jerusalem in year…

  16. 42 CFR 435.217 - Individuals receiving home and community-based services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Individuals receiving home and community-based... Families and Children and the Aged, Blind, and Disabled § 435.217 Individuals receiving home and community.... (b) In the absence of home and community-based services under a waiver granted under part 441—...

  17. Effect of a Consumer-Directed Voucher and a Disease-Management-Health-Promotion Nurse Intervention on Home Care Use

    ERIC Educational Resources Information Center

    Meng, Hongdao; Friedman, Bruce; Wamsley, Brenda R.; Mukamel, Dana; Eggert, Gerald M.

    2005-01-01

    Purpose: We describe the impact of two interventions, a consumer-directed voucher for in-home supportive services and a chronic disease self-management-health-promotion nurse intervention, on the probability of use of two types of home care-skilled home health care and personal assistance services-received by functionally impaired Medicare…

  18. Patients' acceptance of Internet-based home asthma telemonitoring.

    PubMed

    Finkelstein, J; Hripcsak, G; Cabrera, M R

    1998-01-01

    We studied asthma patients from a low-income inner-city community without previous computer experience. The patients were given portable spirometers to perform spirometry tests and palmtop computers to enter symptoms in a diary, to exchange messages with physician and to review test results. The self-testing was performed at home on a daily basis. The results were transmitted to the hospital information system immediately after completion of each test. Physician could review results using an Internet Web browser from any location. A constantly active decision support server monitored all data traffic and dispatched alerts when certain clinical conditions were met. Seventeen patients, out of 19 invited, agreed to participate in the study and have been monitored for three weeks. They have been surveyed then using standardized questionnaire. Most of the patients (82.4%) characterized self-testing procedures as "not complicated at all." In 70.6% of cases self-testing did not interfere with usual activities, and 82.4% of patients felt the self-testing required a "very little" amount of their time. All patients stated that it is important for them to know that the results can be reviewed by professional staff in a timely manner. However, only 29.5% of patients reviewed their results at least once a week at home independently. The majority of the patients (94.1%) were strongly interested in using home asthma telemonitoring in the future. We concluded that Internet-based home asthma telemonitoring can be successfully implemented in the group of patients without previous computer background. PMID:9929237

  19. Role of home automation in demand-side management. Topical report, May 1994

    SciTech Connect

    Davis, K.W.

    1994-05-01

    The report explores the role of home automation (HA) in utility demand-side management (DSM) programs, in order to demonstrate the potential usefulness of a combined HA/DSM strategy in meeting the changing needs of the gas industry and providing the industry with a timely and competitive edge in the coming decade. Research was conducted using primary and secondary sources, on-line databases, and documentary research. Factors leading to the development and implementation of demand-side management and home automation were analyzed in order to best define opportunities and interests for the gas industry.

  20. Exploring pharmacy and home-based sexually transmissible infection testing

    PubMed Central

    Habel, Melissa A.; Scheinmann, Roberta; Verdesoto, Elizabeth; Gaydos, Charlotte; Bertisch, Maggie; Chiasson, Mary Ann

    2015-01-01

    Background This study assessed the feasibility and acceptability of pharmacy and home-based sexually transmissible infection (STI) screening as alternate testing venues among emergency contraception (EC) users. Methods The study included two phases in February 2011–July 2012. In Phase I, customers purchasing EC from eight pharmacies in Manhattan received vouchers for free STI testing at onsite medical clinics. In Phase II, three Facebook ads targeted EC users to connect them with free home-based STI test kits ordered online. Participants completed a self-administered survey. Results Only 38 participants enrolled in Phase I: 90% female, ≤29 years (74%), 45% White non-Hispanic and 75% college graduates; 71% were not tested for STIs in the past year and 68% reported a new partner in the past 3 months. None tested positive for STIs. In Phase II, ads led to >45 000 click-throughs, 382 completed the survey and 290 requested kits; 28% were returned. Phase II participants were younger and less educated than Phase I participants; six tested positive for STIs. Challenges included recruitment, pharmacy staff participation, advertising with discretion and cost. Conclusions This study found low uptake of pharmacy and home-based testing among EC users; however, STI testing in these settings is feasible and the acceptability findings indicate an appeal among younger women for testing in non-traditional settings. Collaborating with and training pharmacy and medical staff are key elements of service provision. Future research should explore how different permutations of expanding screening in non-traditional settings could improve testing uptake and detect additional STI cases. PMID:26409484

  1. Effects and costs of home-based training with telemonitoring guidance in low to moderate risk patients entering cardiac rehabilitation: The FIT@Home study

    PubMed Central

    2013-01-01

    Background Physical training has beneficial effects on exercise capacity, quality of life and mortality in patients after a cardiac event or intervention and is therefore a core component of cardiac rehabilitation. However, cardiac rehabilitation uptake is low and effects tend to decrease after the initial rehabilitation period. Home-based training has the potential to increase cardiac rehabilitation uptake, and was shown to be safe and effective in improving short-term exercise capacity. Long-term effects on physical fitness and activity, however, are disappointing. Therefore, we propose a novel strategy using telemonitoring guidance based on objective training data acquired during exercise at home. In this way, we aim to improve self-management skills like self-efficacy and action planning for independent exercise and, consequently, improve long-term effectiveness with respect to physical fitness and physical activity. In addition, we aim to compare costs of this strategy with centre-based cardiac rehabilitation. Methods/design This randomized controlled trial compares a 12-week telemonitoring guided home-based training program with a regular, 12-week centre-based training program of equal duration and training intensity in low to moderate risk patients entering cardiac rehabilitation after an acute coronary syndrome or cardiac intervention. The home-based group receives three supervised training sessions before they commence training with a heart rate monitor in their home environment. Participants are instructed to train at 70-85% of their maximal heart rate for 45–60 minutes, twice a week. Patients receive individual coaching by telephone once a week, based on measured heart rate data that are shared through the internet. Primary endpoints are physical fitness and physical activity, assessed at baseline, after 12 weeks and after one year. Physical fitness is expressed as peak oxygen uptake, assessed by symptom limited exercise testing with gas exchange

  2. Database Management Systems: New Homes for Migrating Bibliographic Records.

    ERIC Educational Resources Information Center

    Brooks, Terrence A.; Bierbaum, Esther G.

    1987-01-01

    Assesses bibliographic databases as part of visionary text systems such as hypertext and scholars' workstations. Downloading is discussed in terms of the capability to search records and to maintain unique bibliographic descriptions, and relational database management systems, file managers, and text databases are reviewed as possible hosts for…

  3. First-Line Nursing Home Managers in Sweden and their Views on Leadership and Palliative Care.

    PubMed

    Håkanson, Cecilia; Cronfalk, Berit Seiger; Henriksen, Eva; Norberg, Astrid; Ternestedt, Britt-Marie; Sandberg, Jonas

    2014-01-01

    The aim of this study was to investigate first-line nursing home managers' views on their leadership and related to that, palliative care. Previous research reveals insufficient palliation, and a number of barriers towards implementation of palliative care in nursing homes. Among those barriers are issues related to leadership quality. First-line managers play a pivotal role, as they influence working conditions and quality of care. Nine first-line managers, from different nursing homes in Sweden participated in the study. Semi-structured interviews were conducted and analysed using qualitative descriptive content analysis. In the results, two categories were identified: embracing the role of leader and being a victim of circumstances, illuminating how the first-line managers handle expectations and challenges linked to the leadership role and responsibility for palliative care. The results reveal views corresponding to committed leaders, acting upon demands and expectations, but also to leaders appearing to have resigned from the leadership role, and who express powerlessness with little possibility to influence care. The first line managers reported their own limited knowledge about palliative care to limit their possibilities of taking full leadership responsibility for implementing palliative care principles in their nursing homes. The study stresses that for the provision of high quality palliative care in nursing homes, first-line managers need to be knowledgeable about palliative care, and they need supportive organizations with clear expectations and goals about palliative care. Future action and learning oriented research projects for the implementation of palliative care principles, in which first line managers actively participate, are suggested. PMID:25628769

  4. Healthy Homes University: A Home-Based Environmental Intervention and Education Program for Families with Pediatric Asthma in Michigan

    PubMed Central

    Largo, Thomas W.; Borgialli, Michele; Wisinski, Courtney L.; Wahl, Robert L.; Priem, Wesley F.

    2011-01-01

    Environmental conditions within the home can exacerbate asthmatic children's symptoms. To improve health outcomes among this group, we implemented an in-home environmental public health program—Healthy Homes University—for low-income families in Lansing, Michigan, from 2005 to 2008. Families received four visits during a six-month intervention. Program staff assessed homes for asthma triggers and subsequently provided products and services to reduce exposures to cockroaches, dust mites, mold, tobacco smoke, and other triggers. We also provided asthma education that included identification of asthma triggers and instructions on specific behaviors to reduce exposures. Based on self-reported data collected from 243 caregivers at baseline and six months, the impact of asthma on these children was substantially reduced, and the proportion who sought acute unscheduled health care for their asthma decreased by more than 47%. PMID:21563708

  5. ASCOT data base management system

    SciTech Connect

    Barbieri, J.; Nyholm, R.; Castro, C.; Hill, K.

    1980-07-01

    The ASCOT data base management system is designed to handle the data produced by both the experimental and theoretical efforts of the DOE Atmospheric Studies in Complex Terrain (ASCOT) project. The data base envisioned is hierarchically structured, sparse, and compact. Information concerning any given data file is stored in a directory file. The data base management system uses a relational data management approach. Presently three management schema are being developed for use with the data base. 5 figures.

  6. Cost Analysis of a Home-Based Nurse Care Coordination Program

    PubMed Central

    Marek, Karen Dorman; Stetzer, Frank; Adams, Scott J; Bub, Linda Denison; Schlidt, Andrea; Colorafi, Karen Jiggins

    2014-01-01

    Objectives To determine whether a home-based care coordination program focused on medication self-management would affect the cost of care to the Medicare program and whether the addition of technology, a medication-dispensing machine, would further reduce cost. Design Randomized, controlled, three-arm longitudinal study. Setting Participant homes in a large Midwestern urban area. Participants Older adults identified as having difficulty managing their medications at discharge from Medicare Home Health Care (N = 414). Intervention A team consisting of advanced practice nurses (APNs) and registered nurses (RNs) coordinated care for two groups: home-based nurse care coordination (NCC) plus a pill organizer group and NCC plus a medication-dispensing machine group. Measurements To measure cost, participant claims data from 2005 to 2011 were retrieved from Medicare Part A and B Standard Analytical Files. Results Ordinary least squares regression with covariate adjustment was used to estimate monthly dollar savings. Total Medicare costs were $447 per month lower in the NCC plus pill organizer group (P = .11) than in a control group that received usual care. For participants in the study at least 3 months, total Medicare costs were $491 lower per month in the NCC plus pill organizer group (P = .06) than in the control group. The cost of the NCC plus pill organizer intervention was $151 per month, yielding a net savings of $296 per month or $3,552 per year. The cost of the NCC plus medication-dispensing machine intervention was $251 per month, and total Medicare costs were $409 higher per month than in the NCC plus pill organizer group. Conclusion Nurse care coordination plus a pill organizer is a cost-effective intervention for frail elderly Medicare beneficiaries. The addition of the medication machine did not enhance the cost effectiveness of the intervention. PMID:25482242

  7. Developing Student Knowledge and Skills for Home-Based Social Work Practice

    ERIC Educational Resources Information Center

    Allen, Susan F.; Tracy, Elizabeth M.

    2008-01-01

    Providing social work services for clients in their homes is often a distinguishing feature of social work practice. The home environment affects the intervention process at each stage of contact with a family. Home-based practice requires specific skills to deal with clients' presenting concerns as well as safety, boundary, confidentiality, and…

  8. The Relative Benefits and Cost of Medicaid Home- and Community-Based Services in Florida

    ERIC Educational Resources Information Center

    Mitchell, Glenn, II; Salmon, Jennifer R.; Polivka, Larry; Soberon-Ferrer, Horacio

    2006-01-01

    Purpose: We compared inpatient days, nursing home days, and total Medicaid claims for five Medicaid-funded home- and community-based services (HCBS) programs for in-home and assisted living services in Florida. Design and Methods: We studied a single cohort of Medicaid enrollees in Florida aged 60 and older, who were enrolled for the first time in…

  9. First-Line Nursing Home Managers in Sweden and their Views on Leadership and Palliative Care

    PubMed Central

    Håkanson, Cecilia; Cronfalk, Berit Seiger; Henriksen, Eva; Norberg, Astrid; Ternestedt, Britt-Marie; Sandberg, Jonas

    2015-01-01

    The aim of this study was to investigate first-line nursing home managers’ views on their leadership and related to that, palliative care. Previous research reveals insufficient palliation, and a number of barriers towards implementation of palliative care in nursing homes. Among those barriers are issues related to leadership quality. First-line managers play a pivotal role, as they influence working conditions and quality of care. Nine first-line managers, from different nursing homes in Sweden participated in the study. Semi-structured interviews were conducted and analysed using qualitative descriptive content analysis. In the results, two categories were identified: embracing the role of leader and being a victim of circumstances, illuminating how the first-line managers handle expectations and challenges linked to the leadership role and responsibility for palliative care. The results reveal views corresponding to committed leaders, acting upon demands and expectations, but also to leaders appearing to have resigned from the leadership role, and who express powerlessness with little possibility to influence care. The first line managers reported their own limited knowledge about palliative care to limit their possibilities of taking full leadership responsibility for implementing palliative care principles in their nursing homes. The study stresses that for the provision of high quality palliative care in nursing homes, first-line managers need to be knowledgeable about palliative care, and they need supportive organizations with clear expectations and goals about palliative care. Future action and learning oriented research projects for the implementation of palliative care principles, in which first line managers actively participate, are suggested. PMID:25628769

  10. A Coordinated Program to Transfer Self-Management Skills from School to Home.

    ERIC Educational Resources Information Center

    Irvine, A. Blair; And Others

    1992-01-01

    This report describes a self-management skills intervention utilizing a picture schedule for four high school students with moderate to severe mental retardation. The program was initiated at school and continued at home with different tasks. Students continued to successfully use the schedules on follow up after summer vacation. (DB)

  11. Evaluation of a Behavior Management Training Program for Nursing Home Caregivers.

    ERIC Educational Resources Information Center

    Marsiske, Michael; And Others

    This study examined the effectiveness of a new skills training program designed to increase nurse aides' knowledge of behavior management. The training program, designed as five 90-minute group learning modules, was implemented in two Western Pennsylvania nursing homes over a 5-month period. Topics covered within the training program included…

  12. Indiana Resource Guide for Consumer Education and Home Management: Working Papers.

    ERIC Educational Resources Information Center

    Indiana Research Coordinating Unit, Indianapolis.

    The guide presents units of instruction for secondary consumer education and home management education which were developed at a workshop. The subject areas covered by the units, their teaching time, and suggested grade level areas are as follows: (1) organizing resources (one to two weeks, grade 7), (2) making personal and consumer decisions (two…

  13. Relationship between Social Class and Racial Prejudice on Home Management Skills among Black Americans.

    ERIC Educational Resources Information Center

    Wilson, Catherine Walker

    The relationship of social class and racial prejudice to the home management skills of black Americans was the focus of this study. A questionnaire (a copy of which appears in an appendix) was used to interview a sample of 100 people divided into four subgroups: low social class blacks, low social class whites, middle social class blacks, and…

  14. Hospice Care in Nursing Homes: Does It Contribute to Higher Quality Pain Management?

    ERIC Educational Resources Information Center

    Kayser-Jones, Jeanie S.; Kris, Alison E.; Miaskowski, Christine A.; Lyons, William L.; Paul, Steven M.

    2006-01-01

    Purpose: The purpose of this study was to investigate pain management among 42 hospice and 65 non-hospice residents in two proprietary nursing homes. Design and Methods: In this prospective, anthropological, quantitative, and qualitative study, we used participant observation, event analysis, and chart review to obtain data. The Medication…

  15. Managing the Drivers of Air Flow and Water Vapor Transport in Existing Single Family Homes (Revised)

    SciTech Connect

    Cummings, J.; Withers, C.; Martin, E.; Moyer, N.

    2012-10-01

    This document focuses on managing the driving forces which move air and moisture across the building envelope. While other previously published Measure Guidelines focus on elimination of air pathways, the ultimate goal of this Measure Guideline is to manage drivers which cause air flow and water vapor transport across the building envelope (and also within the home), control air infiltration, keep relative humidity (RH) within acceptable limits, avoid combustion safety problems, improve occupant comfort, and reduce house energy use.

  16. Serious Games for Home-based Stroke Rehabilitation.

    PubMed

    Friedrich, Raoul; Hiesel, Patrick; Peters, Sebastian; Siewiorek, Daniel P; Smailagic, Asim; Brügge, Bernd

    2015-01-01

    On average, two thousand residents in the United States experience a stroke every day. These circumstances account for $28 billion direct costs annually and given the latest predictions, these costs will more than triple by 2030. In our research, we propose a portfolio of serious games for home-based stroke rehabilitation. The objective of the game approach is to enrich the training experience and establish a higher level of compliance to prescribed exercises, while maintaining a supportive training environment as found in common therapy sessions. Our system provides a collection of mini games based on rehabilitation exercises used in conventional physical therapy, monitors the patient's performance while exercising and provides clinicians with an interface to personalize the training. The clinician can set the current state of rehabilitation and change the playable games over time to drive diversification. While the system still has to be evaluated, an early stage case study with one patient offered positive indications towards this concept. PMID:26152980

  17. The Home Independence Program with non-health professionals as care managers: an evaluation.

    PubMed

    Lewin, Gill; Concanen, Karyn; Youens, David

    2016-01-01

    The Home Independence Program (HIP), an Australian restorative home care/reablement service for older adults, has been shown to be effective in reducing functional dependency and increasing functional mobility, confidence in everyday activities, and quality of life. These gains were found to translate into a reduced need for ongoing care services and reduced health and aged care costs over time. Despite these positive outcomes, few Australian home care agencies have adopted the service model - a key reason being that few Australian providers employ health professionals, who act as care managers under the HIP service model. A call for proposals from Health Workforce Australia for projects to expand the scope of practice of health/aged care staff then provided the opportunity to develop, implement, and evaluate a service delivery model, in which nonprofessionals replaced the health professionals as Care Managers in the HIP service. Seventy older people who received the HIP Coordinator (HIPC) service participated in the outcomes evaluation. On a range of personal outcome measures, the group showed statistically significant improvement at 3 and 12 months compared to baseline. On each outcome, the improvement observed was larger than that observed in a previous trial in which the service was delivered by health professionals. However, differences in the timing of data collection between the two studies mean that a direct comparison cannot be made. Clients in both studies showed a similarly reduced need for ongoing home care services at both follow-up points. The outcomes achieved by HIPC, with non-health professionals as Care Managers, were positive and can be considered to compare favorably with the outcomes achieved in HIP when health professionals take the Care Manager role. These findings will be of interest to managers of home care services and to policy makers interested in reducing the long-term care needs of older community dwelling individuals. PMID:27382264

  18. The Home Independence Program with non-health professionals as care managers: an evaluation

    PubMed Central

    Lewin, Gill; Concanen, Karyn; Youens, David

    2016-01-01

    The Home Independence Program (HIP), an Australian restorative home care/reablement service for older adults, has been shown to be effective in reducing functional dependency and increasing functional mobility, confidence in everyday activities, and quality of life. These gains were found to translate into a reduced need for ongoing care services and reduced health and aged care costs over time. Despite these positive outcomes, few Australian home care agencies have adopted the service model – a key reason being that few Australian providers employ health professionals, who act as care managers under the HIP service model. A call for proposals from Health Workforce Australia for projects to expand the scope of practice of health/aged care staff then provided the opportunity to develop, implement, and evaluate a service delivery model, in which nonprofessionals replaced the health professionals as Care Managers in the HIP service. Seventy older people who received the HIP Coordinator (HIPC) service participated in the outcomes evaluation. On a range of personal outcome measures, the group showed statistically significant improvement at 3 and 12 months compared to baseline. On each outcome, the improvement observed was larger than that observed in a previous trial in which the service was delivered by health professionals. However, differences in the timing of data collection between the two studies mean that a direct comparison cannot be made. Clients in both studies showed a similarly reduced need for ongoing home care services at both follow-up points. The outcomes achieved by HIPC, with non-health professionals as Care Managers, were positive and can be considered to compare favorably with the outcomes achieved in HIP when health professionals take the Care Manager role. These findings will be of interest to managers of home care services and to policy makers interested in reducing the long-term care needs of older community dwelling individuals. PMID:27382264

  19. Backyard waste management - problems and benefits of individuals managing their solid waste at home

    SciTech Connect

    Whalen, M.

    1995-05-01

    The problems and benefits of individuals managing their solid wastes at home are surveyed. The survey indicates that as the population rises people tend to burn only the combustible portions of their waste. Some communities have limited ordinances that ban the burning of raw garbage, but other municipalities allow residents to burn all of their wastestream, even though some materials are not combustible and cannot be burned. Potential environmental effects involve both the ash residue and the air emissions. While selected burning can reduce some of the environmental hazards these would probably only be marginally less than the impacts of burning it all. The study clearly indicates that the environmental problems of burn barrels are not insignificant. However, the attitudes and motivations of those who burn waste will have to be addressed by the communities that attempt or should attempt to control this problem. These include: avoidance of waste collection costs; availability of trash cartage services; and habit. Habit is probably as strong a motivation as cost avoidance and ease of collection combined. Residents have often burned trash for several generations and regard the practice as a {open_quotes}god-given right.{close_quotes}

  20. Adherence of pain assessment to the German national standard for pain management in 12 nursing homes

    PubMed Central

    Osterbrink, Jürgen; Bauer, Zsuzsa; Mitterlehner, Barbara; Gnass, Irmela; Kutschar, Patrick

    2014-01-01

    BACKGROUND: Pain is very common among nursing home residents. The assessment of pain is a prerequisite for effective multiprofessional pain management. Within the framework of the German health services research project, ‘Action Alliance Pain-Free City Muenster’, the authors investigated pain assessment adherence according to the German national Expert Standard for Pain Management in Nursing, which is a general standard applicable to all chronic/acute pain-affected persons and highly recommended for practice. OBJECTIVES: To evaluate the state of pain assessment and to identify need for improvement in 12 nursing homes in a German city. METHODS: In the present study, the authors used an ex-post-facto design (survey methodology). Available written policies for routine pain assessment in residents ≥65 years of age were reviewed and a standardized online survey completed by 151 of 349 nurses in 12 nursing home facilities was conducted between September 2010 and April 2011. RESULTS: Most of the included nursing homes provided written policies for pain assessment, and the majority of nurses reported that they assess and regularly reassess pain. However, observational tools for residents with severe cognitive impairment and written reassessment schedules were lacking in many facilities or were inconsistent. CONCLUSIONS: Essentially, pain assessment appeared to be feasible in the majority of the German nursing homes studied. However, the absence or inconsistency of reassessment schedules indicate that pain management guidelines should include a detailed and explicit reassessment schedule for the heterogenic needs of nursing home residents. For residents with severe cognitive impairment, assessment tools are needed that are simple to use and clearly indicate the presence or absence of pain. PMID:24851238

  1. Evaluation of a Home-Based Environmental and Educational Intervention to Improve Health in Vulnerable Households: Southeastern Pennsylvania Lead and Healthy Homes Program.

    PubMed

    Mankikar, Deepa; Campbell, Carla; Greenberg, Rachael

    2016-01-01

    This evaluation examined whether participation in a home-based environmental educational intervention would reduce exposure to health and safety hazards and asthma-related medical visits. The home intervention program focused on vulnerable, low-income households, where children had asthma, were at risk for lead poisoning, or faced multiple unsafe housing conditions. Home visitors conducted two home visits, two months apart, consisting of an environmental home assessment, Healthy Homes education, and distribution of Healthy Homes supplies. Measured outcomes included changes in participant knowledge and awareness of environmental home-based hazards, rate of children's asthma-related medical use, and the presence of asthma triggers and safety hazards. Analysis of 2013-2014 baseline and post-intervention program data for a cohort of 150 families revealed a significantly lower three-month rate (p < 0.05) of children's asthma-related doctor visits and hospital admissions at program completion. In addition, there were significantly reduced reports of the presence of home-based hazards, including basement or roof leaks (p = 0.011), plumbing leaks (p = 0.019), and use of an oven to heat the home (p < 0.001). Participants' pre- and post- test scores showed significant improvement (p < 0.05) in knowledge and awareness of home hazards. Comprehensive home interventions may effectively reduce environmental home hazards and improve the health of asthmatic children in the short term. PMID:27618087

  2. Improving heart failure in home care with chronic disease management and telemonitoring.

    PubMed

    Hall, Pamela; Morris, Mollie

    2010-01-01

    Home Health Compare rates for Emergent Care and Acute Hospitalization increased undesirably for Athens Regional Home Health. Data revealed that the increase was due to heart failure exacerbation. It was hypothesized that a chronic disease management program with telemonitoring, to include chest fluid bioimpedance, would allow for earlier intervention, thus preventing emergency department visits and acute care readmissions. This article describes the agency's performance improvement initiative that resulted in a decrease in these rates while improving patient outcomes and increasing agency referrals. PMID:21057230

  3. Managing patients with bipolar disorder at home: a family affair and a psychiatric challenge in home healthcare.

    PubMed

    Carson, Verna Benner; Yambor, Sandra L

    2012-05-01

    Medicare has covered psychiatric home care for many years, but the delivery of psychiatric services in the home continues to raise questions related to coverage and criteria. What services do psychiatric nurses provide in the home? What are the rules and regulations governing this service? This article presents information related to psychiatric nursing in home care and specifically bipolar disease. These questions are answered within Chapter 7 of the Medicare Benefit Policy Manual, April 2011. Section 40.1.2.15. PMID:22565349

  4. Managing Your Home's Energy Dollar: An Energy Management Workbook for the Homeowner.

    ERIC Educational Resources Information Center

    Energy Information Associates, Inc., Littleton, CO.

    This workbook is intended to teach the homeowner some actions to be taken in the home to conserve energy and reduce energy-related costs. The workbook is arranged around five steps: (1) read utility meters, (2) study utility bills, (3) "tune-up" home energy systems, (4) make informed decisions about energy conservation products, and (5) compare…

  5. A Mobile Cloud-Based Parkinson’s Disease Assessment System for Home-Based Monitoring

    PubMed Central

    Petitti, Diana B

    2015-01-01

    and accuracy was .81. In PD severity estimation, the captured motion features also demonstrated strong correlation with PD severity stage, hand resting tremor severity, and gait difficulty. The system is simple to use, user friendly, and economically affordable. Conclusions The key contribution of this study was building a mobile PD assessment and monitoring system to extend current PD assessment based in the clinic setting to the home-based environment. The results of this study proved feasibility and a promising future for utilizing mobile technology in PD management. PMID:25830687

  6. User Interaction Design for a Home-Based Telecare System

    NASA Astrophysics Data System (ADS)

    Raptis, Spyros; Tsiakoulis, Pirros; Chalamandaris, Aimilios; Karabetsos, Sotiris

    This paper presents the design of the user-interaction component of a home-based telecare system for congestive heart failure patients. It provides a short overview of the overall system and offers details on the different interaction types supported by the system. Interacting with the user occurs either as part of a scheduled procedure or as a consequence of identifying or predicting a potentially hazardous deterioration of the patients' health state. The overall logic of the interaction is structured around event-scenario associations, where a scenario consists of concrete actions to be performed, some of which may involve the patient. A key objective in this type of interaction that it is very simple, intuitive and short, involving common everyday objects and familiar media such as speech.

  7. Montessori-based training makes a difference for home health workers & their clients.

    PubMed

    Gorzelle, Gregg J; Kaiser, Kathy; Camp, Cameron J

    2003-01-01

    Home care visits can last several hours. Home care workers are often at a loss on how to fill time spent in homes of clients. The challenge is how to use this time in ways that are productive and engaging for both clients and home health workers. The authors trained home health aides to implement Montessori-based activities while interacting with clients who have dementia. The results were amazing. Among other positive results, the authors found a statistically significant increase in the amount of pleasure displayed by clients after health workers received training. PMID:12557465

  8. A Web-Based Contingency Management Program with Adolescent Smokers

    ERIC Educational Resources Information Center

    Reynolds, Brady; Dallery, Jesse; Shroff, Palak; Patak, Michele; Leraas, Kristen

    2008-01-01

    The present study evaluated a new 30-day Web-based contingency management program for smoking abstinence with 4 daily-smoking adolescents. Participants made 3 daily video recordings of themselves giving breath carbon monoxide (CO) samples at home that were sent electronically to study personnel. Using a reversal design, participants could earn…

  9. Family Members Providing Home-Based Palliative Care to Older Adults: The Enactment of Multiple Roles

    ERIC Educational Resources Information Center

    Clemmer, Sarah J.; Ward-Griffin, Catherine; Forbes, Dorothy

    2008-01-01

    Canadians are experiencing increased life expectancy and chronic illness requiring end-of-life care. There is limited research on the multiple roles for family members providing home-based palliative care. Based on a larger ethnographic study of client-family-provider relationships in home-based palliative care, this qualitative secondary analysis…

  10. Entrepreneurial Checklist Tool for Beginning Farm and Home-Based Businesses

    ERIC Educational Resources Information Center

    Rafie, A. R.; Nartea, Theresa

    2012-01-01

    Extension educators entertain frequent questions on beginning a farm or starting a home-based business. Retired, unemployed, and displaced workers consider starting a small farm or home-based business. Determining educational needs or individual business aptitude is time consuming. Lengthy and comprehensive skill-based checklists exist for…

  11. 42 CFR 440.180 - Home and community-based waiver services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Home and community-based waiver services. 440.180... and community-based waiver services. (a) Description and requirements for services. “Home or community... community-based services may include the following services, as they are defined by the agency and...

  12. Service oriented network architecture for control and management of home appliances

    NASA Astrophysics Data System (ADS)

    Hayakawa, Hiroshi; Koita, Takahiro; Sato, Kenya

    2005-12-01

    Recent advances in multimedia network systems and mechatronics have led to the development of a new generation of applications that associate the use of various multimedia objects with the behavior of multiple robotic actors. The connection of audio and video devices through high speed multimedia networks is expected to make the system more convenient to use. For example, many home appliances, such as a video camera, a display monitor, a video recorder, an audio system and so on, are being equipped with a communication interface in the near future. Recently some platforms (i.e. UPnP1, HAVi2 and so on) are proposed for constructing home networks; however, there are some issues to be solved to realize various services by connecting different equipment via the pervasive peer-to-peer network. UPnP offers network connectivity of PCs of intelligent home appliances, practically, which means to require a PC in the network to control other devices. Meanwhile, HAVi has been developed for intelligent AV equipments with sophisticated functions using high CPU power and large memory. Considering the targets of home alliances are embedded systems, this situation raises issues of software and hardware complexity, cost, power consumption and so on. In this study, we have proposed and developed the service oriented network architecture for control and management of home appliances, named SONICA (Service Oriented Network Interoperability for Component Adaptation), to address these issues described before.

  13. Home Away from Home: International Students and Their Identity-Based Social Networks in Australia

    ERIC Educational Resources Information Center

    Gomes, Catherine; Berry, Marsha; Alzougool, Basil; Chang, Shanton

    2014-01-01

    This paper explores the role of identity in helping international students form social networks at an Australian institution and how these networks contribute to creating a sense of home away. The findings suggest that international students form distinct social networks that are not necessarily solely made up of fellow students from their home…

  14. Home-based Art Therapy for Older Adults.

    ERIC Educational Resources Information Center

    Sezaki, Shinya; Bloomgarden, Joan

    2000-01-01

    Addresses art therapy for homebound people, giving special attention to the set of needs for this environment; the desired personality traits of the in-home therapist; the structure of the therapeutic relationship; and appropriate art therapy goals. Presents two case studies of home-bound art therapy which demonstrate the complexities and…

  15. House Calls: The Impact of Home-Based Care for Older Adults With Alzheimer's and Dementia.

    PubMed

    Wilson, Kasey; Bachman, Sara S

    2015-01-01

    Older adults with Alzheimer's/dementia have high health care costs; they may benefit from home-based care, but few have home visits. This article describes a home-based care program for frail elders, including those with Alzheimer's/dementia. Descriptive statistics are provided for Medicare-enrolled program participants and matched controls with Alzheimer's/dementia on expenditures along six services: skilled nursing facility, inpatient acute, physician, home health, hospice, and social services. Cases with dementia were significantly more likely to have home health and hospice expenditures than controls, suggesting potential for the program to improve end-of-life care. Very few cases or controls had any social service expenditures. Social workers should advocate for the expanded role of home-based care for older adults with dementia and for increased Medicare reimbursement of social work services. PMID:26186425

  16. The application of autostereoscopic display in smart home system based on mobile devices

    NASA Astrophysics Data System (ADS)

    Zhang, Yongjun; Ling, Zhi

    2015-03-01

    Smart home is a system to control home devices which are more and more popular in our daily life. Mobile intelligent terminals based on smart homes have been developed, make remote controlling and monitoring possible with smartphones or tablets. On the other hand, 3D stereo display technology developed rapidly in recent years. Therefore, a iPad-based smart home system adopts autostereoscopic display as the control interface is proposed to improve the userfriendliness of using experiences. In consideration of iPad's limited hardware capabilities, we introduced a 3D image synthesizing method based on parallel processing with Graphic Processing Unit (GPU) implemented it with OpenGL ES Application Programming Interface (API) library on IOS platforms for real-time autostereoscopic displaying. Compared to the traditional smart home system, the proposed system applied autostereoscopic display into smart home system's control interface enhanced the reality, user-friendliness and visual comfort of interface.

  17. Portfolio Based Management

    ERIC Educational Resources Information Center

    Daigneau, William A.

    2010-01-01

    In this article, the author talks about Portfolio Management, a concept used to make allocation decisions in the world of financial investments. While much has been written about Portfolio theory, and the term is widely used in the facilities management industry, little is really understood about the concept and its real-world application. The…

  18. Network-Based Management Procedures.

    ERIC Educational Resources Information Center

    Buckner, Allen L.

    Network-based management procedures serve as valuable aids in organizational management, achievement of objectives, problem solving, and decisionmaking. Network techniques especially applicable to educational management systems are the program evaluation and review technique (PERT) and the critical path method (CPM). Other network charting…

  19. The cost-effectiveness of improving malaria home management: shopkeeper training in rural Kenya.

    PubMed

    Goodman, C A; Mutemi, W M; Baya, E K; Willetts, A; Marsh, V

    2006-07-01

    capita US dollars) thereafter could be contained within the budget of a typical District. To reach the Abuja target of 60% of those suffering from malaria in sub-Saharan Africa having access to affordable and appropriate treatment within 24 hours, improvements in community-based malaria treatment are urgently required. From these results, policymakers can estimate costs for district-scale shopkeeper training programmes, and will be able to assess their relative cost-effectiveness as comparable evaluations become available from home management interventions in the future. Extrapolation of the results using a simple decision tree model to estimate the cost per DALY averted indicates that the intervention is likely to be considered highly cost-effective in comparison with standard benchmarks for interventions in low-income countries. PMID:16682433

  20. Groundwater level and nitrate concentration trends on Mountain Home Air Force Base, southwestern Idaho

    USGS Publications Warehouse

    Williams, Marshall L.

    2014-01-01

    Mountain Home Air Force Base in southwestern Idaho draws most of its drinking water from the regional aquifer. The base is located within the State of Idaho's Mountain Home Groundwater Management Area and is adjacent to the State's Cinder Cone Butte Critical Groundwater Area. Both areas were established by the Idaho Department of Water Resources in the early 1980s because of declining water levels in the regional aquifer. The base also is listed by the Idaho Department of Environmental Quality as a nitrate priority area. The U.S. Geological Survey, in cooperation with the U.S. Air Force, began monitoring wells on the base in 1985, and currently monitors 25 wells for water levels and 17 wells for water quality, primarily nutrients. This report provides a summary of water-level and nitrate concentration data collected primarily between 2001 and 2013 and examines trends in those data. A Regional Kendall Test was run to combine results from all wells to determine an overall regional trend in water level. Groundwater levels declined at an average rate of about 1.08 feet per year. Nitrate concentration trends show that 3 wells (18 percent) are increasing in nitrate concentration trend, 3 wells (18 percent) show a decreasing nitrate concentration trend, and 11 wells (64 percent) show no nitrate concentration trend. Six wells (35 percent) currently exceed the U.S. Environmental Protection Agency's maximum contaminant limit of 10 milligrams per liter for nitrate (nitrite plus nitrate, measured as nitrogen).

