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Sample records for adult day services

  1. Adult Day Services

    MedlinePlus

    A Smart Choice Adult Day Services Comparison At-a-Glance 1 Adult Day Services Assisted Living Home Care Nursing Homes Live at home with family ... supervision Nursing care available as needed during the day Flexibility to receive care only on days when ...

  2. Counseling Services in Adult Day Care Centers.

    ERIC Educational Resources Information Center

    Zaki, Gamal; Zaki, Sylvia

    Federal support for adult day care centers began in the United States approximately 10 years ago. To examine the counseling practices in the adult day care centers across the country and to explore how the services are affected by the staffing patterns at these centers, 135 centers completed a questionnaire. The questionnaire addressed…

  3. Diabetes and Adult Day Health Services

    ERIC Educational Resources Information Center

    Dabelko, Holly I.; DeCoster, Vaughn A.

    2007-01-01

    The purpose of this study is to provide a profile of individuals with diabetes who receive services in adult day centers. This exploratory study uses an administrative data set (N = 280) from five programs in central Ohio to examine four areas: demographics, health and mental health, financial and social resources, and disenrollment status. Older…

  4. Enhancing Quality of Life of Families Who Use Adult Day Services: Short- and Long-Term Effects of the Adult Day Services Plus Program

    ERIC Educational Resources Information Center

    Gitlin, Laura N.; Reever, Karen; Dennis, Marie P.; Mathieu, Esther; Hauck, Walter W.

    2006-01-01

    Purpose: This study examined the short- and long-term effects of Adult Day Services Plus (ADS Plus), a low-cost care management intervention designed to enhance family caregiver well-being, increase service utilization, and decrease nursing home placement of impaired older adults enrolled in adult day care. Design and Methods: We used a…

  5. QuickStats: Percentage of Adult Day Services Center Participants, by Selected Diagnoses

    MedlinePlus

    ... MMWR ) MMWR Share Compartir QuickStats: Percentage of Adult Day Services Center Participants,* by Selected Diagnoses † — National Study ... which is the estimated number of enrolled adult day services center participants in the United States on ...

  6. Variation in Adult Day Services Center Participant Characteristics, by Center Ownership: United States, 2014.

    PubMed

    Park-Lee, Eunice; Harris-Kojetin, Lauren D; Rome, Vincent; Lendon, Jessica P

    2015-12-01

    More than one-quarter million participants were enrolled in adult day services centers in the United States on the day of data collection in 2014. The number of for-profit adult day services centers has grown in recent years. In 2012, 40% of adult day services centers were for-profit, serving more than one-half of all participants. This report presents the most current national estimates of selected characteristics of participants in adult day services centers and compares these characteristics by center ownership type. State-level estimates for the characteristics presented in this report are available online at http://www.cdc.gov/nchs/nsltcp/nsltcp_products.htm.

  7. Variation in Operating Characteristics of Adult Day Services Centers, by Center Ownership: United States, 2014.

    PubMed

    Rome, Vincent; Harris-Kojetin, Lauren D; Park-Lee, Eunice

    2015-12-01

    More than one-quarter of a million participants were enrolled in 4,800 adult day services centers in the United States in 2014. Unlike other long-term care providers, such as nursing homes, home health agencies, hospices, and residential care communities, the majority of adult day services centers are nonprofit. However, for-profit ownership of adult day services centers has increased, from 27% in 2010 to 40% in 2012, and more recently to 44% in 2014. This report presents the most current national estimates of selected adult day services center operating characteristics, and compares these characteristics by center ownership. State estimates for the characteristics presented in this data brief are available online at: http://www.cdc.gov/nchs/ nsltcp/nsltcp_products.htm.

  8. Use of Adult Day Care Centers: Do They Offset Utilization of Health Care Services?

    ERIC Educational Resources Information Center

    Iecovich, Esther; Biderman, Aya

    2013-01-01

    Purpose: Based on the medical offset effect, the goal of the study was to examine the extent to which users and nonusers of adult day care centers (ADCC) differ in frequency of use of out-patient health services (visits to specialists) and in-patient health services (number of hospital admissions, length of hospitalizations, and visits to…

  9. 76 FR 43254 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-20

    ... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2011 Through June 30, 2012 AGENCY: Food and Nutrition Service...-risk afterschool care centers, and adult day care centers; the food service payment rates for meals...

  10. 78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-26

    ... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2013 Through June 30, 2014 AGENCY: Food and Nutrition Service...-risk afterschool care centers, and adult day care centers; the food service payment rates for meals...

  11. 75 FR 41793 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-19

    ... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2010 Through June 30, 2011 AGENCY: Food and Nutrition Service...-risk afterschool care centers, and adult day care centers; the food service payment rates for meals...

  12. Impact of Adult Day Services on Behavioral and Psychological Symptoms of Dementia

    ERIC Educational Resources Information Center

    Femia, Elia E.; Zarit, Steven H.; Stephens, Mary Ann Parris; Greene, Rick

    2007-01-01

    Purpose: This study explored whether adult day service (ADS) use was associated with reductions in behavioral and psychological symptoms of dementia (BPSD) in individuals with dementia. Design and Methods: We used a quasi-experimental design to compare a group of 133 persons with dementia (PWDs) who initially enrolled in an ADS program to a…

  13. Adult Day Care

    MedlinePlus

    ... Page Resize Text Printer Friendly Online Chat Adult Day Care Adult Day Care Centers are designed to provide care and ... adults who need assistance or supervision during the day. Programs offer relief to family members and caregivers, ...

  14. The adult day care workforce in England at a time of policy change: implications for learning disability support services.

    PubMed

    Hussein, Shereen; Manthorpe, Jill

    2010-06-01

    More people will receive personal budgets to pay for social care services in England. Such people may or may not continue using services such as adult day care centres. Many day centres are under threat of closure. These trends will affect those working in adult day care. This article examines the profile of this workforce, using recent NMDS-SC data and applying multinomial statistical modelling. We identified nearly 6000 adult day care workers, over half supporting adults with learning disability. The results of the analysis show significant variations between the adult day care, residential care and domiciliary workforces. At the personal level, day care workers are significantly older and less ethnically diverse than other workers. They tend to have been working in the sector for longer, and their work patterns are more stable. The findings are discussed within the context of policy changes affecting learning disabilities and social care workforce strategies.

  15. Integrating Behavioral Psychology Services into Adult Day Programming for Individuals with Dementia

    ERIC Educational Resources Information Center

    LeBlanc, Linda A.

    2010-01-01

    Many individuals with dementia and problem behavior are served in nursing home settings long before health issues necessitate constant medical care. Alternative community-based adult day health care programs allow individuals with dementia to remain in their home with their families at a substantially reduced cost; however, many adult day programs…

  16. 76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2011 Through June 30, 2012 Correction In notice document 2011... page 43255, the table labeled ``Administrative Reimbursement Rates for Sponsoring Organizations of...

  17. Green Care Farms: An Innovative Type of Adult Day Service to Stimulate Social Participation of People With Dementia.

    PubMed

    de Bruin, Simone R; Stoop, Annerieke; Molema, Claudia C M; Vaandrager, Lenneke; Hop, Peter J W M; Baan, Caroline A

    2015-01-01

    Objective: To explore the value of day services at green care farms (GCFs) in terms of social participation for people with dementia. Method: Semi-structured interviews were conducted with people with dementia who attended day services at a GCF (GCF group, n = 21), were on a waiting list (WL) for day services at a GCF (WL group, n = 12), or attended day services in a regular day care facility (RDCF group, n = 17) and with their family caregivers. Results: People with dementia in the GCF and WL group were primarily males, with an average age of 71 and 76 years, respectively, who almost all had a spousal caregiver. People with dementia in the RDCF group were mostly females with an average age of 85 years, most of whom had a non-spousal caregiver. For both the GCF and RDCF groups, it was indicated that day services made people with dementia feel part of society. The most important domains of social participation addressed by RDCFs were social interactions and recreational activities. GCFs additionally addressed the domains "paid employment" and "volunteer work." Conclusion: GCFs are valuable in terms of social participation for a particular group of people with dementia. Matching characteristics of adult day services (ADS) centers to the preferences and capacities of people with dementia is of importance. Diversity in ADS centers is therefore desirable.

  18. Daily Stressors and Adult Day Service Use by Family Caregivers: Effects on Depressive Symptoms, Positive Mood and DHEA-S

    PubMed Central

    Zarit, Steven H.; Whetzel, Courtney A.; Kim, Kyungmin; Femia, Elia E.; Almeida, David M.; Rovine, Michael J.; Klein, Laura Cousino

    2014-01-01

    Objectives This study examines effects of daily use of adult day services (ADS) programs by caregivers of individuals with dementia (IWD) on a salivary biomarker of stress reactivity, dehydroepiandrosterone-sulfate (DHEA-S), and whether these effects on DHEA-S are associated with daily variability in positive mood and depressive symptoms. Design We used a daily diary design of 8 consecutive days with alternation of intervention (ADS) and non-intervention days to evaluate within- and between-person effects of the intervention. Setting Caregivers were interviewed daily by telephone at home. Participants 151 family caregivers of IWD who were using ADS. Measurements Saliva samples were collected from caregivers 5 times a day for 8 consecutive days and were assayed for DHEA-S. Daily telephone interviews assessed daily stressors and mood. Results DHEA-S levels were significantly higher on days following ADS use. Daily DHEA-S levels covaried significantly with daily positive mood, but not depressive symptoms. Conclusions These results demonstrate an association of ADS use by family caregivers and higher DHEA-S levels on the next day. Prior research has found that higher DHEA-S levels are protective against the physiological damaging effects of stressor exposure and may reduce risks of illness. Regular use of ADS may help reduce depletion of DHEA-S and allow the body to mount a protective and restorative response to the physiological demands of caregiving. To our knowledge, this is the first study to examine DHEA-S levels across the day in connection with an intervention that affected daily exposure to stressors. PMID:24566240

  19. The day of your surgery - adult

    MedlinePlus

    Same-day surgery - adult; Ambulatory surgery - adult; Surgical procedure - adult; Preoperative care - day of surgery ... meet with them at an appointment before the day of surgery or on the same day of ...

  20. 49 CFR 230.18 - Service days.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Service days. 230.18 Section 230.18 Transportation... Service days. (a) Service day record. For every steam locomotive currently in service, the steam... current copy of the service day record that contains the number of service days the steam locomotive...

  1. 49 CFR 230.18 - Service days.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Service days. 230.18 Section 230.18 Transportation... Service days. (a) Service day record. For every steam locomotive currently in service, the steam... current copy of the service day record that contains the number of service days the steam locomotive...

  2. 49 CFR 230.18 - Service days.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Service days. 230.18 Section 230.18 Transportation... Service days. (a) Service day record. For every steam locomotive currently in service, the steam... current copy of the service day record that contains the number of service days the steam locomotive...

  3. 49 CFR 230.18 - Service days.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Service days. 230.18 Section 230.18 Transportation... Service days. (a) Service day record. For every steam locomotive currently in service, the steam... current copy of the service day record that contains the number of service days the steam locomotive...

  4. 49 CFR 230.18 - Service days.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Service days. 230.18 Section 230.18 Transportation... Service days. (a) Service day record. For every steam locomotive currently in service, the steam... current copy of the service day record that contains the number of service days the steam locomotive...

  5. Young Adult Services Manual.

    ERIC Educational Resources Information Center

    Boegen, Anne, Ed.

    Designed to offer guidelines, ideas and help to those who provide library service to young adults, this manual includes information about the provision of young adult (YA) services in six sections. The first section, which addresses planning and administration, includes a definition of a young adult and a checklist for determining community needs…

  6. Young Adult Library Services.

    ERIC Educational Resources Information Center

    The Bookmark, 1985

    1985-01-01

    Eight articles in this Spring 1985 issue of The Bookmark focus on young adult library services. In addition to these thematic articles, an introduction and three reports are presented. The issue contains: (1) "In Perspective" (E. J. Josey); (2) "Young Adult Literature in the 1980's--Awesome!" (Ellin Chu); (3) "Young Adult…

  7. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Adult day health care... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care requirements. As a condition for receiving a grant and grant funds under this part for an adult day health...

  8. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Adult day health care... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care requirements. As a condition for receiving a grant and grant funds under this part for an adult day health...

  9. Book Display as Adult Service.

    ERIC Educational Resources Information Center

    Moore, Matthew S.

    1997-01-01

    Defines book display as an adult service as choosing and positioning adult books from the library collection to increase their circulation. The author contrasts bookstore arrangement for sales versus library arrangement for access, including contrasting missions, genre grouping, weeding, problems, and dimensions. (Author/LRW)

  10. Adult Learning Program Service (ALPS).

    ERIC Educational Resources Information Center

    Carlisle, Robert

    The Adult Learning Program Service (ALPS) aims to reach eight and a half million adults between ages 25 and 44 and teach them reading and math skills they can use at home and on the job. ALPS proposes to reach those who have never finished high school but do have at least a sixth-grade reading level. They could use their new skills to prepare for…

  11. 78 FR 56807 - Patriot Day and National Day of Service and Remembrance, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-13

    ... September 13, 2013 Part III The President Proclamation 9015--Patriot Day and National Day of Service and... ] Proclamation 9015 of September 10, 2013 Patriot Day and National Day of Service and Remembrance, 2013 By the... going about their day, harming no one, when sudden violence struck. We will never undo the pain...

  12. Evaluation of Purchased Day Care: Texas Department of Human Services Day Care Service Control Pilot Study, 1985 through 1989.

    ERIC Educational Resources Information Center

    Monroe, Marian

    This pilot study of facilities from which the Texas Department of Human Services (TDHS) purchased day care services gathered and analyzed data for use in developing day care service control standards by means of which the quality of purchased day care services could be systematically assessed. Random samples were selected from contract centers,…

  13. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... it is co-located in a nursing home, domiciliary, or other care facility, must have its own separate... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care... necessary to accommodate an increased quality of care for patients, an adult day health care...

  14. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... it is co-located in a nursing home, domiciliary, or other care facility, must have its own separate... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care... necessary to accommodate an increased quality of care for patients, an adult day health care...

  15. Adult Day Care--Extended Family.

    ERIC Educational Resources Information Center

    Smith, Bert Kruger

    This pamphlet describes a multi-purpose day-care center for the elderly in Abilene, Texas which is intended to fill the "extended family" role of offering companionship, medical attention, and other aspects of concern to older persons in the community. The goals of the program are as follows: (1) to keep individuals out of institutions…

  16. Adult Day Care--Extended Family.

    ERIC Educational Resources Information Center

    Smith, Bert K.

    This booklet reports on a community project in Texas involving a day care center for senior citizens. It contains an analysis of successes and failures in attempting to satisfy the project's goals of: (l) keeping individuals out of institutions as long as possible; (2) providing social contact and enrichment experiences; (3) making the burden…

  17. Family Day Care Services: Our Great-Grandmothers' Quilt

    ERIC Educational Resources Information Center

    Arruda, Joan

    2009-01-01

    This article features Family Day Care Services, one of the largest nonprofit providers of licensed home and centre-based child care programs in the Greater Toronto Area with 400 staff serving more than 4,000 children and their families. Family Day Care Services is also the lead agency for five Ontario Early Years Centres which are family…

  18. Adult Services in the Eighties: Final Report.

    ERIC Educational Resources Information Center

    Heim, Kathleen M.

    The American Library Association's (ALA) Adult Services in the Eighties (ASE) project was undertaken to supply information about areas of current and unique concentration to aid librarians in identifying, describing, and planning the scope of adult services in their own libraries. The ASE project updates a study conducted in 1954--the most recent…

  19. Developing Public Library Services for Young Adults.

    ERIC Educational Resources Information Center

    Smith, Jim

    From November 1992 through May 1993, a series of staff development and training workshops were presented as part of the project, "Developing Library Services for Young Adults." The workshops included: "Redirecting Young Adult Behavior" (Glenna O. Auxier & Bob Perchalski); "The Youth Services Librarian and the Law"…

  20. Adult Day Care for Alzheimer's Patients and Their Families.

    ERIC Educational Resources Information Center

    Sands, Dan; Suzuki, Thelma

    1983-01-01

    Harbor Area Adult Day Care Center has operated for two years with a primary purpose of providing respite care to families caring for a relative with Alzheimer's disease or related disorders. The rationale, history, program, staffing, funding, and experience for the first two years of the project are provided. (Author/RC)

  1. Cultural Support Workers and Long Day Care Services

    ERIC Educational Resources Information Center

    Miller, Melinda G.; Knowles, Meg; Grieshaber, Susan

    2011-01-01

    In Australia, eligible long day care services may apply for support at the state level to assist with the transition of children from culturally or linguistically diverse backgrounds into childcare settings. For staff in childcare services, this support comes in the form of a cultural support worker (CSW). The primary role of a CSW is to build…

  2. Sleep characteristics of Veterans Affairs Adult Day Health Care participants.

    PubMed

    Hughes, Jaime M; Martin, Jennifer L

    2015-01-01

    Addressing sleep disturbance can help to slow functional decline, delay nursing home admission, and improve overall health among older adults; however, sleep is not widely studied in high-risk older adults such as Adult Day Health Care (ADHC) participants. Sixty-eight ADHC participants were interviewed for sleep disturbance using a 28-item screening questionnaire. More than two thirds (n = 48, 70.6%) reported one or more characteristics of poor sleep, and 38% of participants met basic criteria for insomnia. Individuals with insomnia attended ADHC less frequently, reported worse sleep quality and shorter sleep duration, and were more likely to endorse trouble falling asleep, staying asleep, and waking up too early (ps < 0.001). Research is needed to better understand perceptions, predictors, and outcomes of sleep disturbance within ADHC participants.

  3. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be...

  4. 7 CFR 226.19a - Adult day care center provisions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 4 2014-01-01 2014-01-01 false Adult day care center provisions. 226.19a Section 226... § 226.19a Adult day care center provisions. (a) Adult day care centers may participate in the Program... auspices of a for-profit sponsoring organization. Adult day care centers participating as...

  5. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be...

  6. 7 CFR 226.19a - Adult day care center provisions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 4 2013-01-01 2013-01-01 false Adult day care center provisions. 226.19a Section 226... § 226.19a Adult day care center provisions. (a) Adult day care centers may participate in the Program... auspices of a for-profit sponsoring organization. Adult day care centers participating as...

  7. 7 CFR 226.19a - Adult day care center provisions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 4 2011-01-01 2011-01-01 false Adult day care center provisions. 226.19a Section 226... § 226.19a Adult day care center provisions. (a) Adult day care centers may participate in the Program... auspices of a for-profit sponsoring organization. Adult day care centers participating as...

  8. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be...

  9. 7 CFR 226.19a - Adult day care center provisions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 4 2012-01-01 2012-01-01 false Adult day care center provisions. 226.19a Section 226... § 226.19a Adult day care center provisions. (a) Adult day care centers may participate in the Program... auspices of a for-profit sponsoring organization. Adult day care centers participating as...

  10. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be...

  11. Making an Adult Careers Service Work

    ERIC Educational Resources Information Center

    McNair, Stephen

    2012-01-01

    In the current climate, the launch of the new National Careers Service in England is a cheering ray of light in a gloomy world. Despite fierce constraints on public spending, the government has secured the resources, and political will, and the Skills Funding Agency is now funding a service, which provides online and phone guidance to adults and…

  12. Services for Visually Impaired Adults in Canada.

    ERIC Educational Resources Information Center

    Magarrell, G.

    1990-01-01

    The article examines the partnership between the Canadian government and nonprofit organizations in delivering rehabilitation services to blind/visually impaired adults. Discussed are legislation, concessions to blind persons, services of the Canadian National Institute for the Blind, special equipment, dog guide schools, consumer groups, and the…

  13. Brain Awareness Day: A Service-Learning Experience in Neuroscience

    ERIC Educational Resources Information Center

    Fox, Cecilia M.

    2007-01-01

    Three local colleges in the Lehigh Valley collaborate on a service-learning project called Brain Awareness Day to enhance neuroscience literacy among the public regarding the functions of the brain and benefits of brain research. (Contains 1 table and 1 figure.)

  14. Alternate-day dosing of itraconazole in healthy adult cats.

    PubMed

    Middleton, S M; Kubier, A; Dirikolu, L; Papich, M G; Mitchell, M A; Rubin, S I

    2016-02-01

    The current available formulations of itraconazole are not ideal for dosing in cats. The capsular preparation often does not allow for accurate dosing, the oral solution is difficult to administer and poorly tolerated, and the bioavailability of compounded formulations has been shown to be poor in other species. The aim of this study was to evaluate every other day dosing of 100 mg itraconazole capsule in healthy adult cats. Ten healthy adult cats received a 100 mg capsule of itraconazole orally every 48 h for 8 weeks. Peak and trough serum concentrations of itraconazole were measured weekly using high-performance liquid chromatography (HPLC). Physical examination, complete blood count (CBC), and chemistry profiles were performed weekly. The dosage regimen achieved average therapeutic trough concentrations (>0.5 μg/mL) within 3 weeks. The protocol yielded no adverse effects in 8 of the 10 study cats, with affected cats recovering fully with discontinuation of the drug and supportive care. At 8 weeks, an average peak concentration of 1.79 ± 0.952 μg/mL (95% CI: 0.996-2.588) and an average trough concentration of 0.761 ± 0.540 μg/mL (95% CI: 0.314-1.216) were achieved. Overall, a 100 mg every other day oral dosage regimen for itraconazole in cats yielded serum concentrations with minimal fluctuation and with careful monitoring may be considered for treatment of cats with systemic fungal disease.