  1. Managing the Drivers of Air Flow and Water Vapor Transport in Existing Single-Family Homes

    SciTech Connect

    Cummings, James; Withers, Charles; Martin, Eric; Moyer, Neil

    2012-10-01

    This report is a revision of an earlier report titled: Measure Guideline: Managing the Drivers of Air Flow and Water Vapor Transport in Existing Single-Family Homes. Revisions include: Information in the text box on page 1 was revised to reflect the most accurate information regarding classifications as referenced in the 2012 International Residential Code. “Measure Guideline” was dropped from the title of the report. An addition was made to the reference list.

  2. Latino Parent Home-Based Practices that Bolster Student Academic Persistence

    ERIC Educational Resources Information Center

    Mena, Jasmine A.

    2011-01-01

    Home-based parental involvement practices (i.e., educational encouragement, monitoring, and support) and their impact on students' academic persistence were investigated with a sample of 137, ninth-grade Latino students in a northeast high school. Structural Equation Modeling results indicate that the relationship between home-based parental…

  3. 42 CFR 435.217 - Individuals receiving home and community-based services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Individuals receiving home and community-based... Families and Children and the Aged, Blind, and Disabled § 435.217 Individuals receiving home and community-based services. The agency may provide Medicaid to any group or groups of individuals in the...

  4. 42 CFR 436.217 - Individuals receiving home and community-based services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Individuals receiving home and community-based... receiving home and community-based services. The agency may provide Medicaid to any group or groups of individuals in the community who meet the following requirements: (a) The group would be eligible for...

  5. 42 CFR 440.180 - Home or community-based services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Home or community-based services. 440.180 Section 440.180 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.180 Home or community-based services. (a) Description...

  6. 42 CFR 440.180 - Home or community-based services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Home or community-based services. 440.180 Section 440.180 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.180 Home or community-based services. (a) Description...

  7. Physical Activity and Beverages in Home- and Center-Based Child Care Programs

    ERIC Educational Resources Information Center

    Tandon, Pooja S.; Garrison, Michelle M.; Christakis, Dimitri A.

    2012-01-01

    Objective: To describe and compare obesity prevention practices related to physical activity and beverages in home- and center-based child care programs. Methods: A telephone survey of licensed home- and center-based child care programs in Florida, Massachusetts, Michigan, and Washington between October and December 2008. Results: Most programs…

  8. Developmental Characteristics of Home-Based Counselors: A Key to Serving At-Risk Families

    ERIC Educational Resources Information Center

    Lawson, Gerard; Foster, Victoria

    2005-01-01

    Home-based counseling is an incredibly demanding intervention, yet little is known about the counselors providing this important service. This study sought to profile ego development, conceptual complexity, and supervision satisfaction for 120 home-based counselors. Counselors scored at moderate levels on measures of both ego development and…

  9. Home-Based Preschool Education: Leaders' Guide for Inservice Training Filmstrips (Educator 1, 2, 3, 4).

    ERIC Educational Resources Information Center

    1973

    This guide is to be used by leaders of inservice training workshops for instructors of parent study groups interested in learning new parenting skills that will foster home-based preschool education. The introduction provides suggestions on how a school might begin a program of school-sponsored, home-based early childhood education. The guidelines…

  10. In-Service Education for Case Workers in Home Management Improvement for Welfare Recipient Families in Ten Eastern Kentucky Counties.

    ERIC Educational Resources Information Center

    Morehead State Univ., KY. School of Applied Sciences and Technology.

    Morehead State University conducted inservice workshops in home management for 42 social caseworkers in eastern Kentucky. The subjects covered were community resources; family planning; clothing, gardening, and nutrition; and environmental sanitation and home nursing. Teaching methods included lectures, field trips, buzz sessions, questions and…

  11. An HL7-FHIR-based Object Model for a Home-Centered Data Warehouse for Ambient Assisted Living Environments.

    PubMed

    Schwartze, Jonas; Jansen, Lars; Schrom, Harald; Wolf, Klaus-Hendrik; Haux, Reinhold; Marschollek, Michael

    2015-01-01

    Current AAL environments focus on assisting a single person with seperated technologies. There is no interoperability between sub-domains in home environments, like building energy management or housing industry services. BASIS (Building Automation by a Scalable and Intelligent System) aims to integrate all sensors and actuators into a single, efficient home bus. First step is to create a semtically enriched data warehouse object model. We choose FHIR and built an object model mainly based on the Observation, Device and Location resources with minor extensions needed by AAL-foreign sub domains. FHIR turned out to be very flexible and complete for other home related sub-domains. The object model is implemented in a separated software-partition storing all structural and procedural data of BASIS. PMID:26262359

  12. Challenges in Implementing Center-Based and Home-Based Early Head Start Programs

    ERIC Educational Resources Information Center

    Golas, Julianna C.; Horm, Diane; Caruso, David A.

    2006-01-01

    Early Head Start services are typically offered through home- or center-based delivery models. A formative evaluation of an example of each service delivery model was conducted. The purpose was to examine the issues involved in the implementation of these two service delivery models relative to the content of services, intensity of services,…

  13. Parental Perceptions of Child Care Quality in Centre-Based and Home-Based Settings: Associations with External Quality Ratings

    ERIC Educational Resources Information Center

    Lehrer, Joanne S.; Lemay, Lise; Bigras, Nathalie

    2015-01-01

    The current study examined how parental perceptions of child care quality were related to external quality ratings and considered how parental perceptions of quality varied according to child care context (home-based or centre-based settings). Parents of 179 4-year-old children who attended child care centres (n = 141) and home-based settings…

  14. Evaluation of the web-based "home helper" support system using wireless Internet mobile phones.

    PubMed

    Ogawa, Hidekuni; Yonezawa, Yoshiharu; Maki, Hiromichi; Sato, Haruhiko; Hahn, Allen W; Caldwell, W Morton

    2002-01-01

    In Japan, Home Helpers provide the home welfare and care services such as cooking, bathing, washing, cleaning, shopping, etc. Last year, we developed the web-based Home Helper support system using wireless Internet mobile phones for improving scheduling and record keeping efficiency and for eliminating unnecessary travel. We have evaluated by questionnaire whether the system can be easily operated. All in all, the system has performed satisfactorily and is in functional use daily. PMID:12085624

  15. Best practices in nursing homes. Clinical supervision, management, and human resource practices.

    PubMed

    Dellefield, Mary Ellen

    2008-07-01

    Human resource practices including supervision and management are associated with organizational performance. Evidence supportive of such an association in nursing homes is found in the results of numerous research studies conducted during the past 17 years. In this article, best practices related to this topic have been culled from descriptive, explanatory, and intervention studies in a range of interdisciplinary research journals published between 1990 and 2007. Identified best practices include implementation of training programs on supervision and management for licensed nurses, certified nursing assistant job enrichment programs, implementation of consistent nursing assignments, and the use of electronic documentation. Organizational barriers and facilitators of these best practices are described. PMID:20077964

  16. Multi-site videoconferencing for home-based education of older people with chronic conditions: the Telehealth Literacy Project.

    PubMed

    Banbury, Annie; Parkinson, Lynne; Nancarrow, Susan; Dart, Jared; Gray, Len; Buckley, Jennene

    2014-10-01

    We examined the acceptability of multi-site videoconferencing as a method of providing group education to older people in their homes. There were 9 groups comprising 52 participants (mean age 73 years) with an average of four chronic conditions. Tablet computers or PCs were installed in participant's homes and connected to the Internet by the National Broadband Network (high-speed broad band network) or by the 4G wireless network. A health literacy and self-management programme was delivered by videoconference for 5 weeks. Participants were able to view and interact with all group members and the facilitator on their devices. During the study, 44 group videoconferences were conducted. Evaluation included 16 semi-structured interviews, 3 focus groups and a journal detailing project implementation. The participants reported enjoying home-based group education by videoconference and found the technology easy to use. Using home-based groups via videoconference was acceptable for providing group education, and considered particularly valuable for people living alone and/or with limited mobility. Audio difficulties were the most commonly reported problem. Participants connected with 4G experienced more problems (audio and visual) than participants on the National Broadband Network and those living in multi-dwelling residences reported more problems than those living in single-dwelling residences. Older people with little computer experience can be supported to use telehealth equipment. Telehealth has the potential to improve access to education about chronic disease self-management. PMID:25399994

  17. Home Care and Management of the Mentally Retarded Child: Basic Skills Assessment.

    ERIC Educational Resources Information Center

    Vulpe, Shirley German

    The assessment battery is intended to establish the mentally retarded child's highest level of performance in each activity as a prerequisite to and planning aid for the development of an occupational therapy-based home training program designed to stimulate the child to operate at maximum ability levels. The battery, with a graduated rating…

  18. Safety and Efficacy Outcomes of Home and Hospital Warfarin Management Within a Pediatric Anticoagulation Clinic.

    PubMed

    Jones, Sophie; McLoughlin, Siobhan; Piovesan, Dana; Savoia, Helen; Monagle, Paul; Newall, Fiona

    2016-04-01

    The complexity of managing children with chronic disease has led to an increase in the use of long-term warfarin therapy. Time in therapeutic range (TTR) is the preferred method for determining efficacy and stability of warfarin management. This study aimed to determine the TTR achievement and incidence of adverse events among pediatric warfarin patients managed by an anticoagulation clinic over 12 months and to compare TTR achievement between patients self-testing (PST) at home and those monitored using routine methods. International normalized ratio (INR) results reported for 2012 for children currently having their warfarin therapy managed by a dedicated pediatric anticoagulation clinic were analyzed. Warfarin-related adverse events were recorded. A total of 164 patients were included. In total, 93 children performed PST and 71 children tested their INR at a hospital or pathology service. TTR achievement for the cohort was 67.1% (95% confidence interval, 64.4-69.7). A total of 69.2% of INR tests conducted at home were within the TTR compared with 64.3% of INR tests conducted at a hospital or pathology service (P=0.07). One major bleeding event occurred and there was 1 thrombotic episode. PST demonstrated noninferior warfarin stability compared with routine methods. Routine outcome evaluation of pediatric anticoagulation management within single institutions is necessary to confirm the success of such programs. PMID:26808370

  19. Privacy and information security risks in a technology platform for home-based chronic disease rehabilitation and education

    PubMed Central

    2013-01-01

    Background Privacy and information security are important for all healthcare services, including home-based services. We have designed and implemented a prototype technology platform for providing home-based healthcare services. It supports a personal electronic health diary and enables secure and reliable communication and interaction with peers and healthcare personnel. The platform runs on a small computer with a dedicated remote control. It is connected to the patient’s TV and to a broadband Internet. The platform has been tested with home-based rehabilitation and education programs for chronic obstructive pulmonary disease and diabetes. As part of our work, a risk assessment of privacy and security aspects has been performed, to reveal actual risks and to ensure adequate information security in this technical platform. Methods Risk assessment was performed in an iterative manner during the development process. Thus, security solutions have been incorporated into the design from an early stage instead of being included as an add-on to a nearly completed system. We have adapted existing risk management methods to our own environment, thus creating our own method. Our method conforms to ISO’s standard for information security risk management. Results A total of approximately 50 threats and possible unwanted incidents were identified and analysed. Among the threats to the four information security aspects: confidentiality, integrity, availability, and quality; confidentiality threats were identified as most serious, with one threat given an unacceptable level of High risk. This is because health-related personal information is regarded as sensitive. Availability threats were analysed as low risk, as the aim of the home programmes is to provide education and rehabilitation services; not for use in acute situations or for continuous health monitoring. Conclusions Most of the identified threats are applicable for healthcare services intended for patients or

  20. Effects of the Evidence-Based Nursing Care Algorithm of Dysphagia for Nursing Home Residents.

    PubMed

    Park, Yeonhwan; Oh, Seieun; Chang, Heekyung; Bang, Hwal Lan

    2015-11-01

    Dysphagia (ENCAD) in long-term care settings. 2. Review the outcome of implementing the ENCAD for dysphagia management in a nursing home. DISCLOSURE STATEMENT Neither the planners nor the authors have any conflicts of interest to disclose. Standardized nursing care protocols for dysphagia management have not been established in nursing home settings in Korea. The purpose of the current study was to examine the effect of the Evidence-Based Nursing Care Algorithm of Dysphagia (ENCAD) on risk of dysphagia, oral health, and dysphagia-specific quality of life among nursing home residents. The ENCAD was administered to 40 residents in one nursing home in urban South Korea for 6 months. A control-intervention, time-series design was used, under which participants served as their own controls. Oral health, risk of aspiration, and dysphagia-specific quality of life were measured at baseline, post-control, and post-intervention. Findings showed that risk of aspiration (p < 0.01) and dysphagia-related quality of life (p < 0.001) improved significantly after the ENCAD was applied, whereas oral health status did not change over time (p = 0.06). Results suggest that implementing the ENCAD contributed to a reduction in the risk of aspiration and an improvement in the quality of life in nursing home residents. PMID:26505245

  1. Career Education: Learning with a Purpose. Secondary Guide-Vol. 4. Home Economics, Family/Community Relations, Home Management, Foods and Nutrition, Clothing and Textiles, Field Trip Sites and Guest Speakers.

    ERIC Educational Resources Information Center

    Atkinson, Marilyn; And Others

    The guide offers a compilation of teacher-developed career education materials which may be integrated with secondary level curriculum in home economics. Suggested activities and ideas are presented as unit plans in the following areas of home economics: family relations/family living, home management, child development, foods and nutrition,…

  2. Home-Based Mental Health Services for Older Adults: A Review of Ten Model Programs

    PubMed Central

    Bruce, Martha L.

    2015-01-01

    Objective The objective is to provide information on successful programs providing home-based services to mentally ill elderly in order to assist other communities wishing to establish such programs. Participants The ten programs described in this article were selected by peer review from applications for an award given by the American Association for Geriatric Psychiatry and were participants in an invitational conference. Results Eight of the programs were components of a community agency while two were components of a medical school department of psychiatry. Six of the programs focused primarily on individuals with anxiety and depression and employed a range of individual psychotherapies. The other four accepted patients with any psychiatric diagnosis including dementia and included medication management as part of their services. The numbers served by the ten programs ranged from about 50 to 300 new cases per year, and the staffing ranged from 2 to 13 often with a combination of full and part time. The annual budget for the ten programs ranged from $30,000 to $1,250,000. Budget sources usually included some combination of public funds, philanthropy, and fee-for-service income. Conclusions Despite the logistic and fiscal challenges of providing home-based services to mentally ill older adults there are many long-standing successful programs that can serve as models for communities wishing to establish similar programs. A great opportunity exists for a unified outcome research endeavor as well as expansion into many more communities. PMID:23567412

  3. Childhood burns in Ghana: epidemiological characteristics and home-based treatment.

    PubMed

    Forjuoh, S N; Guyer, B; Smith, G S

    1995-02-01

    The objectives of this research were to study the epidemiological characteristics and home-based treatment of childhood burns in the Ashanti Region of Ghana. Children aged 0-5 years with a burn history were identified through a community-based, multisite survey. A standard questionnaire was administered to mothers of 630 of these children to elicit information on their sociodemographic characteristics and the circumstances of the burn event. Ninety-two per cent of the burns occurred in the home, particularly in the kitchen (51 per cent) and the house yard (36 per cent), with most of them happening in the late morning and around the evening meal. The main causes of the burns were scalds (45 per cent), contact with a hot object (34 per cent) and flame (20 per cent). 'Cool' water was applied to the burned area in 30 per cent of cases. Otherwise, treatment with a traditional preparation was the most popular first-aid choice. Since a considerable proportion of burns happened between meals when children 'play with fire' in the house yard, the provision of alternative play activities and community play areas may reduce the incidence of burns to these children. Secondly, we recommend that education on first-aid management of burns be intensified, with special emphasis on alternatives to the use of traditional preparations. PMID:7718113

  4. Assessing the Need for Evidence-Based Home Visiting (EBHV): Experiences of EBHV Grantees. Brief 1

    ERIC Educational Resources Information Center

    Paulsell, Diane; Coffee-Borden, Brandon

    2010-01-01

    The Maternal, Infant, and Early Childhood Home Visiting Program, authorized by Section 2951 of the Affordable Care Act of 2010 (P.L. 111-148), will provide $1.5 billion to states over five years to provide comprehensive, evidence-based home visiting services to improve a range of outcomes for families and children residing in at-risk communities…

  5. Informed Decision Making for In-Home Use of Motion Sensor-Based Monitoring Technologies

    ERIC Educational Resources Information Center

    Bruce, Courtenay R.

    2012-01-01

    Motion sensor-based monitoring technologies are designed to maintain independence and safety of older individuals living alone. These technologies use motion sensors that are placed throughout older individuals' homes in order to derive information about eating, sleeping, and leaving/returning home habits. Deviations from normal behavioral…

  6. Home-Based Comprehensive Assessment of Rural Elderly Persons: The CARE Project

    ERIC Educational Resources Information Center

    Cravens, David D.; Mehr, David R.; Campbell, James D.; Armer, Jane; Kruse, Robin L.; Rubenstein, Laurence Z.

    2005-01-01

    Context: Home-based comprehensive geriatric assessment (CGA) has been effective in urban areas but has had little study in rural areas. CGA involves medical history taking, a physical exam, and evaluation of functional status, mental status, cognitive status, gait and balance, medications, vision, extent of social supports, and home safety. We…

  7. Rural Alberta Home-Based Businesses: A Profile of Workshop Participants.

    ERIC Educational Resources Information Center

    Capjack, M. Linda; Fetterman, Nelma I.

    1992-01-01

    Of 252 rural Alberta attendees of home-based business workshops, 60 were in business. Of these, 65 percent produced sewing, textile, or food-related products; 73 percent contributed less than 5 percent of family income; 72 percent worked at home because a hobby became profitable; and the majority were married women over 40. (SK)

  8. Home Literacy Environments of Young Children with Down Syndrome: Findings from a Web-Based Survey

    ERIC Educational Resources Information Center

    Al Otaiba, Stephanie; Lewis, Sandra; Whalon, Kelly; Dyrlund, Allison; McKenzie, Amy R.

    2009-01-01

    Early home literacy experiences, including parent--child book reading, account for a significant amount of children's later reading achievement. Yet there is a very limited research base about the home literacy environments and experiences of children with cognitive disabilities. The purpose of this study is to describe findings from a Web-based…

  9. The Social Context of Mother-Infant Relations: A Study of Home Based Education.

    ERIC Educational Resources Information Center

    Fein, Greta G.

    This paper describes the results of a longitudinal study which compared the effects of three types of home-based, parent-oriented, infant education curricula. One curriculum stressed language, another stressed play, and a third stressed social development. Mothers and children from 108 middle and working class families received home visits…

  10. Application of Optimal Production Control theory for Home Energy Management in a Micro Grid

    SciTech Connect

    Malikopoulos, Andreas; Djouadi, Seddik M; Kuruganti, Teja

    2016-01-01

    We consider the optimal stochastic control problem for home energy systems with solar and energy storage devices when the demand is realized from the grid. The demand is subject to Brownian motions with both drift and variance parameters modulated by a continuous-time Markov chain that represents the regime of electricity price. We model the systems as pure stochastic differential equation models, and then we follow the completing square technique to solve the stochastic home energy management problem. The effectiveness of the efficiency of the proposed approach is validated through a simulation example. For practical situations with constraints consistent to those studied here, our results imply the proposed framework could reduce the electricity cost from short-term purchase in peak hour market.

  11. Top Nurse-Management Staffing Collapse and Care Quality in Nursing Homes

    PubMed Central

    Hunt, Selina R.; Corazzini, Kirsten; Anderson, Ruth A.

    2014-01-01

    Director of nursing turnover is linked to staff turnover and poor quality of care in nursing homes; however the mechanisms of these relationships are unknown. Using a complexity science framework, we examined how nurse management turnover impacts system capacity to produce high quality care. This study is a longitudinal case analysis of a nursing home (n = 97 staff) with 400% director of nursing turnover during the study time period. Data included 100 interviews, observations and documents collected over 9 months and were analyzed using immersion and content analysis. Turnover events at all staff levels were nonlinear, socially mediated and contributed to dramatic care deficits. Federal mandated, quality assurance mechanisms failed to ensure resident safety. High multilevel turnover should be elevated to a sentinel event for regulators. Suggestions to magnify positive emergence in extreme conditions and to improve quality are provided. PMID:24652943

  12. Cost-Effectiveness of a Community-Integrated Home Based Depression Intervention in Older African Americans

    PubMed Central

    Pizzi, Laura T.; Jutkowitz, Eric; Frick, Kevin D.; Suh, Dong-Churl; Prioli, Katherine M.; Gitlin, Laura N.

    2014-01-01

    Objectives To test the cost-effectiveness of a home-based depression program, Beat the Blues (BTB). Design We conducted a cost-effectiveness analysis as part of a previously reported randomized controlled trial that tested BTB versus a wait-list control group. Setting Community-dwelling older African American adults. Participants African Americans who were ≥55 years of age, English speaking, cognitively intact (MMSE ≥24), and had depressive symptoms (PHQ-9 score ≥5) (N=129). Intervention Participants randomly assigned to BTB received up to 10 home visits over a period of 4 months by licensed social workers who provided care management, referral/linkage, stress reduction, depression education, and behavioral activation to help participants achieve self-identified goals. Measurements Incremental cost effectiveness ratios (ICERs) of BTB versus wait-list controls during the 4-month study period. The primary ICER was defined as cost/quality-adjusted life year using the EQ-5D and secondarily using the HUI-3. Additional ICERs were calculated using clinical measures (cost per depression improvement, cost per depression remission). Costs included BTB intervention, depression-related healthcare visits and medications, caregiver time, and social services. Results BTB cost per participant per month was $146. Base case ICERs were $64,896 per QALY (EQ-5D) and $36,875 per QALY (HUI-3). Incremental cost per depression improvement was $2,906 and per remission was $3,507. Univariate and probabilistic sensitivity analyses yielded cost/QALY range of $20,500-$76,500. Conclusion Based on the range of cost effectiveness values resulting from this study, BTB is a cost-effective treatment for managing depressive symptoms in older African Americans that compares favorably with the cost effectiveness of previously tested approaches. PMID:25516025

  13. Data base management systems activities

    NASA Technical Reports Server (NTRS)

    1983-01-01

    The Data Management System-1100 is designed to operate in conjunction with the UNIVAC 1100 Series Operating System on any 1100 Series computer. DMS-1100 is divided into the following four major software components: (1) Data Definition Languages (DDL); (2) Data Management Routine (DMR); (3) Data Manipulation Languages (DML); and (4) Data Base Utilities (DBU). These software components are described in detail.

  14. Nonpharmacologic Pain Management Interventions in German Nursing Homes: A Cluster Randomized Trial.

    PubMed

    Kalinowski, Sonja; Budnick, Andrea; Kuhnert, Ronny; Könner, Franziska; Kissel-Kröll, Angela; Kreutz, Reinhold; Dräger, Dagmar

    2015-08-01

    The reported prevalence of pain among nursing home residents (NHRs) is high. Insufficient use of analgesics, the conventional pain management strategy, is often reported. Whether and to what extent nonpharmacologic therapies (NPTs) are used to manage the pain of NHRs in Germany is largely unknown. The aim of this cluster-randomized trial was to assess the NPTs provided and to enhance the application and prescription of NPTs in NHRs on an individual level. There were six nursing homes in the intervention group and six in the control group. There were 239 NHRs, aged ≥65 years, with an average Mini-Mental State Examination score of at least 18 at baseline. Pain management interventions (cluster level) included an online course for physicians and 1-day seminar for nurses. Data on NPT applied by nurses and therapeutic NPT prescribed by physicians were obtained from residents' nursing documentation. Face-to-face interviews with NHRs assessed the NPT received. At baseline, 82.6% of NHR (mean age 83 years) were affected by pain, but less than 1 in 10 received NPT. The intervention did not result in a significant increase in the NPT applied by nurses, but did significantly increase the therapeutic NPT prescribed by physicians. Residents were active in using NPT to self-manage their pain. Given the prevalence of pain in NHRs, there is a clear need to improve pain management in this population. Extended use of NPT offers a promising approach. We recommend that nurses provide residents with education on pain-management techniques to support them in taking a proactive role in managing their pain. PMID:26256216

  15. Home in the heat: dramatic seasonal variation in home range of desert golden eagles informs management for renewable energy development

    USGS Publications Warehouse

    Braham, Melissa; Miller, Tricia A.; Duerr, Adam E.; Lanzone, Michael; Fesnock, Amy; LaPre, Larry; Driscoll, Daniel; Katzner, Todd Eli

    2015-01-01

    Renewable energy is expanding quickly with sometimes dramatic impacts to species and ecosystems. To understand the degree to which sensitive species may be impacted by renewable energy projects, it is informative to know how much space individuals use and how that space may overlap with planned development. We used global positioning system–global system for mobile communications (GPS-GSM) telemetry to measure year-round movements of golden eagles (Aquila chrysaetos) from the Mojave Desert of California, USA. We estimated monthly space use with adaptive local convex hulls to identify the temporal and spatial scales at which eagles may encounter renewable energy projects in the Desert Renewable Energy Conservation Plan area. Mean size of home ranges was lowest and least variable from November through January and greatest in February–March and May–August. These monthly home range patterns coincided with seasonal variation in breeding ecology, habitat associations, and temperature. The expanded home ranges in hot summer months included movements to cooler, prey-dense, mountainous areas characterized by forest, grasslands, and scrublands. Breeding-season home ranges (October–May) included more lowland semi-desert and rock vegetation. Overlap of eagle home ranges and focus areas for renewable energy development was greatest when eagle home ranges were smallest, during the breeding season. Golden eagles in the Mojave Desert used more space and a wider range of habitat types than expected and renewable energy projects could affect a larger section of the regional population than was previously thought.

  16. Self-delivered home-based mirror therapy for lower limb phantom pain.

    PubMed

    Darnall, Beth D

    2009-01-01

    Home-based patient-delivered mirror therapy is a promising approach in the treatment of phantom limb pain. Previous studies and case reports of mirror therapy have used a therapist-guided, structured protocol of exercises. No case report has described treatment for either upper or lower limb phantom pain by using home-based patient-delivered mirror therapy. The success of this case demonstrates that home-based patient-delivered mirror therapy may be an efficacious, low-cost treatment option that would eliminate many traditional barriers to care. PMID:19096290

  17. The outcome of combining home based and clinic based amblyopia therapy among preschool children.

    PubMed

    Rokiah, O; Knight, V F; Duratul, A H

    2013-06-01

    This study determined the outcome of combining home based and clinic based amblyopia therapy among preschool children. A total of 479 preschool children were randomly selected for vision screening. Amblyopic therapy was prescribed to children whose visual acuity (VA) could not be improved to <0.1 LogMAR after a 6 week adaptation period with glasses. Intensive near work activities were conducted daily at home for 12 weeks, monitored by parents while weekly therapy was conducted at the optometry clinic by an optometrist. Six preschool children were diagnosed with refractive amblyopia, spherical equivalent (SE) was -11.25D to +0.75D. Significant improvement was found in the VA of right eye, t(6) = 3.07, left eye t(6) = 3.07 and both eyes t(6) = 3.42) p<0.05, at the end of the 12 week therapy. Combining home based and clinic based amblyopia therapy among preschool children showed a positive improvement in VA after 12 weeks of therapy. PMID:23749015

  18. Experiences from development of home health care applications based on emerging Java technology.

    PubMed

    Lind, L; Sundvall, E; Ahlfeldt, H

    2001-01-01

    Home health care is an expanding area within the health care system. The idea of moving parts of the health care process from expensive specialised hospital care to primary health care and home health care might be attractive in a cost perspective. The introduction of home health care applications must be based on a rigorous analysis of necessary requirements to secure a safe and reliable health care. This article reports early experiences from the development of a home health care application based on emerging Java technologies such as the OSGi platform. A pilot application for follow-up of diabetes patients is presented and discussed in relation to a list of general requirements on home health care applications. PMID:11604851

  19. 42 CFR 440.181 - Home and community-based services for individuals age 65 or older.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Home and community-based services for individuals... Definitions § 440.181 Home and community-based services for individuals age 65 or older. (a) Description of services— Home and community-based services for individuals age 65 or older means services, not...

  20. The Incidence and Wage Consequences of Home-Based Work in the United States, 1980-2000

    ERIC Educational Resources Information Center

    Oettinger, Gerald S.

    2011-01-01

    This study documents the rapid growth in home-based wage and salary employment and the sharp decline in the home-based wage penalty in the United States between 1980 and 2000. These twin patterns, observed for both men and women in most occupation groups, suggest that employer costs of providing home-based work arrangements have decreased.…

  1. Care Coordination/Home Telehealth: the systematic implementation of health informatics, home telehealth, and disease management to support the care of veteran patients with chronic conditions.

    PubMed

    Darkins, Adam; Ryan, Patricia; Kobb, Rita; Foster, Linda; Edmonson, Ellen; Wakefield, Bonnie; Lancaster, Anne E

    2008-12-01

    Between July 2003 and December 2007, the Veterans Health Administration (VHA) introduced a national home telehealth program, Care Coordination/Home Telehealth (CCHT). Its purpose was to coordinate the care of veteran patients with chronic conditions and avoid their unnecessary admission to long-term institutional care. Demographic changes in the veteran population necessitate VHA increase its noninstitutional care (NIC) services 100% above its 2007 level to provide care for 110,000 NIC patients by 2011. By 2011, CCHT will meet 50% of VHA's anticipated NIC provision. CCHT involves the systematic implementation of health informatics, home telehealth, and disease management technologies. It helps patients live independently at home. Between 2003 and 2007, the census figure (point prevalence) for VHA CCHT patients increased from 2,000 to 31,570 (1,500% growth). CCHT is now a routine NIC service provided by VHA to support veteran patients with chronic conditions as they age. CCHT patients are predominantly male (95%) and aged 65 years or older. Strict criteria determine patient eligibility for enrollment into the program and VHA internally assesses how well its CCHT programs meet standardized clinical, technology, and managerial requirements. VHA has trained 5,000 staff to provide CCHT. Routine analysis of data obtained for quality and performance purposes from a cohort of 17,025 CCHT patients shows the benefits of a 25% reduction in numbers of bed days of care, 19% reduction in numbers of hospital admissions, and mean satisfaction score rating of 86% after enrolment into the program. The cost of CCHT is $1,600 per patient per annum, substantially less than other NIC programs and nursing home care. VHA's experience is that an enterprise-wide home telehealth implementation is an appropriate and cost-effective way of managing chronic care patients in both urban and rural settings. PMID:19119835

  2. Home based versus centre based cardiac rehabilitation: Cochrane systematic review and meta-analysis

    PubMed Central

    Zawada, Anna; Jolly, Kate; Moxham, Tiffany; Taylor, Rod S

    2010-01-01

    Objective To compare the effect of home based and supervised centre based cardiac rehabilitation on mortality and morbidity, health related quality of life, and modifiable cardiac risk factors in patients with coronary heart disease. Design Systematic review. Data sources Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, Medline, Embase, CINAHL, and PsycINFO, without language restriction, searched from 2001 to January 2008. Review methods Reference lists checked and advice sought from authors. Included randomised controlled trials that compared centre based cardiac rehabilitation with home based programmes in adults with acute myocardial infarction, angina, or heart failure or who had undergone coronary revascularisation. Two reviewers independently assessed the eligibility of the identified trials and extracted data independently. Authors were contacted when possible to obtain missing information. Results 12 studies (1938 participants) were included. Most studies recruited patients with a low risk of further events after myocardial infarction or revascularisation. No difference was seen between home based and centre based cardiac rehabilitation in terms of mortality (relative risk 1.31, 95% confidence interval 0.65 to 2.66), cardiac events, exercise capacity (standardised mean difference −0.11, −0.35 to 0.13), modifiable risk factors (weighted mean difference systolic blood pressure (0.58 mm Hg, −3.29 mm Hg to 4.44 mm Hg), total cholesterol (−0.13 mmol/l, −0.31 mmol/l to 0.05 mmol/l), low density lipoprotein cholesterol (−0.15 mmol/l, −0.31 mmol/l to 0.01 mmol/l), or relative risk for proportion of smokers at follow-up (0.98, 0.73 to 1.31)), or health related quality of life, with the exception of high density lipoprotein cholesterol (−0.06, −0.11 to −0.02) mmol/l). In the home based participants, there was evidence of superior adherence. No consistent difference was seen in the healthcare costs of the two forms

  3. Healthcare standards based sensory data exchange for Home Healthcare Monitoring System.

    PubMed

    Khan, Wajahat Ali; Hussain, Maqbool; Afzal, Muhammad; Amin, Muhammad Bilal; Lee, Sungyoung

    2012-01-01

    Interoperability is the among the key functionalities of an intelligent systems. Home Healthcare Monitoring Systems (HHMS) investigates patients activities at home, but lacks critical information exchange with Health Management Information System (HMIS). This information is vital for physicians to take necessary steps for timely and effective healthcare provisioning for patients. Physicians can only monitor and prescribe patients in time, if the data is shared with their HMIS. HMIS can be compliant to different healthcare standards. Therefore, mediation system is required to enable interoperability between HHMS and HMIS such that physicians and patients information can easily be exchanged. We propose Interoperability Mediation System (IMS) that provides interoperability services for exchange of information among HHMS and HMIS. We consider that HMIS are compliant to two heterogeneous EHR standards (HL7 CDA and openEHR). Alzheimer's patient case study is described as a proof of concept. Sensory information gathered at HHMS, is communicated with HMIS compliant to EHR based healthcare standards. Sensors information in XML form is converted by interoperability service to HL7 CDA and openEHR instances and communicated to HMIS afterwards. This allows the physicians registered with HHMS to monitor the patient using their HMIS and provide timely healthcare information. PMID:23366131

  4. Individualised home-based rehabilitation after stroke in eastern Finland--the client's perspective.

    PubMed

    Reunanen, Merja A T; Järvikoski, Aila; Talvitie, Ulla; Pyöriä, Outi; Härkäpää, Kristiina

    2016-01-01

    Reintegration into society is one of the main purposes of post-stroke rehabilitation. The experiences of clients returning home after a stroke have been studied before. There is, however, little knowledge about activities carried out during home-based rehabilitation interventions and about the involvement of clients in the process. This study focused on clients' experiences of a 3-month individualised, home-based rehabilitation programme supervised by a multidisciplinary team. The data were collected in 2009-2010, and it was based on interviews with 14 clients (48-83 years of age) conducted approximately 7 months after stroke. In the thematic analysis, five main topics describing the goals and functions of the home-based rehabilitation were identified as follows: (i) learning strategies for solving problems in daily activities at home and in the community; (ii) receiving exercise coaching; (iii) exploring community services and facilities; (iv) having a dialogue with professionals; and (v) engaging in activities aimed at returning to work. Implementing rehabilitation activities in the home environment seemed to enhance the participants' active involvement and their ability to evaluate themselves and to set goals for their recovery. Work was an important goal for clients of working age, but work-related tasks were not sufficiently integrated with home-based rehabilitation. A challenge for local communities is to provide health promotion and recreation services that are also suitable for persons with limited functioning. PMID:25676161

  5. An Innovative Home-Based Interdisciplinary Service-Learning Experience

    ERIC Educational Resources Information Center

    McWilliams, Andrew; Rosemond, Cherie; Roberts, Ellen; Calleson, Diane; Busby-Whitehead, Jan

    2008-01-01

    The University of North Carolina Mobile Student Health Action Coalition (UNC MSHAC) at Chapel Hill, North Carolina is a voluntary service-learning program in which interdisciplinary teams of graduate level health professional students provide monthly home visits to isolated, community-dwelling elders with complex medical and social issues.…

  6. Estimating the impact of the home appliances trade-in policy on WEEE management in China.

    PubMed

    Zhu, Shuguang; He, Wenzhi; Li, Guangming; Zhuang, Xuning; Huang, Juwen; Liang, Honggen; Han, Yuebin

    2012-11-01

    The ever-increasing amount of waste electric and electronic equipment (WEEE) has become a global problem. In view of the deleterious effects of WEEE on the environment and the valuable materials that can be reused in them, many countries have focused their attention on the management of WEEE and the recovery technologies of WEEE. The Chinese government has been active in creating a legislative and institutional framework to realize WEEE recycling. In June 2009, Chinese government launched home appliances and electronics trade-in implementation solution. This paper elaborates the home appliances trade-in policy and its significant impact on the WEEE management. The trade-in policy is not only conducive to expanding the consumption demand and promoting the balance of domestic and overseas demand, but also favorable to improving the energy efficiency and reducing environmental pollution. Under this policy, China has successfully established an effective WEEE recycling system, using the financial means and network design. Experiences gained from the trade-in policy have shown that management systems of WEEE need to be designed and implemented in a multi-stakeholder dialogue. PMID:22492263

  7. Home haemodialysis: trends in technology

    PubMed Central

    Farrington, Ken; Greenwood, Roger

    2011-01-01

    Self management and home-based dialysis therapies offer the prospect of improved patient experience and outcomes. To allow more patients to realize these benefits requires changes in technology which focus on maximizing the ease and minimizing the burdens of undertaking home dialysis. These developments are underway. PMID:25949513

  8. Home-Based versus Hospital-Based Rehabilitation Program after Total Knee Replacement

    PubMed Central

    López-Liria, Remedios; Padilla-Góngora, David; Catalan-Matamoros, Daniel; Rocamora-Pérez, Patricia; Pérez-de la Cruz, Sagrario; Fernández-Sánchez, Manuel

    2015-01-01

    Objectives. To compare home-based rehabilitation with the standard hospital rehabilitation in terms of improving knee joint mobility and recovery of muscle strength and function in patients after a total knee replacement. Materials and Methods. A non-randomised controlled trial was conducted. Seventy-eight patients with a prosthetic knee were included in the study and allocated to either a home-based or hospital-based rehabilitation programme. Treatment included various exercises to restore strength and joint mobility and to improve patients' functional capacity. The primary outcome of the trial was the treatment effectiveness measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results. The groups did not significantly differ in the leg side (right/left) or clinical characteristics (P > 0.05). After the intervention, both groups showed significant improvements (P < 0.001) from the baseline values in the level of pain (visual analogue scale), the range of flexion-extension motion and muscle strength, disability (Barthel and WOMAC indices), balance, and walking. Conclusions. This study reveals that the rehabilitation treatments offered either at home or in hospital settings are equally effective. PMID:25961017

  9. Multilevel and Hybrid Architecture for Device Abstraction and Context Information Management in Smart Home Environments

    NASA Astrophysics Data System (ADS)

    Peláez, Víctor; González, Roberto; San Martín, Luis Ángel; Campos, Antonio; Lobato, Vanesa

    Hardware device management, and context information acquisition and abstraction are key factors to develop the ambient intelligent paradigm in smart homes. This work presents an architecture that addresses these two problems and provides a usable framework to develop applications easily. In contrast to other proposals, this work addresses performance issues specifically. Results show that the execution performance of the developed prototype is suitable for deployment in a real environment. In addition, the modular design of the system allows the user to develop applications using different techniques and different levels of abstraction.

  10. Medication management at home: enhancing nurse's skills and improving patient satisfaction--a longitudinal study.

    PubMed

    Mager, Diana R; Morrissey Ross, Mary

    2013-01-01

    The purpose of this longitudinal study was to improve nurse medication management skills during home care (HC) visits, and thus improve care quality and the related patient ratings of nurse performance. Nurses completed presurveys asking how often they asked to see, taught about, and explained side effects of patient medications. Two focus groups were held with HC nurses to determine barriers to provision of such medication interventions, followed by presentation of a series of 5 medication-related educational sessions. HC nurse's surveys 6 months later reveal an increased frequency of medication skill performance, and patient ratings in these same areas improved statistically significantly, nearing or surpassing national benchmarks. PMID:23659219

  11. Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent aging: a systematic review

    PubMed Central

    Reeder, Blaine; Meyer, Ellen; Lazar, Amanda; Chaudhuri, Shomir; Thompson, Hilaire J.; Demiris, George

    2013-01-01

    Introduction There is a critical need for public health interventions to support the independence of older adults as the world’s population ages. Health smart homes (HSH) and home-based consumer health (HCH) technologies may play a role in these interventions. Methods We conducted a systematic review of HSH and HCH literature from indexed repositories for health care and technology disciplines (e.g., MEDLINE, CINAHL, and IEEE Xplore) and classified included studies according to an evidence-based public health (EBPH) typology. Results One thousand, six hundred and thirty nine candidate articles were identified. Thirty-one studies from the years 1998–2011 were included. Twenty-one included studies were classified as emerging, 10 as promising and 3 as effective (first tier). Conclusion The majority of included studies were published in the period beginning in the year 2005. All 3 effective (first tier) studies and 9 of 10 of promising studies were published during this period. Almost all studies included an activity sensing component and most of these used passive infrared motion sensors. The three effective (first tier) studies all used a multicomponent technology approach that included activity sensing, reminders and other technologies tailored to individual preferences. Future research should explore the use of technology for self-management of health by older adults, social support and self-reported health measures incorporated into personal health records, electronic medical records, and community health registries. PMID:23639263

  12. HOME-BASED THERAPY FOR OEDEMATOUS MALNUTRITION WITH READY-TO-USE THERAPEUTIC FOOD

    Technology Transfer Automated Retrieval System (TEKTRAN)

    BACKGROUND: Standard recommendations are that children with oedematous malnutrition receive inpatient therapy with a graduated feeding regimen. Aim: To investigate exclusive home-based therapy for children with oedematous malnutrition. METHODS: Children with oedematous malnutrition, good appetite, a...

  13. Personal vulnerability and work-home interaction: the effect of job performance-based self-esteem on work/home conflict and facilitation.

    PubMed

    Innstrand, Siw Tone; Langballe, Ellen Melbye; Espnes, Geir Arild; Aasland, Olaf Gjerløw; Falkum, Erik

    2010-12-01

    The aim of the present study was to examine the longitudinal relationship between job performance-based self-esteem (JPB-SE) and work-home interaction (WHI) in terms of the direction of the interaction (work-to-home vs. home-to-work) and the effect (conflict vs. facilitation). A sample of 3,475 respondents from eight different occupational groups (lawyers, physicians, nurses, teachers, church ministers, bus drivers, and people working in advertising and information technology) supplied data at two points of time with a two-year time interval. The two-wave, cross-lagged structural equations modeling (SEM) analysis demonstrated reciprocal relationships between these variables, i.e., job performance-based self-esteem may act as a precursor as well as an outcome of work-home interaction. The strongest association was between job performance-based self-esteem and work-to-home conflict. Previous research on work-home interaction has mainly focused on situational factors. This longitudinal study expands the work-home literature by demonstrating how individual vulnerability (job performance-based self-esteem) contributes to the explanation of work-home interactions. PMID:20338010

  14. Home Care

    MedlinePlus

    ... Help Related Topics Assisted Living Community-Based Care Nursing Homes Related Video Join our e-newsletter! Aging & Health A to Z Home Care Basic Facts & Information Role of Health Care Professionals in Home Care Your physician is the leader ...

  15. EVALUATION STUDY OF FARM AND HOME MANAGEMENT PROGRAM IN NEW YORK STATE. A SIX-PART REPORT.

    ERIC Educational Resources Information Center

    ALEXANDER, FRANK D.

    IN 1954 CONGRESS EARMARKED FUNDS FOR A FARM AND HOME MANAGEMENT PROGRAM TO OFFER INTENSIVE ON-THE FARM COUNSELING IN MANAGEMENT AND DECISION MAKING. THIS SIX-PART EVALUATION OF THE PROGRAM AS IT WAS CONDUCTED IN NEW YORK STATE, PRIMARILY WITH DAIRY OPERATORS, WAS DESIGNED TO DETERMINE THE PROGRAM'S EFFECTIVENESS RELATIVE TO LESS INTENSIVE…

  16. Prevention of urinary tract infections in nursing homes: lack of evidence-based prescription?

    PubMed Central

    2011-01-01

    Background Urinary tract infections (UTIs, including upper and lower symptomatic) are the most common infections in nursing homes and prevention may reduce patient suffering, antibiotic use and resistance. The spectre of agents used in preventing UTIs in nursing homes is scarcely documented and the aim of this study was to explore which agents are prescribed for this purpose. Methods We conducted a one-day, point-prevalence study in 44 Norwegian nursing homes during April-May 2006. Nursing home residents prescribed any agent for UTI prophylaxis were included. Information recorded was type of agent and dose, patient age and gender, together with nursing home characteristics. Appropriateness of prophylactic prescribing was evaluated with references to evidence in the literature and current national guidelines. Results The study included 1473 residents. 18% (n = 269) of the residents had at least one agent recorded as prophylaxis of UTI, varying between 0-50% among the nursing homes. Methenamine was used by 48% of residents prescribed prophylaxis, vitamin C by 32%, and cranberry products by 10%. Estrogens were used by 30% but only one third was for vaginal administration. Trimethoprim and nitrofurantoin were used as prophylaxis by 5% and 4%, respectively. Conclusions The agents frequently prescribed to prevent UTIs in Norwegian nursing homes lack documented efficacy including methenamine and vitamin C. Recommended agents like trimethoprim, nitrofurantoin and vaginal estrogens are infrequently used. We conclude that prescribing of prophylactic agents for UTIs in nursing homes is not evidence-based. PMID:22040144

  17. Value-Based Emergency Management.

    PubMed

    Corrigan, Zachary; Winslow, Walter; Miramonti, Charlie; Stephens, Tim

    2016-02-01

    This article touches on the complex and decentralized network that is the US health care system and how important it is to include emergency management in this network. By aligning the overarching incentives of opposing health care organizations, emergency management can become resilient to up-and-coming changes in reimbursement, staffing, and network ownership. Coalitions must grasp the opportunity created by changes in value-based purchasing and impending Centers for Medicare and Medicaid Services emergency management rules to engage payers, physicians, and executives. Hope and faith in doing good is no longer enough for preparedness and health care coalitions; understanding how physicians are employed and health care is delivered and paid for is now necessary. Incentivizing preparedness through value-based compensation systems will become the new standard for emergency management. PMID:26878308

  18. Sensor Network-Based and User-Friendly User Location Discovery for Future Smart Homes

    PubMed Central

    Ahvar, Ehsan; Lee, Gyu Myoung; Han, Son N.; Crespi, Noel; Khan, Imran

    2016-01-01

    User location is crucial context information for future smart homes where many location based services will be proposed. This location necessarily means that User Location Discovery (ULD) will play an important role in future smart homes. Concerns about privacy and the need to carry a mobile or a tag device within a smart home currently make conventional ULD systems uncomfortable for users. Future smart homes will need a ULD system to consider these challenges. This paper addresses the design of such a ULD system for context-aware services in future smart homes stressing the following challenges: (i) users’ privacy; (ii) device-/tag-free; and (iii) fault tolerance and accuracy. On the other hand, emerging new technologies, such as the Internet of Things, embedded systems, intelligent devices and machine-to-machine communication, are penetrating into our daily life with more and more sensors available for use in our homes. Considering this opportunity, we propose a ULD system that is capitalizing on the prevalence of sensors for the home while satisfying the aforementioned challenges. The proposed sensor network-based and user-friendly ULD system relies on different types of inexpensive sensors, as well as a context broker with a fuzzy-based decision-maker. The context broker receives context information from different types of sensors and evaluates that data using the fuzzy set theory. We demonstrate the performance of the proposed system by illustrating a use case, utilizing both an analytical model and simulation. PMID:27355951

  19. Sensor Network-Based and User-Friendly User Location Discovery for Future Smart Homes.

    PubMed

    Ahvar, Ehsan; Lee, Gyu Myoung; Han, Son N; Crespi, Noel; Khan, Imran

    2016-01-01

    User location is crucial context information for future smart homes where many location based services will be proposed. This location necessarily means that User Location Discovery (ULD) will play an important role in future smart homes. Concerns about privacy and the need to carry a mobile or a tag device within a smart home currently make conventional ULD systems uncomfortable for users. Future smart homes will need a ULD system to consider these challenges. This paper addresses the design of such a ULD system for context-aware services in future smart homes stressing the following challenges: (i) users' privacy; (ii) device-/tag-free; and (iii) fault tolerance and accuracy. On the other hand, emerging new technologies, such as the Internet of Things, embedded systems, intelligent devices and machine-to-machine communication, are penetrating into our daily life with more and more sensors available for use in our homes. Considering this opportunity, we propose a ULD system that is capitalizing on the prevalence of sensors for the home while satisfying the aforementioned challenges. The proposed sensor network-based and user-friendly ULD system relies on different types of inexpensive sensors, as well as a context broker with a fuzzy-based decision-maker. The context broker receives context information from different types of sensors and evaluates that data using the fuzzy set theory. We demonstrate the performance of the proposed system by illustrating a use case, utilizing both an analytical model and simulation. PMID:27355951

  20. Loyalty-based management.

    PubMed

    Reichheld, F F

    1993-01-01

    Despite a flurry of activities aimed at serving customers better, few companies have systematically revamped their operations with customer loyalty in mind. Instead, most have adopted improvement programs ad hoc, and paybacks haven't materialized. Building a highly loyal customer base must be integral to a company's basic business strategy. Loyalty leaders like MBNA credit cards are successful because they have designed their entire business systems around customer loyalty--a self-reinforcing system in which the company delivers superior value consistently and reinvents cash flows to find and keep high-quality customers and employees. The economic benefits of high customer loyalty are measurable. When a company consistently delivers superior value and wins customer loyalty, market share and revenues go up, and the cost of acquiring new customers goes down. The better economics mean the company can pay workers better, which sets off a whole chain of events. Increased pay boosts employee moral and commitment; as employees stay longer, their productivity goes up and training costs fall; employees' overall job satisfaction, combined with their experience, helps them serve customers better; and customers are then more inclined to stay loyal to the company. Finally, as the best customers and employees become part of the loyalty-based system, competitors are left to survive with less desirable customers and less talented employees. To compete on loyalty, a company must understand the relationships between customer retention and the other parts of the business--and be able to quantify the linkages between loyalty and profits. It involves rethinking and aligning four important aspects of the business: customers, product/service offering, employees, and measurement systems. PMID:10124634

  1. A Case for Increasing Empirical Attention to Head Start's Home-Based Program: An Exploration of Routine Collaborative Goal Setting

    ERIC Educational Resources Information Center

    Manz, Patricia H.; Lehtinen, Jaana; Bracaliello, Catherine

    2013-01-01

    Collaborative goal setting among home visitors and family members is a mandate for Head Start's home-based program. Yet, a dearth of research is available for advancing evidence-based practices for setting and monitoring home visiting goals or for understanding how family characteristics or program features are associated with them. With the…

  2. 42 CFR 435.726 - Post-eligibility treatment of income of individuals receiving home and community-based services...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... spouse at home, an additional amount for the maintenance needs of the spouse. This amount must be based... option. (3) For an individual with a family at home, an additional amount for the maintenance needs of... receiving home and community-based services furnished under a waiver: Application of patient income to...

  3. Going Home: The Influence of Workforce Performance Management Systems on the Decision to Engage in Remote Work Environments

    ERIC Educational Resources Information Center

    Jones, Kenneth E., Jr.

    2011-01-01

    Since 1975, the advance of home-based or remote work has been predicted and encouraged (Nilles). Remote work entails the ability of workers to function as productively from distant locations as those workers in face-to-face office environments: e.g. secondary offices, co-workplace offices, mobile workstations, and home. This study will look at the…

  4. The Impact of Electronic Health Records on Risk Management of Information Systems in Australian Residential Aged Care Homes.

    PubMed

    Jiang, Tao; Yu, Ping; Hailey, David; Ma, Jun; Yang, Jie

    2016-09-01

    To obtain indications of the influence of electronic health records (EHR) in managing risks and meeting information system accreditation standard in Australian residential aged care (RAC) homes. The hypothesis to be tested is that the RAC homes using EHR have better performance in meeting information system standards in aged care accreditation than their counterparts only using paper records for information management. Content analysis of aged care accreditation reports from the Aged Care Standards and Accreditation Agency produced between April 2011 and December 2013. Items identified included types of information systems, compliance with accreditation standards, and indicators of failure to meet an expected outcome for information systems. The Chi-square test was used to identify difference between the RAC homes that used EHR systems and those that used paper records in not meeting aged care accreditation standards. 1,031 (37.4%) of 2,754 RAC homes had adopted EHR systems. Although the proportion of homes that met all accreditation standards was significantly higher for those with EHR than for homes with paper records, only 13 RAC homes did not meet one or more expected outcomes. 12 used paper records and nine of these failed the expected outcome for information systems. The overall contribution of EHR to meeting aged care accreditation standard in Australia was very small. Risk indicators for not meeting information system standard were no access to accurate and appropriate information, failure in monitoring mechanisms, not reporting clinical incidents, insufficient recording of residents' clinical changes, not providing accurate care plans, and communication processes failure. The study has provided indications that use of EHR provides small, yet significant advantages for RAC homes in Australia in managing risks for information management and in meeting accreditation requirements. The implication of the study for introducing technology innovation in RAC in

  5. The Role of the Consequence Management Home Team in the Fukushima Daiichi Response

    SciTech Connect

    Pemberton, Wendy; Mena, RaJah; Beal, William

    2012-05-01

    The Consequence Management Home Team (CMHT) is a U.S. Department of Energy/National Nuclear Security Administration asset and played an important role in the U.S. response effort to the Fukushima Daiichi accident, ranging from the early days of the response to a continued involvement in supporting late phase efforts. Each stage of their work had distinct characteristics in terms of management of incoming data streams and creation of products. The CMHT assisted a variety of response organizations with modeling; radiological operations planning; field monitoring techniques; and the analysis, interpretation, and distribution of radiological data. In the Fukushima Daiichi response, the CMHT grew to include a broader range of support than was historically planned. Through their work, the social and economic impacts of a nuclear or radiological incident were minimized. The CMHT was an integral component of the response in Japan and acted as the central point from which all of the data and products flowed.

  6. Home-based rehabilitation interventions for adults living with HIV: a scoping review.

    PubMed

    Cobbing, Saul; Hanass-Hancock, Jill; Myezwa, Hellen

    2016-01-01

    Home-based rehabilitation (HBR) has been shown to improve the lives of people living with a wide range of chronic diseases in resource-rich settings. This may also be a particularly effective strategy in resource-poor settings, where access to institution-based rehabilitation is limited. This review aimed to summarise and discuss the evidence related to the effectiveness of home-based rehabilitation (HBR) interventions designed specifically for adults living with HIV. A scoping review methodology was employed, involving systematic search techniques and appraisal of appropriate evidence. English-language journal articles that assessed the quality of life or functional ability outcomes of HBR interventions for adults living with HIV were considered for this review. Out of an initial 1 135 publications retrieved from the search of databases, six articles met this review's inclusion criteria. While this review highlights the scarcity of empirical evidence related to HBR interventions for adults living with HIV, the findings of these six articles are that HBR is a safe management option that may confer a number of physical and psychological benefits for this population. Future research on HBR interventions should include a wider range of assessment measures, including cost-benefit analyses and specific tools designed to assess the functional ability and participation in activities of daily living of participants involved in these programmes. In particular, more research on HBR is required in resource-poor environments, such as sub-Saharan Africa where HIV is endemic, to assess whether this is a feasible strategy that is both effective and practical in the areas that may need it most. PMID:27002360

  7. [Inefficient management of personal health in oral anticoagulation. Home nursing care in primary health care].

    PubMed

    López Castañón, Lorena

    2012-01-01

    This case report describes an 83 year-old immobilised patient with multiple diseases and on polypharmacy. Nursing care is developed at home. The patient is included in patient care programs for the anticoagulated and polymedicated patient. Nursing assessments were made using the Marjory Gordon functional health patterns, by which we identified, among others, problems related to non-compliance with the pharmacological treatment. The Nurse's Diagnosis was: Ineffective Management of own health. With the support of NANDA, NOC and NIC taxonomy we determined the nursing objectives and interventions. The expected results of the Care Plan were achieved. Polypharmacy in the elderly can lead to treatment problems, increasing hospital admissions, morbidity and mortality and health expenditure Nursing care at home is a continuous development process and is increasing due to aging of the population, the prevalence of chronic diseases, as well as the increased life expectancy. It is estimated that in 2030, 24% of the Spanish population will be over 64 years. The physical, sensory, cognitive and chronic disabilities of aging make this type of care necessary. It is a major element in the comprehensive care of these patients, by checking the correct use of medication, symptom control, helping them to be autonomous in managing their disease and establishing a fluid relationship between the patients and their family. PMID:22284363

  8. Putting Residents First: Strategies Developed by CNAs to Prevent and Manage Resident-to-Resident Violence in Nursing Homes

    PubMed Central

    Snellgrove, Susan; Beck, Cornelia; Green, Angela; McSweeney, Jean C.

    2015-01-01

    Purpose of the Study: Resident-to-resident violence (RRV) in nursing homes (NHs) is common and threatens the safety and quality of life of both residents and caregivers. The purpose of this portion of a larger qualitative study was to explore strategies developed by certified nurses’ assistants (CNAs) to prevent and manage RRV in NHs. Design and Methods: Semistructured interviews were used to collect data. Data were analyzed utilizing content analysis and constant comparison. Results: Analysis revealed one overriding theme, “Putting Residents First” which the CNAs described as a conscious effort to put themselves or a beloved family member in the place of the resident while administering care. Within this theme, there were three related subthemes: (a) Knowing the Residents, (b) Keeping Residents Safe, and (c) Spending Quality Time. Implications: Together, these themes suggest that the formulation of strategies for decreasing and managing RRV was influenced significantly by the ability of the CNAs to empathize with the residents for whom they were caring. The results indicate that in the absence of evidence-based interventions, CNAs have developed their own strategies for the management and prevention of RRV. These strategies may provide a foundation for the development and testing of interventions aimed at preventing and managing RRV in NHs. PMID:26055786

  9. Facilitating the Career Development of Home-Based Adults: The Home/Community-Based Career Education Model. Final Report. Volume I. The Model: Its Nature, Context, and Products.

    ERIC Educational Resources Information Center

    Guilfoy, Vivian M.; Grothe, Mardell S.

    This first volume of a three-volume final report describes the activities of a 3-year project to design, develop, and implement a comprehensive delivery system to meet the career-related information, guidance, and referral needs of home-based adults, those 16 and older neither working nor attending school on a full-time basis. The volume begins…

  10. Effects of Web-Based Support on Early Head Start Home Visitors' Use of Evidence-Based Intervention Decision Making and Growth in Children's Expressive Communication

    ERIC Educational Resources Information Center

    Buzhardt, Jay; Greenwood, Charles R.; Walker, Dale; Anderson, Rawni; Howard, Waylon; Carta, Judith J.

    2011-01-01

    We investigated Early Head Start home visitors' use of evidence-based practices and the efficacy of a web-based system to support these practices. Home visitors learned to use 3 evidence-based practices: (a) frequent assessment of children's early communication for screening and progress monitoring, (b) 2 home-based language-promoting…

  11. Exploring Factors that Influence Informal Caregiving in Medication Management for Home Hospice Patients

    PubMed Central

    Berman, Rebecca; Halpern, Leslie; Pickard, A. Simon; Schrauf, Robert; Witt, Whitney

    2010-01-01

    Abstract Objective To explore factors that influence how informal caregivers manage medications as part of caring for hospice patients. Methods : Semistructured, open-ended interviews were conducted with 23 informal caregivers and 22 hospice providers from 4 hospice programs in the Chicago metropolitan areas. Qualitative analysis was conducted consistent with the grounded theory approach. Results : In general, informal caregivers and hospice providers identified similar key factors that facilitated or impeded caregivers' process in managing medications. Caregivers' life experience and self-confidence were considered assets that facilitated medication management. Limitations impeding the process included caregivers' negative emotional states, cognitive and physical impairments, low literacy, other competing responsibilities, as well as patients' negative emotional states and complex medication needs. Furthermore, the social context of medication management emerged as a salient theme: caregivers' good interpersonal relations with patients facilitated medication management, whereas poor communication/relations among caregivers within a support network impeded the process. While both study groups discussed the positive attributes of good caregiver–patient relations and support from multiple caregivers, hospice providers were cautious about the potential adverse influence of close relations with patients on caregivers' decision making about medications and discussed poor communication/relations among informal and privately hired caregivers that often resulted from family conflicts and/or a lack of long-standing leadership. Conclusion Our findings suggest additional intervention points, beyond knowledge and skill building, that could be addressed to support caregivers in executing medication responsibilities at home for hospice patients. PMID:20836633

  12. Public health assessment for USAF Mountain Home Air Force Base, Mountain Home AFB, Elmore County, Idaho, Region 10. CERCLIS Number ID3572124557; Final report

    SciTech Connect

    1999-01-25

    Mountain Home Air Force Base (Mountain Home AFB) is located approximately 50 miles southeast of Boise and 10 miles southwest of the city of Mountain Home in Elmore County, Idaho. The US Environmental Protection Agency (EPA) placed Mountain Home AFB on the National Priority List on August 30, 1990, as a result of concerns regarding groundwater contamination throughout the base, and soil contamination at the Fire Training Area and a closed sanitary landfill. Contaminants of potential concern are metals, volatile organic compounds, and petroleum hydrocarbons. On the basis of a review of available information on contamination of soil, groundwater, and surface water and sediment, ATSDR concludes that Mountain Home AFB should be assigned to the No Apparent Public Health Hazard category.

  13. Automated Cognitive Health Assessment From Smart Home-Based Behavior Data.

    PubMed

    Dawadi, Prafulla Nath; Cook, Diane Joyce; Schmitter-Edgecombe, Maureen

    2016-07-01

    Smart home technologies offer potential benefits for assisting clinicians by automating health monitoring and well-being assessment. In this paper, we examine the actual benefits of smart home-based analysis by monitoring daily behavior in the home and predicting clinical scores of the residents. To accomplish this goal, we propose a clinical assessment using activity behavior (CAAB) approach to model a smart home resident's daily behavior and predict the corresponding clinical scores. CAAB uses statistical features that describe characteristics of a resident's daily activity performance to train machine learning algorithms that predict the clinical scores. We evaluate the performance of CAAB utilizing smart home sensor data collected from 18 smart homes over two years. We obtain a statistically significant correlation ( r=0.72) between CAAB-predicted and clinician-provided cognitive scores and a statistically significant correlation ( r=0.45) between CAAB-predicted and clinician-provided mobility scores. These prediction results suggest that it is feasible to predict clinical scores using smart home sensor data and learning-based data analysis. PMID:26292348

  14. Multichannel broadcast based on home channel for cognitive radio sensor networks.

    PubMed

    Zeng, Fanzi; Tang, Yuting; Pu, Jianjie

    2014-01-01

    Considering the limited resources and the dynamic spectrum distribution in the cognitive radio sensor networks (CRSN), a half-duplex Multichannel broadcast protocol for CRSN is presented based on the home channel. This protocol maintains the networks topology only through the home channel, so there is no need for the public channel to transmit the control information and no need for the synchronization. After network initialization, node broadcasts data via home channel in half-duplex transmission way. The simulation results show that, compared with complete broadcast, the proposed protocol effectively reduces broadcast delay and overhead. PMID:25161397

  15. 42 CFR 440.182 - State plan home and community-based services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... management services. (2) Homemaker services. (3) Home health aide services. (4) Personal care services. (5... specified in § 440.180(c). (7) Respite care services. (8) Subject to the conditions in § 440.180(d)(2), for... temporary food and shelter provided as an integral part of respite care services in a facility approved...

  16. EVALUATION OF THE FARM MANAGEMENT PHASE OF THE FARM AND HOME MANAGEMENT PROGRAM IN NEW YORK STATE. EXTENSION STUDY, NUMBER 1.

    ERIC Educational Resources Information Center

    ALEXANDER, FRANK D.; LONGEST, JAMES W.

    THE MAIN PURPOSE OF THIS 1956-60 LONGITUDINAL STUDY WAS TO COMPARE CHANGES IN FARM PRACTICES AND RELATED KNOWLEDGE AND IN INCOME AND RELATED BUSINESS FACTORS AMONG 87 PARTICIPANTS (DAIRYMEN) IN THE FARM MANAGEMENT PHASE OF THE NEW YORK STATE FARM AHD HOME MANAGEMENT PROGRAM, WITH THOSE OF A CONTROL GROUP OF 87 WHO DID NOT PARTICIPATE. IN 1956, THE…

  17. Preliminary Data from the Caring for Older Adults and Caregivers at Home (COACH) Program: A Care Coordination Program for Home-Based Dementia Care and Caregiver Support in a Veterans Affairs Medical Center.

    PubMed

    D'Souza, Maria F; Davagnino, Judith; Hastings, S Nicole; Sloane, Richard; Kamholz, Barbara; Twersky, Jack

    2015-06-01

    Caring for Older Adults and Caregivers at Home (COACH) is an innovative care coordination program of the Durham Veteran's Affairs Medical Center in Durham, North Carolina, that provides home-based dementia care and caregiver support for individuals with dementia and their family caregivers, including attention to behavioral symptoms, functional impairment, and home safety, on a consultation basis. The objectives of this study were to describe the COACH program in its first 2 years of operation, assess alignment of program components with quality measures, report characteristics of program participants, and compare rates of placement outside the home with those of a nontreatment comparison group using a retrospective cohort design. Participants were community-dwelling individuals with dementia aged 65 and older who received primary care in the medical center's outpatient clinics and their family caregivers, who were enrolled as dyads (n = 133), and a control group of dyads who were referred to the program and met clinical eligibility criteria but did not enroll (n = 29). Measures included alignment with Dementia Management Quality Measures and time to placement outside the home during 12 months of follow-up after referral to COACH. Results of the evaluation demonstrated that COACH aligns with nine of 10 clinical process measures identified using quality measures and that COACH delivers several other valuable services to enhance care. Mean time to placement outside the home was 29.6 ± 14.3 weeks for both groups (P = .99). The present study demonstrates the successful implementation of a home-based care coordination intervention for persons with dementia and their family caregivers that is strongly aligned with quality measures. PMID:26032224

  18. Intelligent Systems for Assessing Aging Changes: Home-Based, Unobtrusive, and Continuous Assessment of Aging

    PubMed Central

    Maxwell, Shoshana A.; Mattek, Nora; Hayes, Tamara L.; Dodge, Hiroko; Pavel, Misha; Jimison, Holly B.; Wild, Katherine; Boise, Linda; Zitzelberger, Tracy A.

    2011-01-01

    Objectives. To describe a longitudinal community cohort study, Intelligent Systems for Assessing Aging Changes, that has deployed an unobtrusive home-based assessment platform in many seniors homes in the existing community. Methods. Several types of sensors have been installed in the homes of 265 elderly persons for an average of 33 months. Metrics assessed by the sensors include total daily activity, time out of home, and walking speed. Participants were given a computer as well as training, and computer usage was monitored. Participants are assessed annually with health and function questionnaires, physical examinations, and neuropsychological testing. Results. Mean age was 83.3 years, mean years of education was 15.5, and 73% of cohort were women. During a 4-week snapshot, participants left their home twice a day on average for a total of 208 min per day. Mean in-home walking speed was 61.0 cm/s. Participants spent 43% of days on the computer averaging 76 min per day. Discussion. These results demonstrate for the first time the feasibility of engaging seniors in a large-scale deployment of in-home activity assessment technology and the successful collection of these activity metrics. We plan to use this platform to determine if continuous unobtrusive monitoring may detect incident cognitive decline. PMID:21743050

  19. WSN- and IOT-Based Smart Homes and Their Extension to Smart Buildings.

    PubMed

    Ghayvat, Hemant; Mukhopadhyay, Subhas; Gui, Xiang; Suryadevara, Nagender

    2015-01-01

    Our research approach is to design and develop reliable, efficient, flexible, economical, real-time and realistic wellness sensor networks for smart home systems. The heterogeneous sensor and actuator nodes based on wireless networking technologies are deployed into the home environment. These nodes generate real-time data related to the object usage and movement inside the home, to forecast the wellness of an individual. Here, wellness stands for how efficiently someone stays fit in the home environment and performs his or her daily routine in order to live a long and healthy life. We initiate the research with the development of the smart home approach and implement it in different home conditions (different houses) to monitor the activity of an inhabitant for wellness detection. Additionally, our research extends the smart home system to smart buildings and models the design issues related to the smart building environment; these design issues are linked with system performance and reliability. This research paper also discusses and illustrates the possible mitigation to handle the ISM band interference and attenuation losses without compromising optimum system performance. PMID:25946630

  20. WSN- and IOT-Based Smart Homes and Their Extension to Smart Buildings

    PubMed Central

    Ghayvat, Hemant; Mukhopadhyay, Subhas; Gui, Xiang; Suryadevara, Nagender

    2015-01-01

    Our research approach is to design and develop reliable, efficient, flexible, economical, real-time and realistic wellness sensor networks for smart home systems. The heterogeneous sensor and actuator nodes based on wireless networking technologies are deployed into the home environment. These nodes generate real-time data related to the object usage and movement inside the home, to forecast the wellness of an individual. Here, wellness stands for how efficiently someone stays fit in the home environment and performs his or her daily routine in order to live a long and healthy life. We initiate the research with the development of the smart home approach and implement it in different home conditions (different houses) to monitor the activity of an inhabitant for wellness detection. Additionally, our research extends the smart home system to smart buildings and models the design issues related to the smart building environment; these design issues are linked with system performance and reliability. This research paper also discusses and illustrates the possible mitigation to handle the ISM band interference and attenuation losses without compromising optimum system performance. PMID:25946630

  1. Home and Away: An Inquiry into Home-Based and Overseas Teacher Perceptions Regarding International Schools

    ERIC Educational Resources Information Center

    Hrycak, John

    2015-01-01

    The world of international schools is expanding, fuelled in part by globalisation and the ease with which employees can relocate across the globe as they seek new employment opportunities. As these mobile families relocate overseas, international schools provide an education for their children which may offer a curriculum based on a common and…

  2. Insights in public health: the Hawai'i Home Visiting Network: evidence-based home visiting services in Hawai'i.

    PubMed

    Yoshimoto, D Kaulana; Robertson, N Tod; Hayes, Donald K

    2014-05-01

    Home visiting services are cost-effective and improve the health of children and families among those at increased risk. From 1985-2008, home visiting services in Hawai'i were provided primarily through state funding of the Hawai'i Healthy Start Program, but the program was severely reduced due to the economy and state budget changes over the past decade. The Maternal and Child Health Branch (MCHB) in the Family Health Services Division responded to these changes by seeking out competitive grant opportunities and collaborations in order to continue to promote home visiting services to those children and families in need. In 2010, the MCHB was awarded a federally funded Maternal, Infant and Early Childhood Home Visiting (MIECHV) grant for home visiting services to promote maternal, infant, and early childhood health, safety and development, strong parent-child relationships, and responsible parenting. In 2011, the MCHB was also awarded a competitive MIECHV development grant that funded the re-establishment of the hospital Early Identification program. Families in need of additional support identified through this program are referred for family strengthening services to a network of existing home visiting programs called the Hawai'i Home Visiting Network (HHVN). The HHVN is supported by MIECHV and a small amount of state funds to assist programs with capacity building, training, professional development, quality assurance, and accreditation/certification support. The MIECHV grant requires that programs are evidence-based and address specific outcome measures and benchmarks. The HHVN provides home visiting services to families prenatally through 5 years of age that reside in specific at-risk communities, and is aimed at fostering positive parenting and reducing child maltreatment using a strength-based approach by targeting six protective factors: (1) social connections, (2) nurturing and attachment, (3) knowledge of parenting and child development, (4) parental

  3. Home-based music therapy - a systematic overview of settings and conditions for an innovative service in healthcare

    PubMed Central

    2010-01-01

    Background Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT) programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. Methods The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. Results A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8), were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. Conclusions We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely impaired people. Apart from

  4. Cost-Effectiveness of a Home Based Intervention for Secondary Prevention of Readmission with Chronic Heart Disease.

    PubMed

    Byrnes, Joshua; Carrington, Melinda; Chan, Yih-Kai; Pollicino, Christine; Dubrowin, Natalie; Stewart, Simon; Scuffham, Paul A

    2015-01-01

    The aim of this study is to consider the cost-effectiveness of a nurse-led, home-based intervention (HBI) in cardiac patients with private health insurance compared to usual post-discharge care. A within trial analysis of the Young @ Heart multicentre, randomized controlled trial along with a micro-simulation decision analytical model was conducted to estimate the incremental costs and quality adjusted life years associated with the home based intervention compared to usual care. For the micro-simulation model, future costs, from the perspective of the funder, and effects are estimated over a twenty-year time horizon. An Incremental Cost-Effectiveness Ratio, along with Incremental Net Monetary Benefit, is evaluated using a willingness to pay threshold of $50,000 per quality adjusted life year. Sub-group analyses are conducted for men and women across three age groups separately. Costs and benefits that arise in the future are discounted at five percent per annum. Overall, home based intervention for secondary prevention in patients with chronic heart disease identified in the Australian private health care sector is not cost-effective. The estimated within trial incremental net monetary benefit is -$3,116 [95% CI: -11,145, $4,914]; indicating that the costs outweigh the benefits. However, for males and in particular males aged 75 years and above, home based intervention indicated a potential to reduce health care costs when compared to usual care (within trial: -$10,416 [95% CI: -$26,745, $5,913]; modelled analysis: -$1,980 [95% CI: -$22,843, $14,863]). This work provides a crucial impetus for future research to understand for whom disease management programs are likely to benefit most. PMID:26657844

  5. Cost-Effectiveness of a Home Based Intervention for Secondary Prevention of Readmission with Chronic Heart Disease

    PubMed Central

    Byrnes, Joshua; Carrington, Melinda; Chan, Yih-Kai; Pollicino, Christine; Dubrowin, Natalie; Stewart, Simon; Scuffham, Paul A.