  15. 3 CFR 8710 - Proclamation 8710 of September 9, 2011. Patriot Day and National Day of Service and Remembrance...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Proclamation 8710 of September 9, 2011. Patriot Day and National Day of Service and Remembrance, 2011 8710 Proclamation 8710 Presidential Documents Proclamations Proclamation 8710 of September 9, 2011 Proc. 8710 Patriot Day and National Day of Service...

  16. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52... knowledge and skills necessary to manage care requirements in the home. Adult day health care is...

  17. Services for Older Adults: Curriculum Guide.

    ERIC Educational Resources Information Center

    Mumme, Debbie

    This curriculum guide contains materials for a course that provides occupationally specific training designed to develop knowledge and skills for employment in the area of services for older adults. Contents include an introduction, the Texas Essential Knowledge and Skills (TEKS) covered; sample course outlines; instructional strategies organized…

  18. Characteristics of older adults rehospitalized within 7 and 30 days of discharge: implications for nursing practice.

    PubMed

    Hain, Debra J; Tappen, Ruth; Diaz, Sanya; Ouslander, Joseph G

    2012-08-01

    Rehospitalization within 30 days consumes a significant portion of health care costs; therefore, interventions aimed at reducing the risk of rehospitalization are needed. A retrospective study was conducted examining rehospitalization rates and diagnoses according to discharge location and comparing characteristics of older adults within 7 and 30 days of discharge from a community hospital. Data on rehospitalization for Medicare fee-for-service patients (75 and older) over a 12-month period were obtained from the information technology department of a not-for-profit community hospital. A total of 6,809 patients were discharged, with 12% rehospitalized within 30 days. Skilled nursing facilities had the highest rehospitalization rates (15%), followed by home with home health care (13%) and then home with self-care (8%). The highest rehospitalization rates were in areas where nursing has a strong presence, suggesting that nurses can play an important role in the development of interventions aimed at reducing rehospitalizations.

  19. 39 CFR Appendix A to Part 121 - Tables Depicting Service Standard Day Ranges

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Tables Depicting Service Standard Day Ranges A... Standard Day Ranges The following tables reflect the service standard day ranges resulting from the... through 121.4: Table 1. End-to-end service standard day ranges for mail originating and destinating...

  20. Day-to-day dynamics of experience--cortisol associations in a population-based sample of older adults.

    PubMed

    Adam, Emma K; Hawkley, Louise C; Kudielka, Brigitte M; Cacioppo, John T

    2006-11-07

    In 156 older adults, day-to-day variations in cortisol diurnal rhythms were predicted from both prior-day and same-day experiences, to examine the temporal ordering of experience-cortisol associations in naturalistic environments. Diary reports of daily psychosocial, emotional, and physical states were completed at bedtime on each of three consecutive days. Salivary cortisol levels were measured at wakeup, 30 min after awakening, and at bedtime each day. Multilevel growth curve modeling was used to estimate diurnal cortisol profiles for each person each day. The parameters defining those profiles (wakeup level, diurnal slope, and cortisol awakening response) were predicted simultaneously from day-before and same-day experiences. Prior-day feelings of loneliness, sadness, threat, and lack of control were associated with a higher cortisol awakening response the next day, but morning awakening responses did not predict experiences of these states later the same day. Same-day, but not prior-day, feelings of tension and anger were associated with flatter diurnal cortisol rhythms, primarily because of their association with higher same-day evening cortisol levels. Although wakeup cortisol levels were not predicted by prior-day levels of fatigue and physical symptoms, low wakeup cortisol predicted higher levels of fatigue and physical symptoms later that day. Results are consistent with a dynamic and transactional function of cortisol as both a transducer of psychosocial and emotional experience into physiological activation and an influence on feelings of energy and physical well-being.

  1. Tracking Healthy Days -- a window on the health of older adults.

    PubMed

    Moriarty, David G; Kobau, Rosemarie; Zack, Matthew M; Zahran, Hatice S

    2005-07-01

    In collaboration with its partners in the public health and aging services communities, the Centers for Disease Control and Prevention (CDC) Health Care and Aging Studies Branch has developed and validated a brief set of health-related quality of life (CDC HRQOL) measures for tracking the perceived physical and mental health of adults over time. For the past 12 years, these measures -- also called the Healthy Days measures -- have been used in an expanding set of population health surveys, surveillance systems, performance report cards, and evaluation studies, and they have provided useful disease and disability burden data to inform decision making and provide new insights for prevention research. Although now used continuously to assess health-related quality of life for Americans aged 12 years and older, the measures and population data have been especially valuable in applications affecting older adults, for which health-related quality of life is an outcome of primary importance. The CDC HRQOL measures are recommended to public health and social service professionals as a feasible way to assess perceived physical and mental health needs of older adults and to document the effects of policies and interventions.

  2. 49 CFR 230.17 - One thousand four hundred seventy-two (1472) service day inspection.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) service day inspection. 230.17 Section 230.17 Transportation Other Regulations Relating to Transportation... (1472) service day inspection. (a) General. Before any steam locomotive is initially put in service or brought out of retirement, and after every 1472 service days or 15 years, whichever is earlier,...

  3. 49 CFR 230.17 - One thousand four hundred seventy-two (1472) service day inspection.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) service day inspection. 230.17 Section 230.17 Transportation Other Regulations Relating to Transportation... (1472) service day inspection. (a) General. Before any steam locomotive is initially put in service or brought out of retirement, and after every 1472 service days or 15 years, whichever is earlier,...

  4. 49 CFR 230.17 - One thousand four hundred seventy-two (1472) service day inspection.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) service day inspection. 230.17 Section 230.17 Transportation Other Regulations Relating to Transportation... (1472) service day inspection. (a) General. Before any steam locomotive is initially put in service or brought out of retirement, and after every 1472 service days or 15 years, whichever is earlier,...

  5. Older adults' perceptions of home telehealth services.

    PubMed

    Cimperman, Miha; Brenčič, Maja Makovec; Trkman, Peter; Stanonik, Mateja de Leonni

    2013-10-01

    The success of home telemedicine depends on end-user adoption, which has been slow despite rapid advances in technological development. This study focuses on an examination of significant factors that may predict the successful adoption of home telemedicine services (HTS) among older adults. Based on previous studies in the fields of remote patient monitoring, assisted living technologies, and consumer health information technology acceptance, eight factors were identified as a framework for qualitative testing. Twelve focus groups were conducted with an older population living in both urban and rural environments. The results reveal seven predictors that play an important role in perceptions of HTS: perceived usefulness, effort expectancy, social influence, perceived security, computer anxiety, facilitating conditions, and physicians' opinion. The results provide important insights in the field of older adults' acceptance of HTS, with guidelines for the strategic planning, developing, and marketing of HTS for the graying market.

  6. Older Adults' Perceptions of Home Telehealth Services

    PubMed Central

    Brenčič, Maja Makovec; Trkman, Peter; de Leonni Stanonik, Mateja

    2013-01-01

    Abstract The success of home telemedicine depends on end-user adoption, which has been slow despite rapid advances in technological development. This study focuses on an examination of significant factors that may predict the successful adoption of home telemedicine services (HTS) among older adults. Based on previous studies in the fields of remote patient monitoring, assisted living technologies, and consumer health information technology acceptance, eight factors were identified as a framework for qualitative testing. Twelve focus groups were conducted with an older population living in both urban and rural environments. The results reveal seven predictors that play an important role in perceptions of HTS: perceived usefulness, effort expectancy, social influence, perceived security, computer anxiety, facilitating conditions, and physicians' opinion. The results provide important insights in the field of older adults' acceptance of HTS, with guidelines for the strategic planning, developing, and marketing of HTS for the graying market. PMID:23931702

  7. Bare Bones Young Adult Services: Tips for Public Library Generalists.

    ERIC Educational Resources Information Center

    Vaillancourt, Renee J.

    This book is a hands-on guide to the philosophy and practice of young adult services in the public libraries. The following chapters are included: (1) "Young Adult Services Philosophy," including reasons to serve teens, why teens are the way they are, who serves young adults, and how to interact with teens; (2) "Youth Participation," including…

  8. 39 CFR Appendix A to Part 121 - Tables Depicting Service Standard Day Ranges

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Tables Depicting Service Standard Day Ranges A Appendix A to Part 121 Postal Service UNITED STATES POSTAL SERVICE POST OFFICE SERVICES SERVICE STANDARDS FOR MARKET-DOMINANT MAIL PRODUCTS Pt. 121, App. A Appendix A to Part 121—Tables Depicting...

  9. 49 CFR 230.14 - Thirty-one (31) service day inspection.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Thirty-one (31) service day inspection. 230.14... General Inspection Requirements § 230.14 Thirty-one (31) service day inspection. (a) General. An individual competent to conduct the inspection shall perform the 31 service day inspection after the...

  10. 49 CFR 230.15 - Ninety-two (92) service day inspection.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Ninety-two (92) service day inspection. 230.15... General Inspection Requirements § 230.15 Ninety-two (92) service day inspection. (a) General. An individual competent to conduct the inspection shall perform the 92 service day inspection after the...

  11. 49 CFR 230.14 - Thirty-one (31) service day inspection.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Thirty-one (31) service day inspection. 230.14... General Inspection Requirements § 230.14 Thirty-one (31) service day inspection. (a) General. An individual competent to conduct the inspection shall perform the 31 service day inspection after the...

  12. 49 CFR 230.14 - Thirty-one (31) service day inspection.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Thirty-one (31) service day inspection. 230.14... General Inspection Requirements § 230.14 Thirty-one (31) service day inspection. (a) General. An individual competent to conduct the inspection shall perform the 31 service day inspection after the...

  13. 49 CFR 230.15 - Ninety-two (92) service day inspection.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Ninety-two (92) service day inspection. 230.15... General Inspection Requirements § 230.15 Ninety-two (92) service day inspection. (a) General. An individual competent to conduct the inspection shall perform the 92 service day inspection after the...

  14. 49 CFR 230.14 - Thirty-one (31) service day inspection.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Thirty-one (31) service day inspection. 230.14... General Inspection Requirements § 230.14 Thirty-one (31) service day inspection. (a) General. An individual competent to conduct the inspection shall perform the 31 service day inspection after the...

  15. 49 CFR 230.14 - Thirty-one (31) service day inspection.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Thirty-one (31) service day inspection. 230.14... General Inspection Requirements § 230.14 Thirty-one (31) service day inspection. (a) General. An individual competent to conduct the inspection shall perform the 31 service day inspection after the...

  16. 29 CFR 2530.200b-7 - Day of service for employees in the maritime industry.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Day of service for employees in the maritime industry. 2530... BENEFIT PLANS Scope and General Provisions § 2530.200b-7 Day of service for employees in the maritime industry. (a) General rule. A day of service in the maritime industry which must, as a minimum, be...

  17. 49 CFR 230.15 - Ninety-two (92) service day inspection.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Ninety-two (92) service day inspection. 230.15... General Inspection Requirements § 230.15 Ninety-two (92) service day inspection. (a) General. An individual competent to conduct the inspection shall perform the 92 service day inspection after the...