    2015-01-01

    The aim of this study is to consider the cost-effectiveness of a nurse-led, home-based intervention (HBI) in cardiac patients with private health insurance compared to usual post-discharge care. A within trial analysis of the Young @ Heart multicentre, randomized controlled trial along with a micro-simulation decision analytical model was conducted to estimate the incremental costs and quality adjusted life years associated with the home based intervention compared to usual care. For the micro-simulation model, future costs, from the perspective of the funder, and effects are estimated over a twenty-year time horizon. An Incremental Cost-Effectiveness Ratio, along with Incremental Net Monetary Benefit, is evaluated using a willingness to pay threshold of $50,000 per quality adjusted life year. Sub-group analyses are conducted for men and women across three age groups separately. Costs and benefits that arise in the future are discounted at five percent per annum. Overall, home based intervention for secondary prevention in patients with chronic heart disease identified in the Australian private health care sector is not cost-effective. The estimated within trial incremental net monetary benefit is -$3,116 [95%CI: -11,145, $4,914]; indicating that the costs outweigh the benefits. However, for males and in particular males aged 75 years and above, home based intervention indicated a potential to reduce health care costs when compared to usual care (within trial: -$10,416 [95%CI: -$26,745, $5,913]; modelled analysis: -$1,980 [95%CI: -$22,843, $14,863]). This work provides a crucial impetus for future research to understand for whom disease management programs are likely to benefit most. PMID:26657844

  6. Pain Medication Management Processes Used by Oncology Outpatients and Family Caregivers Part II: Home and Lifestyle Contexts

    PubMed Central

    Schumacher, Karen L.; Plano Clark, Vicki L.; West, Claudia M.; Dodd, Marylin J.; Rabow, Michael W.; Miaskowski, Christine

    2014-01-01

    Context Despite the increasing complexity of medication regimens for persistent cancer pain, little is known about how oncology outpatients and their family caregivers manage pain medications at home. Objectives To describe the day-to-day management of pain medications from the perspectives of oncology outpatients and their family caregivers who participated in a randomized clinical trial (RCT) of a psycho-educational intervention called the Pro-Self © Plus Pain Control Program. In this article, we focus on pain medication management in the context of highly individualized home environments and lifestyles. Methods This qualitative study was conducted as part of a RCT in which an embedded mixed methods research design was used. Audio-recorded dialogue among patients, family caregivers, and intervention nurses was analyzed using qualitative research methods. Results Home and lifestyle contexts for managing pain medications included highly individualized home environments, work and recreational activities, personal routines, and family characteristics. Pain medication management processes particularly relevant in these contexts included understanding, organizing, storing, scheduling, remembering, and taking the medications. With the exception of their interactions with the intervention nurses, most study participants had little involvement with clinicians as they worked through these processes. Conclusion Pain medication management is an ongoing multidimensional process, each step of which has to be mastered by patients and family caregivers when cancer treatment and supportive care is provided on an outpatient basis. Realistic patient- and family-centered skill-building interventions are needed to achieve effective and safe pain medication management in the contexts of individual home environments and lifestyles. PMID:24709364

  7. Effects of Home Energy Management Systems on Distribution Utilities and Feeders Under Various Market Structures: Preprint

    SciTech Connect

    Ruth, Mark; Pratt, Annabelle; Lunacek, Monte; Mittal, Saurabh; Wu, Hongyu; Jones, Wesley

    2015-07-17

    The combination of distributed energy resources (DER) and retail tariff structures to provide benefits to both utility consumers and the utilities is poorly understood. To improve understanding, an Integrated Energy System Model (IESM) is being developed to simulate the physical and economic aspects of DER technologies, the buildings where they reside, and feeders servicing them. The IESM was used to simulate 20 houses with home energy management systems on a single feeder under a time of use tariff to estimate economic and physical impacts on both the households and the distribution utilities. HEMS reduce consumers’ electric bills by precooling houses in the hours before peak electricity pricing. Household savings are greater than the reduction utility net revenue indicating that HEMS can provide a societal benefit providing tariffs are structured so that utilities remain solvent. Utilization of HEMS reduce peak loads during high price hours but shifts it to hours with off-peak and shoulder prices and resulting in a higher peak load.

  8. Guidelines for management of home parenteral support in adult chronic intestinal failure patients.

    PubMed

    Messing, Bernard; Joly, Francisca

    2006-02-01

    Management of home parenteral support in adult benign but chronic intestinal failure patients requires a nutrition support team using disease-specific pathways. Education of patients to ensure they self manage home parenteral nutrition (HPN) is cornerstone to obtain minimal rate of technical complications and improvement in quality of life. Nutritive mixtures, compounded by pharmacists in single "all-in-one" bags, must be tailored according to the nutritional and intestinal status of individual patients with definition of macronutrients and water-electrolyte needs, respectively. Each PN cycle should be complete in essential nutrients to be nutritionally efficient and should have sufficient amounts of amino acids, dextrose, water, minerals, and micronutrients to avoid deficiency. When the nutritional goal is achieved, a minimum number of PN cycles per week should be implemented, guided ideally by digestive balance(s) (In-Out) of macronutrients and minerals of individual patients. Indeed, HPN is, in most cases, a complementary nonexclusive mode of nutritional support. In short gut patients--who represent 75% of chronic intestinal failure patients--encouraging enteral feeding decrease PN delivery and the risk of metabolic liver disease associated with HPN. In short gut patients with no severe renal impairment, blood citrulline dosage, in association with the remnant anatomy, is a tool to delineate transient from permanent intestinal failure. The latter group includes candidates for trophic gut factors and rehabilitative or reconstructive surgery, including intestinal transplantation. Thus, outcome improvement for intestinal failure patients needs intestinal failure teams having expertise in all medical and surgical aspects of this field. PMID:16473071

  9. Design and Rationale for Home Blood Pressure Telemonitoring and Case Management to Control Hypertension (HyperLink): A Cluster Randomized Trial

    PubMed Central

    Margolis, Karen L.; Kerby, Tessa J.; Asche, Stephen E.; Bergdall, Anna R.; Maciosek, Michael V.; O’Connor, Patrick J.; Sperl-Hillen, Joann

    2012-01-01

    Background Patients with high blood pressure (BP) visit a physician an average of 4 times or more per year in the U.S., yet BP is controlled in fewer than half. Practical, robust and sustainable models are needed to improve BP in patients with uncontrolled hypertension. Objectives The Home Blood Pressure Telemonitoring and Case Management to Control Hypertension study (HyperLink) is a clinic-randomized trial designed to determine whether an intervention that combines home BP telemonitoring with pharmacist case management improves BP control compared to usual care at 6 and 12 months in patients with uncontrolled hypertension. Secondary outcomes are maintenance of BP control at 18 months, patient satisfaction with their health care, and costs of care. Methods HyperLink enrolled 450 hypertensive patients with uncontrolled BP from 16 primary care clinics. Eight clinics were randomized to provide usual care (UC) to their patients (n = 222) and 8 were randomized to provide the telemonitoring intervention (TI) (n = 228). TI patients received home BP telemonitors that internally store and electronically transmit BP data to a secure database. Pharmacist case managers adjust antihypertensive therapy based on the home BP data under a collaborative practice agreement with the clinics’ primary care teams. The length of the intervention is 12 months, with follow-up to 18 months to determine the durability of the intervention. Conclusions We will test in a real primary care setting whether combining BP telemonitoring and pharmacist case management can achieve and maintain high rates of BP control compared to usual care. PMID:22498720

  10. A state-level examination of the association between home and community-based services and rates of nursing home residency with special attention to nutrition programs.

    PubMed

    Buys, David R; Borch, Casey; Kilgore, Meredith; Zizza, Claire A; Locher, Julie L

    2012-01-01

    Federal food and nutrition programs implemented by the Administration on Aging and funded by the Older Americans Act (OAA) seek to enable older adults to remain in their homes and communities through a comprehensive, coordinated, and cost-effective array of services. We hypothesized that expenditures devoted to nutrition programs for home and community-based nutrition services were inversely related to changes in state-level rates of institutionalization for older adults from one year to the next, such that states that spend more money per capita on community-based nutrition programs would have smaller increases or greater decreases in rates of institutionalization, controlling for expenditures on other home and community-based services. We found, however, that there was not an effect of OAA Nutrition Services on the change in rates of nursing home residency. We noted, though, that states that direct a greater proportion of their long-term care expenditures to home and community-based services appear to have more reduction in their rates of nursing home residency. Further longitudinal work at the state and individual levels is warranted. PMID:23157217

  11. Partnering to Reduce Environmental Hazards Through a Community-Based “Healthy Home Museum”:Education for Action

    PubMed Central

    Korfmacher, Katrina Smith; Garrison, Valerie

    2015-01-01

    Home environmental hazards can pose health threats, particularly to low-income children living in substandard housing. National agencies urge integrated treatment of such hazards; locally, however, home hazard reduction is often managed issue-by-issue. Helping diverse local groups understand the sources, health impacts, and solutions to home hazards is a critical first step toward action. Rochester's Healthy Home was a hands-on museum operated by a community-university partnership from 2006–2009 with the goal of supporting community members' and groups' efforts to address key environmental health hazards in high-risk housing. A secondary goal was to build connections between interest groups, government, and academic stakeholders to advance systems changes in support of environmental justice. Rochester's Healthy Home educated nearly 3,500 visitors about reducing home environmental hazards, served as a focal point for community action, and integrated over 30 local groups into the Healthy Home Partnership, which continues to meet regularly. Over 75% of visitors reported taking an action to improve their home's health following their visit. This hands-on and action-oriented training model generated attention and interest in replication in other cities. This collaboration showed that a collaboratively operated, interactive “healthy home museum” can build residents' capacity to reduce home health hazards while changing local policies and practices to sustainably promote healthier homes. PMID:25897345

  12. 7 CFR Exhibit A to Subpart B of... - Memorandum of Understanding Between the Federal Emergency Management Agency and the Farmers Home...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 14 2013-01-01 2013-01-01 false Memorandum of Understanding Between the Federal Emergency Management Agency and the Farmers Home Administration or Its Successor Agency under Public Law 103... Understanding Between the Federal Emergency Management Agency and the Farmers Home Administration or...

  13. 7 CFR Exhibit A to Subpart B of... - Memorandum of Understanding Between the Federal Emergency Management Agency and the Farmers Home...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 14 2014-01-01 2014-01-01 false Memorandum of Understanding Between the Federal Emergency Management Agency and the Farmers Home Administration or Its Successor Agency under Public Law 103... Understanding Between the Federal Emergency Management Agency and the Farmers Home Administration or...

  14. 7 CFR Exhibit A to Subpart B of... - Memorandum of Understanding Between the Federal Emergency Management Agency and the Farmers Home...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 14 2012-01-01 2012-01-01 false Memorandum of Understanding Between the Federal Emergency Management Agency and the Farmers Home Administration or Its Successor Agency under Public Law 103... Understanding Between the Federal Emergency Management Agency and the Farmers Home Administration or...

  15. 7 CFR Exhibit A to Subpart B of... - Memorandum of Understanding Between the Federal Emergency Management Agency and the Farmers Home...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Memorandum of Understanding Between the Federal Emergency Management Agency and the Farmers Home Administration or Its Successor Agency under Public Law 103... Emergency Management Agency and the Farmers Home Administration or Its Successor Agency under Public Law...

  16. Study protocol: home-based telehealth stroke care: a randomized trial for veterans

    PubMed Central

    2010-01-01

    Background Stroke is one of the most disabling and costly impairments of adulthood in the United States. Stroke patients clearly benefit from intensive inpatient care, but due to the high cost, there is considerable interest in implementing interventions to reduce hospital lengths of stay. Early discharge rehabilitation programs require coordinated, well-organized home-based rehabilitation, yet lack of sufficient information about the home setting impedes successful rehabilitation. This trial examines a multifaceted telerehabilitation (TR) intervention that uses telehealth technology to simultaneously evaluate the home environment, assess the patient's mobility skills, initiate rehabilitative treatment, prescribe exercises tailored for stroke patients and provide periodic goal oriented reassessment, feedback and encouragement. Methods We describe an ongoing Phase II, 2-arm, 3-site randomized controlled trial (RCT) that determines primarily the effect of TR on physical function and secondarily the effect on disability, falls-related self-efficacy, and patient satisfaction. Fifty participants with a diagnosis of ischemic or hemorrhagic stroke will be randomly assigned to one of two groups: (a) TR; or (b) Usual Care. The TR intervention uses a combination of three videotaped visits and five telephone calls, an in-home messaging device, and additional telephonic contact as needed over a 3-month study period, to provide a progressive rehabilitative intervention with a treatment goal of safe functional mobility of the individual within an accessible home environment. Dependent variables will be measured at baseline, 3-, and 6-months and analyzed with a linear mixed-effects model across all time points. Discussion For patients recovering from stroke, the use of TR to provide home assessments and follow-up training in prescribed equipment has the potential to effectively supplement existing home health services, assist transition to home and increase efficiency. This may

  17. Home-Based School Teachers in Afghanistan: Teaching for Tarbia and Student Well-Being

    ERIC Educational Resources Information Center

    Kirk, Jackie; Winthrop, Rebecca

    2008-01-01

    Teachers in community-based or home-based schools in Afghanistan play a critical role in extending access to education to children who are unable to access the government schools, especially girls. These teachers--men and women--are nominated by the community to teach, without necessarily having teaching experience or even completing their own…

  18. Effects of Home Energy Management Systems on Distribution Utilities and Feeders Under Various Market Structure; NREL (National Renewable Energy Laboratory)

    SciTech Connect

    Ruth, M.; Pratt, A.; Lunacek, M.; Mittal, S.; Wu, H.; Jones, W.

    2015-06-15

    The combination of distributed energy resources (DER) and retail tariff structures to provide benefits to both utility consumers and the utilities is not well understood. To improve understanding, an Integrated Energy System Model (IESM) is being developed to simulate the physical and economic aspects of DER technologies, the buildings where they reside, and feeders servicing them. The IESM was used to simulate 20 houses with home energy management systems on a single feeder under a time-of-use (TOU) tariff to estimate economic and physical impacts on both the households and the distribution utilities. Home energy management systems (HEMS) reduce consumers’ electric bills by precooling houses in the hours before peak electricity pricing. Utilization of HEMS reduce peak loads during high price hours but shifts it to hours with off-peak and shoulder prices, resulting in a higher peak load. used to simulate 20 houses with home energy management systems on a single feeder under a time-of-use (TOU) tariff to estimate economic and physical impacts on both the households and the distribution utilities. Home energy management systems (HEMS) reduce consumers’ electric bills by precooling houses in the hours before peak electricity pricing. Utilization of HEMS reduce peak loads during high price hours but shifts it to hours with off-peak and shoulder prices, resulting in a higher peak load.

  19. Life Management: Moving Out! Solving Practical Problems for Independent Living. Utah Home Economics and Family Life Curriculum Guide.

    ERIC Educational Resources Information Center

    Utah State Office of Education, Salt Lake City.

    This guide, which has been developed for Utah's home economics and family life education program, contains materials for use in teaching a life management course emphasizing the problem-solving skills required for independent living. Discussed first are the assumptions underlying the curriculum, development of the guide, and suggestions for its…

  20. Heart rate dynamics after controlled training followed by a home-based exercise program.

    PubMed

    Hautala, Arto J; Mäkikallio, Timo H; Kiviniemi, Antti; Laukkanen, Raija T; Nissilä, Seppo; Huikuri, Heikki V; Tulppo, Mikko P

    2004-07-01

    Daily aerobic training results in autonomic control of the heart toward vagal dominance. The constancy of vagal dominance after controlled training followed by a home-based training program in accordance with contemporary guidelines is not known. We set out here to study whether the vagal dominance induced by 8 weeks of controlled aerobic training is preserved after a 10-month home-based training program. For the controlled study, healthy men were randomized as training (n=18) and control subjects (n=6). The training was started by a supervised 8-week period with six training sessions a week [45 (15) min each] at an intensity of 70-80% of maximum heart rate, followed by a home-based training program for 10 months in accordance with the American College of Sports Medicine recommendations. Cardiovascular autonomic function was assessed by analyzing HR variability over a 24-h period and separately during the night hours (midnight-6 a.m.). Maximal running performance improved during the controlled training 16 (7)% (range 4-31%, P<0.001) and remained 8 (8)% (range -3 to 23%, P<0.001) above the baseline level after the home-based training program. At night, the vagally mediated high-frequency (HF) power of R-R intervals increased during the controlled training from 6.7 (1.3) to 7.3 (1.1) ln ms2 ( P<0.001) and remained higher than the baseline after the home-based training [7.0 (1.3) ln ms2, P<0.05]. The changes in running performance correlated with the changes in HF power at night (r=0.41, P<0.05) and over 24 h (r=0.44, P<0.05) after the home-based training program. Similarly, the changes in body mass index correlated with the changes in HF power over 24 h (r=-0.44, P<0.05) after the home-based training program. The high vagal outflow to the heart after the home-based training is associated with good physical performance and body mass control. PMID:15083365

  1. Predictors and processes associated with home-based family therapists' professional quality of life.

    PubMed

    Macchi, C R; Johnson, Matthew D; Durtschi, Jared A

    2014-07-01

    This study examined whether home-based family therapists' (HBFT) workload and clinical experience were associated with therapists' professional quality of life directly and indirectly through self-care activities and frequency of clinical supervision. Hypotheses were tested using structural equation modeling with a sample of 225 home-based therapists. Results suggested that therapists' workload and HBFT experience significantly predicted therapists' professional quality of life. These associations between therapists' workload and HBFT experience were partially mediated through participation in self-care and frequency of clinical supervision. Implications for improving therapists' quality of life are discussed as a function of therapists' workload, clinical experience, self-care, and supervision. PMID:24749929

  2. Guidelines for Environmental Health Management in Children’s Homes in Sub-Sahara Africa

    PubMed Central

    Muruka, Charles; Muruka, Andrew

    2007-01-01

    organizations have sprung up to establish homes for such children, especially those orphaned by AIDS or those infected with HIV. It is important to ensure that environmental health hazards and risks are minimized in these children’s homes. By use of a conceptual synthesis approach, the authors attempt to generate guidelines from literature for environmental health management in children’s homes in sub-Saharan Africa. PMID:18180543

  3. Home-based administration of Sayana® Press: review and assessment of needs in low-resource settings.

    PubMed

    Keith, Bonnie; Wood, Siri; Tifft, Sara; Hutchings, Jane

    2014-05-01

    A new presentation of the subcutaneous (SC) injectable contraceptive depot medroxyprogesterone acetate (DMPA) increases the possibilities for home and self-administration of this popular contraceptive method. Sayana® Press is DMPA-SC in the prefilled Uniject™ injection system and consists of one dose that provides 3 months of contraceptive protection. Studies indicate that lay caregiver and self-injection of various medications, including other injectable presentations of DMPA-SC, are acceptable and effective. Introduction of Sayana® Press in developing countries could extend injectable contraceptive delivery safely and effectively beyond the clinic and, eventually, into the home, allowing lay caregiver or self-administration. Research needs for low-resource settings include assessing the acceptability and feasibility of self-injection with Sayana® Press. Feasibility studies necessary for implementing a sustainable home-based delivery program include assessment of training, health systems, policies, infrastructure needs and programmatic considerations to optimize women's ability to manage their self-injection schedule. PMID:24813924

  4. Policy-Based Device and Mobility Management

    NASA Astrophysics Data System (ADS)

    Imai, Pierre; Lamparter, Bernd; Liebsch, Marco

    Each new generation of mobile terminals offers more and better functionality, e.g. terminal mobility, multi-homing or inter-device session mobility. Furthermore, the interaction with consumer devices, e.g. DLNA TV or stereo sets, is becoming more common. Every new feature, however, is likely to result in increased complexity for the end user: Most people do not know how to utilize all features of their mobile terminals, hence devices that offer only a reduced feature set are becoming more popular. Additionally, while the end user expects to be in control, the network operator might want to exert some influence over which features are available or trigger actions, e.g. handovers, based on contract, location, etc. The aim of our research is to offer high flexibility and functionality combined with ease of use. We designed a policy management framework for the mentioned session mobility functions which supports the user in the configuration of the functions and automates commonly performed actions.

  5. The Role of Clinical and Geographic Factors in the Use of Hospital versus Home-Based Cardiac Rehabilitation

    ERIC Educational Resources Information Center

    Brual, Janette; Gravely, Shannon; Suskin, Neville; Stewart, Donna E.; Grace, Sherry L.

    2012-01-01

    Cardiac rehabilitation (CR) is most often provided in a hospital setting. Home-based models of care have been developed to overcome geographic, among other, barriers in patients at a lower risk. This study assessed whether clinical and geographic factors were related to the use of either a hospital-based or a home-based program. Secondary analysis…

  6. Value-based financially sustainable behavioral health components in patient-centered medical homes.

    PubMed

    Kathol, Roger G; Degruy, Frank; Rollman, Bruce L

    2014-01-01

    Because a high percentage of primary care patients have behavioral problems, patient-centered medical homes (PCMHs) that wish to attain true comprehensive whole-person care will find ways to integrate behavioral health services into their structure. Yet in today's health care environment, the incorporation of behavioral services into primary care is exceptional rather than usual practice. In this article, we discuss the components considered necessary to provide sustainable, value-added integrated behavioral health care in the PCMH. These components are to: (1) combine medical and behavioral benefits into one payment pool; (2) target complex patients for priority behavioral health care; (3) use proactive onsite behavioral "teams;" (4) match behavioral professional expertise to the need for treatment escalation inherent in stepped care; (5) define, measure, and systematically pursue desired outcomes; (6) apply evidence-based behavioral treatments; and (7) use cross-disciplinary care managers in assisting the most complicated and vulnerable. By adopting these 7 components, PCHMs will augment their ability to achieve improved health in their patients at lower cost in a setting that enhances ease of access to commonly needed services. PMID:24615314

  7. Frequency and Type of Use of a Home-Based, Internet Intervention for Adolescent Smoking Cessation

    PubMed Central

    Patten, Christi A.; Rock, Emily; Meis, Tracy M.; Decker, Paul A.; Colligan, Robert C.; Pingree, Suzanne; Dornelas, Ellen A.; Offord, Kenneth P.; Boberg, Eric W.; Gustafson, David H.

    2007-01-01

    Purpose The Internet offers a potential medium for delivering smoking cessation treatment to adolescents. However, few Internet-based cessation programs for adolescents have been evaluated. We describe adolescent use of a home-based Internet intervention to stop smoking (Stomp Out Smokes; SOS) and explore baseline characteristics associated with SOS use. Methods Participants were 70 adolescent smokers aged 12–18 years (50% female, 90% Caucasian) randomized to receive the SOS intervention for 24 weeks as part of a larger clinical trial. SOS comprised 40 components of which 8 were primarily interactive (e.g., discussion support group, ask an expert, quit plan) and 32 were primarily informational (e.g., managing withdrawal, medications to stop smoking). SOS use data were captured electronically, including total logins to the site, and type of SOS components used defined by page hits on the interactive and information components. Results A total of 7,708 SOS Web site pages (6825 interactive and 883 informational) were accessed over the 24 weeks. The highest proportion of page hits was for the discussion support group (35%) and quit plan (30%). Interactive pages were significantly more likely to be used than informational pages (median 65 vs. 6, p<0.001). Males accessed fewer interactive pages compared to females (p=0.04). No other baseline characteristics were univariately associated with total logins or use of informational or interactive pages. Conclusions Adolescent smokers most often utilized a discussion support group and other interactive Internet based cessation components. Future studies designed to increase adolescent use, and efficacy of, Internet based cessation programs are warranted. PMID:17950163

  8. Accountability, responsiveness and quality for clients model of home support: a model for improved home support services to promote aging at home.

    PubMed

    Kelly, Judy; Orr, Alison

    2009-01-01

    As the proportion of older adults increases within the Canadian population, healthcare systems across the country are facing increased demands for home-based services, including home care nursing, rehabilitation, case management, adult day programs, respite, meal programs and home support. Home support is one of the core care services required in the community to enable older adults to remain at home as long as possible. In 2006, Vancouver Community introduced a new home support delivery and performance management model: the Accountability, Responsiveness and Quality for Clients Model of Home Support (ARQ Model) (VCH 2006). The main components of the ARQ Model are an expanded use of "cluster care" along with stable monthly funding for high-density buildings and neighbourhoods; the introduction of specific monthly and quarterly quality performance reporting; and the implementation of performance-based funding for home support. This article discusses the setup of the ARQ model, its ongoing evaluation and results achieved thus far. PMID:20057219

  9. Stroke patients’ utilisation of extrinsic feedback from computer-based technology in the home: a multiple case study realistic evaluation

    PubMed Central

    2014-01-01

    Background Evidence indicates that post − stroke rehabilitation improves function, independence and quality of life. A key aspect of rehabilitation is the provision of appropriate information and feedback to the learner. Advances in information and communications technology (ICT) have allowed for the development of various systems to complement stroke rehabilitation that could be used in the home setting. These systems may increase the provision of rehabilitation a stroke survivor receives and carries out, as well as providing a learning platform that facilitates long-term self-managed rehabilitation and behaviour change. This paper describes the application of an innovative evaluative methodology to explore the utilisation of feedback for post-stroke upper-limb rehabilitation in the home. Methods Using the principles of realistic evaluation, this study aimed to test and refine intervention theories by exploring the complex interactions of contexts, mechanisms and outcomes that arise from technology deployment in the home. Methods included focus groups followed by multi-method case studies (n = 5) before, during and after the use of computer-based equipment. Data were analysed in relation to the context-mechanism-outcome hypotheses case by case. This was followed by a synthesis of the findings to answer the question, ‘what works for whom and in what circumstances and respects?’ Results Data analysis reveals that to achieve desired outcomes through the use of ICT, key elements of computer feedback, such as accuracy, measurability, rewarding feedback, adaptability, and knowledge of results feedback, are required to trigger the theory-driven mechanisms underpinning the intervention. In addition, the pre-existing context and the personal and environmental contexts, such as previous experience of service delivery, personal goals, trust in the technology, and social circumstances may also enable or constrain the underpinning theory-driven mechanisms

  10. Self-reported impact of caregiving on voluntary home-based caregivers in Mutale Municipality, South Africa

    PubMed Central

    Netshandama, Vhonani O.; Mudau, Makondelela J.

    2016-01-01

    Background The establishment of home-based care (HBC) programmes in developing countries has resulted in a shift of burden from hospitals to communities where palliative care is provided by voluntary home-based caregivers. Aim The study investigated the impact of caregiving on voluntary home-based caregivers. Setting The study was conducted at HBC organisations located in Mutale Municipality of Limpopo Province, South Africa. Methods A quantitative cross-sectional descriptive survey design was applied to investigate the impact of caregiving on voluntary home-based caregivers. The sample was comprised of (N = 190) home-based caregivers. Home-based caregivers provide care to people in need of care in their homes, such as orphans, the elderly and those suffering from chronic illnesses such as tuberculosis, HIV and/or AIDS, cancer and stroke. Self-administered questionnaires were used to collect data which were analysed descriptively using the Statistical Package for the Social Sciences software, Version 20. Results The results showed that 101 (53.2%) participants were worried about their financial security because they were not registered as workers, whilst 74 (39.0%) participants were always worried about getting infection from their clients because they often do not have protective equipment. Conclusion Voluntary home-based caregivers have an important role in the provision of palliative care to people in their own homes, and therefore, the negative caregiving impact on the lives of caregivers may compromise the provision of quality palliative care. PMID:27380854

  11. A P300-based brain-computer interface aimed at operating electronic devices at home for severely disabled people.

    PubMed

    Corralejo, Rebeca; Nicolás-Alonso, Luis F; Alvarez, Daniel; Hornero, Roberto

    2014-10-01

    The present study aims at developing and assessing an assistive tool for operating electronic devices at home by means of a P300-based brain-computer interface (BCI). Fifteen severely impaired subjects participated in the study. The developed tool allows users to interact with their usual environment fulfilling their main needs. It allows for navigation through ten menus and to manage up to 113 control commands from eight electronic devices. Ten out of the fifteen subjects were able to operate the proposed tool with accuracy above 77 %. Eight out of them reached accuracies higher than 95 %. Moreover, bitrates up to 20.1 bit/min were achieved. The novelty of this study lies in the use of an environment control application in a real scenario: real devices managed by potential BCI end-users. Although impaired users might not be able to set up this system without aid of others, this study takes a significant step to evaluate the degree to which such populations could eventually operate a stand-alone system. Our results suggest that neither the type nor the degree of disability is a relevant issue to suitably operate a P300-based BCI. Hence, it could be useful to assist disabled people at home improving their personal autonomy. PMID:25163823

  12. MST radar data-base management

    NASA Technical Reports Server (NTRS)

    Wickwar, V. B.

    1983-01-01

    Data management for Mesospheric-Stratospheric-Tropospheric, (MST) radars is addressed. An incoherent-scatter radar data base is discussed in terms of purpose, centralization, scope, and nature of the data base management system.

  13. The impact of simulation-based teaching on home hemodialysis patient training

    PubMed Central

    Chan, Doris T.; Faratro, Rose; Chan, Christopher T.

    2015-01-01

    Background Simulation has been associated with positive educational benefits in the training of healthcare professionals. It is unknown whether the use of simulation to supplement patient training for home hemodialysis (HHD) will assist in improving a patient's transition to home. We aim to assess the impact of simulation training on home visits, retraining and technique failure. Methods Since February 2013, patients training for HHD are required to dialyze independently in a dedicated training room (innovation room) which simulates a patient's home prior to graduation from the program. We performed a single-center retrospective, observational, cohort study comparing patients who completed training using the innovation room (n = 28) versus historical control (n = 21). The outcome measures were number of home visits, retraining visits and technique failure. Results Groups were matched for age, gender, race, body mass index and comorbidities. Compared with controls, significantly more cases had a permanent vascular access at the commencement of training (57.1 versus 28.6%, χ2 P = 0.04). Cases spent a median of 2 days [IQR (1.75)] in the innovation room. Training duration was not statistically different between groups {cases: median 10.0 weeks [IQR (6.0)] versus controls: 11.0 [IQR (4.0)]}. Compared with controls, cases showed a trend towards needing less home visits with no difference in the number of re-training session or technique failure. Conclusions Simulation-based teaching in NHHD training is associated with a trend to a reduction in the number of home visits but had no effect on the number of re-training sessions or proportion of patients with technique failure. PMID:26413287

  14. A Web-based home welfare and care services support system using a pen type image sensor.

    PubMed

    Ogawa, Hidekuni; Yonezawa, Yoshiharu; Maki, Hiromichi; Sato, Haruhiko; Hahn, Allen W; Caldwell, W Morton

    2003-01-01

    A long-term care insurance law for elderly persons was put in force two years ago in Japan. The Home Helpers, who are employed by hospitals, care companies or the welfare office, provide home welfare and care services for the elderly, such as cooking, bathing, washing, cleaning, shopping, etc. We developed a web-based home welfare and care services support system using wireless Internet mobile phones and Internet client computers, which employs a pen type image sensor. The pen type image sensor is used by the elderly people as the entry device for their care requests. The client computer sends the requests to the server computer in the Home Helper central office, and then the server computer automatically transfers them to the Home Helper's mobile phone. This newly-developed home welfare and care services support system is easily operated by elderly persons and enables Homes Helpers to save a significant amount of time and extra travel. PMID:12724894

  15. A means to an end: a web-based client management system in palliative care.

    PubMed

    O'Connor, Margaret; Erwin, Trudy; Dawson, Linda

    2009-03-01

    Home-based palliative care (hospice) services require comprehensive and fully integrated information systems to develop and manage the various aspects of their business, incorporating client data and management information. These systems assist in maintaining the quality of client care as well as improved management efficiencies. This article reports on a large not-for-profit home-based palliative care service in Australia, which embarked on a project to develop an electronic data management system specifically designed to meet the needs of the palliative care sector. This web-based client information management system represents a joint venture between the organization and a commercial company and has been a very successful project. PMID:19218311

  16. Rural Home Schooling and Place-Based Education. ERIC Digest.

    ERIC Educational Resources Information Center

    Jaycox, Rebecca

    Place-based education, which draws from local culture, history, and geography to create a meaningful curriculum, holds particular promise for rural homeschooling. Following a brief review of the homeschooling phenomenon, this digest identifies ways that rural place-based education can counter common concerns about homeschooling. In 1999 about 1.7…

  17. Multimodal wireless sensor network-based ambient assisted living in real homes with multiple residents.

    PubMed

    Tunca, Can; Alemdar, Hande; Ertan, Halil; Incel, Ozlem Durmaz; Ersoy, Cem

    2014-01-01

    Human activity recognition and behavior monitoring in a home setting using wireless sensor networks (WSNs) provide a great potential for ambient assisted living (AAL) applications, ranging from health and wellbeing monitoring to resource consumption monitoring. However, due to the limitations of the sensor devices, challenges in wireless communication and the challenges in processing large amounts of sensor data in order to recognize complex human activities, WSN-based AAL systems are not effectively integrated in the home environment. Additionally, given the variety of sensor types and activities, selecting the most suitable set of sensors in the deployment is an important task. In order to investigate and propose solutions to such challenges, we introduce a WSN-based multimodal AAL system compatible for homes with multiple residents. Particularly, we focus on the details of the system architecture, including the challenges of sensor selection, deployment, networking and data collection and provide guidelines for the design and deployment of an effective AAL system. We also present the details of the field study we conducted, using the systems deployed in two different real home environments with multiple residents. With these systems, we are able to collect ambient sensor data from multiple homes. This data can be used to assess the wellbeing of the residents and identify deviations from everyday routines, which may be indicators of health problems. Finally, in order to elaborate on the possible applications of the proposed AAL system and to exemplify directions for processing the collected data, we provide the results of several human activity inference experiments, along with examples on how such results could be interpreted. We believe that the experiences shared in this work will contribute towards accelerating the acceptance of WSN-based AAL systems in the home setting. PMID:24887044

  18. Appearance-Based Multimodal Human Tracking and Identification for Healthcare in the Digital Home

    PubMed Central

    Yang, Mau-Tsuen; Huang, Shen-Yen

    2014-01-01

    There is an urgent need for intelligent home surveillance systems to provide home security, monitor health conditions, and detect emergencies of family members. One of the fundamental problems to realize the power of these intelligent services is how to detect, track, and identify people at home. Compared to RFID tags that need to be worn all the time, vision-based sensors provide a natural and nonintrusive solution. Observing that body appearance and body build, as well as face, provide valuable cues for human identification, we model and record multi-view faces, full-body colors and shapes of family members in an appearance database by using two Kinects located at a home's entrance. Then the Kinects and another set of color cameras installed in other parts of the house are used to detect, track, and identify people by matching the captured color images with the registered templates in the appearance database. People are detected and tracked by multisensor fusion (Kinects and color cameras) using a Kalman filter that can handle duplicate or partial measurements. People are identified by multimodal fusion (face, body appearance, and silhouette) using a track-based majority voting. Moreover, the appearance-based human detection, tracking, and identification modules can cooperate seamlessly and benefit from each other. Experimental results show the effectiveness of the human tracking across multiple sensors and human identification considering the information of multi-view faces, full-body clothes, and silhouettes. The proposed home surveillance system can be applied to domestic applications in digital home security and intelligent healthcare. PMID:25098207

  19. Multimodal Wireless Sensor Network-Based Ambient Assisted Living in Real Homes with Multiple Residents

    PubMed Central

    Tunca, Can; Alemdar, Hande; Ertan, Halil; Incel, Ozlem Durmaz; Ersoy, Cem

    2014-01-01

    Human activity recognition and behavior monitoring in a home setting using wireless sensor networks (WSNs) provide a great potential for ambient assisted living (AAL) applications, ranging from health and wellbeing monitoring to resource consumption monitoring. However, due to the limitations of the sensor devices, challenges in wireless communication and the challenges in processing large amounts of sensor data in order to recognize complex human activities, WSN-based AAL systems are not effectively integrated in the home environment. Additionally, given the variety of sensor types and activities, selecting the most suitable set of sensors in the deployment is an important task. In order to investigate and propose solutions to such challenges, we introduce a WSN-based multimodal AAL system compatible for homes with multiple residents. Particularly, we focus on the details of the system architecture, including the challenges of sensor selection, deployment, networking and data collection and provide guidelines for the design and deployment of an effective AAL system. We also present the details of the field study we conducted, using the systems deployed in two different real home environments with multiple residents. With these systems, we are able to collect ambient sensor data from multiple homes. This data can be used to assess the wellbeing of the residents and identify deviations from everyday routines, which may be indicators of health problems. Finally, in order to elaborate on the possible applications of the proposed AAL system and to exemplify directions for processing the collected data, we provide the results of several human activity inference experiments, along with examples on how such results could be interpreted. We believe that the experiences shared in this work will contribute towards accelerating the acceptance of WSN-based AAL systems in the home setting. PMID:24887044

  20. A Mixed-Method Approach to Investigating the Adoption of Evidence-Based Pain Practices in Nursing Homes

    PubMed Central

    Ersek, Mary; Jablonski, Anita

    2014-01-01

    This mixed methods study examined perceived facilitators and obstacles to adopting evidence-based pain management protocols vis-a-vis documented practice changes that were measured using a chart audit tool. This analysis used data from a subgroup of four nursing homes that participated in a clinical trial. Focus group interviews with staff yielded qualitative data about perceived factors that affected their willingness and ability to use the protocols. Chart audits determined whether pain assessment and management practices changed over time in light of these reported facilitators and barriers. Reported facilitators included administrative support, staff consistency, and policy and procedure changes. Barriers were staff attitudes, regulatory issues, and provider mistrust of nurses’ judgment. Overall, staff reported improvements in pain practices. These reports were corroborated by modest but significant increases in adherence to recommended practices. Change in clinical practice is complex and requires attention to both structural and process aspects of care. PMID:24640959

  1. A mixed-methods approach to investigating the adoption of evidence-based pain practices in nursing homes.

    PubMed

    Ersek, Mary; Jablonski, Anita

    2014-07-01

    This mixed methods study examined perceived facilitators and obstacles to adopting evidence-based pain management protocols vis-a-vis documented practice changes that were measured using a chart audit tool. This analysis used data from a subgroup of four nursing homes that participated in a clinical trial. Focus group interviews with staff yielded qualitative data about perceived factors that affected their willingness and ability to use the protocols. Chart audits determined whether pain assessment and management practices changed over time in light of these reported facilitators and barriers. Reported facilitators included administrative support, staff consistency, and policy and procedure changes. Barriers were staff attitudes, regulatory issues, and provider mistrust of nurses' judgment. Overall, staff reported improvements in pain practices. These reports were corroborated by modest but significant increases in adherence to recommended practices. Change in clinical practice is complex and requires attention to both structural and process aspects of care. PMID:24640959

  2. [Assisted peritoneal dialysis: home-based renal replacement therapy for the elderly patient].