  18. 49 CFR 230.15 - Ninety-two (92) service day inspection.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Ninety-two (92) service day inspection. 230.15... General Inspection Requirements § 230.15 Ninety-two (92) service day inspection. (a) General. An individual competent to conduct the inspection shall perform the 92 service day inspection after the...

  19. 49 CFR 230.15 - Ninety-two (92) service day inspection.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Ninety-two (92) service day inspection. 230.15... General Inspection Requirements § 230.15 Ninety-two (92) service day inspection. (a) General. An individual competent to conduct the inspection shall perform the 92 service day inspection after the...

  20. 29 CFR 2530.200b-7 - Day of service for employees in the maritime industry.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Day of service for employees in the maritime industry. 2530... industry. (a) General rule. A day of service in the maritime industry which must, as a minimum, be counted... and care), or unemployment compensation or disability insurance laws; and (iii) Days of service...

  1. 29 CFR 2530.200b-7 - Day of service for employees in the maritime industry.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Day of service for employees in the maritime industry. 2530... industry. (a) General rule. A day of service in the maritime industry which must, as a minimum, be counted... and care), or unemployment compensation or disability insurance laws; and (iii) Days of service...

  2. 29 CFR 2530.200b-7 - Day of service for employees in the maritime industry.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Day of service for employees in the maritime industry. 2530... industry. (a) General rule. A day of service in the maritime industry which must, as a minimum, be counted... and care), or unemployment compensation or disability insurance laws; and (iii) Days of service...

  3. Validity of a Self-Administered 3-Day Physical Activity Recall in Young Adults

    ERIC Educational Resources Information Center

    Han, Jennifer L.; Dinger, Mary K.

    2009-01-01

    Background: Most physical activity recall questionnaires assess activity over a 7-day period. However, questionnaires have been validated in adolescents and adults using shorter recall timeframes. Purpose: The purpose of this study was to assess the validity of a self-administered 3-day physical activity recall instrument (3DR) in young adults.…

  4. 3 CFR 9015 - Proclamation 9015 of September 10, 2013. Patriot Day and National Day of Service and Remembrance...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Proclamation 9015 of September 10, 2013. Patriot Day and National Day of Service and Remembrance, 2013 9015 Proclamation 9015 Presidential Documents... memories. Let us also live up to the selfless example of the heroes who gave of themselves in the face...

  5. 77 FR 67657 - Request for Public Comment: 30-Day Proposed Information Collection: Indian Health Service (IHS...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-13

    ... health care and preventive health services. To support the IHS mission and to provide the product/service... HUMAN SERVICES Indian Health Service Request for Public Comment: 30-Day Proposed Information Collection: Indian Health Service (IHS) Sharing What Works--Best Practice, Promising Practice, and Local...

  6. 77 FR 56745 - Patriot Day and National Day of Service and Remembrance, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-13

    ... volunteering and helping survivors who had borne so much. We were united, and the outpouring of generosity... spirit of compassion by serving their communities in the days and weeks ahead. From volunteering with...

  7. 76 FR 56943 - Patriot Day and National Day of Service and Remembrance, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... values that define us do not simply endure--they are stronger than ever. As a Nation, we responded to... in the days and months that followed. By volunteering our time and unique skills, we can...

  8. Disposition of acetaminophen at 4, 6, and 8 g/day for 3 days in healthy young adults.

    PubMed

    Gelotte, C K; Auiler, J F; Lynch, J M; Temple, A R; Slattery, J T

    2007-06-01

    The objective of this study was to determine the disposition and tolerability of 1, 1.5, and 2 g acetaminophen every 6 h for 3 days. Group I healthy adults received acetaminophen (4 then 6 g/day) or placebo; Group II received acetaminophen (4 then 8 g/day) or placebo. Acetaminophen and metabolites were measured in plasma and urine. Hepatic aminotransferases were measured daily. At steady state, acetaminophen concentrations were surprisingly lower than predicted from single-dose data, although sulfate formation clearance (fCL) was lower as expected, indicating cofactor depletion with possible sulfotransferase saturation. In contrast, glucuronide fCL was unexpectedly higher, strongly suggesting glucuronosyltransferase induction. This is the first evidence that acetaminophen induces its own glucuronidation. No dose-dependent differences were detected in fCL of thiol metabolites formed via cytochrome P4502E1. Hepatic aminotransferases stayed within reference ranges, and the incidence and frequency of adverse events were similar for acetaminophen and placebo. Although dose-dependence of acetaminophen disposition was reported previously, this study shows a novel finding of time-dependent disposition during repeated dosing. Unexpected increases in glucuronide fCL more than offset decreases in sulfate fCL, thus increasing acetaminophen clearance overall. Thiol metabolite fCL remained constant up to 8 g/day. These findings have important implications in short-term (3 day) tolerability of supratherapeutic acetaminophen doses in healthy adults.

  9. Family Day Care Mothers Work Together to Improve Services

    ERIC Educational Resources Information Center

    Sale, June Solnit

    1975-01-01

    Describes the history of Women Attentive to Children's Happiness (WATCH), a self-help organization of family day care mothers which has developed an effective method of producing developmental programs for children and families. (ED)

  10. Utah Adult Education Services. Adult Education Report 1968-69.

    ERIC Educational Resources Information Center

    Utah State Board of Education, Salt Lake City.

    Major purposes for the preparation of this report on public school adult education in Utah were: to provide the public with a description of achievements, trends, and needs, and with meaningful cost accounting information; to make comparisons and analyses of adult education by program, school district, and year; and to provide the adult education…

  11. A Comparative Analysis of the Functional Disability Levels of Adult Day Care, Adult Day Health and ICF-Level Nursing Home Elderly in Hawaii.

    ERIC Educational Resources Information Center

    Hayashida, Cullen T.

    This study compared the functional disability levels of participants in adult day centers with patients in intermediate care facilities (ICFs). A three-page questionnaire measuring demographics, social resources, physical health, mental health, and activities of daily living as assessed by the Activities of Daily Living scale and the Instrumental…

  12. 20 CFR 404.1311 - Ninety-day active service requirement for World War II veterans.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... World War II veterans. 404.1311 Section 404.1311 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... Uniformed Services World War II Veterans § 404.1311 Ninety-day active service requirement for World War II veterans. (a) The 90 days of active service required for World War II veterans do not have to...

  13. 20 CFR 404.1311 - Ninety-day active service requirement for World War II veterans.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... World War II veterans. 404.1311 Section 404.1311 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... Uniformed Services World War II Veterans § 404.1311 Ninety-day active service requirement for World War II veterans. (a) The 90 days of active service required for World War II veterans do not have to...

  14. 20 CFR 404.1311 - Ninety-day active service requirement for World War II veterans.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... World War II veterans. 404.1311 Section 404.1311 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... Uniformed Services World War II Veterans § 404.1311 Ninety-day active service requirement for World War II veterans. (a) The 90 days of active service required for World War II veterans do not have to...

  15. 20 CFR 404.1311 - Ninety-day active service requirement for World War II veterans.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... World War II veterans. 404.1311 Section 404.1311 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... Uniformed Services World War II Veterans § 404.1311 Ninety-day active service requirement for World War II veterans. (a) The 90 days of active service required for World War II veterans do not have to...

  16. 20 CFR 404.1311 - Ninety-day active service requirement for World War II veterans.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... World War II veterans. 404.1311 Section 404.1311 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... Uniformed Services World War II Veterans § 404.1311 Ninety-day active service requirement for World War II veterans. (a) The 90 days of active service required for World War II veterans do not have to...

  17. Reflections from Graduate Adult Learners about Service Learning

    ERIC Educational Resources Information Center

    Alston, Geleana Drew; Clegg, T. E.; Clodfelter, Roy J., Jr.; Drye, Kimberly C.; Farrer, J. V.; Gould, Derek; Mohsin, Nidhal M.; Rankin, Tomiko N.; Ray, Sherri L.

    2016-01-01

    Adult education is grounded in responding to the needs of others, and the field places emphasis on adult learning theories such as transformative learning and experiential learning. Service learning is an educational approach that balances formal instruction and direction with the opportunity for adult learners to serve in the community as a…

  18. Patterns of Service Utilization by Adults with a Developmental Disability: Type of Service Makes a Difference

    ERIC Educational Resources Information Center

    Pruchno, Rachel A.; McMullen, William F.

    2004-01-01

    Patterns and correlates of service utilization by adults with a developmental disability were examined using data from 831 mothers of an adult child with a developmental disability. A modified Andersen model of health services was used to examine service utilization in seven domains. Multinomial logistic regression revealed that predictors of…

  19. The Relationship Between Nurse Staffing and 30-Day Readmission for Adults With Heart Failure

    PubMed Central

    Giuliano, Karen K.; Danesh, Valerie; Funk, Marjorie

    2016-01-01

    OBJECTIVE The purpose of this study was to better understand the relationship between nurse staffing and 30-day excess readmission ratios for patients with heart failure in the top US adult cardiology and heart surgery hospitals. BACKGROUND Heart failure is the most common cause of hospitalization for patients older than 65 years and is the most frequent diagnosis associated with 30-day hospital readmission in the United States. METHODS A secondary data analysis was conducted using nurse staffing data from 661 cardiology and heart surgery hospitals from the 2013 US News & World Report “Best Hospitals” survey. These data were combined with excess readmission ratios from the Centers for Medicare & Medicaid Services Hospital Compare database from 2013. An independent-samples t test was used to compare staffing (low/high) and excess hospital readmissions rates. RESULTS A significant difference (P = .021) was found between the low nurse staffing group (n = 358) and the high nurse staffing group (n = 303). Hospitals with a lower nurse staffing index had a significantly higher excess readmission rate. CONCLUSION These data provide further support to the body of research showing a positive relationship between nurse staffing and positive outcomes. PMID:26579974

  20. Religious congregations as social services providers for older adults.

    PubMed

    Cnaan, Ram A; Boddie, Stephanie C; Kang, Jennifer

    2005-01-01

    A large proportion of older adults are affiliated with congregations. The literature suggests that, in general, religious participation among the older adults enhances their quality of life and provides a network of social care. In this article, we explored the relevant literature on organized religion and social support for older adults. Based on a census study of congregations in Philadelphia (N = 1,393), we documented the following: (1) the number of congregations serving older adults, (2) the types of services provided, and (3) the number of beneficiaries. The study also identified the organizational factors that predict the provision of congregation-based services for older adults. The findings suggest that serving older adults is not a top priority for most congregations. Most senior programs are small and often informal. Approximately half (48%) of the congregations do not provide a formal social service. However, those congregations that are more likely to serve older adults have larger budgets, more members over 65-years-old, and a moderate political orientation. We recommend that congregations, social service providers, and older adults explore ways to maximize this underutilized resource of congregational services to meet the needs of the increasing number of older adults.