    PubMed

    Wiesholzer, Martin

    2013-06-01

    The number of elderly patients with end stage renal disease is constantly increasing. Conventional hämodiaylsis as the mainstay of renal replacement therapy is often poorly tolerated by frail eldery patients with multiple comorbidities. Although many of these patients would prefer a home based dialysis treatment, the number of elderly patients using peritoneal dialysis (PD) is still low. Impaired physical and cognitive function often generates insurmountable barriers for self care peritoneal dialysis. Assisted peritoneal dialysis can overcome many of these barriers and give elderly patients the ability of a renal replacement therapy in their own homes respecting their needs. PMID:23797681

  3. Assistive Technology in Medicaid Home- and Community-Based Waiver Programs

    ERIC Educational Resources Information Center

    Kitchener, Martin; Ng, Terence; Lee, Hyang Yuol; Harrington, Charlene

    2008-01-01

    Purpose: As consensus emerges concerning the need to extend publicly funded home- and community-based services that support the independence of seniors, studies have reported the efficacy and cost effectiveness of assistive technology (AT). This article presents the latest available national AT expenditure and participation trends (1999-2002) for…

  4. Barriers to Home and Community-Based Service Referrals: The Physician's Role

    ERIC Educational Resources Information Center

    Reder, Sheri; Hedrick, Susan; Guihan, Marylou; Miller, Sara

    2009-01-01

    The purpose of this study was to obtain information about Department of Veteran Affairs (VA) long-term care (LTC) referrals that could be used to develop interventions that increase the likelihood of referrals to home and community-based services (HCBS) instead of institutional care. This primarily qualitative study was conducted at five VA…

  5. Recurrent Vascular Headache: Home-Based Behavioral Treatment versus Abortive Pharmacological Treatment.

    ERIC Educational Resources Information Center

    Holroyd, Kenneth A.; And Others

    1988-01-01

    Compared the effectiveness of a home-based behavioral intervention (relaxation and thermal biofeedback training) with an abortive pharmacological intervention (with compliance training) for treating recurrent migraine and migraine/tension headaches. Both interventions yielded reductions in headache activity, psychosomatic symptoms, and daily life…

  6. Perceptions of Personal Well-Being among Youth Accessing Residential or Intensive Home-Based Treatment

    ERIC Educational Resources Information Center

    Preyde, Michele; Watkins, Hanna; Ashbourne, Graham; Lazure, Kelly; Carter, Jeff; Penney, Randy; White, Sara; Frensch, Karen; Cameron, Gary

    2013-01-01

    The outcomes of youth accessing residential treatment or intensive home-based treatment are varied. Understanding youth's perceptions of their well-being may inform service. The purpose of this report was to explore perceptions of youth's mental health, life satisfaction, and outlook for the future. Youth reported ongoing struggles with mental…

  7. Medicaid 1915(c) Home- and Community-Based Services Waivers for Children with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Velott, Diana L.; Agbese, Edeanya; Mandell, David; Stein, Bradley D.; Dick, Andrew W.; Yu, Hao; Leslie, Douglas L.

    2016-01-01

    This research aims to describe the characteristics of 1915(c) Home- and Community-Based Services waivers for children with autism spectrum disorder across states and over time. While increasingly popular, little is known about these Medicaid waivers. Understanding the characteristics of these programs is important to clinicians and policymakers in…

  8. A Pilot Study on the Impact of a Home-Based Parenting Intervention: Parents Plus

    ERIC Educational Resources Information Center

    Byrne, Ellie; Holland, Sally; Jerzembek, Gabi

    2010-01-01

    This article reports on a pilot study undertaken in order to explore the impact of a home-based parenting intervention (Parents Plus), on parents and families. Parents Plus is part of a Welsh Early Years strategy called Flying Start and aims to promote positive parent-child interactions. This article explores the medium-term to long-term impact of…

  9. Rural Older Adults' Access Barriers to In-Home and Community-Based Services

    ERIC Educational Resources Information Center

    Li, Hong

    2006-01-01

    This study identified specific access barriers to seven commonly used in-home and community-based services (CBS) and examined factors that were related to barriers to these services. The data used in this study were extracted from the 1999 National Long Term Care Survey and included 283 dyads of rural older adults and their caregivers. The CBS to…

  10. School-Based Health Centers and the Patient-Centered Medical Home. Position Statement

    ERIC Educational Resources Information Center

    National Assembly on School-Based Health Care, 2010

    2010-01-01

    The patient-centered medical home (PCMH) is an innovative care delivery model designed to provide comprehensive primary care services to people of all ages by fostering partnerships between patients, families, health care providers and the community. National Assembly on School-Based Health Care (NASBHC) recommends practices and policies that…

  11. Effects of Parent-Based Video Home Training in Children with Developmental Language Delay

    ERIC Educational Resources Information Center

    van Balkom, Hans; Verhoeven, Ludo; van Weerdenburg, Marjolijn; Stoep, Judith

    2010-01-01

    An efficacy study of an indirect or Parent-based intervention programme involving Video Home Training (PVHT) was conducted with a focus on parental strategies to (re-)establish coherence in conversations between young children with Developmental Language Delay (DLD) and their parents or caregivers. In order to assess the efficacy of the PVHT…

  12. School- And Home-Based Drug Prevention: Environmental, Parent, and Child Risk Reduction

    ERIC Educational Resources Information Center

    Hahn, Ellen J.; Hall, Lynne A.; Rayens, Mary Kay; Myers, April V.; Bonnel, Galadriel

    2007-01-01

    The study purpose was to test the effect of a school- and home-based alcohol, tobacco, and other drug (ATOD) prevention program on reducing environmental, parent, and child risk factors for ATOD use. The design was a three-group pretest-posttest with interviews at baseline and 1 and 6 months post-intervention. The sample was 126 parents and their…

  13. Dutch Home-Based Pre-Reading Intervention with Children at Familial Risk of Dyslexia

    ERIC Educational Resources Information Center

    van Otterloo, Sandra G.; van der Leij, Aryan

    2009-01-01

    Children (5 and 6 years old, n = 30) at familial risk of dyslexia received a home-based intervention that focused on phoneme awareness and letter knowledge in the year prior to formal reading instruction. The children were compared to a no-training at-risk control group (n = 27), which was selected a year earlier. After training, we found a small…

  14. Home-based therapy for severe acute malnutrition with ready-to-use food

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Severe acute malnutrition is a devastating condition afflicting children under 5 years in many developing countries, but concentrated in sub-Saharan Africa. This paper examines the development of home-based lipid-nutrient therapeutic foods for the treatment of acute malnutrition in sub-Saharan Afric...

  15. Treatment Integrity in a Home-Based Pre-Reading Intervention Programme

    ERIC Educational Resources Information Center

    van Otterloo, Sandra G.; van der Leij, Aryan; Veldkamp, Esther

    2006-01-01

    Treatment integrity is an underexposed issue in the phonological awareness intervention research. The current study assessed the integrity of treatment of the families (N = 32) participating in the experimental condition of a home-based pre-reading intervention study. The participating kindergartners were all genetically at risk for developing…

  16. A Home-Based Orientation and Mobility Program for Infants and Toddlers.

    ERIC Educational Resources Information Center

    Joffee, E.

    1988-01-01

    A home-based orientation and mobility program was developed for blind/visually impaired infants and toddlers. Three stages in functional mobility were identified focusing on the development of gross motor skills, related conceptual activities, auditory awareness, orientation skills, and mobility skills. The program included parent education and a…

  17. 42 CFR 436.219 - Individuals receiving State plan home and community-based services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Individuals receiving State plan home and community-based services. 436.219 Section 436.219 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN GUAM, PUERTO RICO, AND THE VIRGIN ISLANDS Options...

  18. Early Home-Based Intervention in the Netherlands for Children at Familial Risk of Dyslexia

    ERIC Educational Resources Information Center

    van Otterloo, Sandra G.; van der Leij, Aryan; Henrichs, Lotte F.

    2009-01-01

    Dutch children at higher familial risk of reading disability received a home-based intervention programme before formal reading instruction started to investigate whether this would reduce the risk of dyslexia. The experimental group (n = 23) received a specific training in phoneme awareness and letter knowledge. A control group (n = 25) received…

  19. THE VALUE OF HOME-BASED COLLECTION OF BIOSPECIMENS IN REPRODUCTIVE EPIDEMIOLOGY

    EPA Science Inventory

    The Value of Home-Based Collection of Biospecimens in Reproductive Epidemiology
    John C. Rockett1, Germaine M. Buck2, Courtney D. Johnson2 and Sally D. Perreault1
    1Reproductive Toxicology Division, National Health and Environmental Effects Research Laboratory, Office of Rese...

  20. Parent Perspective on the Home-Based Interim Alternative Educational Setting: A Phenomenological Study

    ERIC Educational Resources Information Center

    Jones, Gregory L.

    2011-01-01

    The purpose of this study was to explore and describe the perspectives of parents of expelled disabled students placed in home-based interim alternative educational settings (IAES). The study consisted of three parent participants whose disabled children, by virtue of their violations of the school district's discipline policy, were…

  1. The Global Classroom Model Simultaneous Campus-and Home-Based Education Using Videoconferencing

    ERIC Educational Resources Information Center

    Weitze, Charlotte Laerke; Ørngreen, Rikke

    2014-01-01

    This paper presents and discusses findings about how students, teachers, and the organization experience a start-up-project applying videoconferences between campus and home. This is new territory for adult learning centers. The research is based on the "Global Classroom Model" as it is implemented and used at an adult learning center in…

  2. 76 FR 21311 - Medicaid Program; Home and Community-Based Services (HCBS) Waivers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-15

    ..., 1994 (59 FR 37719). In the June 22, 2009 Federal Register (74 FR 29453), we published the Medicaid... all of the three target groups in one HCBS waiver (74 FR 29453). We sought public comments on how we... Medicaid home and community-based services (HCBS) waivers under section 1915(c) of the Social Security...

  3. Management of intestinal failure in inflammatory bowel disease: Small intestinal transplantation or home parenteral nutrition?

    PubMed Central

    Harrison, Elizabeth; Allan, Philip; Ramu, Amrutha; Vaidya, Anil; Travis, Simon; Lal, Simon

    2014-01-01

    Inflammatory bowel disease and Crohn’s disease in particular, is a common cause of intestinal failure. Current therapeutic options include home parenteral nutrition and intestinal transplantation. For most patients, home intravenous therapy including parenteral nutrition, with a good probability of long-term survival, is the favoured choice. However, in selected patients, with specific features that may shorten survival or complicate home parenteral nutrition, intestinal transplantation presents a viable alternative. We present survival, complications, quality of life and economic considerations that currently influence individualised decision-making between home parenteral nutrition and intestinal transplantation. PMID:24696601

  4. Prescription drugs in nursing homes: managing costs and quality in a complex environment.

    PubMed

    Mendelson, Dan; Ramchand, Rajeev; Abramson, Richard; Tumlinson, Anne

    2002-11-12

    This brief provides a description of prescription drug use in nursing homes and a summary of current policy issues in this area. The brief first profiles the nursing home pharmaceutical market, outlining the major trends in demographics and drug utilization, the supply chain by which drugs go from manufacturers to pharmacies to nursing home residents, and the alternative arrangements by which prescription drugs in nursing homes are financed. The brief then provides a synopsis of current policy issues, focusing in turn on cost containment and quality improvement initiatives. PMID:12463231

  5. Strategies for classifying patients based on office, home, and ambulatory blood pressure measurement.

    PubMed

    Zhang, Lu; Li, Yan; Wei, Fang-Fei; Thijs, Lutgarde; Kang, Yuan-Yuan; Wang, Shuai; Xu, Ting-Yan; Wang, Ji-Guang; Staessen, Jan A

    2015-06-01

    Hypertension guidelines propose home or ambulatory blood pressure monitoring as indispensable after office measurement. However, whether preference should be given to home or ambulatory monitoring remains undetermined. In 831 untreated outpatients (mean age, 50.6 years; 49.8% women), we measured office (3 visits), home (7 days), and 24-h ambulatory blood pressures. We applied hypertension guidelines for cross-classification of patients into normotension or white-coat, masked, or sustained hypertension. Based on office and home blood pressures, the prevalence of white-coat, masked, and sustained hypertension was 61 (10.3%), 166 (20.0%), and 162 (19.5%), respectively. Using daytime (from 8 am to 6 pm) instead of home blood pressure confirmed the cross-classification in 575 patients (69.2%), downgraded risk from masked hypertension to normotension (n=24) or from sustained to white-coat hypertension (n=9) in 33 (4.0%), but upgraded risk from normotension to masked hypertension (n=179) or from white-coat to sustained hypertension (n=44) in 223 (26.8%). Analyses based on 24-h ambulatory blood pressure were confirmatory. In adjusted analyses, both the urinary albumin-to-creatinine ratio (+20.6%; confidence interval, 4.4-39.3) and aortic pulse wave velocity (+0.30 m/s; confidence interval, 0.09-0.51) were higher in patients who moved up to a higher risk category. Both indexes of target organ damage and central augmentation index were positively associated (P≤0.048) with the odds of being reclassified. In conclusion, for reliably diagnosing hypertension and starting treatment, office measurement should be followed by ambulatory blood pressure monitoring. Using home instead of ambulatory monitoring misses the high-risk diagnoses of masked or sustained hypertension in over 25% of patients. PMID:25870194

  6. Research and Development of Information and Communication Technology-based Home Blood Pressure Monitoring from Morning to Nocturnal Hypertension.

    PubMed

    Kario, Kazuomi; Tomitani, Naoko; Matsumoto, Yuri; Hamasaki, Haruna; Okawara, Yukie; Kondo, Maiko; Nozue, Ryoko; Yamagata, Hiromi; Okura, Ayako; Hoshide, Satoshi

    2016-01-01

    . These data are now collected using an information and communication technology (ICT)-based monitoring system. The BP variability includes different time-phase variability from the shortest beat-by-beat, positional, diurnal, day-by-day, visit-to-visit, seasonal, and the longest yearly changes. The synergistic resonance of each type of BP variability would produce great dynamic BP surges, which trigger cardiovascular events. Thus, in the future, the management of HTN based on the simultaneous assessment of the resonance of all of the BP variability phenotypes using a wearable "surge" BP monitoring device with an ICT-based data analysis system will contribute to the ultimate individualized medication for cardiovascular disease. PMID:27372530

  7. Facilitators and barriers to self-management of nursing home residents: perspectives of health-care professionals in Korean nursing homes

    PubMed Central

    Park, Yeon-Hwan; Bang, Hwal Lan; Kim, Ga Hye; Ha, Ji Yeon

    2015-01-01

    Purpose To explore facilitators and barriers to self-management from the viewpoint of staff taking care of nursing home (NH) residents with chronic diseases in South Korea. Patients and methods A qualitative content analysis was done using the focus group interview method. A total of 23 health-care professionals (16 registered nurses and 7 social workers) were interviewed from three urban NHs, each with more than 100 beds. Results Five facilitators were identified: grouping the residents; the resident’s awareness of his/her current health status; the willingness of residents to engage in self-management; residence in the facility; and support from the staff. Additionally, seven barriers were identified: deterioration of the resident’s health; the dependency expectations of the resident; hesitation in asking for help; difference in expectations between the staff and the resident’s family; insufficient staffing and time; lack of standardized guidelines; and conservative tendencies of the staff due to rigid policies. Conclusion The findings of this study can help health-care professionals recognize the factors that influence self-management and provide direction for registered nurses and other health professionals involved in supporting self-management programs for NH residents. PMID:26491277

  8. Associations of Caregiver Stress with Working Conditions, Caregiving Practices, and Child Behaviour in Home-Based Child Care

    ERIC Educational Resources Information Center

    Rusby, Julie C.; Jones, Laura Backen; Crowley, Ryann; Smolkowski, Keith

    2013-01-01

    Home-based child caregivers face unique stressors related to the nature of their work. One hundred and fifty-five home-based child care providers in Oregon, USA, participated in this cross-sectional correlational study. We investigated associations between indicators of caregiver stress and child care working conditions, the quality of caregiver…

  9. Home management of febrile convulsion in an African population: a comparison of urban and rural mothers' knowledge attitude and practice.

    PubMed

    Ofovwe, G E; Ibadin, O M; Ofovwe, E C; Okolo, A A

    2002-08-15

    To determine the knowledge, attitude and practice (KAP) of home management of febrile convulsion (FC), by mothers in the community, focus group discussions (FGD) were conducted in two communities, Uselu (urban) and Evbuomodu village (rural), both in Edo State, Southern Nigeria. The study was conducted between December 2000 and February 2001. Our findings show that 71% of urban mothers compared to 25% of rural mothers attributed the cause of FC to fever (chi(2)=24.17: p<0.001). Seventy-five percent of mothers from rural community and 28.6% of urban mothers attributed the cause to witchcraft and/or evil spirits. Twenty-five percent of rural mothers also attributed abnormality of the spleen as a cause of FC. All the mothers, both urban and rural, were not directly involved in the management of the convulsive episode due to panic and confusion. Ninety-two percent of urban and all the rural mothers permitted the use of traditional medicine while 7.1% of urban mothers employed prayers during convulsion. Twenty percent of urban and twenty-two percent of rural mothers use urine (human and or cow's) for treating FC at home. Other home remedies include kerosene, fuel and crude oil. Mass enlightenment campaign for the community, especially the rural, against use of harmful traditional remedies to treat FC at home is strongly advised. PMID:12127675

  10. XLearning Object Organization Behaviors in a Home-Made Learning Content Management System

    ERIC Educational Resources Information Center

    Akpinar, Yavuzz; Simsek, Huseyin

    2006-01-01

    This study designed, implemented and evaluated a learning content management system to facilitate creating both standard based and free style learning objects. The system, BULeCoMas, also enabled users to tag learning objects with usage data and tools supported with components accommodated under a Global Activity Center, are Global Task Pool,…

  11. Effectiveness of nursing home staff as managers of disruptive behavior: perceptions of nursing directors.

    PubMed

    Borson, S; Reichman, W E; Coyne, A C; Rovner, B; Sakauye, K

    2000-01-01

    Nursing directors of 899 geographically diverse skilled nursing facilities reported substantial limitations in the competence of staff at all levels in managing behaviorally disturbed patients and a broad-based need for improvements in skills. The authors propose an interdisciplinary team training model as an appropriate design for improving competence and promoting collaborative care. PMID:10910425

  12. An evaluation of patient self-testing competency of prothrombin time for managing anticoagulation: pre-randomization results of VA Cooperative Study #481--The Home INR Study (THINRS).

    PubMed

    Dolor, Rowena J; Ruybalid, R Lynne; Uyeda, Lauren; Edson, Robert G; Phibbs, Ciaran; Vertrees, Julia E; Shih, Mei-Chiung; Jacobson, Alan K; Matchar, David B

    2010-10-01

    Prior studies suggest patient self-testing (PST) of prothrombin time (PT) can improve the quality of anticoagulation (AC) and reduce complications (e.g., bleeding and thromboembolic events). "The Home INR Study" (THINRS) compared AC management with frequent PST using a home monitoring device to high-quality AC management (HQACM) with clinic-based monitoring on major health outcomes. A key clinical and policy question is whether and which patients can successfully use such devices. We report the results of Part 1 of THINRS in which patients and caregivers were evaluated for their ability to perform PST. Study-eligible patients (n = 3643) were trained to use the home monitoring device and evaluated after 2-4 weeks for PST competency. Information about demographics, medical history, warfarin use, medications, plus measures of numeracy, literacy, cognition, dexterity, and satisfaction with AC were collected. Approximately 80% (2931 of 3643) of patients trained on PST demonstrated competency; of these, 8% (238) required caregiver assistance. Testers who were not competent to perform PST had higher numbers of practice attempts, higher cuvette wastage, and were less able to perform a fingerstick or obtain blood for the cuvette in a timely fashion. Factors associated with failure to pass PST training included increased age, previous stroke history, poor cognition, and poor manual dexterity. A majority of patients were able to perform PST. Successful home monitoring of PT with a PST device required adequate levels of cognition and manual dexterity. Training a caregiver modestly increased the proportion of patients who can perform PST. PMID:20628787

  13. Grip on challenging behaviour: a multidisciplinary care programme for managing behavioural problems in nursing home residents with dementia. Study protocol

    PubMed Central

    2011-01-01

    Background Behavioural problems are common in nursing home residents with dementia and they often are burdensome for both residents and nursing staff. In this study, the effectiveness and cost-effectiveness of a new care programme for managing behavioural problems will be evaluated. Methods/Design The care programme is based on Dutch national guidelines. It will consist of four steps: detection, analysis, treatment and evaluation. A stepped wedge design will be used. A total of 14 dementia special care units will implement the care programme. The primary outcome is behavioural problems. Secondary outcomes will include quality of life, prescription rate of antipsychotics, use of physical restraints and workload and job satisfaction of nursing staff. The effect of the care programme will be estimated using multilevel linear regression analysis. An economic evaluation from a societal perspective will also be carried out. Discussion The care programme is expected to be cost-effective and effective in decreasing behavioural problems, workload of nursing staff and in increasing quality of life of residents. Trial registration The Netherlands National Trial Register (NTR). Trial number: NTR 2141 PMID:21338502

  14. The Critical Role of Social Workers in Home Based Primary Care

    PubMed Central

    Reckrey, Jennifer M.; Gettenberg, Gabrielle; Ross, Helena; Kopke, Victoria; Soriano, Theresa; Ornstein, Katherine

    2016-01-01

    The growing homebound population has many complex biomedical and psychosocial needs and requires a team based approach to care (Smith, Ornstein, Soriano, Muller, & Boal, 2006). The [XX] Visiting Doctors Program (MSVD), a large interdisciplinary home based primary care program in [XX], has a vibrant social work program that is integrated into the routine care of homebound patients. We describe the assessment process used by MSVD social workers, highlight examples of successful social work care, and discuss why social workers’ individualized care plans are essential for keeping patients with chronic illness living safely in the community. Despite barriers to widespread implementation, such social work involvement within similar home based clinical programs is essential in the interdisciplinary care of our most needy patients. PMID:24717182

  15. Home health care

    MedlinePlus

    ... and exercises, wound care, and daily living. Home health care nurses can help manage problems with your wound, ... Centers for Medicare and Medicaid Services. Home health care: what it is and what to expect. ... ...

  16. Home-based care provision within the German welfare mix.

    PubMed

    Theobald, Hildegard

    2012-05-01

    With the introduction of long-term care insurance (LTCI) in 1995/96, Germany established a universal long-term care scheme within a cost containment framework to provide public support in defined situations of care dependency. The scheme aimed to promote ageing in place with an emphasis on public support for family care provision as a precondition. A further aim was the expansion of market-oriented professional care services to offer users a choice between family and professional care provision and care providers. The focus of this study is on the interplay of formal and informal family care provision within the institutional framework of LTCI, as well as the organisation, regulations and mix of different types of formal care services. In a first step, an examination of the interplay of formal and informal care provision shows the largely family-oriented care strategy, the burdened situation of informal carers, the mix of rationalities of service use and their interrelationship with socioeconomic inequality. In a second step, an analysis of the organisation of different types of formal services reveals paid care provision that emerges in the interplay of politicians' strategies to develop professional care services within the framework of LTCI, bottom-up strategies of users to increase the range of services outside the framework of LTCI and efforts of politicians to regulate the latter. Basic orientations of care provision underlying the development process such as user orientation, quality and comprehensiveness guided the process and are used to analyse the development. Finally, the discussion of the situation of care workers reveals a contradictory picture with increasing employment opportunities, a comparably well-qualified workforce and worsening employment conditions. Empirically, the research is based on an institutional analysis of LTCI combined with a literature review and representative statistics. PMID:22462396

  17. Visual homing in the absence of feature-based landmark information.

    PubMed

    Gillner, Sabine; Weiss, Anja M; Mallot, Hanspeter A

    2008-10-01

    Despite that fact that landmarks play a prominent role in human navigation, experimental evidence on how landmarks are selected and defined by human navigators remains elusive. Indeed, the concept of a 'landmark' is itself not entirely clear. In everyday language, the term landmark refers to salient, distinguishable, and usually nameable objects, rendering the problem of landmark recognition a special case of the general object recognition problem. In contrast, in the insect and robot literature, this notion of landmarks is often replaced by the "local position information" [e.g., Trullier, O., Wiener, S., Berthoz, A., & Meyer, J.-A. (1997). Biologically based artificial navigation systems: Review and prospects. Progress in Neurobiology, 51, 483-544], referring to the entire set of sensor readings obtained at one location. This set may then serve as a characteristic of the particular location. Honey bees have been shown to base place recognition and homing on a snapshot-like memory of the place's visual environment, not on the distances to recognized objects [Cartwright, B., & Collett, T. (1983). Landmark learning in bees. Experiments and models. Journal of Comparative Physiology A, 151, 521-543]. A number of theoretical models of snapshot-based homing [e.g., Franz, M., Schölkopf, B., Mallot, H. A., Bülthoff, H. H. (1998). Where did I take that snapshot? Scene-based homing by image matching. Biological Cybernetics, 79, 191-202; Vardy, A., & Möller, R. (2005). Biologically plausible visual homing methods based on optical flow techniques. Connection Science, 17, 47-89] predict that the accuracy of snapshot-based homing should depend on image contrast. For rodent hippocampal place fields, models have been developed using additional image information such as three-dimensional depth and allocentric orientations (e.g., room axes) and are thus less sensitive to image contrast and noise [e.g. Barry, C., Lever, C., Hayman, R., Hartley, T., Burton, S., O'Keefe, J., et al

  18. The impact of managed competition on diversity, innovation and creativity in the delivery of home-care services.

    PubMed

    Randall, Glen E

    2008-07-01

    Reforming publicly funded healthcare systems by introducing elements of competition, often by allowing for-profit providers to compete with not-for-profit providers, is a strategy that has become commonplace in Western democracies. It is widely thought that the competitive forces of the marketplace will lead to greater efficiency, diversity and even innovation in the delivery of services. Between 1997 and 2000, a model of 'managed competition' was introduced as a major reform to the delivery of home-care services in Ontario, Canada. It was expected that by allowing greater competition within the home-care sector, this model would constrain costs and encourage provider agencies to become more innovative and creative in meeting service delivery needs. The purpose of this case study is to explore the impact of the managed competition reform on the for-profit and the not-for-profit organisations that provided rehabilitation home-care services, and, more specifically, to assess the extent to which the goal of greater diversity, innovation and creativity was achieved following implementation of the reform. A purposive sample of 49 key informants were selected for in-depth interviews, and a survey of the 36 organisations that provided rehabilitation home-care services and the 43 community care access centres that purchased services from these provider agencies was conducted. Data were collected between November 2002 and May 2003. Findings demonstrate that a combination of coercive, mimetic and normative isomorphic pressures have constrained diversity, innovation and creativity within the home-care sector. The implication is that the features that have traditionally distinguished for-profit and not-for-profit provider agencies from each other are rapidly disappearing, and a new hybrid organisational structure is evolving. PMID:18613910

  19. Managing geometric information with a data base management system

    NASA Technical Reports Server (NTRS)

    Dube, R. P.

    1984-01-01

    The strategies for managing computer based geometry are described. The computer model of geometry is the basis for communication, manipulation, and analysis of shape information. The research on integrated programs for aerospace-vehicle design (IPAD) focuses on the use of data base management system (DBMS) technology to manage engineering/manufacturing data. The objectives of IPAD is to develop a computer based engineering complex which automates the storage, management, protection, and retrieval of engineering data. In particular, this facility must manage geometry information as well as associated data. The approach taken on the IPAD project to achieve this objective is discussed. Geometry management in current systems and the approach taken in the early IPAD prototypes are examined.

  20. Older Adult Perceptions of Participation in Group- and Home-Based Falls Prevention Exercise.

    PubMed

    Robins, Lauren M; Hill, K D; Day, Lesley; Clemson, Lindy; Finch, Caroline; Haines, Terry

    2016-07-01

    This paper describes why older adults begin, continue, and discontinue group- and home-based falls prevention exercise and benefits and barriers to participation. Telephone surveys were used to collect data for 394 respondents. Most respondents reported not participating in group- (66%) or home-based (78%) falls prevention exercise recently. Reasons for starting group-based falls prevention exercise include health benefits (23-39%), health professional recommendation (13-19%), and social interaction (4-16%). They discontinued because the program finished (44%) or due to poor health (20%). Commonly reported benefits were social interaction (41-67%) and health (15-31%). Disliking groups was the main barrier (2-14%). Home-based falls prevention exercise was started for rehabilitation (46-63%) or upon health professional recommendation (22-48%) and stopped due to recovery (30%). Improvement in health (18-46%) was the main benefit. These findings could assist health professionals in prescribing group-based falls prevention exercise by considering characteristics of older adults who perceive social interaction to be beneficial. PMID:26539657

  1. Testing a Theory-Based Mobility Monitoring Protocol Using In-Home Sensors: A Feasibility Study

    PubMed Central

    Reeder, Blaine; Chung, Jane; Lazar, Amanda; Joe, Jonathan; Demiris, George; Thompson, Hilaire J.

    2014-01-01

    Mobility is a key factor in the performance of many everyday tasks required for independent living as a person grows older. The purpose of this mixed methods study was to test a theory-based mobility monitoring protocol by comparing sensor-based measures to self-report measures of mobility and assessing the acceptability of in-home sensors with older adults. Standardized instruments to measure physical, psychosocial and cognitive parameters were administered to 8 community-dwelling older adults at baseline, 3 month and 6 month visits (examples: FES, GDS-SF, Mini-cog). Semi-structured interviews to characterize acceptability of the technology were conducted at 3 month and 6 month visits. Technical issues prevented comparison of sensor-based measures with self-report measures. In-home sensor technology for monitoring mobility is acceptable to older adults. Implementing our theory-based mobility monitoring protocol in a field study in the homes of older adults is a feasible undertaking but requires more robust technology for sensor-based measure validation. PMID:23938159

  2. Effect of home-based well-rounded exercise in community-dwelling older adults.

    PubMed

    Yamauchi, Tomoko; Islam, Mohammod M; Koizumi, Daisuke; Rogers, Michael E; Rogers, Nicole L; Takeshima, Nobuo

    2005-12-01

    The purpose of this study was to assess the efficacy of a home-based well-rounded exercise program (WREP) in older adults. Forty sedentary community-dwelling older adults were randomly assigned to an exercise group (n = 23; aged 62-80 yr, average: 69.2 ± 5.2; 12 men and 11 women) or a control group (n = 17; aged 63-85 yr, average: 70.1 ± 6.6; 5 men and 12 women). The exercise group performed a 12-wk WREP which included aerobic exercise (walking) on about 3 days·wk(-1) for 37 min·day(-1); elastic band-based resistance exercises for the major muscle groups on about 3 days·wk(-1) for 26 min; and flexibility exercises (stretching) on about 4 days·wk(-1) for 19 min·day(-1). General physical characteristics, functional strength (Arm Curl [AC], Chair Stand [CS]), dynamic balance and agility (Up & Go [UG]), flexibility (Back Scratch [BS], Sit & Reach [SR]), and endurance (12-min walk [12-MW]) were measured. Following the 12-wk home-based WREP, improvements were observed in AC, CS, UG, BS, SR and 12-MW for the exercise group but not for the control group. These results suggest that the home-based WREP can improve overall fitness in older adults. Key PointsWalking, elastic band exercise and stretching were prescribed as a Well-Rounded Exercise Program for older adults.By combining aerobic, resistance and flexibility exercises, a Well-Rounded Exercise Program was effective for improving endurance, functional strength, dynamic balance and agility, and flexibility.Community-based exercise classes motivated older adults to perform home-based exercises. PMID:24501569

  3. Design of Alarm Sound of Home Care Equipment Based on Age-related Auditory Sense

    NASA Astrophysics Data System (ADS)

    Shibano, Jun-Ichi; Tadano, Shigeru; Kaneko, Hirotaka

    A wide variety of home care equipment has been developed to support the independent lifestyle and care taking of elderly persons. Almost all of the equipment has an alarm designed to alert a care person or to sound a warning in case of an emergency. Due to the fact that aging human beings' senses physiologically, weaken and deteriorate, each alarm's sound must be designed to account for the full range of elderly person's hearing loss. Since the alarms are usually heard indoors, it is also necessary to evaluate the relationship between the basic characteristics of the sounds and living area's layout. In this study, we investigated the sounds of various alarms of the home care equipment based on both the age-related hearing characteristics of elderly persons and the propagation property of the sounds indoors. As a result, it was determined that the hearing characteristics of elderly persons are attuned to sounds which have a frequency from 700Hz to 1kHz, and it was learned that the indoor absorption ratio of sound is smallest when the frequency is 1kHz. Therefore, a frequency of 1kHz is good for the alarm sound of home care equipment. A flow chart to design the alarm sound of home care equipment was proposed, taking into account the extent of age-related auditory sense deterioration.

  4. Translating an Evidence-Based Injury Prevention Program for Implementation in a Home Visitation Setting.

    PubMed

    Nicks, Shannon E; Weaver, Nancy L; Recktenwald, Angela; Jupka, Keri A; Elkana, Maia; Tompkins, Ron

    2016-07-01

    Safe N' Sound (SNS), a computer-based childhood injury prevention program, provides individually tailored information to parents about their child's injury risks with specific behavioral recommendations. We translated SNS for implementation in a home visitation organization in order to increase its capacity to effectively address injury prevention and decrease the burden of injury experienced by high-need families. The aim of this study was to identify behavioral and organizational barriers and facilitators to translating and implementing SNS in a home visitation setting. Nurse home visitors (NHVs) participated in semistructured interviews that examined perceptions of program implementation, intervention characteristics, individual characteristics of NHVs, and recommendations for improving implementation. The utility of the program for promoting injury prevention systematically and its alignment with the organization's mission were facilitators of successful implementation. Barriers included NHVs' concerns about overburdening clients and missed educational opportunities related to injury risks not addressed by the program and delayed delivery of educational reports. Findings illustrate the dynamic interactions of intervention characteristics with organizational and individual factors and suggest that customizing implementation to organizational capacity and specific needs may better support successful program implementation in home visitation settings. PMID:26826110

  5. A randomized controlled trial of telephone-mentoring with home-based walking preceding rehabilitation in COPD

    PubMed Central

    Cameron-Tucker, Helen Laura; Wood-Baker, Richard; Joseph, Lyn; Walters, Julia A; Schüz, Natalie; Walters, E Haydn

    2016-01-01

    Purpose With the limited reach of pulmonary rehabilitation (PR) and low levels of daily physical activity in chronic obstructive pulmonary disease (COPD), a need exists to increase daily exercise. This study evaluated telephone health-mentoring targeting home-based walking (tele-rehab) compared to usual waiting time (usual care) followed by group PR. Patients and methods People with COPD were randomized to tele-rehab (intervention) or usual care (controls). Tele-rehab delivered by trained nurse health-mentors supported participants’ home-based walking over 8–12 weeks. PR, delivered to both groups simultaneously, included 8 weeks of once-weekly education and self-management skills, with separate supervised exercise. Data were collected at three time-points: baseline (TP1), before (TP2), and after (TP3) PR. The primary outcome was change in physical capacity measured by 6-minute walk distance (6MWD) with two tests performed at each time-point. Secondary outcomes included changes in self-reported home-based walking, health-related quality of life, and health behaviors. Results Of 65 recruits, 25 withdrew before completing PR. Forty attended a median of 6 (4) education sessions. Seventeen attended supervised exercise (5±2 sessions). Between TP1 and TP2, there was a statistically significant increase in the median 6MWD of 12 (39.1) m in controls, but no change in the tele-rehab group. There were no significant changes in 6MWD between other time-points or groups, or significant change in any secondary outcomes. Participants attending supervised exercise showed a nonsignificant improvement in 6MWD, 12.3 (71) m, while others showed no change, 0 (33) m. The mean 6MWD was significantly greater, but not clinically meaningful, for the second test compared to the first at all time-points. Conclusion Telephone-mentoring for home-based walking demonstrated no benefit to exercise capacity. Two 6-minute walking tests at each time-point may not be necessary. Supervised exercise

  6. An Economic Evaluation of Home Management of Malaria in Uganda: An Interactive Markov Model

    PubMed Central

    Lubell, Yoel; Mills, Anne J.; Whitty, Christopher J. M.; Staedke, Sarah G.

    2010-01-01

    Background Home management of malaria (HMM), promoting presumptive treatment of febrile children in the community, is advocated to improve prompt appropriate treatment of malaria in Africa. The cost-effectiveness of HMM is likely to vary widely in different settings and with the antimalarial drugs used. However, no data on the cost-effectiveness of HMM programmes are available. Methods/Principal Findings A Markov model was constructed to estimate the cost-effectiveness of HMM as compared to conventional care for febrile illnesses in children without HMM. The model was populated with data from Uganda, but is designed to be interactive, allowing the user to adjust certain parameters, including the antimalarials distributed. The model calculates the cost per disability adjusted life year averted and presents the incremental cost-effectiveness ratio compared to a threshold value. Model output is stratified by level of malaria transmission and the probability that a child would receive appropriate care from a health facility, to indicate the circumstances in which HMM is likely to be cost-effective. The model output suggests that the cost-effectiveness of HMM varies with malaria transmission, the probability of appropriate care, and the drug distributed. Where transmission is high and the probability of appropriate care is limited, HMM is likely to be cost-effective from a provider perspective. Even with the most effective antimalarials, HMM remains an attractive intervention only in areas of high malaria transmission and in medium transmission areas with a lower probability of appropriate care. HMM is generally not cost-effective in low transmission areas, regardless of which antimalarial is distributed. Considering the analysis from the societal perspective decreases the attractiveness of HMM. Conclusion Syndromic HMM for children with fever may be a useful strategy for higher transmission settings with limited health care and diagnosis, but is not appropriate for all

  7. A Correlational Study of Telework Frequency, Information Communication Technology, and Job Satisfaction of Home-Based Teleworkers

    ERIC Educational Resources Information Center

    Webster-Trotman, Shana P.

    2010-01-01

    In 2008, 33.7 million Americans teleworked from home. The Telework Enhancement Act (S. 707) and the Telework Improvements Act (H.R. 1722) of 2009 were designed to increase the number of teleworkers. The research problem addressed was the lack of understanding of factors that influence home-based teleworkers' job satisfaction. Job dissatisfaction…

  8. Coping with pilot stress: resting at home compared with resting away from home.

    PubMed

    Cooper, C L; Sloan, S J

    1987-12-01

    This study assessed the impact of "resting at home" vs. "resting away from home" among 272 British commercial airline pilots. The purpose of the investigation was two-fold; to see whether resting at home and resting away from home are equivalent in the quality of rest they provide pilots (in view of the increasing trend in the industry for encouraging pilots to "rest while away from home base"); and second, to highlight the factors that may be predictive of poor mental health and mood shifts while resting away or at home. On balance, pilots away from home managed to rest, but not really to relax (from a psychological perspective). Explanations of this are discussed, based on bi-variate and multi-variate statistical analyses. PMID:3426491

  9. Home-Based Care Program Reduces Disability And Promotes Aging In Place.

    PubMed

    Szanton, Sarah L; Leff, Bruce; Wolff, Jennifer L; Roberts, Laken; Gitlin, Laura N

    2016-09-01

    The Community Aging in Place, Advancing Better Living for Elders (CAPABLE) program, funded by the Center for Medicare and Medicaid Innovation, aims to reduce the impact of disability among low-income older adults by addressing individual capacities and the home environment. The program, described in this innovation profile, uses an interprofessional team (an occupational therapist, a registered nurse, and a handyman) to help participants achieve goals they set. For example, it provides assistive devices and makes home repairs and modifications that enable participants to navigate their homes more easily and safely. In the period 2012-15, a demonstration project enrolled 281 adults ages sixty-five and older who were dually eligible for Medicare and Medicaid and who had difficulty performing activities of daily living (ADLs). After completing the five-month program, 75 percent of participants had improved their performance of ADLs. Participants had difficulty with an average of 3.9 out of 8.0 ADLs at baseline, compared to 2.0 after five months. Symptoms of depression and the ability to perform instrumental ADLs such as shopping and managing medications also improved. Health systems are testing CAPABLE on a larger scale. The program has the potential to improve older adults' ability to age in place. PMID:27605633

  10. Home-Based and Facility-Based Directly Observed Therapy of Tuberculosis Treatment under Programmatic Conditions in Urban Tanzania

    PubMed Central

    Hella, Jerry; Maroa, Thomas; Kisandu, Shadrack; Chiryamkubi, Magreth; Said, Khadija; Mhalu, Grace; Mkopi, Abdallah; Mutayoba, Beatrice; Reither, Klaus; Gagneux, Sébastien; Fenner, Lukas

    2016-01-01

    Introduction Decentralization of Directly Observed Treatment (DOT) for tuberculosis (TB) to the community (home-based DOT) has improved the coverage of TB treatment and reduced the burden to the health care facilities (facility-based DOT). We aimed to compare TB treatment outcomes in home-based and facility-based DOT under programmatic conditions in an urban setting with a high TB burden. Methodology A retrospective analysis of a cohort of adult TB patients (≥15 years) routinely notified between 2010 and 2013 in two representative TB sub-districts in the Temeke district, Dar es Salaam, Tanzania. We assessed differences in treatment outcomes by calculating Risk Ratios (RRs). We used logistic regression to assess the association between DOT and treatment outcomes. Results Data of 4,835 adult TB patients were analyzed, with a median age of 35 years, 2,943 (60.9%) were men and TB/HIV co-infection prevalence of 39.9%. A total of 3,593 (74.3%) patients were treated under home-based DOT. Patients on home-based DOT were more likely to die compared to patients on facility-based DOT (RR 2.04, 95% Confidence Interval [95% CI]: 1.52–2.73), and more likely to complete TB treatment (RR 1.14, 95% CI: 1.06–1.23), but less likely to have a successful treatment outcome (RR 0.94, 95% CI: 0.92–0.97). Home-based DOT was preferred by women (adjusted Odds Ratio [aOR] 1.55, 95% CI: 1.34–1.80, p<0.001), older people (aOR 1.01 for each year increase, 95% CI: 1.00–1.02, p = 0.001) and patients with extra-pulmonary TB (aOR 1.45, 95% CI: 1.16–1.81, p = 0.001), but less frequently by patients on a retreatment regimen (aOR 0.12, 95% CI: 0.08–0.19, p<0.001). Conclusions/significance TB patients under home-based DOT had more frequently risk factors of death such as older age, HIV infection and sputum smear-negative TB, and had higher mortality compared to patients under facility-based DOT. Further operational research is needed to monitor the implementation of DOT under

  11. Analyzing the Interprofessional Working of a Home-Based Primary Care Team.

    PubMed

    Smith-Carrier, Tracy; Neysmith, Sheila

    2014-09-01

    Increasingly, interprofessional teams are responsible for providing integrated health care services. Effective teams, however, are not the result of chance but require careful planning and ongoing attention to team processes. Based on a case study involving interviews, participant observation, and a survey, we identified key attributes for effective interprofessional working (IPW) within a home-based primary care (HBPC) setting. Recognizing the importance of a theoretical model that reflects the multidimensional nature of team effectiveness research, we employed the integrated team effectiveness model to analyze our findings. The results indicated that a shared vision, common goals, respect, and trust among team members – as well as processes for ongoing communication, effective leadership, and mechanisms for conflict resolution – are vital in the development of a high-functioning IPW team. The ambiguity and uncertainty surrounding the context of service provision (clients' homes), as well the negotiation of external relationships in the HBPC field, require further investigation. PMID:26261888

  12. Transition to an elastomeric infusion pump in home care: an evidence-based approach.

    PubMed

    Broadhurst, Daphne

    2012-01-01

    A fatal overdose of a chemotherapeutic agent delivered to a patient via an electronic infusion device served as a stark reminder of the risks that infusion therapy poses to patients and health care providers and as the impetus for a strategy to optimize safe and efficient delivery of home infusion therapy. The Academic Center for Evidence-Based Practice Star Model of Knowledge Transformation was used as the evidence-based framework for the implementation of a portable infusion pump that supports home infusion of high-risk medications, leading to increased patient and caregiver satisfaction. Evaluation of this implementation supports the use of an elastomeric infusion device for a high-risk therapy. PMID:22498484

  13. Evaluation of A Novel Information-Sharing Instrument for Home-Based Palliative Care

    PubMed Central

    Sawada, Koichiro; Shimada, Masanari; Kadoya, Shinichi; Endo, Naoki; Ishiguro, Kaname; Takashima, Rumi; Amemiya, Yoko; Fujikawa, Yasunaga; Ikezaki, Tomoaki; Takeuchi, Miyako; Kitazawa, Hidenori; Iida, Hiroyuki; Koseki, Shiro; Morita, Tatsuya; Sasaki, Koji; Kashii, Tatsuhiko; Murakami, Nozomu

    2015-01-01

    Aim: To examine the feasibility and usefulness of a novel region-based pathway: the Regional Referral Clinical Pathway for Home-Based Palliative Care. Method: This was a feasibility study to evaluate the frequency of variances and the perceived usefulness of pathway using in-depth interviews. All patients with cancer referred to the palliative care team between 2011 and 2013 and received home care services were enrolled. Result: A total of 44 patients were analyzed, and pathway was completed in all the patients. The target outcome was achieved in 61.4% while some variances occurred in 54.5%. Nine categories were identified as the usefulness of the pathway, such as reviewing and sharing information and promoting communication, education, motivation, and relationships. Conclusion: This novel pathway is feasible and seems to be useful. PMID:24814723

  14. Investment in home-based maternal, newborn and child health records improves immunization coverage in Indonesia.

    PubMed

    Osaki, K; Hattori, T; Kosen, Soewarta; Singgih, Budihardja

    2009-08-01

    Indonesia Demographic and Health Surveys show that the ownership of home-based immunization records among children aged 12-23 months increased from 30.8% in 1997 and 30.7% in 2002-3 to 37% in 2007. In 2002-3, 70.9% of children who owned records had received all vaccines by the time of the survey, whereas 42.9% of children who did not own records had been fully immunized. An Indonesian ministerial decree of 2004 stated that the Maternal and Child Health Handbook (MCH handbook) was to be the only home-based record of maternal, newborn and child health. The increased immunization coverage seen would be a reflection of MCH handbook implementation, through raising awareness of immunization among community and health personnel and children's parents or guardians and allowing more accurate measurement of immunization coverage. PMID:19375141

  15. Creating technological boundaries to protect bedtime: examining work-home boundary management, psychological detachment and sleep.

    PubMed

    Barber, Larissa K; Jenkins, Jade S

    2014-08-01

    This study examined the mechanism by which information and communication technology (ICT) use at home for work purposes may affect sleep. In this investigation, data from 315 employees were used to examine the indirect effect of ICT use at home on sleep outcomes through psychological detachment, and how boundary creation may moderate this effect. Results revealed the indirect effect of increased work-home boundary crossing on sleep (quantity, quality and consistency) through psychological detachment occurred only among individuals with low boundaries around ICT use and not among those with high boundaries. These results suggest that creating boundaries around work-relevant ICT use while at home is beneficial to sleep as a recovery process through being able to psychologically disengage from work. PMID:24123651

  16. Managing children's postural risk when using mobile technology at home: Challenges and strategies.

    PubMed

    Ciccarelli, Marina; Chen, Janice D; Vaz, Sharmila; Cordier, Reinie; Falkmer, Torbjörn

    2015-11-01

    Maintaining the musculoskeletal health of children using mobile information and communication technologies (ICT) at home presents a challenge. The physical environment influences postures during ICT use and can contribute to musculoskeletal complaints. Few studies have assessed postures of children using ICT in home environments. The present study investigated the Rapid Upper Limb Assessment (RULA) scores determined by 16 novice and 16 experienced raters. Each rater viewed 11 videotaped scenarios of a child using two types of mobile ICT at home. The Grand Scores and Action Levels determined by study participants were compared to those of an ergonomist experienced in postural assessment. All postures assessed were rated with an Action Level of 2 or above; representing a postural risk that required further investigation and/or intervention. The sensitivity of RULA to assess some of the unconventional postures adopted by children in the home is questioned. PMID:26154217

  17. The uniqueness of elderly care: registered nurses' experience as preceptors during clinical practice in nursing homes and home-based care.

    PubMed

    Carlson, Elisabeth; Bengtsson, Mariette

    2014-04-01

    The expected shortage of registered nurses with an advanced degree as specialists in geriatric care or gerontology is imminent. Previous studies report that clinical practice where student nurses are supervised by registered nurses has a direct impact on how students perceive nursing as a profession and future career choice. Considering the anticipated need for well-educated and specialised nurses it is therefore, relevant as well as necessary to describe clinical learning with a focus on preceptorship in geriatric nursing care. This paper is a report of a study describing registered nurses' experience of precepting undergraduate student nurses during clinical practice in nursing homes and home-based care. A qualitative design, based on seven focus group interviews, was employed with 30 registered nurses with preceptor experience from nursing homes and home-based care for the elderly. Our findings present three precepting strategies that are unique to elderly care: preparing students for end of life care, facilitating a respectful approach to the older person and promoting creativity and independent work. The findings are discussed using a socio-cultural perspective and illustrate how communities of elderly practice can be valuable learning environments. PMID:23954003

  18. Impact of home industries on water quality in a tributary of the Marimba River, Harare: implications for urban water management

    NASA Astrophysics Data System (ADS)

    Mvungi, A.; Hranova, R. K.; Love, D.

    Sustainable use of water resources requires the integration of demand management with source quality management. The City of Harare is a case in point, where wastewater and runoff from the city flow into its reservoirs. Little has yet been established on the quality of runoff from home industries in the high-density urban environment. In Harare, most of these are located close to streams draining into the city’s reservoirs. The impact of runoff from different land uses on water quality in a tributary of the Marimba River, Kuwadzana high-density suburb, Harare, was assessed. The water quality from two sub-catchments, one of which contained home industries and residential areas and the other, which contained residential areas only, was compared over the 2001-2002 rainy season. It was found that phosphate (1.08 mg/l), TKN (3.2 mg/l), ammonia (1.14 mg/l), faecal coliforms (1000/100 ml), iron (6.9 mg/l), and lead (0.53 mg/l) were the major water quality pollutants. The SCS-SA model was used to estimate the runoff in different sampling points. Pollution loads for certain parameters were, on average, four times higher in the sub-catchment containing home industries (287 kg total phosphates, 319 kg TKN nitrate, 115 kg ammonia, 744 kg iron and 41 kg lead), than in the sub-catchment containing residential areas only (74kg total phosphates, 50 kg TKN nitrate, 21 kg ammonia, 138 kg iron and 12 kg lead). This is due to the higher runoff volumes from the area containing the home industries, while the pollution concentrations at both representative points where not statistically different. Accordingly, it is recommended that the City authorities should reassess current practice and make provision for sewer and drainage systems and adequate disposal of solid and hazardous wastes in areas zoned for home industries and to improve the solid waste management in high-density areas. Efforts should be made to control the storage of materials and scrap in these areas. Most importantly

  19. Process Evaluation of a Home-Based Program to Reduce Diet-Related Cancer Risk: The "WIN at Home Series."

    ERIC Educational Resources Information Center

    Finnegan, John R.; And Others

    1992-01-01

    Following media recruitment campaign, WIN at Home, series of diet-related booklets mailed to participants, was evaluated through survey of 226 participants (75 percent). Results showed that 97 percent learned about program through media, women were more likely to learn about it from personal sources, 57 percent shared information with spouses, and…

  20. Effect of home based HIV counselling and testing intervention in rural South Africa: cluster randomised trial

    PubMed Central

    Tabana, Hanani; Jackson, Debra; Naik, Reshma; Zembe, Wanga; Lombard, Carl; Swanevelder, Sonja; Fox, Matthew P; Thorson, Anna; Ekström, Anna Mia; Chopra, Mickey

    2013-01-01

    Objective To assess the effect of home based HIV counselling and testing on the prevalence of HIV testing and reported behavioural changes in a rural subdistrict of South Africa. Design Cluster randomised controlled trial. Setting 16 communities (clusters) in uMzimkhulu subdistrict, KwaZulu-Natal province, South Africa. Participants 4154 people aged 14 years or more who participated in a community survey. Intervention Lay counsellors conducted door to door outreach and offered home based HIV counselling and testing to all consenting adults and adolescents aged 14-17 years with guardian consent. Control clusters received standard care, which consisted of HIV counselling and testing services at local clinics. Main outcome measures Primary outcome measure was prevalence of testing for HIV. Other outcomes were HIV awareness, stigma, sexual behaviour, vulnerability to violence, and access to care. Results Overall, 69% of participants in the home based HIV counselling and testing arm versus 47% in the control arm were tested for HIV during the study period (prevalence ratio 1.54, 95% confidence interval 1.32 to 1.81). More couples in the intervention arm had counselling and testing together than in the control arm (2.24, 1.49 to 3.03). The intervention had broader effects beyond HIV testing, with a 55% reduction in multiple partners (0.45, 0.33 to 0.62) and a stronger effect among those who had an HIV test (0.37, 0.24 to 0.58) and a 45% reduction in casual sexual partners (0.55, 0.42 to 0.73). Conclusions Home based HIV counselling and testing increased the prevalence of HIV testing in a rural setting with high levels of stigma. Benefits also included higher uptake of couple counselling and testing and reduced sexual risk behaviour. Trial registration Current Controlled Trials ISRCTN31271935. PMID:23766483

  1. Clinics and home-based care organisations: an interface between theformal and informal health sectors.

    PubMed

    Boros, Adam Kenneth

    2010-12-01

    The article outlines the findings of a study designed to explore the working relationship between home-based caregivers and clinic nurses at locations in two informal settlements in Johannesburg, South Africa. By considering the views and experiences of both sponsored and unsponsored caregivers, the research focused on how degrees of informality affect this relationship. The nurse/caregiver relationship represents a primary interface between the formal and informal health sectors and is an important part of the country's primary healthcare system. Despite the attention given to linking home-based care (HBC) with the formal health system, very little research has examined the functionality of this link at the ground level. Through a number of qualitative, semi-structured interviews with nurses, home-based caregivers, and staff from the Department of Health, information was collected to better understand what systems are in place to facilitate the relationship between clinics and HBC organisations, and whether these systems are helping to create the desired results. Do the formal and informal health sectors complement and strengthen or do they distract and damage each other? By examining the influence of degrees of informality, the research also lends insight into how this distinction plays a role in healthcare provision. For instance, how does state support impact the link between the formal and informal health sectors and the ultimate quality of care? And what steps can be taken to improve the health system in this regard, as a whole? The findings point to a number of problems and challenges with integrating HBC into the formal health sector. Degrees of informality are found to have a profound impact on the work of home-based caregivers in some respects, but a surprising lack of impact in others. These issues need to be confronted in order to improve the existing system and, ultimately, health outcomes in South Africa. PMID:25875880

  2. Muscle Strength Enhancement Following Home-Based Virtual Cycling Training in Ambulatory Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Chen, Chia-Ling; Hong, Wei-Hsien; Cheng, Hsin-Yi Kathy; Liaw, Mei-Yun; Chung, Chia-Ying; Chen, Chung-Yao

    2012-01-01

    This study is the first well-designed randomized controlled trial to assess the effects of a novel home-based virtual cycling training (hVCT) program for improving muscle strength in children with spastic cerebral palsy (CP). Twenty-eight ambulatory children with spastic CP aged 6-12 years were randomly assigned to an hVCT group (n = 13) or a…

  3. Home-based Exercise among Cancer Survivors: Adherence and its Predictors

    PubMed Central

    Pinto, Bernardine M.; Rabin, Carolyn; Dunsiger, Shira

    2010-01-01

    Objective Evidence of the benefits of exercise for those treated for cancer has led to several exercise interventions for this population. Some have questioned whether cancer patients offered a home-based intervention adhere to the exercise prescribed. Method We examined exercise adherence in a randomized controlled trial of a 12-week, home-based exercise trial for breast cancer patients. Three adherence outcomes were examined: minutes of exercise participation during each week of the intervention, number of steps taken during planned exercise during each intervention week, and whether the participant met her weekly exercise goal. Predictors of adherence (e.g., demographic and medical variables, Transtheoretical Model variables, history of exercise) were examined. Results Findings indicate that participants significantly increased their minutes of exercise and steps taken during planned exercise from the first to the last week of the intervention. The percentage of participants achieving exercise goals was highest in the first few weeks of the intervention. Exercise self-efficacy significantly predicted each adherence outcome. Baseline PA predicted mean exercise session steps over the 12 weeks. Conclusion Adherence to a home-based exercise intervention for breast cancer patients changes over time and may be related to baseline levels of self-efficacy for exercise. PMID:19242921

  4. Managing Inquiry-Based Classrooms

    ERIC Educational Resources Information Center

    Wolfgang, Christie Nicole

    2009-01-01

    Though it may seem that classroom management comes naturally to some teachers, upon closer examination you'll probably discover that preparation and adaptation are more important than any innate ability when it comes to successful classroom management. Any experienced middle school science teacher can tell you that successful classroom management…

  5. Performance-Based Enrollment Management.

    ERIC Educational Resources Information Center

    McIntyre, Chuck

    Accountability in higher education most often concentrates on what and how to measure performance, but less often on how it can be used for planning, managing, and teaching. Besides serving higher education's consumers, accountability measures should also serve those who plan and manage institutions, especially those engaged in managing…

  6. A tool management system based on RFID

    NASA Astrophysics Data System (ADS)

    Wang, Z. G.; Xu, L. D.; Cai, D. S.; Xu, L.; Yu, H. H.

    2010-12-01

    Built the RFID (Radio Frequency Identification) hardware system then developed a tool management system based on Labview in the paper. The software can control the read/write device to read/write data through the serial port and use the database management module to add, query, modify and delete record. So, the automatic identification and management of cutting tool is realized.

  7. A tool management system based on RFID

    NASA Astrophysics Data System (ADS)

    Wang, Z. G.; Xu, L. D.; Cai, D. S.; Xu, L.; Yu, H. H.

    2011-05-01

    Built the RFID (Radio Frequency Identification) hardware system then developed a tool management system based on Labview in the paper. The software can control the read/write device to read/write data through the serial port and use the database management module to add, query, modify and delete record. So, the automatic identification and management of cutting tool is realized.

  8. A multidimensional home-based care coordination intervention for elders with memory disorders: the Maximizing Independence at Home (MIND) Pilot Randomized Trial

    PubMed Central

    Samus, QM; Johnston, D; Black, BS; Hess, E; Lyman, C; Vavilikolanu, A; Pollutra, J; Leoutsakos, J-M; Gitlin, LN; Rabins, PV; Lyketsos, CG

    2014-01-01

    Objectives To assess whether a dementia care coordination intervention delays time to transition from home and reduces unmet needs in elders with memory disorders. Design 18-month randomized controlled trial of 303 community-living elders. Setting: 28 postal code areas of Baltimore, MD. Participants Age 70+, with a cognitive disorder, community-living, English-speaking, and having a study partner available. Intervention 18-month care coordination intervention to systematically identify and address dementia-related care needs through individualized care planning; referral and linkage to services; provision of dementia education and skill building strategies; and care monitoring by an interdisciplinary team. Measurements Primary outcomes were time to transfer from home and total percent of unmet care needs at 18 months. Results Intervention participants had a significant delay in time to all-cause transition from home and the adjusted hazard of leaving the home was decreased by 37% (HR = 0.63, 95% CI 0.42 to 0.94) compared to control participants. While there was no significant group difference in reduction of total percent of unmet needs from baseline to 18 months, the intervention group had significant reductions in the proportion of unmet needs in safety and legal/advance care domains relative to controls. Intervention participants had a significant improvement in self-reported quality of life (QOL) relative to control participants. No group differences were found in proxy-rated QOL, neuropsychiatric symptoms, or depression. Conclusions A home-based dementia care coordination intervention delivered by non-clinical community workers trained and overseen by geriatric clinicians led to delays in transition from home, reduced unmet needs, and improved self-reported QOL. PMID:24502822

  9. SBIR Phase II Final Report - Multi-Protocol Energy Management Gateway for Home-Area Networks

    SciTech Connect

    Hanna, Jason

    2015-02-06

    Significant amounts of electricity, natural gas, and heating oil are wasted by homeowners due to inefficient operation and inadequate maintenance of heating, ventilation, and air conditioning (HVAC) equipment. Coincident’s work under this award reduces energy waste, saves consumers money, and reduces carbon emissions. It does so in three ways: First, Coincident’s approach replaces the traditional thermostat with a wireless network of sensors and controllers that measure temperature, humidity and occupancy in multiple rooms in the house. The “Internet of Things” is a technology trend holding the promise of ubiquitous inexpensive sensors. The reality, however, is that energy and HVAC monitoring and management is a patchwork of incompatible protocols and expensive proprietary technologies. Coincident’s multi-protocol architecture, developed in part under this award tackles this problem and brings low cost interoperable sensor and control devices to market. Second, the Coincident system eliminates hard-to-program and rigid thermostat schedules and instead provides automatic operation of heating and cooling by combining individual temperature and comfort preferences with energy-saving targets, real-time utility use information, weather data, and room utilization patterns. Energy efficiency technology must be appealing to consumers otherwise it will not be used. The Coincident user interface has engaging features such as remote control from any smart phone or web browser and per-room performance breakdowns. Expected energy savings resulting from more efficient operation of heating and air conditioning equipment are in the range of 10-20%. Third, the Coincident system provides heating and air-conditioning contractors with fine-grained performance data for every residence they support (subject to customer privacy controls). This data is integrated from diverse networks within the residence and includes HVAC performance and fuel use data. This information allows

  10. Presentation and Management Outcomes of Corneal and Scleral Perforations in Geriatric Nursing Home Residents

    PubMed Central

    Ying Fong, Yoly Yeuk; Yu, Marco; Young, Alvin Lerrmann; Jhanji, Vishal

    2015-01-01

    Abstract We compared the clinical presentation and treatment outcomes of corneal and scleral perforations in geriatric nursing home residents, geriatric community residents, and non-geriatric population. The medical records of patients who were treated for corneal and scleral perforations at the Prince of Wales Hospital, Hong Kong between January 1, 2004 and May 1, 2013, were reviewed retrospectively. Of 144 cases, 53 (37%) occurred in the geriatric population, of which 16 (11%) lived in nursing homes, and 37 (26%) were community residents. There were 91 (63%) patients in the non-geriatric group. The mean age of the patients in nursing home geriatric group was 86.5 years (87.5% females). The most common etiology of perforation was trauma. Rupture due to fall was more common in geriatric patients (P < 0.001) whereas laceration due to penetrating eye injury was more common in non-geriatric patients (P < 0.001). There were more cases of infection leading to spontaneous perforation in geriatric nursing home group compared to the other groups (P = 0.001). In the geriatric nursing home group, visual acuity at presentation (P < 0.001) and postoperative visual acuity (P = 0.012) was worse compared to the other groups. Our study showed that corneal and scleral perforations in the geriatric nursing home residents carry a poor visual prognosis. The causes and anatomical outcomes of such events in geriatric age group differ from those in the general population. In our study, geriatric patients residing in nursing homes had worse baseline as well as posttreatment visual acuity, compared to community residents. PMID:26356724

  11. Normalizing suffering: A meta-synthesis of experiences of and perspectives on pain and pain management in nursing homes

    PubMed Central

    Vaismoradi, Mojtaba; Skär, Lisa; Söderberg, Siv; Bondas, Terese E.

    2016-01-01

    Older people who live in nursing homes commonly suffer from pain. Therefore, relieving suffering among older people that stems from pain demands knowledge improvement through an integration of international knowledge. This study aimed to integrate current international findings and strengthen the understanding of older people's experiences of and perspectives on pain and pain management in nursing homes. A meta-synthesis study using Noblit and Hare's interpretative meta-ethnography approach was conducted. Empirical research papers from journals were collected from various databases. The search process and appraisal determined six articles for inclusion. Two studies were conducted in the US and one each in Iceland, Norway, the UK, and Australia. The older people's experiences of pain as well as perspectives on pain management from all involved (older people, their family members, and healthcare staff) were integrated into a theoretical model using three themes of “identity of pain,” “recognition of pain,” and “response to pain.” The metaphor of “normalizing suffering” was devised to illustrate the meaning of pain experiences and pain management in nursing homes. Society's common attitude that pain is unavoidable and therefore acceptable in old age in society—among older people themselves as well as those who are responsible for reporting, acknowledging, and relieving pain—must change. The article emphasizes that pain as a primary source of suffering can be relieved, provided that older people are encouraged to report their pain. In addition, healthcare staff require sufficient training to take a person-centered approach towards assessment and management of pain that considers all elements of pain. PMID:27173102

  12. Normalizing suffering: A meta-synthesis of experiences of and perspectives on pain and pain management in nursing homes.

    PubMed

    Vaismoradi, Mojtaba; Skär, Lisa; Söderberg, Siv; Bondas, Terese E

    2016-01-01

    Older people who live in nursing homes commonly suffer from pain. Therefore, relieving suffering among older people that stems from pain demands knowledge improvement through an integration of international knowledge. This study aimed to integrate current international findings and strengthen the understanding of older people's experiences of and perspectives on pain and pain management in nursing homes. A meta-synthesis study using Noblit and Hare's interpretative meta-ethnography approach was conducted. Empirical research papers from journals were collected from various databases. The search process and appraisal determined six articles for inclusion. Two studies were conducted in the US and one each in Iceland, Norway, the UK, and Australia. The older people's experiences of pain as well as perspectives on pain management from all involved (older people, their family members, and healthcare staff) were integrated into a theoretical model using three themes of "identity of pain," "recognition of pain," and "response to pain." The metaphor of "normalizing suffering" was devised to illustrate the meaning of pain experiences and pain management in nursing homes. Society's common attitude that pain is unavoidable and therefore acceptable in old age in society-among older people themselves as well as those who are responsible for reporting, acknowledging, and relieving pain-must change. The article emphasizes that pain as a primary source of suffering can be relieved, provided that older people are encouraged to report their pain. In addition, healthcare staff require sufficient training to take a person-centered approach towards assessment and management of pain that considers all elements of pain. PMID:27173102

  13. Outcomes of a home-based pulmonary maintenance program for individuals with COPD: a pilot study.

    PubMed

    Cooke, Marie; Moyle, Wendy; Griffiths, Susan; Shields, Louise

    This preliminary pilot study explores sustained benefits of pulmonary rehabilitation (PR) in people with chronic obstructive pulmonary disease (COPD) attending a 12-month home-based pulmonary maintenance program. The incidence of COPD is high and ageing populations will see this continue and possibly increase. PR programs are effective, however, benefits may dissipate if the program is not continued. The maintenance program involved: strength retraining exercises; collaborative goal setting; regular telephone calls; and home visits. Around half of the 29 participants remained in contact with the program for 12 months and 21 completed final or 6-month assessment. Most participants maintained: respiratory functioning; quality of life; and self-efficacy, with some showing improvements. Outcomes provide knowledge for improving patient care through a home-based strategy to maintain benefits of PR programs. Results suggest that in light of likely decline in benefits 6-12 months after PR, the maintenance program contributed to sustained benefits for COPD individuals and also provide information to aid investigators planning the design of similar larger research with this population. PMID:20230175

  14. Home- and community-based services utilization and aging in place.

    PubMed

    Tang, Fengyan; Lee, Yeonjung

    2010-07-01

    This study examines the relationship between home- and community-based service (HCBS) utilization and perceived service needs for aging in place versus relocation, using the data from the Community Partnership for Older Adults Survey. Among the vulnerable, community-dwelling older adult sample (N = 2,001), users of adult day programs, housekeeping, senior lunch, helpline, or personal assistance services were more likely to indicate they would need regular help to remain living on their own. By contrast, users of senior centers, personal assistance, or visiting nurse services were more likely to indicate they would move out due to health problems. Home repair service users were less likely to perceive the need for relocation. Findings have implications for improving long-term care and supportive service systems to meet the current and future needs of community-dwelling older adults. PMID:20845175

  15. Cost Effectiveness of a Home-Based Intervention That Helps Functionally Vulnerable Older Adults Age in Place at Home

    PubMed Central

    Jutkowitz, Eric; Gitlin, Laura N.; Pizzi, Laura T.; Lee, Edward; Dennis, Marie P.