  1. Educational Brokering; A New Service for Adult Learners.

    ERIC Educational Resources Information Center

    Heffernan, James M.; And Others

    The emerging educational brokering service, functioning between adult learners and educational resources, aims to help them find their way into formal postsecondary education via counseling, advocacy, assessment and referral services. This monograph presents nine major issues concerning the educational brokering service: (1) definition and…

  2. 7 CFR 226.13 - Food service payments to sponsoring organizations for day care homes.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... day care homes. 226.13 Section 226.13 Agriculture Regulations of the Department of Agriculture... CARE FOOD PROGRAM Payment Provisions § 226.13 Food service payments to sponsoring organizations for day... children and eligible enrolled children of day care home providers, at approved day care homes. (b)...

  3. 7 CFR 226.13 - Food service payments to sponsoring organizations for day care homes.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... day care homes. 226.13 Section 226.13 Agriculture Regulations of the Department of Agriculture... CARE FOOD PROGRAM Payment Provisions § 226.13 Food service payments to sponsoring organizations for day... children and eligible enrolled children of day care home providers, at approved day care homes. (b)...

  4. Civic Engagement for Older Adults With Functional Limitations: Piloting an Intervention for Adult Day Health Participants

    ERIC Educational Resources Information Center

    Dabelko-Schoeny, Holly; Anderson, Keith A.; Spinks, Katie

    2010-01-01

    Purpose: Past research has demonstrated the importance of civic engagement for older adults, yet previous studies have not focused specifically on the potential benefits of civic engagement for older adults with functional limitations. This pilot study explored the feasibility and effectiveness of an intervention designed to promote civic…

  5. Measuring Physical Activity with Pedometers in Older Adults with Intellectual Disability: Reactivity and Number of Days

    ERIC Educational Resources Information Center

    Hilgenkamp, Thessa; Van Wijck, Ruud; Evenhuis, Heleen

    2012-01-01

    The minimum number of days of pedometer monitoring needed to estimate valid average weekly step counts and reactivity was investigated for older adults with intellectual disability. Participants (N = 268) with borderline to severe intellectual disability ages 50 years and older were instructed to wear a pedometer for 14 days. The outcome measure…

  6. Staff Morale in Day Care Centres for Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Mascha, Katerina

    2007-01-01

    Background: Levels of burnout, job satisfaction and intended turnover of staff working in day care centres for adults with intellectual disabilities are investigated in relation to role clarity, staff support and supervision, and coping strategies used by staff. Materials and methods: Thirty six direct-care staff of four day care centres in the UK…

  7. Day Habilitation Services for People with Intellectual and Developmental Disabilities in Medicaid Home and Community-Based Services Waivers

    ERIC Educational Resources Information Center

    Friedman, Carli

    2016-01-01

    Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers are one of the largest providers of long-term services and supports for people with intellectual and developmental disabilities (IDD). HCBS waivers also play a prominent role in providing day habilitation services for people with IDD. The purpose of this study was to examine how…

  8. Time-of-Day-Dependent Enhancement of Adult Neurogenesis in the Hippocampus

    PubMed Central

    Fukada, Yoshitaka

    2008-01-01

    Background Adult neurogenesis occurs in specific regions of the mammalian brain such as the dentate gyrus of the hippocampus. In the neurogenic region, neural progenitor cells continuously divide and give birth to new neurons. Although biological properties of neurons and glia in the hippocampus have been demonstrated to fluctuate depending on specific times of the day, it is unclear if neural progenitors and neurogenesis in the adult brain are temporally controlled within the day. Methodology/Principal Findings Here we demonstrate that in the dentate gyrus of the adult mouse hippocampus, the number of M-phase cells shows a day/night variation throughout the day, with a significant increase during the nighttime. The M-phase cell number is constant throughout the day in the subventricular zone of the forebrain, another site of adult neurogenesis, indicating the daily rhythm of progenitor mitosis is region-specific. Importantly, the nighttime enhancement of hippocampal progenitor mitosis is accompanied by a nighttime increase of newborn neurons. Conclusions/Significance These results indicate that neurogenesis in the adult hippocampus occurs in a time-of-day-dependent fashion, which may dictate daily modifications of dentate gyrus physiology. PMID:19048107

  9. Service Patterns of Adult Survivors of Childhood versus Adult Sexual Assault/Abuse

    ERIC Educational Resources Information Center

    Grossman, Susan F.; Lundy, Marta; Bertrand, Cathy; Ortiz, Cynthia; Tomas-Tolentino, Grace; Ritzema, Kim; Matson, Julia

    2009-01-01

    This analysis compared the characteristics and service patterns of adult survivors of childhood sexual assault/abuse and adult survivors of adult sexual assault/abuse. Utilizing data from sexual assault crisis centers serving survivors in a Midwestern state over a six year period and controlling for revictimization, we describe and compare the…

  10. Developing Multicultural Awareness: An In-service Day Proposal for Rend Lake College, Ina, Illinois.

    ERIC Educational Resources Information Center

    Rust, Joseph Henry

    Noting that the state of Illinois mandates that community colleges address cultural diversity in their curriculum, this paper presents a proposal for a day-long in-service faculty education program to make faculty aware that cultural diversity exists at Rend Lake College (Illinois). The paper begins with a schedule for the in-service day, offering…

  11. A novel accelerometer-based method to describe day-to-day exposure to potentially osteogenic vertical impacts in older adults: findings from a multi-cohort study.

    PubMed

    Hannam, K; Deere, K C; Hartley, A; Clark, E M; Coulson, J; Ireland, A; Moss, C; Edwards, M H; Dennison, E; Gaysin, T; Cooper, R; Wong, A; McPhee, J S; Cooper, C; Kuh, D; Tobias, J H

    2017-03-01

    This observational study assessed vertical impacts experienced in older adults as part of their day-to-day physical activity using accelerometry and questionnaire data. Population-based older adults experienced very limited high-impact activity. The accelerometry method utilised appeared to be valid based on comparisons between different cohorts and with self-reported activity.

  12. How many steps/day are enough? For older adults and special populations

    PubMed Central

    2011-01-01

    Older adults and special populations (living with disability and/or chronic illness that may limit mobility and/or physical endurance) can benefit from practicing a more physically active lifestyle, typically by increasing ambulatory activity. Step counting devices (accelerometers and pedometers) offer an opportunity to monitor daily ambulatory activity; however, an appropriate translation of public health guidelines in terms of steps/day is unknown. Therefore this review was conducted to translate public health recommendations in terms of steps/day. Normative data indicates that 1) healthy older adults average 2,000-9,000 steps/day, and 2) special populations average 1,200-8,800 steps/day. Pedometer-based interventions in older adults and special populations elicit a weighted increase of approximately 775 steps/day (or an effect size of 0.26) and 2,215 steps/day (or an effect size of 0.67), respectively. There is no evidence to inform a moderate intensity cadence (i.e., steps/minute) in older adults at this time. However, using the adult cadence of 100 steps/minute to demark the lower end of an absolutely-defined moderate intensity (i.e., 3 METs), and multiplying this by 30 minutes produces a reasonable heuristic (i.e., guiding) value of 3,000 steps. However, this cadence may be unattainable in some frail/diseased populations. Regardless, to truly translate public health guidelines, these steps should be taken over and above activities performed in the course of daily living, be of at least moderate intensity accumulated in minimally 10 minute bouts, and add up to at least 150 minutes over the week. Considering a daily background of 5,000 steps/day (which may actually be too high for some older adults and/or special populations), a computed translation approximates 8,000 steps on days that include a target of achieving 30 minutes of moderate-to-vigorous physical activity (MVPA), and approximately 7,100 steps/day if averaged over a week. Measured directly and

  13. Competency-Based Adult High School Completion Student Services Guide.

    ERIC Educational Resources Information Center

    Singer, Elizabeth; And Others

    Designed as part of a 310 Special Demonstration and Teacher Training Project undertaken at Brevard Community College, this student services guide contains information to assist adult education administrators, counselors, instructors, and office personnel in meeting the needs of students enrolled in adult/community education schools. Primary…

  14. Medicaid and service use among homeless adults.

    PubMed

    Glied, S; Hoven, C; Moore, R E; Garrett, A B

    This paper examines the effect of Medicaid recipiency on the level and site of medical service use among homeless single men and women in New York City. Simple regressions of Medicaid on service use indicate that Medicaid significantly increases the likelihood that homeless individuals receive services, especially emergency and inpatient hospital services. In further analyses that control for health status, use instrumental variables procedures, and examine differences between a similar population in 1985 and 1987, we find that Medicaid neither increases nor diminishes access to emergency rooms. We find some evidence suggesting that Medicaid does improve access to nonhospital medical care.

  15. Trajectories of Health and Behavioral Health Services Use among Community Corrections–Involved Rural Adults

    PubMed Central

    Mowbray, Orion; McBeath, Bowen; Bank, Lew; Newell, Summer

    2016-01-01

    This article seeks to establish time-based trajectories of health and behavioral health services utilization for community corrections–involved (CCI) adults and to examine demographic and clinical correlates associated with these trajectories. To accomplish this aim, the authors applied a latent class growth analysis (LCGA) to services use data from a sample of rural CCI adults who reported their medical, mental health, and substance use treatment utilization behavior every 60 days for 1.5 years. LCGA established 1.5-year trajectories and demographic correlates of health services among rural CCI adults. For medical services, three classes emerged (stable-low users, 13%; stable-intermediate users, 40%; and stable-high users, 47%). For mental health and substance use services, three classes emerged (stable-low, 69% and 61%, respectively; low-baseline-increase, 10% and 12%, respectively; high-baseline decline, 21% and 28%, respectively). Employment, gender, medication usage, and depression severity predicted membership across all services. Results underscore the importance of social workers and other community services providers aligning health services access with the needs of the CCI population, and highlight CCI adults as being at risk of underservice in critical prevention and intervention domains. PMID:27257353

  16. 7 CFR 226.19a - Adult day care center provisions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... beneficiaries. Menus and any other nutritional records required by the State agency shall be maintained to... day care centers shall have Federal, State or local licensing or approval to provide day care services... participate in the Program during the renewal process, unless the State agency has information which...

  17. Community Service by Visually Impaired Older Adults.

    ERIC Educational Resources Information Center

    Berkman, Susan C. J.