    2012-01-01

    Evaluating cost effectiveness of interventions for aging in place is essential for adoption in service settings. We present the cost effectiveness of Advancing Better Living for Elders (ABLE), previously shown in a randomized trial to reduce functional difficulties and mortality in 319 community-dwelling elders. ABLE involved occupational and physical therapy sessions and home modifications to address client-identified functional difficulties, performance goals, and home safety. Incremental cost-effectiveness ratio (ICER), expressed as additional cost to bring about one additional year of life, was calculated. Two models were then developed to account for potential cost differences in implementing ABLE. Probabilistic sensitivity analyses were conducted to account for variations in model parameters. By two years, there were 30 deaths (9: ABLE; 21: control). Additional costs for 1 additional year of life was $13,179 for Model 1 and $14,800 for Model 2. Investment in ABLE may be worthwhile depending on society's willingness to pay. PMID:21876812

  16. Pilot Testing of Triage Coding System in Home-based Palliative Care Using Edmonton Symptom Assessment Scale

    PubMed Central

    Dhiliwal, Sunil; Salins, Naveen; Deodhar, Jayitha; Rao, Raghavendra; Muckaden, Mary Ann

    2016-01-01

    Introduction: Home-based palliative care is an essential model of palliative care that aims to provide continuity of care at patient's own home in an effective and timely manner. This study was a pilot test of triage coding system in home-based palliative care using Edmonton Symptom Assessment System (ESAS) scale. Methods: Objective of the study was to evaluate if the triage coding system in home-based palliative care: (a) Facilitated timely intervention, (b) improved symptom control, and (c) avoided hospital deaths. Homecare services were coded as high (Group 1 - ESAS scores ≥7), medium (Group 2 - ESAS scores 4–6), and low (Group 3 - ESAS scores 0–3) priority based on ESAS scores. In high priority group, patients received home visit in 0–3 working days; medium priority group, patients received home visit in 0–10 working days; and low priority group, patients received home visit in 0–15 working days. The triage duration of home visit was arbitrarily decided based on the previous retrospective audit and consensus of the experts involved in prioritization and triaging in home care. Results: “High priority” patients were visited in 2.63 ± 0.75 days; “medium priority” patients were visited in 7.00 ± 1.5 days, and “low priority” patients were visited in 10.54 ± 2.7 days. High and medium priority groups had a statistically significant improvement in most of the ESAS symptoms following palliative home care intervention. Intergroup comparison showed that improvement in symptoms was the highest in high priority group compared to medium and low priority group. There was an 8.5% increase in home and hospice deaths following the introduction of triage coding system. There was a significant decrease in deaths in the hospital in Group 1 (6.3%) (χ2 = 27.3, P < 0.001) compared to Group 2 (28.6%) and Group 3 (15.4%). Group 2 had more hospital deaths. Interval duration from triaging to first intervention was a significant predictor of survival with odds

  17. Impact of Relative Contraindications to Home Management in Emergency Department Patients with Low-Risk Pulmonary Embolism

    PubMed Central

    Drenten, Carrieann E.; Huang, Jie; Morley, J. Eileen; Anderson, Megan L.; Reed, Mary E.; Nishijima, Daniel K.; Liu, Vincent

    2015-01-01

    Rationale: Studies of adults presenting to the emergency department (ED) with acute pulmonary embolism (PE) suggest that those who are low risk on the PE Severity Index (classes I and II) can be managed safely without hospitalization. However, the impact of relative contraindications to home management on outcomes has not been described. Objectives: To compare 5-day and 30-day adverse event rates among low-risk ED patients with acute PE without and with outpatient ineligibility criteria. Methods: We conducted a retrospective multicenter cohort study of adults presenting to the ED with acute low-risk PE between 2010 and 2012. We evaluated the association between outpatient treatment eligibility criteria based on a comprehensive list of relative contraindications and 5-day adverse events and 30-day outcomes, including major hemorrhage, recurrent venous thromboembolism, and all-cause mortality. Measurements and Main Results: Of 423 adults with acute low-risk PE, 271 (64.1%) had no relative contraindications to outpatient treatment (outpatient eligible), whereas 152 (35.9%) had at least one contraindication (outpatient ineligible). Relative contraindications were categorized as PE-related factors (n = 112; 26.5%), comorbid illness (n = 42; 9.9%), and psychosocial barriers (n = 19; 4.5%). There were no 5-day events in the outpatient-eligible group (95% upper confidence limit, 1.7%) and two events (1.3%; 95% confidence interval [CI], 0.1–5.0%) in the outpatient-ineligible group (P = 0.13). At 30 days, there were five events (two recurrent venous thromboemboli and three major bleeding events) in the outpatient-eligible group (1.8%; 95% CI, 0.7–4.4%) compared with nine in the ineligible group (5.9%; 95% CI, 2.7–10.9%; P < 0.05). This difference remained significant when controlling for PE severity class. Conclusions: Nearly two-thirds of adults presenting to the ED with low-risk PE were potentially eligible for outpatient therapy. Relative

  18. Predictors of caregiver burden across the home-based palliative care trajectory in Ontario, Canada.

    PubMed

    Guerriere, Denise; Husain, Amna; Zagorski, Brandon; Marshall, Denise; Seow, Hsien; Brazil, Kevin; Kennedy, Julia; Burns, Sheri; Brooks, Heather; Coyte, Peter C

    2016-07-01

    Family caregivers of patients enrolled in home-based palliative care programmes provide unpaid care and assistance with daily activities to terminally ill family members. Caregivers often experience caregiver burden, which is an important predictor of anxiety and depression that can extend into bereavement. We conducted a longitudinal, prospective cohort study to comprehensively assess modifiable and non-modifiable patient and caregiver factors that account for caregiver burden over the palliative care trajectory. Caregivers (n = 327) of patients with malignant neoplasm were recruited from two dedicated home-based palliative care programmes in Southern Ontario, Canada from 1 July 2010 to 31 August 2012. Data were obtained from bi-weekly telephone interviews with caregivers from study admission until death, and from palliative care programme and home-care agency databases. Information collected comprised patient and caregiver demographics, utilisation of privately and publicly financed resources, patient clinical status and caregiver burden. The average age of the caregivers was 59.0 years (SD: 13.2), and almost 70% were female. Caregiver burden increased over time in a non-linear fashion from study admission to patient death. Increased monthly unpaid care-giving time costs, monthly public personal support worker costs, emergency department visits and low patient functional status were associated with higher caregiver burden. Greater use of hospice care was associated with lower burden. Female caregivers tended to report more burden compared to men as death approached, and burden was higher when patients were male. Low patient functional status was the strongest predictor of burden. Understanding the influence of modifiable and non-modifiable factors on the experience of burden over the palliative trajectory is essential for the development and targeting of programmes and policies to support family caregivers and reduce burden. Supporting caregivers can have

  19. Evaluation of the efficacy of a nurse practitioner-led home-based congestive heart failure clinical pathway.

    PubMed

    Moore, Jo-Ann Mary

    2016-01-01

    Frequent exacerbations of symptoms and financial penalties for 30-day hospital readmissions of patients with congestive heart failure (CHF) have led to new disease management approaches. A nurse practitioner (NP)-led interdisciplinary program for CHF management that included home telemonitoring and early NP assessments and interventions was piloted by a home health agency. A 4-month evaluation of the efficacy of a clinical pathway for CHF patients resulted in the enrollment of 22 CHF patients in the program. Two clients were readmitted within 30 days. The new program was effective in reducing 30-day readmission rates to 9% compared to the national average of 23%. PMID:27064361

  20. Advantages and disadvantages for receiving Internet-based HIV/AIDS interventions at home or at community-based organizations.

    PubMed

    Green, Shana M; Lockhart, Elizabeth; Marhefka, Stephanie L

    2015-01-01

    Within recent years, public health interventions have become technology based to reflect the digital age we currently live in and appeal to the public in innovative and novel ways. The Internet breaks down boundaries distance imposes and increases our ability to reach and connect with people. Internet-based interventions have the potential to expand access to effective behavioral interventions (EBIs). The US National HIV/AIDS Strategy states that people living with HIV should have access to EBIs such as healthy relationships (HR) to help them develop safe sex and disclosure skills. However, access to HR is limited across the country, especially for people in remote or rural areas. Internet-based healthy relationships video groups (HR-VG) delivered at home or community-based organizations (CBOs) can possibly expand access. This study assesses the preferences of women living with HIV (WLH) for participation in HR-VG among 21 WLH who participated in a randomized control trial (RCT) testing HR-VG and completed open-ended semi-structured telephone interviews. Transcripts were thematically analyzed to determine advantages and disadvantages of home or CBO delivery of HR-VG. Themes relating to convenience, technology access, privacy, distractions, HIV serostatus disclosure, and social opportunities were identified as advantages or disadvantages to participating in HR-VG at each location. Overall, privacy was the most salient concern of accessing HR-VG at home or at a CBO. Considering the concerns expressed by WLH, further studies are needed to assess how an Internet-based intervention delivered at home for WLH can maintain privacy while being cost effective. PMID:26357907

  1. Evidence-based practice for pain identification in cognitively impaired nursing home residents.

    PubMed

    Sacoco, Christina; Ishikawa, Sally

    2014-09-01

    Pain identification of cognitively impaired elderly is very challenging. This project aimed to identify best practices for pain assessment in nursing home residents with cognitive impairment and to establish a standardized pain assessment guide to optimize nursing practice and resident outcomes. The Iowa Model of Evidence-Based Practice to Promote Quality of Care guided the project's process. Phase I of the project analyzed data gained from chart reviews on current practices of pain assessment, and Phase II used the results of Phase I to develop, implement, and evaluate an evidence-based practice standard for nursing assessment of pain for cognitively impaired residents. PMID:25155534

  2. [Research of controlling of smart home system based on P300 brain-computer interface].

    PubMed

    Wang, Jinjia; Yang, Chengjie

    2014-08-01

    Using electroencephalogram (EEG) signal to control external devices has always been the research focus in the field of brain-computer interface (BCI). This is especially significant for those disabilities who have lost capacity of movements. In this paper, the P300-based BCI and the microcontroller-based wireless radio frequency (RF) technology are utilized to design a smart home control system, which can be used to control household appliances, lighting system, and security devices directly. Experiment results showed that the system was simple, reliable and easy to be populirised. PMID:25464783

  3. [Research of controlling of smart home system based on P300 brain-computer interface].

    PubMed

    Wang, Jinjia; Yang, Chengjie

    2014-08-01

    Using electroencephalogram (EEG) signal to control external devices has always been the research focus in the field of brain-computer interface (BCI). This is especially significant for those disabilities who have lost capacity of movements. In this paper, the P300-based BCI and the microcontroller-based wireless radio frequency (RF) technology are utilized to design a smart home control system, which can be used to control household appliances, lighting system, and security devices directly. Experiment results showed that the system was simple, reliable and easy to be populirised. PMID:25508414

  4. Caregivers' Cortisol Levels and Perceived Stress in Home-Based and Center-Based Childcare

    ERIC Educational Resources Information Center

    Groeneveld, Marleen G.; Vermeer, Harriet J.; van IJzendoorn, Marinus H.; Linting, Marielle

    2012-01-01

    The current study examined professional caregivers' perceived and physiological stress, and associations with the quality of care they provide. Participants were 55 female caregivers from childcare homes and 46 female caregivers from childcare centers in the Netherlands. In both types of settings, equivalent measures and procedures were used. On…

  5. Children's Wellbeing and Cortisol Levels in Home-Based and Center-Based Childcare

    ERIC Educational Resources Information Center

    Groeneveld, Marleen G.; Vermeer, Harriet J.; van IJzendoorn, Marinus H.; Linting, Marielle

    2010-01-01

    The central question in this study is whether individual variability in children's cortisol levels and wellbeing at childcare can be explained by indices of quality of care and child characteristics. Participants were 71 children from childcare homes and 45 children from childcare centers in the age range of 20-40 months. In both types of settings…

  6. Mountain Home Air Force Base, Idaho Geothermal Resource Assessment and Future Recommendations

    SciTech Connect

    Joseph C. Armstrong; Robert P. Breckenridge; Dennis L. Nielson; John W. Shervais; Thomas R. Wood

    2013-03-01

    The U.S. Air Force is facing a number of challenges as it moves into the future, one of the biggest being how to provide safe and secure energy to support base operations. A team of scientists and engineers met at Mountain Home Air Force Base in early 2011 near Boise, Idaho, to discuss the possibility of exploring for geothermal resources under the base. The team identified that there was a reasonable potential for geothermal resources based on data from an existing well. In addition, a regional gravity map helped identify several possible locations for drilling a new well. The team identified several possible sources of funding for this well—the most logical being to use U.S. Department of Energy funds to drill the upper half of the well and U.S. Air Force funds to drill the bottom half of the well. The well was designed as a slimhole well in accordance with State of Idaho Department of Water Resources rules and regulations. Drilling operations commenced at the Mountain Home site in July of 2011 and were completed in January of 2012. Temperatures increased gradually, especially below a depth of 2000 ft. Temperatures increased more rapidly below a depth of 5500 ft. The bottom of the well is at 5976 ft, where a temperature of about 140°C was recorded. The well flowed artesian from a depth below 5600 ft, until it was plugged off with drilling mud. Core samples were collected from the well and are being analyzed to help understand permeability at depth. Additional tests using a televiewer system will be run to evaluate orientation and directions at fractures, especially in the production zone. A final report on the well exploitation will be forthcoming later this year. The Air Force will use it to evaluate the geothermal resource potential for future private development options at Mountain Home Air Force Base. In conclusion, Recommendation for follow-up efforts include the following:

  7. Treating chronic food refusal in young children: home-based parent training.

    PubMed Central

    Werle, M A; Murphy, T B; Budd, K S

    1993-01-01

    We evaluated the effects of behavioral parent training program on parent and child feeding-related behaviors in the home. We trained mothers to initiate regular offerings of previously rejected (target) foods and to provide contingent attention (i.e., specific prompts, positive reinforcement) to increase their child's acceptance of nonpreferred foods. For 1 subject, we also directed training at increasing self-eating. Results of a nonconcurrent multiple baseline design across 3 mother-child dyads demonstrated that, with training, all mothers increased offerings of target foods and use of specific prompts, and 2 mothers increased levels of positive attention. In turn, children increased their acceptance of target foods and self-eating, thus demonstrating the functional effects of parent training on in-home meal times. Temporary increases in food refusals occurred when treatment was initiated but declined as treatment continued. We discuss the results in terms of the potential benefits and limitations of a home-based treatment model. PMID:8307827

  8. ECG telemonitoring during home-based cardiac rehabilitation in heart failure patients.

    PubMed

    Piotrowicz, Ewa; Jasionowska, Anna; Banaszak-Bednarczyk, Maria; Gwilkowska, Joanna; Piotrowicz, Ryszard

    2012-06-01

    We assessed ECGs recorded during home-based telemonitored cardiac rehabilitation (HTCR) in stable patients with heart-failure. The study included 75 patients with heart failure (NYHA II, III), with a mean age of 56 years. They participated in an eight-week programme of home cardiac rehabilitation which was telemonitored with a device which recorded 16-s fragments of their ECG. These fragments were transmitted via mobile phone to a monitoring centre. The times of the automatic ECG recordings were pre-set and coordinated with the cardiac rehabilitation. Patients were able to make additional recordings when they felt unwell using a tele-event-Holter ECG facility. During the study, 5757 HTCR sessions were recorded and 11,534 transmitted ECG fragments were evaluated. Most ECGs originated from the automatic recordings. Singular supraventricular and ventricular premature beats and ventricular couplets were detected in 16%, 69% and 16% of patients, respectively. Twenty ECGs were recorded when patients felt unwell: non sustained ventricular tachycardia occurred in three patients and paroxysmal atrial fibrillation episode in two patients. Heart failure patients undergoing HTCR did not develop any arrhythmia which required a change of the procedure, confirming it was safe. Cardiac rehabilitation at home was improved by utilizing the tele-event-Holter ECG facility. PMID:22604276

  9. Creating a national home visiting research network.

    PubMed

    Duggan, Anne; Minkovitz, Cynthia S; Chaffin, Mark; Korfmacher, Jon; Brooks-Gunn, Jeanne; Crowne, Sarah; Filene, Jill; Gonsalves, Kay; Landsverk, John; Harwood, Robin

    2013-11-01

    Home visiting can play a key role in the early childhood system of services. For home visiting to achieve its potential, decision-makers must make informed choices regarding adoption, adaptation, coordination, scale-up, and sustainment. We need a coordinated, focused, and theory-based home visiting research infrastructure to inform such decisions. The transdisciplinary Home Visiting Research Network (HVRN) was established in July 2012 with funding from the Health Resources and Services Administration. Its goal is to promote the translation of research findings into policy and practice. Its objectives are to (1) develop a national home visiting research agenda, (2) advance the use of innovative research methods; and (3) provide a research environment that is supportive of the professional development of emerging researchers interested in home visiting. A Management Team designs and directs activities to achieve these objectives through Work Teams. A Steering Committee of national leaders representing stakeholder groups oversees progress. HVRN's Coordinating Center supports the Work Teams and HVRN's Home visiting Applied Research Collaborative, a practice-based research network of home visiting programs. This article describes HVRN's rationale, approach, and anticipated products. We use home visiting-primary care coordination as an illustration, noting potential roles for pediatric practices and pediatric researchers and research educators in HVRN activities. HVRN creates the infrastructure for a rigorous program of research to inform policy and practice on home visiting as part of the system of services to improve family functioning, parenting, and child outcomes. PMID:24187127

  10. Daily home-based spirometry during withdrawal of inhaled corticosteroid in severe to very severe chronic obstructive pulmonary disease

    PubMed Central

    Rodriguez-Roisin, Roberto; Tetzlaff, Kay; Watz, Henrik; Wouters, Emiel FM; Disse, Bernd; Finnigan, Helen; Magnussen, Helgo; Calverley, Peter MA

    2016-01-01

    The WISDOM study (NCT00975195) reported a change in lung function following withdrawal of fluticasone propionate in patients with severe to very severe COPD treated with tiotropium and salmeterol. However, little is known about the validity of home-based spirometry measurements of lung function in COPD. Therefore, as part of this study, following suitable training, patients recorded daily home-based spirometry measurements in addition to undergoing periodic in-clinic spirometric testing throughout the study duration. We subsequently determined the validity of home-based spirometry for detecting changes in lung function by comparing in-clinic and home-based forced expiratory volume in 1 second in patients who underwent stepwise fluticasone propionate withdrawal over 12 weeks versus patients remaining on fluticasone propionate for 52 weeks. Bland–Altman analysis of these data confirmed good agreement between in-clinic and home-based measurements, both across all visits and at the individual visits at study weeks 6, 12, 18, and 52. There was a measurable difference between the forced expiratory volume in 1 second values recorded at home and in the clinic (mean difference of −0.05 L), which may be due to suboptimal patient effort in performing unsupervised recordings. However, this difference remained consistent over time. Overall, these data demonstrate that home-based and in-clinic spirometric measurements were equally valid and reliable for assessing lung function in patients with COPD, and suggest that home-based spirometry may be a useful tool to facilitate analysis of changes in lung function on a day-to-day basis. PMID:27578972

  11. Daily home-based spirometry during withdrawal of inhaled corticosteroid in severe to very severe chronic obstructive pulmonary disease.

    PubMed

    Rodriguez-Roisin, Roberto; Tetzlaff, Kay; Watz, Henrik; Wouters, Emiel Fm; Disse, Bernd; Finnigan, Helen; Magnussen, Helgo; Calverley, Peter Ma

    2016-01-01

    The WISDOM study (NCT00975195) reported a change in lung function following withdrawal of fluticasone propionate in patients with severe to very severe COPD treated with tiotropium and salmeterol. However, little is known about the validity of home-based spirometry measurements of lung function in COPD. Therefore, as part of this study, following suitable training, patients recorded daily home-based spirometry measurements in addition to undergoing periodic in-clinic spirometric testing throughout the study duration. We subsequently determined the validity of home-based spirometry for detecting changes in lung function by comparing in-clinic and home-based forced expiratory volume in 1 second in patients who underwent stepwise fluticasone propionate withdrawal over 12 weeks versus patients remaining on fluticasone propionate for 52 weeks. Bland-Altman analysis of these data confirmed good agreement between in-clinic and home-based measurements, both across all visits and at the individual visits at study weeks 6, 12, 18, and 52. There was a measurable difference between the forced expiratory volume in 1 second values recorded at home and in the clinic (mean difference of -0.05 L), which may be due to suboptimal patient effort in performing unsupervised recordings. However, this difference remained consistent over time. Overall, these data demonstrate that home-based and in-clinic spirometric measurements were equally valid and reliable for assessing lung function in patients with COPD, and suggest that home-based spirometry may be a useful tool to facilitate analysis of changes in lung function on a day-to-day basis. PMID:27578972

  12. Time Investment and Time Management: An Analysis of Time Students Spend Working at Home for School

    ERIC Educational Resources Information Center

    Wagner, Petra; Schober, Barbara; Spiel, Christiane

    2008-01-01

    This paper deals with the time students spend working at home for school. In Study 1, we investigated amount and regulation of time. Study 2 serves to validate the results of Study 1 and, in addition, investigates the duration of the time units students used and their relation to scholastic success. In Study 1, the participants were 332 students…

  13. Behavior and Behavioral Determinants in the Management of Demented People in Residential Homes.

    ERIC Educational Resources Information Center

    Savelkoul, Manon; Commissaris, Kees; Kok, Gerjo

    1998-01-01

    This Dutch study compares the behavior of staff (N=136) toward demented patients in residential homes with five expert recommendations for dealing with dementia. Results show that staff carried out the recommendations of encouraging activity, establishing effective communication, and not changing the patients' routine, but the staff tested and…

  14. Interactional communication challenges in end-of-life care: dialectical tensions and management strategies experienced by home hospice nurses.

    PubMed

    Gilstrap, Cristina M; White, Zachary M

    2015-01-01

    This study examines the dialectical tensions experienced by home hospice nurses in interactions with patients, families, and health care providers. In-depth, semistructured interviews were conducted with 24 home hospice nurses from a mid-size for-profit hospice organization serving approximately 230 patients on an annual basis. Interviews revealed hospice nurses experience both interpersonal and organizational dialectics during hospice interactions: authoritative-nonauthoritative, revelation-concealment, independence-collaboration, and quality of care-business of care. Dialectics often resulted as a by-product of (a) responding to expectations and care choices of patients and families particular to the emotionally charged home context, (b) obtaining authorization from health care providers who are not members of the interdisciplinary team, and (c) pressures associated with providing quality patient care while fulfilling organizational role requirements. The praxis strategies used to negotiate tensions included segmentation, balance, recalibration, and spiraling inversion. Specifically, nurses employed strategies such as ascertaining family/patient acceptance, using persuasive tactics when communicating with external health care providers, relying on effective time management, and working off the clock to provide more in-person care. Although functional for patients and hospice organizations, nurses who continually rely on these strategies may experience job stress when their interpersonal commitments repeatedly conflict with organizational role demands. PMID:24991918

  15. Exploration and Resource Assessment at Mountain Home Air Force Base, Idaho Using an Integrated Team Approach

    SciTech Connect

    Joseph C. Armstrong; Robert P. Breckenridge; Dennis L. Nielson; John W. Shervais; Thomas R. Wood

    2012-10-01

    The U.S. Air Force is facing a number of challenges as it moves into the future, one of the biggest being how to provide safe and secure energy to support base operations. A team of scientists and engineers met at Mountain Home Air Force Base near Boise, Idaho, to discuss the possibility of exploring for geothermal resources under the base. The team identified that there was a reasonable potential for geothermal resources based on data from an existing well. In addition, a regional gravity map helped identify several possible locations for drilling a new well. The team identified several possible sources of funding for this well—the most logical being to use U.S. Department of Energy funds to drill the upper half of the well and U.S. Air Force funds to drill the bottom half of the well. The well was designed as a slimhole well in accordance with State of Idaho Department of Water Resources rules and regulations. Drilling operations commenced at the Mountain Home site in July of 2011 and were completed in January of 2012. Temperatures increased gradually, especially below a depth of 2000 ft. Temperatures increased more rapidly below a depth of 5500 ft. The bottom of the well is at 5976 ft, where a temperature of about 140°C was recorded. The well flowed artesian from a depth below 5600 ft, until it was plugged off with drilling mud. Core samples were collected from the well and are being analyzed to help understand permeability at depth. Additional tests using a televiewer system will be run to evaluate orientation and directions at fractures, especially in the production zone. A final report on the well exploitation will be forthcoming later this year. The Air Force will use it to evaluate the geothermal resource potential for future private development options at Mountain Home AFB.

  16. Medicaid 1915(c) Home- and Community-Based Services waivers for children with autism spectrum disorder.

    PubMed

    Velott, Diana L; Agbese, Edeanya; Mandell, David; Stein, Bradley D; Dick, Andrew W; Yu, Hao; Leslie, Douglas L

    2016-05-01

    This research aims to describe the characteristics of 1915(c) Home- and Community-Based Services waivers for children with autism spectrum disorder across states and over time. While increasingly popular, little is known about these Medicaid waivers. Understanding the characteristics of these programs is important to clinicians and policymakers in designing programs to meet the needs of this vulnerable population and to set the stage for evaluating changes that occur with the implementation of health-care reform. Home- and Community-Based Services waiver applications that included children with autism spectrum disorder as a target population were collected from the Centers for Medicare and Medicaid Services website, state websites, and state administrators. A data extraction tool was used to document waiver inclusions and restrictions, estimated service provision and institutional costs, and the inclusion of four core autism spectrum disorder services: respite, caregiver support and training, personal care, and evidence-based treatments. Investigators identified 50 current or former waivers across 29 states that explicitly included children with autism spectrum disorder in their target populations. Waivers differed substantially across states in the type and breadth of autism spectrum disorder coverage provided. Specifically, waivers varied in the populations they targeted, estimated cost of services, cost control methods employed, and services offered to children with autism spectrum disorder. Home- and Community-Based Services waivers for children with autism spectrum disorder are very complex and are not consistent across states or over time. Further efforts are needed to examine the characteristics of programs that are associated with improved access to care and clinical outcomes to maximize the benefits to individuals with autism spectrum disorder and their families. PMID:26088059

  17. A telemedicine instrument for Internet-based home monitoring of thoracoabdominal motion in patients with respiratory diseases

    NASA Astrophysics Data System (ADS)

    da Silva Junior, Evert Pereira; Esteves, Guilherme Pompeu; Dames, Karla Kristine; Melo, Pedro Lopes de

    2011-01-01

    Changes in thoracoabdominal motion are highly prevalent in patients with chronic respiratory diseases. Home care services that use telemedicine techniques and Internet-based monitoring have the potential to improve the management of these patients. However, there is no detailed description in the literature of a system for Internet-based monitoring of patients with disturbed thoracoabdominal motion. The purpose of this work was to describe the development of a new telemedicine instrument for Internet-based home monitoring of thoracoabdominal movement. The instrument directly measures changes in the thorax and abdomen circumferences and transfers data through a transmission control protocol/Internet protocol connection. After the design details are described, the accuracy of the electronic and software processing units of the instrument is evaluated by using electronic signals simulating normal subjects and individuals with thoracoabdominal motion disorders. The results obtained during in vivo studies on normal subjects simulating thoracoabdominal motion disorders showed that this new system is able to detect a reduction in abdominal movement that is associated with abnormal thoracic breathing (p < 0.0001) and the reduction in thoracic movement during abnormal abdominal breathing (p < 0.005). Simulated asynchrony in thoracoabdominal motion was also adequately detected by the system (p < 0.0001). The experimental results obtained for patients with respiratory diseases were in close agreement with the expected values, providing evidence that this instrument can be a useful tool for the evaluation of thoracoabdominal motion. The Internet transmission tests showed that the acquisition and analysis of the thoracoabdominal motion signals can be performed remotely. The user can also receive medical recommendations. The proposed system can be used in a spectrum of telemedicine scenarios, which can reduce the costs of assistance offered to patients with respiratory diseases.

  18. A national survey of home-based care kits for palliative HIV/AIDS care in South Africa.

    PubMed

    Mabude, Z A; Beksinska, M E; Ramkissoon, A; Wood, S; Folsom, M

    2008-09-01

    The objective of this study was to assess home-based care (HBC) kits and programs in South Africa to evaluate the feasibility of scaling up kit production and distribution. South African HBC organizations received structured questionnaires; key informant interviews and a literature review were completed to assess systems for production, distribution and supply of HBC kits. Meetings with stakeholders were held in two Provinces to share and analyze the study findings. The study team distributed questionnaires to 466 organizations and conducted interviews with representatives from 45 organizations, the Provincial Department of Health (DoH) and manufacturers of kits. All identifiable HBC organizations in South Africa were included in the survey. As a result 215 HBC organizations returned questionnaires; including non-governmental organizations (56%), community-based organizations (32%) and organizations affiliated with government health departments. Two types of kits were available: a home kit and a professional kit. The demand for HBC kits exceeded availability, kit contents and availability varied considerably and the supply chain was irregular. Kit production and distribution systems were fragmented. Replenishment of kit items was problematic. End-users are mostly caregivers who have not received adequate training on their use. The study shows that substantial work has been done by HBC organizations in South Africa to respond to the need for palliative care supplies within resource constraints. The growing demand for kits exceeds the supply. There is a need to improve the supply chain management of HBC kits, strengthen referral systems and links between community-based organizations and government departments, expand training opportunities for care givers, and develop monitoring and evaluation systems. PMID:18608083

  19. A home-based comprehensive care model in patients with Multiple Sclerosis: A study pre-protocol

    PubMed Central

    Young, Lufei; Healey, Kathleen; Charlton, Mary; Schmid, Kendra; Zabad, Rana; Wester, Rebecca

    2015-01-01

    Background Disability is prevalent in individuals with multiple sclerosis (MS), leading to difficulty in care access, significant caregiver burden, immense challenges in self-care and great societal burden.  Without highly coordinated, competent and accessible care, individuals living with progressive MS experience psychological distress, poor quality of life, suffer from life-threatening complications, and have frequent but avoidable healthcare utilizations. Unfortunately, current healthcare delivery models present severe limitations in providing easily accessible, patient-centered, coordinated comprehensive care to those with progressive MS. We propose a home-based comprehensive care model (MAHA) to address the unmet needs, challenges, and avoidable complications in individuals with progressive MS with disabling disease. Objective The article aims to describe the study design and methods used to implement and evaluate the proposed intervention.   Method The study will use a randomized controlled design to evaluate the feasibility of providing a 24-month, home-based, patient-centered comprehensive care program to improve quality of life, reduce complications and healthcare utilizations overtime (quarterly) for 24 months. A transdisciplinary team led by a MS-Comprehensivist will carry out this project. Fifty MS patients will be randomly assigned to the intervention and usual care program using block randomization procedures. We hypothesize that patients in the intervention group will have fewer complications, higher quality of life, greater satisfaction with care, and reduced healthcare utilization. The proposed project is also expected to be financially sustainable in fee-for-service models but best suited for and gain financial success in valued-based care systems.   Discussion This is the first study to examine the feasibility and effectiveness of a home-based comprehensive care management program in MS patients living with progressive disability. If

  20. A home-based comprehensive care model in patients with Multiple Sclerosis: A study pre-protocol.

    PubMed

    Young, Lufei; Healey, Kathleen; Charlton, Mary; Schmid, Kendra; Zabad, Rana; Wester, Rebecca

    2015-01-01

    Background Disability is prevalent in individuals with multiple sclerosis (MS), leading to difficulty in care access, significant caregiver burden, immense challenges in self-care and great societal burden.  Without highly coordinated, competent and accessible care, individuals living with progressive MS experience psychological distress, poor quality of life, suffer from life-threatening complications, and have frequent but avoidable healthcare utilizations. Unfortunately, current healthcare delivery models present severe limitations in providing easily accessible, patient-centered, coordinated comprehensive care to those with progressive MS. We propose a home-based comprehensive care model (MAHA) to address the unmet needs, challenges, and avoidable complications in individuals with progressive MS with disabling disease. Objective The article aims to describe the study design and methods used to implement and evaluate the proposed intervention.   Method The study will use a randomized controlled design to evaluate the feasibility of providing a 24-month, home-based, patient-centered comprehensive care program to improve quality of life, reduce complications and healthcare utilizations overtime (quarterly) for 24 months. A transdisciplinary team led by a MS-Comprehensivist will carry out this project. Fifty MS patients will be randomly assigned to the intervention and usual care program using block randomization procedures. We hypothesize that patients in the intervention group will have fewer complications, higher quality of life, greater satisfaction with care, and reduced healthcare utilization. The proposed project is also expected to be financially sustainable in fee-for-service models but best suited for and gain financial success in valued-based care systems.   Discussion This is the first study to examine the feasibility and effectiveness of a home-based comprehensive care management program in MS patients living with progressive disability. If

  1. Evidence-Based Management Education

    ERIC Educational Resources Information Center

    Burke-Smalley, Lisa A.

    2014-01-01

    In this rejoinder to "Let's Burn Them All: Reflections on the Learning-Inhibitory Nature of Introduction to Management and Introduction to Organizational Behavior Textbooks," by Robert A. Snyder (see EJ1039748), Lisa Burke-Smalley touches upon a number of Snyder's claims and explores questions sparked by his essay. She argues…

  2. Apparel. Vocational Home Economics Education.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This curriculum guide for apparel is one of a number of guides developed for use in vocational home economics education in Texas. Introductory materials address use of the guide and list the essential elements upon which the content is based. The guide is divided into six units: individual and family apparel decisions, apparel management,…

  3. Patients’ practices and experiences of using nebuliser therapy in the management of COPD at home

    PubMed Central

    Alhaddad, B; Smith, F J; Robertson, T; Watman, G; Taylor, K M G

    2015-01-01

    Background and aim How patients use their nebulisers at home is vital to ensure effective treatment and optimal health outcomes for patients with chronic obstructive pulmonary disease (COPD). The aim of the study was to identify the practicalities and problems associated with nebuliser use by patients with COPD at home, which may impact on the safety and effectiveness of therapy. Design and setting A cross-sectional descriptive study in which participants were recruited from two levels of care: primary care, involving 38 GP practices in North West London, and intermediate care with a major acute hospital. Method In-depth interviews were conducted with a representative sample of 50 patients with COPD using nebulisers in their home, recruited from general practice populations and at hospital discharge. A checklist was used to record activities and patients demonstrated use of their nebuliser. Qualitative procedures were employed to identify the range of problems experienced with nebuliser use. Results A wide range of practical issues was identified at all stages: problems prior to nebulisation: setting up equipment, lack of instructions, manual dexterity and time required. Problems during medication administration: inhalation technique, duration of nebulisation and understanding how to achieve optimal efficacy. Problems post-administration: inadequate cleaning of nebuliser components, access to accessories and use of damaged parts or self-repairs. Other problems included noise, weight and non-portability of equipment. Conclusions Patients with COPD using nebulisers at home experienced problems with all aspects, many of which may be anticipated to compromise clinical outcomes. Healthcare providers should be aware of these problems to effectively support patients with COPD with the use of their nebulisers at home. PMID:25806114

  4. Honey-Based Mixtures Used in Home Medicine by Nonindigenous Population of Misiones, Argentina

    PubMed Central

    Kujawska, Monika; Zamudio, Fernando; Hilgert, Norma I.