    1984-01-01

    The Braille Institute's Community Outreach Program provides adventitiously blinded older adults with opportunities to volunteer in local community agencies, schools, and hospitals upon completion of the institute's special education program. Students use new independence skills in a functional social environment, thereby increasing their…

  18. Adult Day Health Center Participation and Health-Related Quality of Life

    ERIC Educational Resources Information Center

    Schmitt, Eva M.; Sands, Laura P.; Weiss, Sara; Dowling, Glenna; Covinsky, Kenneth

    2010-01-01

    Purpose: The purpose of this study was to assess the association between Adult Day Health Center (ADHC) participation and health-related quality of life. Design and Methods: Case-controlled prospective study utilizing the Medical Outcomes Survey Form 36 (SF-36) to compare newly enrolled participants from 16 ADHC programs with comparable…

  19. Richmond Wellbeing Service Access Strategy for Older Adults.

    PubMed

    Gowling, Sarah; Persson, Jennie; Holt, Genevieve; Ashbourne, Sue; Bloomfield, James; Shortland, Hannah; Bate, Clare

    2016-01-01

    IAPT (Improving Access to Psychological Therapies) is a national programme aimed at increasing availability of evidence based psychological therapies in the NHS. IAPT is primarily for people who have mild to moderate, common mental health difficulties such as depression, anxiety, phobias and post traumatic stress disorder (PTSD). The programme seeks to use the least intrusive method of care possible to treat people at the time when it will be of most help to them. Individuals are able to self-refer into most IAPT services or alternatively can request to be referred by their GP or other services in the community. Richmond Wellbeing Service (RWS) is one such IAPT Service and this research is based on our work to promote accessibility of the service to one of the harder to reach population groups - older adults. We know that IAPT services could have a positive impact on older adults as it is believed on average, 25% of over 65 year olds face common mental health problems. However, only a third of these people discuss this with their GP and so are less likely to be referred to an IAPT Service. In relation to the above, this project was designed to look at increasing access for older adults into Richmond Wellbeing Service (RWS) specifically to improve access to the RWS by older adults by 100. The overall goal was to increase older adult (65+) referral rates by 20% over a year, in raw number this would translate to an increase of 100 over a year period, and in percentage terms an average of 8% of total referrals. Results yielded an increase of 39 referrals between baseline and test period. The majority of this increase had occurred in the final five months of the projects duration(31). Interestingly the number of older adults in the older age band (85+) almost doubled within this period (from 12 to 21). In total, in percentage terms this translates to an an increase of OA referrals from 6% up to 6.7%, as above we are aiming for 8% or an additional increase of 61 patients

  20. Adaptations of young adult rat cortical bone to 14 days of spaceflight

    NASA Technical Reports Server (NTRS)

    Vailas, A. C.; Vanderby, R., Jr.; Martinez, D. A.; Ashman, R. B.; Ulm, M. J.; Grindeland, R. E.; Durnova, G. N.; Kaplanskii, A.

    1992-01-01

    To determine whether mature humeral cortical bone would be modified significantly by an acute exposure to weightlessness, adult rats (110 days old) were subjected to 14 days of microgravity on the COSMOS 2044 biosatellite. There were no significant changes in peak force, stiffness, energy to failure, and displacement at failure in the flight rats compared with ground-based controls. Concentrations and contents of hydroxyproline, calcium, and mature stable hydroxylysylpyridinoline and lysylpyridinoline collagen cross-links remained unchanged after spaceflight. Bone lengths, cortical and endosteal areas, and regionl thicknesses showed no significant differences between flight animals and ground controls. The findings suggest that responsiveness of cortical bone to microgravity is less pronounced in adult rats than in previous spaceflight experiments in which young growing animals were used. It is hypothesized that 14 days of spaceflight may not be sufficient to impact the biochemical and biomechanical properties of cortical bone in the mature rat skeleton.

  1. Extended Day Treatment: A Comprehensive Model of after School Behavioral Health Services for Youth

    ERIC Educational Resources Information Center

    Vanderploeg, Jeffrey J.; Franks, Robert P.; Plant, Robert; Cloud, Marilyn; Tebes, Jacob Kraemer

    2009-01-01

    Extended day treatment (EDT) is an innovative intermediate-level service for children and adolescents with serious emotional and behavioral disorders delivered during the after school hours. This paper describes the core components of the EDT model of care within the context of statewide systems of care, including its core service components,…

  2. Integrated Educational and Mental Health Services within a Day Treatment Setting.

    ERIC Educational Resources Information Center

    Francis, Greta; Radka, Dale F.

    This paper discusses the integration of educational and mental health services for children and adolescents within a psychiatric day treatment setting at the Bradley School housed in a private psychiatric hospital affiliated with Brown University in Rhode Island. A full range of mental health services are used, and therapies are delivered in the…

  3. Connecting the disconnected: adult day care for people with AIDS in New York City.

    PubMed

    Smith, M Y; Knickman, J R; Oppenheimer, L M

    1992-11-01

    Despite pressing need, the development of a continuum of long-term-care services for people with acquired immune deficiency syndrome (AIDS) has been hampered by the dearth of information on the characteristics and service needs of patients eligible for such care. This article presents findings from a process evaluation of an outpatient day care program for people with AIDS in New York City. The AIDS clients were highly functional but had a diverse range of needs and problems related to housing, substance abuse, medical care, and social support. The majority of clients reported being very satisfied with the level of staff support and with the overall program. The findings of the study suggest that day care is a valuable addition to the continuum of services and that the creative dissemination of this program may improve the delivery of services to people with AIDS.

  4. Effects of Fourteen-Day Bed Rest on Trunk Stabilizing Functions in Aging Adults

    PubMed Central

    Sarabon, Nejc; Rosker, Jernej

    2015-01-01

    Bed rest has been shown to have detrimental effects on structural and functional characteristics of the trunk muscles, possibly affecting trunk and spinal stability. This is especially important in populations such as aging adults with often altered trunk stabilizing functions. This study examined the effects of a fourteen-day bed rest on anticipatory postural adjustments and postural reflex responses of the abdominal wall and back muscles in sixteen adult men. Postural activation of trunk muscles was measured using voluntary quick arm movement and sudden arm loading paradigm. Measurements were conducted prior to the bed rest, immediately after, and fourteen days after the bed rest. Immediately after the bed rest, latencies of anticipatory postural adjustments showed significant shortening, especially for the obliquus internus and externus muscles. After a fourteen-day recuperation period, anticipatory postural adjustments reached a near to complete recovery. On the contrary, reactive response latencies increased from pre-bed-rest to both post-bed-rest measurement sessions. Results indicate an important effect of bed rest on stabilizing functions of the trunk muscles in elderly adults. Moreover, there proved to be a significant deterioration of postural reactive responses that outlasted the 14-day post-bed-rest rehabilitation. PMID:26601104

  5. Services for Adults With an Autism Spectrum Disorder

    PubMed Central

    Shattuck, Paul T; Roux, Anne M; Hudson, Laura E; Taylor, Julie Lounds; Maenner, Matthew J; Trani, Jean-Francois

    2012-01-01

    The need for useful evidence about services is increasing as larger numbers of children identified with an autism spectrum disorder (ASD) age toward adulthood. The objective of this review was to characterize the topical and methodological aspects of research on services for supporting success in work, education, and social participation among adults with an ASD and to propose recommendations for moving this area of research forward. We reviewed the literature published in English from 2000 to 2010 and found that the evidence base about services for adults with an ASD is underdeveloped and can be considered a field of inquiry that is relatively unformed. Extant research does not reflect the demographic or impairment heterogeneity of the population, the range of services that adults with autism require to function with purposeful lives in the community, and the need for coordination across service systems and sectors. Future studies must examine issues related to cost and efficiency, given the broader sociopolitical and economic context of service provision. Further, future research needs to consider how demographic and impairment heterogeneity have implications for building an evidence base that will have greater external validity. PMID:22546060

  6. 77 FR 52748 - 60-Day Proposed Information Collection: Indian Health Service (IHS) Sharing What Works-Best...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-30

    ... preventive health services. To support the IHS mission and to provide the product/service to IHS, Tribal, and... HUMAN SERVICES Indian Health Service 60-Day Proposed Information Collection: Indian Health Service (IHS... Comment AGENCY: Indian Health Service, HHS. ACTION: Notice. SUMMARY: In compliance with Section...

  7. Introducing Advanced Clinical Reasoning to an Adult Learning Disability Service

    ERIC Educational Resources Information Center

    Stansfield, Jois; Matthews, Alison

    2014-01-01

    The advanced clinical reasoning approach is widely adopted in speech and language therapy practice. This article reports on the introduction of the approach across a multidisciplinary adult learning disability service and staff reports on the impact of this initiative. Staff and team managers reported that the training had a positive impact on…

  8. Aspirations of Adult Learners in Aboriginal Family Service Agencies

    ERIC Educational Resources Information Center

    Brown, Jason; Fraehlich, Cheryl; Debassige, Brent

    2012-01-01

    There is a gap in the literature on the experiences of Aboriginal adults who have made the transition into education and employment after moving to an urban community. Staff of three Aboriginal inner-city family services agencies participated in an interview that included the question: What changes do you see in your employment and education?…

  9. Services for Older Adults. Reference Book [and] Student Activity Book.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Curriculum Center for Family and Consumer Sciences.

    This student activity book and reference book, which are part of a family and consumer sciences education series focusing on a broad range of employment opportunities, are intended for use in 1- and 2- programs preparing Texas high school students for employment in occupations related to providing services for older adults. The reference book…

  10. Planning Adult Literacy Services. Options for Library Involvement.

    ERIC Educational Resources Information Center

    VanHorn, Barbara Hart; And Others

    The result of interviews with literacy coordinators and library directors of literacy programs in representative libraries throughout Pennsylvania, this document encourages local libraries to develop adult literacy activities as an integral component of basic library service and provides program planners with guidelines and suggestions for…

  11. Outreach Services for Older Adults at the Wadsworth Public Library.

    ERIC Educational Resources Information Center

    Black, Barbara A.

    This paper reports on a study conducted to assist the Wadsworth Public Library in future planning and refining of services to older adults especially in library outreach. A questionnaire was distributed to residents (n=350) of one nursing home, four apartment complexes for seniors, one assisted living complex, one senior center, and any patrons…

  12. On Site Training for Adult Day Care Program Aides that Meet State Certification Requirements and National Standards.

    ERIC Educational Resources Information Center

    Medley, Pamilea

    This document describes a practicum that was conducted to develop a training program appropriate for adult day care program aides that would meet Oklahoma state certification requirements and national standards. The training curriculum for use in delivering onsite competency-based training to students studying to become adult day care program…

  13. The 14-day repeated dose liver micronucleus test with methapyrilene hydrochloride using young adult rats.

    PubMed

    Inoue, Kenji; Ochi, Akimu; Koda, Akira; Wako, Yumi; Kawasako, Kazufumi; Doi, Takaaki

    2015-03-01

    The repeated dose liver micronucleus (RDLMN) assay using young adult rats has the potential to detect genotoxic hepatocarcinogens that can be integrated into a general toxicity study. The assay methods were thoroughly validated by 19 Japanese facilities. Methapyrilene hydrochloride (MP), known to be a non-genotoxic hepatocarcinogen, was examined in the present study. MP was dosed orally at 10, 30 and 100mg/kg/day to 6-week-old male Crl:CD (SD) rats daily for 14 days. Treatment with MP resulted in an increase in micronucleated hepatocytes (MNHEPs) with a dosage of only 100mg/kg/day. At this dose level, cytotoxicity followed by regenerative cell growth was noted in the liver. These findings suggest that MP may induce clastogenic effects indirectly on the liver or hepatotoxicity of MP followed by regeneration may cause increase in spontaneous incidence of MNHEPs.

  14. Multiple Family Groups for Adult Cancer Survivors and Their Families: A 1-Day Workshop Model

    PubMed Central

    STEINGLASS, PETER; OSTROFF, JAMIE S.; STEINGLASS, ABBE STAHL

    2015-01-01

    With marked advances in early detection and aggressive multimodality treatment, many adult cancers are now associated with good prognoses for disease-free survival. A burgeoning literature examining posttreatment quality-of-life issues has highlighted the numerous challenges experienced by patients and families in the aftermath of cancer treatment, further underscoring a need for new family-based psychosocial support interventions for cancer survivors and their families. This paper describes the clinical protocol for one such intervention, a 1-day “workshop” version of a multiple family group (MFG) for head and neck cancer survivors and their families. Data are reported from our experiences in running five 1-day workshops. Families uniformly reported that they were highly satisfied with their MFG participation, leading us to conclude that the abbreviated 1-day MFG model we are advocating is a promising family-focused support intervention for cancer survivors and their families. PMID:21884077

  15. The development of a 7-day community specialist palliative care service.

    PubMed

    Gallagher, Jennifer

    2013-12-01

    The author worked as a clinical nurse specialist (CNS) in community palliative care in the Central Lancashire area of England when the CNS service was extended to a 9am-to-5pm 7-day service. A project group was set up to canvas some of the key stakeholders for their views on the extension of the service. The group undertook a literature search, a telephone survey of services in other areas that were providing this level of service, and interviews to ascertain the views of district nurses in the locality of the proposed service extension. The extension of service has long been advocated and was one of the key recommendations in the UK Department of Health's peer-review process. Such an extension was implemented following the research phase and was then evaluated by the project lead and the community services manager. The extension was found to be effective in the ongoing monitoring and support of patients. Anecdotally, the CNS team also felt it had been proactive in preventing unnecessary hospital admissions, although this specific aspect is difficult to quantify. This article looks at how the service was developed, how it has evolved over time, and how it works today. Consideration is also given to benefits and limitations.

  16. How creation of a parent satisfaction questionnaire improved multidisciplinary service delivery in a paediatric day surgery unit.

    PubMed

    Bradley, Alison

    2013-01-01

    Auditing patient satisfaction has become a keystone of quality patient centred healthcare. A plethora of patient satisfaction studies exist but only a few studies have been evaluated for their validity, reliability, specificity or psychometric properties. And the majority focus on adult health care. However, if validated tools are not utilised, then inaccurate results could stymie service improvement. The level of satisfaction with the paediatric day surgery service at Tayside Children's Hospital was unknown. Our objective was to measure parent satisfaction with the paediatric day surgery by creating a parent satisfaction questionnaire which has undergone satisfactory testing for validity, reliability, specificity and psychometric properties. A Likert-style questionnaire was constructed through literature review and focus group meetings with professionals, parents and patient groups to establish content validity. Statements worded in positive phrasing were re-worded in negative phrasing to ensure intra-rater reliability. A pilot study was conducted and responses analysed for construct validity and inter-rater agreement. Internal reliability was established using Chronbach's alpha analysis, which produced scores for each part of the questionnaire between 0.7 and 0.9. Overall parent satisfaction was high. 95.48% either strongly agreed or agreed with positively worded statements regarding pre-operative clinic service. In particular 100% satisfaction was reported with the pre-operative phone call which only 70% of participants received. 96.60% strongly agreed or agreed with positive statements regarding service provided on the ward and 87.50% strongly agreed or agreed with positive statements regarding the discharge process. 5% specifically requested improved information giving. In conclusion the parent satisfaction questionnaire was found to have proven validity, reliability, specificity and psychometric properties. Overall parent satisfaction was found to be high

  17. 78 FR 52008 - 30-Day Notice of Proposed Information Collection: Multifamily Housing Service Coordinator Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 30-Day Notice of Proposed Information Collection: Multifamily Housing Service..., Department of Housing and Urban Development, 451 7th Street SW., Washington, DC 20410; email Colette...

  18. Opening Our Doors: Taking Public Library Service to Preschool and Day-Care Facilities.

    ERIC Educational Resources Information Center

    Harris, Sally

    The Opening Our Doors Project of the Pioneer Library System of Norman, Oklahoma takes public library service to preschool and day care facilities by means of learning kits housed in tote bags. The sturdy, zippered tote bags are full of books, games, toys, learning folders, and so forth. There is a tote bag for each of 75 different topics. Topics…

  19. Volunteers in Specialist Palliative Care: A Survey of Adult Services in the United Kingdom

    PubMed Central

    Burbeck, Rachel; Low, Joe; Sampson, Elizabeth L.; Bravery, Ruth; Hill, Matthew; Morris, Sara; Ockenden, Nick; Payne, Sheila

    2014-01-01

    Abstract Background: Worldwide, the demand for specialist palliative care is increasing but funding is limited. The role of volunteers is underresearched, although their contribution reduces costs significantly. Understanding what volunteers do is vital to ensure services develop appropriately to meet the challenges faced by providers of palliative care. Objective: The study's objective is to describe current involvement of volunteers with direct patient/family contact in U.K. specialist palliative care. Design: An online survey was sent to 290 U.K. adult hospices and specialist palliative care services involving volunteers covering service characteristics, involvement and numbers of volunteers, settings in which they are involved, extent of involvement in care services, specific activities undertaken in each setting, and use of professional skills. Results: The survey had a 67% response rate. Volunteers were most commonly involved in day care and bereavement services. They entirely ran some complementary therapy, beauty therapy/hairdressing, and pastoral/faith-based care services, and were involved in a wide range of activities, including sitting with dying patients. Conclusions: This comprehensive survey of volunteer activity in U.K. specialist palliative care provides an up-to-date picture of volunteer involvement in direct contact with patients and their families, such as providing emotional care, and the extent of their involvement in day and bereavement services. Further research could focus on exploring their involvement in bereavement care. PMID:24475743

  20. Day Service Provision for People with Intellectual Disabilities: A Case Study Mapping 15-Year Trends in Ireland

    ERIC Educational Resources Information Center

    Fleming, Padraic; McGilloway, Sinead; Barry, Sarah

    2017-01-01

    Background: Day services for people with intellectual disabilities are experiencing a global paradigm shift towards innovative person-centred models of care. This study maps changing trends in day service utilization to highlight how policy, emergent patterns and demographic trends influence service delivery. Methods: National intellectual…

  1. 20 CFR 404.1321 - Ninety-day active service requirement for post-World War II veterans.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... post-World War II veterans. 404.1321 Section 404.1321 Employees' Benefits SOCIAL SECURITY... of the Uniformed Services Post-World War II Veterans § 404.1321 Ninety-day active service requirement for post-World War II veterans. (a) The 90 days of active service required for post-World War...

  2. 20 CFR 404.1321 - Ninety-day active service requirement for post-World War II veterans.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... post-World War II veterans. 404.1321 Section 404.1321 Employees' Benefits SOCIAL SECURITY... of the Uniformed Services Post-World War II Veterans § 404.1321 Ninety-day active service requirement for post-World War II veterans. (a) The 90 days of active service required for post-World War...

  3. 20 CFR 404.1321 - Ninety-day active service requirement for post-World War II veterans.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... post-World War II veterans. 404.1321 Section 404.1321 Employees' Benefits SOCIAL SECURITY... of the Uniformed Services Post-World War II Veterans § 404.1321 Ninety-day active service requirement for post-World War II veterans. (a) The 90 days of active service required for post-World War...

  4. 20 CFR 404.1321 - Ninety-day active service requirement for post-World War II veterans.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... post-World War II veterans. 404.1321 Section 404.1321 Employees' Benefits SOCIAL SECURITY... of the Uniformed Services Post-World War II Veterans § 404.1321 Ninety-day active service requirement for post-World War II veterans. (a) The 90 days of active service required for post-World War...

  5. 20 CFR 404.1321 - Ninety-day active service requirement for post-World War II veterans.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... post-World War II veterans. 404.1321 Section 404.1321 Employees' Benefits SOCIAL SECURITY... of the Uniformed Services Post-World War II Veterans § 404.1321 Ninety-day active service requirement for post-World War II veterans. (a) The 90 days of active service required for post-World War...

  6. 20 CFR 663.300 - What are training services for adults and dislocated workers?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What are training services for adults and..., DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Training Services § 663.300 What are training services for adults and dislocated workers? Training...

  7. 20 CFR 663.800 - What are supportive services for adults and dislocated workers?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are supportive services for adults and..., DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Supportive Services § 663.800 What are supportive services for adults and dislocated workers?...

  8. 20 CFR 663.300 - What are training services for adults and dislocated workers?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false What are training services for adults and..., DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Training Services § 663.300 What are training services for adults and dislocated...

  9. 20 CFR 663.300 - What are training services for adults and dislocated workers?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false What are training services for adults and..., DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Training Services § 663.300 What are training services for adults and dislocated...

  10. 20 CFR 663.800 - What are supportive services for adults and dislocated workers?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false What are supportive services for adults and..., DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Supportive Services § 663.800 What are supportive services for adults and dislocated...

  11. 20 CFR 663.800 - What are supportive services for adults and dislocated workers?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false What are supportive services for adults and..., DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Supportive Services § 663.800 What are supportive services for adults and dislocated...

  12. 20 CFR 663.800 - What are supportive services for adults and dislocated workers?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What are supportive services for adults and..., DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Supportive Services § 663.800 What are supportive services for adults and dislocated workers?...

  13. Collaboration, facilities and communities in day care services for older people.

    PubMed

    Burch, S; Borland, C

    2001-01-01

    Collaborative working in care for older people is often seen as a desirable goal. However, there can be problems with this approach. This paper reports on a single blind randomized controlled trial which was carried out to compare outcomes of rehabilitation in two settings: a day hospital and social services day centres augmented by visiting therapists. The subjects were 105 older patients. Principal outcome measures were the Barthel Index, Philadelphia Geriatric Centre Morale Scale and the Caregiver Strain Index. Two aspects of the trial are examined here. Firstly, we investigated whether trial patients were more disabled than regular day centre attendees. Levels of health and well being amongst trial patients were compared with those of a random sample of 20 regular attendees from both of the participating day centres and an additional voluntary sector day centre. Secondly, key staff from the different settings were interviewed to assess how well the day centre model had worked in practice. Trial patients were significantly more disabled than regular day centre attendees according to the Barthel Index (P < 0.001), but this difference was no longer significant after three months of treatment. The day centre model had several problems, principally discharge policy, acceptability, facilities and attitudes of staff and regular attendees. Positive aspects of the day centre model, as well as successful rehabilitation, included shared skills, knowledge and resources. This paper suggests that collaborative working in day centres requires multipurpose facilities. If health staff maintain a permanent presence, benefits can include improved joint working, easier access to health care and the use of rehabilitative therapy as a preventative strategy. Day care settings can be analyzed as representing different types of communities. Allowing older users a greater degree of choice in facilities may increase the acceptability of care.