    2012-01-01

    Honey-based mixtures used in home medicine by nonindigenous population of Misiones, Argentina. Medicinal mixtures are an underinvestigated issue in ethnomedical literature concerning Misiones, one of the most bioculturally diverse province of Argentina. The new culturally sensitive politics of the Provincial Health System is a response to cultural practices based on the medicinal use of plant and animal products in the home medicine of the local population. Honey-based medicinal formulas were investigated through interviews with 39 farmers of mixed cultural (Criollos) and Polish origins in northern Misiones. Fifty plant species and 8 animal products are employed in honey-based medicines. Plants are the most dominant and variable elements of mixtures. Most of the mixtures are food medicines. The role of honey in more than 90% of formulas is perceived as therapeutic. The ecological distribution of taxa and the cultural aspects of mixtures are discussed, particularly the European and American influences that have shaped the character of multispecies medicinal recipes. PMID:22315632

  5. Smartphone-based analysis of biochemical tests for health monitoring support at home.

    PubMed

    Velikova, Marina; Smeets, Ruben L; van Scheltinga, Josien Terwisscha; Lucas, Peter J F; Spaanderman, Marc

    2014-09-01

    In the context of home-based healthcare monitoring systems, it is desirable that the results obtained from biochemical tests - tests of various body fluids such as blood and urine - are objective and automatically generated to reduce the number of man-made errors. The authors present the StripTest reader - an innovative smartphone-based interpreter of biochemical tests based on paper-based strip colour using image processing techniques. The working principles of the reader include image acquisition of the colour strip pads using the camera phone, analysing the images within the phone and comparing them with reference colours provided by the manufacturer to obtain the test result. The detection of kidney damage was used as a scenario to illustrate the application of, and test, the StripTest reader. An extensive evaluation using laboratory and human urine samples demonstrates the reader's accuracy and precision of detection, indicating the successful development of a cheap, mobile and smart reader for home-monitoring of kidney functioning, which can facilitate the early detection of health problems and a timely treatment intervention. PMID:26609385

  6. Effects of home-based respiratory muscle training in children and adolescents with chronic lung disease* **

    PubMed Central

    Rodríguez, Iván; Zenteno, Daniel; Manterola, Carlos

    2014-01-01

    OBJECTIVE: Respiratory muscle weakness is a functional repercussion of chronic lung disease (CLD). The objective of this study was to assess the effects of home-based respiratory muscle training (RMT) in children and adolescents with CLD or neuromuscular disease (NMD). METHODS: This was a quasi-experimental study involving children and adolescents with CLD or NMD. Before and after 6 months of home-based RMT, we measured respiratory muscle strength (MIP and MEP), PEF, and peak cough flow (PCF). We made statistical comparisons between the pre-RMT and post-RMT values, as well as evaluating the correlation between the duration and effect of RMT. RESULTS: The study included 29 patients, with a mean age of 12 years (range, 5-17 years), of whom 18 (62.1%) were male. The CLD group comprised 11 patients (37.9%), and the NMD group comprised 18 (62.1%). The mean duration of the RMT was 60 weeks (range, 46-90 weeks) in the CLD group and 39 weeks (range, 24-89 weeks) in the NMD group. In comparison with the pre-RMT values, the post-RMT values for MIP and MEP were significantly higher in both groups, whereas those for PEF and PCF were significantly higher only in the NMD group. We found no correlation between the duration and the effect of RMT. CONCLUSIONS: Home-based RMT appears to be an effective strategy for increasing respiratory muscle strength in children and adolescents with CLD or NMD, although it increased the ability to cough effectively only in those with NMD. PMID:25610503

  7. Design versus manufacturing data base management requirements

    NASA Technical Reports Server (NTRS)

    Mckenna, E. G.

    1984-01-01

    Data base management systems are valuable manufacturing and design tools as these disciplines are exceptionally information intensive, requiring precise organization and control of data processing and utilization. One such data base manager is the IPAD* system, which was originally developed to support the design process but was expanded to incorporate the additional needs of manufacturing. To set the stage, an overview of the design and manufacturing process is presented. The different functions of computers in these processes are then discussed. Finally, the design and manufacturing requirements for a data base manager are compared and contrasted.

  8. A home-based nutrition and physical activity intervention for grandparents raising grandchildren: a pilot study.

    PubMed

    Kicklighter, Jana R; Whitley, Deborah M; Kelley, Susan J; Lynch, Judith E; Melton, Tamara S

    2009-04-01

    Five African American grandparents raising their grandchildren participated in a home-based nutrition and physical activity intervention. The primary goals were to increase grandparents' knowledge and skills in selecting and preparing healthy foods and to increase the grandparents' and grandchildren's physical activity levels. Results revealed that grandparents' concerns regarding their chronic diseases and desire to prevent health problems in their grandchildren served as motivators. Following the intervention, grandparents scored higher on nutrition and physical activity knowledge and their self-efficacy improved, although most health status indicators remained unchanged. Self-reported changes included walking more, reading food labels, and switching to a healthier type of fat. PMID:21184365

  9. Constraints on the Interstellar Dust Flux Based on Stardust at Home Search Results

    NASA Technical Reports Server (NTRS)

    Zolensky, Michael E.; Westphal, J.; Allen, C.; Anderson, D.; Bajt, S.; Bechtel, H. A.; Borg, J.; Brenker, F.; Bridges, J.; Brownlee, D. E.; Burchell, M.

    2011-01-01

    Recent advances in active particle selection in the Heidelberg Van de r Graaf (VdG) dust accelerator have led to high-fidelity, low-backgro und calibrations of track sizes in aerogel as a function of particle size and velocity in the difficult regime above 10 km sec..1 and sub micron sizes. To the extent that the VdG shots are analogs for inters tellar dust (ISD) impacts, these new measurements enable us to place preliminary constraints on the ISD flux based on Stardust@home data.

  10. Effectiveness of a nurse-led case management home care model in Primary Health Care. A quasi-experimental, controlled, multi-centre study

    PubMed Central

    Morales-Asencio, JM; Gonzalo-Jiménez, E; Martin-Santos, FJ; Morilla-Herrera, JC; Celdráan-Mañas, M; Carrasco, A Millán; García-Arrabal, JJ; Toral-López, I

    2008-01-01

    Background Demand for home care services has increased considerably, along with the growing complexity of cases and variability among resources and providers. Designing services that guarantee co-ordination and integration for providers and levels of care is of paramount importance. The aim of this study is to determine the effectiveness of a new case-management based, home care delivery model which has been implemented in Andalusia (Spain). Methods Quasi-experimental, controlled, non-randomised, multi-centre study on the population receiving home care services comparing the outcomes of the new model, which included nurse-led case management, versus the conventional one. Primary endpoints: functional status, satisfaction and use of healthcare resources. Secondary endpoints: recruitment and caregiver burden, mortality, institutionalisation, quality of life and family function. Analyses were performed at base-line, and at two, six and twelve months. A bivariate analysis was conducted with the Student's t-test, Mann-Whitney's U, and the chi squared test. Kaplan-Meier and log-rank tests were performed to compare survival and institutionalisation. A multivariate analysis was performed to pinpoint factors that impact on improvement of functional ability. Results Base-line differences in functional capacity – significantly lower in the intervention group (RR: 1.52 95%CI: 1.05–2.21; p = 0.0016) – disappeared at six months (RR: 1.31 95%CI: 0.87–1.98; p = 0.178). At six months, caregiver burden showed a slight reduction in the intervention group, whereas it increased notably in the control group (base-line Zarit Test: 57.06 95%CI: 54.77–59.34 vs. 60.50 95%CI: 53.63–67.37; p = 0.264), (Zarit Test at six months: 53.79 95%CI: 49.67–57.92 vs. 66.26 95%CI: 60.66–71.86 p = 0.002). Patients in the intervention group received more physiotherapy (7.92 CI95%: 5.22–10.62 vs. 3.24 95%CI: 1.37–5.310; p = 0.0001) and, on average, required fewer home care visits (9

  11. Snails home

    NASA Astrophysics Data System (ADS)

    Dunstan, D. J.; Hodgson, D. J.

    2014-06-01

    Many gardeners and horticulturalists seek non-chemical methods to control populations of snails. It has frequently been reported that snails that are marked and removed from a garden are later found in the garden again. This phenomenon is often cited as evidence for a homing instinct. We report a systematic study of the snail population in a small suburban garden, in which large numbers of snails were marked and removed over a period of about 6 months. While many returned, inferring a homing instinct from this evidence requires statistical modelling. Monte Carlo techniques demonstrate that movements of snails are better explained by drift under the influence of a homing instinct than by random diffusion. Maximum likelihood techniques infer the existence of two groups of snails in the garden: members of a larger population that show little affinity to the garden itself, and core members of a local garden population that regularly return to their home if removed. The data are strongly suggestive of a homing instinct, but also reveal that snail-throwing can work as a pest management strategy.

  12. Place of death: hospital-based advanced home care versus conventional care. A prospective study in palliative cancer care.

    PubMed

    Ahlner-Elmqvist, Marianne; Jordhøy, Marit S; Jannert, Magnus; Fayers, Peter; Kaasa, Stein

    2004-10-01

    The purpose of this prospective nonrandomized study was to evaluate time spent at home, place of death and differences in sociodemographic and medical characteristics of patients, with cancer in palliative stage, receiving either hospital-based advanced home care (AHC), including 24-hour service by a multidisciplinary palliative care team or conventional hospital care (CC). Recruitment to the AHC group and to the study was a two-step procedure. The patients were assigned to either hospital-based AHC or CC according to their preferences. Following this, the patients were asked to participate in the study. Patients were eligible for the study if they had malignant disease, were older than 18 years and had a survival expectancy of 2-12 months. A total of 297 patients entered the study and 280 died during the study period of two and a half years, 117 in the AHC group and 163 in the CC group. Significantly more patients died at home in the AHC group (45%) compared with the CC group (10%). Preference for and referral to hospital-based AHC were not related to sociodemographic or medical characteristics. However, death at home was associated with living together with someone. Advanced hospital-based home care targeting seriously ill cancer patients with a wish to remain at home enable a substantial number of patients to die in the place they desire. PMID:15540666

  13. Cross-cultural adaptation and evaluation of a home-based program for alcohol use prevention among urban youth: the "Slick Tracy Home Team Program".

    PubMed

    Komro, Kelli A; Perry, Cheryl L; Veblen-Mortenson, Sara; Farbakhsh, Kian; Kugler, Kari C; Alfano, Karen A; Dudovitz, Bonnie S; Williams, Carolyn L; Jones-Webb, Rhonda

    2006-03-01

    The current study describes the extensive cross-cultural adaptation of a brief home-based alcohol prevention program for racially and ethnically diverse sixth grade students and their families, using a randomized controlled trial design involving 60 public schools in the city of Chicago (N = 3,623 students). The adapted program achieved high participation levels (73%) overall, as well as in single parent families, non-English homes, and low-income students, among other at risk groups. Lower levels of factors associated with the onset of alcohol use (i.e., normative expectations and outcome expectations) were achieved in the intervention group compared to the control group. However, no differences were observed for several other protective factors or alcohol use. PMID:16502143

  14. Agent-based monitoring and alert generation for a home care telemedicine system.

    PubMed

    Koutkias, Vassilios G; Chouvarda, Ioanna; Maglaveras, Nicos

    2002-01-01

    In the present paper, a multi-agent system is proposed, which can be integrated in the home care telemedicine system that was developed in the context of the Citizen Health System (CHS) European project, functioning as a contact center for diabetic and congestive heart failure patients. The objective of the multi-agent system is to provide a set of alert/notification mechanisms for the clinicians, helping them to classify the clinical condition of each patient. Therefore, despite the huge amount of data managed by the system, due to the daily use of the contact center's services, these alert mechanisms provide the clinician with an overview of the cases that need further examination and save him/her time from the trivial cases. The multi-agent system consists of different types of agents, each one assigned with specific tasks, which communicate with each other, in order to share knowledge. PMID:12463854

  15. [The present and future of community/home-based palliative care in Taiwan].

    PubMed

    Ueng, Ruey-Shiuan; Hsu, Su-Hsuan; Shih, Chih-Yuan; Huang, Sheng-Jean

    2015-04-01

    In Taiwan, the Department of Health (DOH) has implemented regulations and policies related to hospice and palliative care since 1995. Taiwan is the first country in Asia to have a Natural Death Act, promulgated in 2000. Although recognition of the need for palliative care in non-cancer terminally ill patients is increasing, at present, the needs of these patients are often not met. Moreover, while a majority of the population prefers to die at home, the percentage of patients who die in the home setting remains small. The palliative care system should be adjusted to improve the accessibility and continuity of care based on the needs of patients. Therefore, the Jin-Shan Branch of the National Taiwan University Hospital has run a pilot community palliative care service model since 2012. National Health Insurance reimbursement was introduced in 2014 for community-based palliative care services. Establishing a formal system of community-based palliative care should be encouraged in order to improve the quality of care at the end of life and to allow more patients to receive end-of-life care and die in their own communities. This system will require that skilled nurses provide discharge planning, symptoms control, end-of-life communications, social-resources integration, and social-support networks in order to achieve a high quality of end-of-life care. PMID:25854944

  16. Principles for ecologically based invasive plant management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Land managers long have identified a critical need for a practical and effective framework to guide the implementation of successful restoration, especially where invasive plants dominate the ecosystem. A holistic, ecologically-based invasive plant management (EBIPM) framework that integrates ecosy...

  17. Applying Ecologically-Based Invasive Plant Management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Developing a guideline to assist land managers in making better decisions when they are faced with invasive annual grasses is critical to gaining greater adoption of ecologically-based invasive plant management. This manual guides users through the EBIPM decision process to assist in restoration of...

  18. Home parenteral nutrition in management of patients with severe radiation enteritis

    SciTech Connect

    Lavery, I.C.; Steiger, E.; Fazio, V.W.

    1980-03-01

    Five patients who would have been unable to survive because of intestinal complications of radiation therapy were able to lead an otherwise normal life with the use of parenteral nutrition administered at home. One patient died of recurrent carcinoma of the cervix after 14 months. Another patient died as the result of a totally avoidable pharmaceutical error after 2 1/2 years. The remaining three are still disease free without morbidity relating to the parenteral nutrition.

  19. Home-based versus hospital-based cardiac rehabilitation after myocardial infarction or revascularisation: design and rationale of the Birmingham Rehabilitation Uptake Maximisation Study (BRUM): a randomised controlled trial [ISRCTN72884263

    PubMed Central

    Jolly, Kate; Lip, Gregory YH; Sandercock, Josie; Greenfield, Sheila M; Raftery, James P; Mant, Jonathan; Taylor, Rod; Lane, Deirdre; Lee, Kaeng Wai; Stevens, AJ

    2003-01-01

    Background Cardiac rehabilitation following myocardial infarction reduces subsequent mortality, but uptake and adherence to rehabilitation programmes remains poor, particularly among women, the elderly and ethnic minority groups. Evidence of the effectiveness of home-based cardiac rehabilitation remains limited. This trial evaluates the effectiveness and cost-effectiveness of home-based compared to hospital-based cardiac rehabilitation. Methods/design A pragmatic randomised controlled trial of home-based compared with hospital-based cardiac rehabilitation in four hospitals serving a multi-ethnic inner city population in the United Kingdom was designed. The home programme is nurse-facilitated, manual-based using the Heart Manual. The hospital programmes offer comprehensive cardiac rehabilitation in an out-patient setting. Patients We will randomise 650 adult, English or Punjabi-speaking patients of low-medium risk following myocardial infarction, coronary angioplasty or coronary artery bypass graft who have been referred for cardiac rehabilitation. Main outcome measures Serum cholesterol, smoking cessation, blood pressure, Hospital Anxiety and Depression Score, distance walked on Shuttle walk-test measured at 6, 12 and 24 months. Adherence to the programmes will be estimated using patient self-reports of activity. In-depth interviews with non-attendees and non-adherers will ascertain patient views and the acceptability of the programmes and provide insights about non-attendance and aims to generate a theory of attendance at cardiac rehabilitation. The economic analysis will measure National Health Service costs using resource inputs. Patient costs will be established from the qualitative research, in particular how they affect adherence. Discussion More data are needed on the role of home-based versus hospital-based cardiac rehabilitation for patients following myocardial infarction and revascularisation, which would be provided by the Birmingham Rehabilitation

  20. Characterization of a multi-user indoor positioning system based on low cost depth vision (Kinect) for monitoring human activity in a smart home.

    PubMed

    Sevrin, Loïc; Noury, Norbert; Abouchi, Nacer; Jumel, Fabrice; Massot, Bertrand; Saraydaryan, Jacques

    2015-01-01

    An increasing number of systems use indoor positioning for many scenarios such as asset tracking, health care, games, manufacturing, logistics, shopping, and security. Many technologies are available and the use of depth cameras is becoming more and more attractive as this kind of device becomes affordable and easy to handle. This paper contributes to the effort of creating an indoor positioning system based on low cost depth cameras (Kinect). A method is proposed to optimize the calibration of the depth cameras, to describe the multi-camera data fusion and to specify a global positioning projection to maintain the compatibility with outdoor positioning systems. The monitoring of the people trajectories at home is intended for the early detection of a shift in daily activities which highlights disabilities and loss of autonomy. This system is meant to improve homecare health management at home for a better end of life at a sustainable cost for the community. PMID:26737415

  1. Home range size and choice of management strategy for lynx in Scandinavia.

    PubMed

    Linnell, J D; Andersen, R; Kvam, T; Andrén, H; Liberg, O; Odden, J; Moa, P F

    2001-06-01

    Annual and seasonal home ranges were calculated for 47 Eurasian lynx in four Scandinavian study sites (two in Sweden and two in Norway). The observed home ranges were the largest reported for the species, with study site averages ranging from 600 to 1,400 km2 for resident males and from 300 to 800 km2 for resident females. When home range sizes were compared to the size of protected areas (national parks and nature reserves) in Scandinavia, it was concluded that very few protected areas contained sufficient forest to provide space for more than a few individuals. As a direct consequence of this, most lynx need to be conserved in the multiuse semi-natural forest habitats that cover large areas in Scandinavia. This conservation strategy leads to a number of conflicts with some land uses (sheep and semidomestic reindeer herding, and roe deer hunters), but not all (forestry and moose harvest). Accordingly research must be aimed at understanding the ecology of these conflicts, and finding solutions. PMID:11393321

  2. Results of a telehealth-enabled chronic care management service to support people with long-term conditions at home.

    PubMed

    Venter, Anton; Burns, Rosemary; Hefford, Martin; Ehrenberg, Nieves

    2012-04-01

    Both congestive heart failure and chronic obstructive pulmonary disease are more common among Māori than non-Māori people, and the cultural acceptability of home-based remote monitoring technology has not been tested. We conducted a 12-month pilot trial of home telemonitoring. Patients were randomly assigned to the control and intervention groups. Patients in the control group showed no clear differences in quality of life at the end of the trial. The telehealth group showed a consistent trend towards improved quality of life on several instruments, including the SF-36, the St George Respiratory Questionnaire and the K10 questionnaire; the improvement in the latter was significant. Hospitalizations were reduced in both the control (-19%) and telehealth group (-25%). Patient interviews indicated that the technology was acceptable to most patients and their families, including the Māori. The results from the pilot trial suggest that wider implementation with a cost benefit evaluation could be worthwhile. PMID:22362838

  3. Integrating community health workers into a patient-centered medical home to support disease self-management among Vietnamese Americans: lessons learned.

    PubMed

    Wennerstrom, Ashley; Bui, Tap; Harden-Barrios, Jewel; Price-Haywood, Eboni G

    2015-01-01

    There is evidence that patient-centered medical homes (PCMHs) and community health workers (CHWs) improve chronic disease management. There are few models for integrating CHWs into PCMHs in order to enhance disease self-management support among diverse populations. In this article, we describe how a community-based nonprofit agency, a PCMH, and academic partners collaborated to develop and implement the Patient Resource and Education Program (PREP). We employed CHWs as PCMH care team members to provide health education and support to Vietnamese American patients with uncontrolled diabetes and/or hypertension. We began by conducting focus groups to assess patient knowledge, desire for support, and availability of community resources. Based on findings, we developed PREP with CHW guidance on cultural tailoring of educational materials and methods. CHWs received training in core competencies related to self-management support principles and conducted the 4-month intervention for PCMH patients. Throughout the program, we conducted process evaluation through structured team meetings and patient satisfaction surveys. We describe successes and challenges associated with PREP delivery including patient recruitment, structuring/documenting visits, and establishing effective care team integration, work flow, and communication. Strategies for mitigating these issues are presented, and we make recommendations for other PCMHs seeking to integrate CHWs into care teams. PMID:25139872

  4. Home-Based Parental Involvement in Young Children's Education: Examining the Effects of Maternal Education across U.S. Ethnic Groups

    ERIC Educational Resources Information Center

    Suizzo, Marie-Anne; Stapleton, Laura M.

    2007-01-01

    This study investigated the contributions of maternal education and ethnicity to three dimensions of home-based parental involvement in young children's education and development: parental expectations about educational attainment, children's activities at home and outside the home, and family routines. Controlling for family background variables…

  5. A computerized recognition system for the home-based physiotherapy exercises using an RGBD camera.

    PubMed

    Ar, Ilktan; Akgul, Yusuf Sinan

    2014-11-01

    Computerized recognition of the home based physiotherapy exercises has many benefits and it has attracted considerable interest among the computer vision community. However, most methods in the literature view this task as a special case of motion recognition. In contrast, we propose to employ the three main components of a physiotherapy exercise (the motion patterns, the stance knowledge, and the exercise object) as different recognition tasks and embed them separately into the recognition system. The low level information about each component is gathered using machine learning methods. Then, we use a generative Bayesian network to recognize the exercise types by combining the information from these sources at an abstract level, which takes the advantage of domain knowledge for a more robust system. Finally, a novel postprocessing step is employed to estimate the exercise repetitions counts. The performance evaluation of the system is conducted with a new dataset which contains RGB (red, green, and blue) and depth videos of home-based exercise sessions for commonly applied shoulder and knee exercises. The proposed system works without any body-part segmentation, bodypart tracking, joint detection, and temporal segmentation methods. In the end, favorable exercise recognition rates and encouraging results on the estimation of repetition counts are obtained. PMID:24860037

  6. Wi-Fi and GSM Based Motion Sensor for Home Security System Apllication

    NASA Astrophysics Data System (ADS)

    Huzaimy Jusoh, Mohamad; Jamali, Muhammad Firdaus Bin; Zainal Abidin, Ahmad Faizal bin; Asari Sulaiman, Ahmad; Fahmi Hussin, Mohamad

    2015-11-01

    The Wi-Fi and GSM based home security system is a system designed to reduce the high rates of crimes in most personal housing. The overall project consists of three major parts; the input part that consists of sensors, the software part that operates the entire hardware structure, and the output part, which consists of camera, alarm system, and micro secure digital (SD) data storage card. It is based on the principle of infrared radiation generated by a human body heat which trigger the passive infrared (PIR) sensor. The microcontroller processes the received signal, then trigger the buzzer alarm, camera and alerts the home owner through an SMS. Once triggered, the camera will capture the image of the intruder and the image will be saved in SD card. As alert to the user (away), the Global System for Mobile Communication (GSM) will send the Short Message Service (SMS) from the device to the user's mobile phone. The image will be sent to Dropbox data cloud storage via Wi-Fi for further clarification. The prototype was successfully developed, tested and has been installed at residential area in Taman Cahaya Alam, Section U12, Shah Alam, Malaysia.

  7. HOME-BASED SELF-DELIVERED MIRROR THERAPY FOR PHANTOM PAIN: A PILOT STUDY*

    PubMed Central

    Darnall, Beth D.; Li, Hong

    2014-01-01

    Objective To test the feasibility and preliminary efficacy of self-delivered home-based mirror therapy for phantom pain. Design Uncontrolled prospective treatment outcome pilot study. Participants Forty community-dwelling adults with unilateral amputation and phantom pain >3 on a 0–10 numeric rating scale enrolled either during a one-time study visit (n = 30) or remotely (n = 10). Methods Participants received an explanation of mirror therapy and were asked to self-treat for 25 min daily. Participants completed and posted back sets of outcomes questionnaires at months 1 and 2 post-treatment. Main outcome was mean phantom pain intensity at post-treatment. Results A significant reduction in mean phantom pain intensity was found at month 1 (n = 31, p = 0.0002) and at month 2 (n = 26, p = 0.002). The overall median percentage reduction at month 2 was 15.4%. Subjects with high education (>16 years) compared with low education (<16 years) (37.5% vs 4.1%) had greater reduction in pain intensity (p = 0.01). Conclusion These findings support the feasibility and efficacy of home-based self-delivered mirror therapy; this low-cost treatment may defray medical costs, therapy visits, and the patient travel burden for people with motivation and a high level of education. More research is needed to determine methods of cost-effective support for people with lower levels of education. PMID:22378591

  8. Web Based Personal Nutrition Management Tool

    NASA Astrophysics Data System (ADS)

    Bozkurt, Selen; Zayim, Neşe; Gülkesen, Kemal Hakan; Samur, Mehmet Kemal

    Internet is being used increasingly as a resource for accessing health-related information because of its several advantages. Therefore, Internet tailoring becomes quite preferable in health education and personal health management recently. Today, there are many web based health programs de-signed for individuals. Among these studies nutrition and weight management is popular because, obesity has become a heavy burden for populations worldwide. In this study, we designed a web based personal nutrition education and management tool, The Nutrition Web Portal, in order to enhance patients’ nutrition knowledge, and provide behavioral change against obesity. The present paper reports analysis, design and development processes of The Nutrition Web Portal.

  9. ¡Miranos! (Look at Us! We Are Healthy!): Home-Based and Parent Peer-Led Childhood Obesity Prevention.

    PubMed

    Sosa, Erica T; Parra-Medina, Deborah; He, Meizi; Trummer, Virginia; Yin, Zenong

    2016-09-01

    Parent interventions for childhood obesity prevention have traditionally experienced low participation rates or used passive methods such as newsletters. In contrast, the ¡Miranos! intervention home-based activities included parent-led face-to-face meetings delivered after school, take-home bags with educational materials, and scavenger hunt games to deliver health information to Head Start families regarding nutrition, physical activity, and healthy growth promotion for their preschooler. This study employed a quasi-experimental design with three intervention centers (two that received only center-based activities and one that received center- and home-based activities) and one comparison center. Data were collected on participating Head Start children and their parents/guardians and included parent attendance, parent health message recall through intercept interviews, parent knowledge through pre- and posttests, and family supportive behaviors and child health behaviors through a parent questionnaire. Parents/guardians that received both center- and home-based activities significantly increased knowledge scores (t = 2.50, degrees of freedom = 123, p < .05) and family supportive behaviors from baseline to follow-up (t = 2.12, degrees of freedom = 122, p < .05). This study demonstrates the effects home-based interventions can have when coupled with center-based activities and implemented in the center at the end of the school day. PMID:26895848

  10. Marketing home care services.

    PubMed

    Moore, S T

    1987-08-01

    With the decline in inpatients, hospital administrators and marketers are seeking revenue opportunities in meeting the needs of a new market, home care patients. The challenge for managers in the home care arena is to target their marketing efforts towards the important decision makers. Managers who can best meet the goal of patients, families and professionals will be most successful. PMID:10301949

  11. Impact of an alcohol-based hand sanitizer intervention on the spread of viruses in homes.

    PubMed

    Tamimi, Akrum H; Carlino, Sheri; Edmonds, Sarah; Gerba, Charles P

    2014-06-01

    The objectives of this study were to determine the movement of a virus throughout a household and the impact of an alcohol-based hand sanitizer (ABHS) on reducing the movement and exposure of the virus to household members. Bacterial virus MS-2 was used as the surrogate for human enteric and respiratory viruses. Seven households with families having at least two children in the age range of 2-18 living in the home were used in this study. The hands of one adult family member were contaminated with 1 × 10(8). MS-2 bacteriophage in each home. After 8 h, the hands of each family member (10 fingers) and 20 frequently touched fomites were sampled to determine baseline contamination without intervention. Within 8 h, MS-2 was detected on all of the family member's hands and most of the fomites. The intervention consisted of providing the families in all selected homes with bottles of an ABHS, which were placed in the kitchen, bathrooms, and nurseries. Smaller individual bottles were provided for each family member greater than 12 years old to place in purses, pockets, backpacks, etc. The families were instructed to use the ABHS one time or three times during the day. For one and three uses, a statistically significant reduction of virus on un-inoculated and inoculated hands of ~99% occurred within 8 h. Similar reductions occurred on fomites throughout the households (97-99%). These results demonstrate that the use of an ABHS can significantly reduce transfer of a virus to the hands, and to the commonly touched surfaces within the household. PMID:24728950

  12. Supporting Replication and Scale-Up of Evidence-Based Home Visiting Programs: Assessing the Implementation Knowledge Base

    PubMed Central

    Del Grosso, Patricia; Supplee, Lauren

    2014-01-01

    In recent years, researchers, policymakers, and practitioners have expressed a growing interest in the use of interventions with scientific evidence of effectiveness. Reproducing positive effects shown in research, however, requires more than simply adopting an evidence-based program. There is growing recognition across disciplines of the importance of implementation research to guide adoption, replication, and scale-up of evidence-based interventions. We evaluate the state of the knowledge base supporting replication and scale-up of evidence-based programs by reviewing information on implementation included in the research literature on 22 home visiting programs that have or are building an evidence base. We used the Interactive Systems Framework for Dissemination and Implementation to assess programs. PMID:25033117

  13. What Is Home Schooling?

    ERIC Educational Resources Information Center

    Ohio State Legislative Office of Education Oversight, Columbus.

    The Ohio Department of Education estimates that 15,000 children were being home-schooled in Ohio, based on a 1991 survey of school superintendents. This document presents an overview of home schooling and describes the nature and extent of home schooling in Ohio. Data are based on a review of literature, information received from national and…

  14. Managing Malnutrition in Older Persons Residing in Care Homes: Nutritional and Clinical Outcomes Following a Screening and Intervention Program.

    PubMed

    Mountford, Christopher G; Okonkwo, Arthur C O; Hart, Kathryn; Thompson, Nick P

    2016-01-01

    This study aimed to establish prevalence of malnutrition in older adult care home residents and investigate whether a nutritional screening and intervention program could improve nutritional and clinical outcomes. A community-based cohort study was conducted in five Newcastle care homes. 205 participants entered; 175 were followed up. Residents already taking oral nutritional supplements (ONS) were excluded from interventions. Those with Malnutrition Universal Screening Tool (MUST) score of 1 received dietetic advice and ≥2 received dietetic advice and were prescribed ONS (220 ml, 1.5 kcal/ml) twice daily for 12 weeks. Body mass index (BMI), MUST, mini nutritional assessment score (MNA)®, mid upper arm muscle circumference (MAMC), and Geriatric Depression Scale (GDS) were recorded at baseline and 12 weeks. Malnutrition prevalence was 36.6% ± 6.6 (95% CI). A higher MUST was associated with greater mortality (p = 0.004). Type of intervention received was significantly associated with change in MUST score (p < 0.001); dietetic advice resulting in the greatest improvement. There were no significant changes in BMI (p = 0.445), MAMC (p = 0.256), or GDS (p = 0.385) following the interventions. Dietitian advice may slow the progression of nutritional decline. In this study oral nutritional supplements over a 3-month period did not significantly improve nutritional status in malnourished care home residents. PMID:26885946

  15. Using oxygen at home

    MedlinePlus

    ... DO NOT use oil-based products, such as petroleum jelly (Vaseline). Ask your oxygen equipment provider about ... oxygen; Hypoxia - home oxygen; Hospice - home oxygen References American Thoracic Society. Why do I need oxygen therapy? ...

  16. Internet Protocol Television for Personalized Home-Based Health Information: Design-Based Research on a Diabetes Education System

    PubMed Central

    Clarke, Ken; Kwong, Mabel; Alzougool, Basil; Hines, Carolyn; Tidhar, Gil; Frukhtman, Feodor

    2014-01-01

    Background The use of Internet protocol television (IPTV) as a channel for consumer health information is a relatively under-explored area of medical Internet research. IPTV may afford new opportunities for health care service providers to provide health information and for consumers, patients, and caretakers to access health information. The technologies of Web 2.0 add a new and even less explored dimension to IPTV’s potential. Objective Our research explored an application of Web 2.0 integrated with IPTV for personalized home-based health information in diabetes education, particularly for people with diabetes who are not strong computer and Internet users, and thus may miss out on Web-based resources. We wanted to establish whether this system could enable diabetes educators to deliver personalized health information directly to people with diabetes in their homes; and whether this system could encourage people with diabetes who make little use of Web-based health information to build their health literacy via the interface of a home television screen and remote control. Methods This project was undertaken as design-based research in two stages. Stage 1 comprised a feasibility study into the technical work required to integrate an existing Web 2.0 platform with an existing IPTV system, populated with content and implemented for user trials in a laboratory setting. Stage 2 comprised an evaluation of the system by consumers and providers of diabetes information. Results The project succeeded in developing a Web 2.0 IPTV system for people with diabetes and low literacies and their diabetes educators. The performance of the system in the laboratory setting gave them the confidence to engage seriously in thinking about the actual and potential features and benefits of a more widely-implemented system. In their feedback they pointed out a range of critical usability and usefulness issues related to Web 2.0 affordances and learning fundamentals. They also described

  17. "Willing but unwilling": attitudinal barriers to adoption of home-based health information technology among older adults.

    PubMed

    Young, Rachel; Willis, Erin; Cameron, Glen; Geana, Mugur

    2014-06-01

    While much research focuses on adoption of electronic health-care records and other information technology among health-care providers, less research explores patient attitudes. This qualitative study examines barriers to adoption of home-based health information technology, particularly personal electronic health records, among older adults. We conducted in-depth interviews (30-90 min duration) with 35 American adults, aged 46-72 years, to determine their perceptions of and attitudes toward home-based health information technology. Analysis of interview data revealed that most barriers to adoption fell under four themes: technological discomfort, privacy or security concerns, lack of relative advantage, and perceived distance from the user representation. Based on our findings, systems to promote home-based health information technology should incorporate familiar computer applications, alleviate privacy and security concerns, and align with older adults' active and engaged self-image. PMID:24056750

  18. SPIRE Data-Base Management System

    NASA Technical Reports Server (NTRS)

    Fuechsel, C. F.

    1984-01-01

    Spacelab Payload Integration and Rocket Experiment (SPIRE) data-base management system (DBMS) based on relational model of data bases. Data bases typically used for engineering and mission analysis tasks and, unlike most commercially available systems, allow data items and data structures stored in forms suitable for direct analytical computation. SPIRE DBMS designed to support data requests from interactive users as well as applications programs.

  19. WiSPH: a wireless sensor network-based home care monitoring system.

    PubMed

    Magaña-Espinoza, Pedro; Aquino-Santos, Raúl; Cárdenas-Benítez, Néstor; Aguilar-Velasco, José; Buenrostro-Segura, César; Edwards-Block, Arthur; Medina-Cass, Aldo

    2014-01-01

    This paper presents a system based on WSN technology capable of monitoring heart rate and the rate of motion of seniors within their homes. The system is capable of remotely alerting specialists, caretakers or family members via a smartphone of rapid physiological changes due to falls, tachycardia or bradycardia. This work was carried out using our workgroup's WiSe platform, which we previously developed for use in WSNs. The proposed WSN architecture is flexible, allowing for greater scalability to better allow event-based monitoring. The architecture also provides security mechanisms to assure that the monitored and/or stored data can only be accessed by authorized individuals or devices. The aforementioned characteristics provide the network versatility and solidity required for use in health applications. PMID:24759112

  20. Willingness to pay for home- and community-based services for seniors in Florida.

    PubMed

    Loh, Chung-Ping; Shapiro, Adam

    2013-01-01

    States are increasingly interested in measuring the benefit of home- and community-based services (HCBS) programs in order to determine if continued provision of HCBS can be justified on a cost-benefit basis. This study attempts to assess the maximum dollar amount HCBS enrollees or eligible applicants are willing to pay as a measure of the value of the services to them. A contingent valuation survey was conducted on a random sample of 409 clients who were enrolled in or waitlisted for HCBS programs in Florida. Based on estimates from a random-effect model, the median and mean willingness to pay amounts are calculated to be $901 and $933 per month per person, respectively, with considerable variation across HCBS programs. The major determinants of willingness to pay include household income and individual functional status. The sizable values for willingness to pay reported in this study suggest that HCBS programs are perceived as a valuable resource for the elderly. PMID:23438507