  14. Extended Day Treatment: A Comprehensive Model of After School Behavioral Health Services for Youth.

    PubMed

    Vanderploeg, Jeffrey J; Franks, Robert P; Plant, Robert; Cloud, Marilyn; Tebes, Jacob Kraemer

    2010-02-01

    This paper describes Extended Day Treatment (EDT), an innovative intermediate-level service for children and adolescents with serious emotional and behavioral disorders, delivered in the after school hours. The current paper describes the core components of the EDT model of care within the context of statewide systems of care, including its theoretical foundations, core service components, relation to evidence-based practices, workforce composition and staff training, and data collection and reporting mechanisms. Recommendations are provided for statewide implementation, followed by discussion of model development as an approach to systems reform for the treatment of children and youth with emotional and behavioral disorders.

  15. Issues in Accessing Services. Tierra de Oportunidad Module 13. LAES: Latino Adult Education Services Project.

    ERIC Educational Resources Information Center

    Kissam, Ed; Dorsey, Holda

    This module, which may be used as the basis for a workshop or as a special topic unit in adult basic education or English-as-a-Second-Language (ESL) courses, discusses how to access the formalized human service delivery systems in the United States, which often replace the networks of extended families and friends that immigrants relied on in…

  16. Adult heavy and low users of dental services: treatment provided.

    PubMed

    Nihtilä, Annamari; Widström, Eeva; Elonheimo, Outi

    2016-01-01

    The aim of this study was to compare treatment provided to adult heavy and low users of dental services in the Finnish Public Dental Service (PDS) and to analyse changes in patients' oral health status. We assigned all adults who attended the PDS in Espoo in 2004 to a group of heavy users (n = 3,173) if they had made six or more dental visits and to a comparison group of low users (n = 22,820), if they had made three or fewer dental visits. Data were obtained from the patient register of the PDS. A sample of 320 patients was randomly selected from each group. Baseline information (year 2004) on age, sex, number and types of visits, oral health status and treatment provided was collected from treatment records. Both groups were followed-up for five years. Restorative treatment measures dominated the heavy and low users'treatments; 88.8% of heavy users and 79.6% low users had received restorations during the five-year period. Fixed prosthetic treatments were provided to just 2% of the heavy users and 0.8% of the low users. Emergency visits were more common for heavy users (74.8%) than for low users (21.6%) (p < 0.001). Fewer than half of the heavy (46.1%) or low (46.5%) users were examined twice. Typical for heavy use of oral health services was a cycle of repetitive repair or replacement of restorations, often as emergency treatment, a lack of proper examinations and preventive care; crown therapy was seldom used. Immediately after the major dental care reform in Finland, the PDS in Espoo had problems providing good quality dental care for the new adult patients. Older patients with lower social class background were not accustomed to regular dental care and the PDS did not actively propose proper comprehensive regular care for adults.

  17. Degree-day prediction of adult emergence of Photinus carolinus (Coleoptera: Lampyridae).

    PubMed

    Faust, Lynn F; Weston, Paul A

    2009-10-01

    The synchronous display of the firefly Photinus carolinus Green in the Great Smoky Mountains National Park has been enjoyed by park visitors and studied by scientists and naturalists for the past 17 yr. A degree-day model is presented offering a means of more accurately predicting the display season of P. carolinus to facilitate advance planning required for researchers and the management of the thousands of nightly visitors who come to witness the peak firefly display. A modified growing degree-day (mGDD) model (base 50 degrees F, starting date 1 March) (centigrade equivalent base 10 degrees C, denoted mGDDC) provided the best fit to phenology data collected over a 15-yr period. The predictive model yielded the following values for P. carolinus phenology: male emergence, 838.6 mGDD (range, 776-922)/465.9 mGDDC (range, 431-512); "good" display, 992.5 mGDD (range, 931-1075)/551.4 mGDDC (range, 517-597); female emergence, 1068.8 mGDD (range, 956-1224)/593.8 mGDDC (range, 531-680); and peak male display, 1094.2 mGDD (range, 1020-1182)/607.9 mGDDC (range, 567-657). The accuracy and range limits of using calendar dates versus degree-day values are presented. Additional degree-day values are provided for 14 other local firefly and 1 phengodid species to broaden the applicability of using degree-days to aid in prediction of adult firefly seasons.

  18. Same-Day Counseling: Study Protocol for the Evaluation of a New Mental Health Service

    PubMed Central

    Ewen, Victoria; Bailey, Kathleen; Haggarty, John M; Dama, Sumeet; Mushquash, Christopher J

    2016-01-01

    Background Single-session counseling is being implemented across Canada to increase the accessibility and availability of mental health services. Despite increasing use, existing research on single-session counseling is sparse and has methodological limitations. In addition, some stakeholders are skeptical that this model of care can support meaningful change for clients. Objective The aim of this study is to evaluate a new single-session counseling program (called Same-Day Counseling) offered in an outpatient community mental health clinic in Northwestern Ontario, Canada. Methods Clients who attend Same-Day Counseling services will be given the opportunity to participate in the program evaluation. Those who consent will complete measures before their session, after their session, and at 1-month follow-up. Data will provide information on who accesses Same-Day Counseling (eg, typical presenting problems, symptom severity), client satisfaction with services, and whether clients benefit from the services (eg, improved functioning and reduced symptom severity). Results Data collection is underway with 80 participants having completed baseline measures and 55 participants having completed follow-up measures. Data collection is expected to conclude in December 2015. Conclusions This study is designed to contribute to the literature regarding the integration of single-session counseling into ongoing mental health services, with additional attention to methodological rigour. Our approach will help to address ongoing concerns regarding the implementation of single-session counseling, and inform health care providers and policy makers regarding the utility of this model for addressing the mental health care need of the community. PMID:26842891

  19. Consuming a multi-ingredient thermogenic supplement for 28 days is apparently safe in healthy adults

    PubMed Central

    Vogel, Roxanne M.; Joy, Jordan M.; Falcone, Paul H.; Mosman, Matt M.; Kim, Michael P.; Moon, Jordan R.

    2015-01-01

    Background Thermogenic (TRM) supplements are often used by people seeking to decrease body weight. Many TRM supplements are formulated with multiple ingredients purported to increase energy expenditure and maximize fat loss. However, in the past some TRM ingredients have been deemed unsafe and removed from the market. Therefore, it is important to verify the safety of multi-ingredient TRM supplements with chronic consumption. Objective To assess the safety of daily consumption of a multi-ingredient TRM supplement over a 28-day period in healthy adults. Design Twenty-three recreationally active adults (11M, 12F; 27.1±5.4 years, 171.6±9.6 cm, 76.8±16.1 kg, 26±5 BMI) were randomly assigned either to consume a multi-ingredient TRM supplement (SUP; n=9) or remain unsupplemented (CRL; n=14) for 28 days. Participants maintained their habitual dietary and exercise routines for the duration of the study. Fasting blood samples, resting blood pressure, and heart rate were taken before and after the supplementation period. Samples were analyzed for complete blood counts, comprehensive metabolic, and lipid panels. Results Significant (p<0.05) group by time interactions were present for diastolic BP, creatinine, estimated glomerular filtration rate (eGFR), chloride, CO2, globulin, albumin:globulin (A/G), and high-density lipoprotein (HDL). Dependent t-tests conducted on significant variables revealed significant (p<0.05) within-group differences in SUP for diastolic BP (+6.2±5.3 mmHG), creatinine (+0.09±0.05 mg/dL), eGFR (−11.2±5.8 mL/min/1.73), globulin (−0.29±0.24 g/dL), A/G (+0.27±0.23), and HDL (−5.0±5.5 mg/dL), and in CRL for CO2 (−1.9±1.5 mmol/L) between time points. Each variable remained within the accepted physiological range. Conclusion Results of the present study support the clinical safety of a multi-ingredient TRM containing caffeine, green tea extract, and cayenne powder. Although there were statistically significant (p<0.05) intragroup

  20. Look at Me! Does the Adult Truly See and Respond to the Child in Finnish Day-Care Centres?

    ERIC Educational Resources Information Center

    Kalliala, Marjatta

    2011-01-01

    The aim of the Kangaroo research project was to enhance the well-being of children under three years of age in Finnish day-care centres. In this experimental intervention study adults were encouraged to take a more sensitive and active role especially during "free play." In six Kangaroo groups and five control groups adults (N = 28) and…

  1. Caffeine Enhances Memory Performance in Young Adults during Their Non-optimal Time of Day

    PubMed Central

    Sherman, Stephanie M.; Buckley, Timothy P.; Baena, Elsa; Ryan, Lee

    2016-01-01

    Many college students struggle to perform well on exams in the early morning. Although students drink caffeinated beverages to feel more awake, it is unclear whether these actually improve performance. After consuming coffee (caffeinated or decaffeinated), college-age adults completed implicit and explicit memory tasks in the early morning and late afternoon (Experiment 1). During the morning, participants ingesting caffeine demonstrated a striking improvement in explicit memory, but not implicit memory. Caffeine did not alter memory performance in the afternoon. In Experiment 2, participants engaged in cardiovascular exercise in order to examine whether increases in physiological arousal similarly improved memory. Despite clear increases in physiological arousal, exercise did not improve memory performance compared to a stretching control condition. These results suggest that caffeine has a specific benefit for memory during students’ non-optimal time of day – early morning. These findings have real-world implications for students taking morning exams. PMID:27895607

  2. Effect of seven days of spaceflight on hindlimb muscle protein, RNA and DNA in adult rats

    NASA Technical Reports Server (NTRS)

    Steffen, J. M.; Musacchia, X. J.

    1985-01-01

    Effects of seven days of spaceflight on skeletal muscle (soleus, gastrocnemius, EDL) content of protein, RNA and DNA were determined in adult rats. Whereas total protein contents were reduced in parallel with muscle weights, myofibrillar protein appeared to be more affected. There were no significant changes in absolute DNA contents, but a significant (P less than 0.05) increase in DNA concentration (microgram/milligram) in soleus muscles from flight rats. Absolute RNA contents were significantly (P less than 0.025) decreased in the soleus and gastrocnemius muscles of flight rats, with RNA concentrations reduced 15-30 percent. These results agree with previous ground-based observations on the suspended rat with unloaded hindlimbs and support continued use of this model.

  3. Characteristics of Adults with Autism Spectrum Disorder Who Use Adult Developmental Disability Services: Results from 25 US States

    ERIC Educational Resources Information Center

    Hewitt, Amy S.; Stancliffe, Roger J.; Sirek, Annie Johnson; Hall-Lande, Jennifer; Taub, Sarah; Engler, Joshua; Bershadsky, Julie; Fortune, Jon; Moseley, Charles R.

    2012-01-01

    There is a significant increase in the prevalence of autism and autism spectrum disorders (ASD) in children with estimates now reaching 1 in 110 children in the United States. Families report difficulties in finding services for their young and adult children. Many adults with ASD receive services and supports through state intellectual and…

  4. Transitions between child and adult mental health services: service design, philosophy and meaning at uncertain times.

    PubMed

    Murcott, W J

    2014-09-01

    A young person's transition of care from child and adolescent mental health services to adult mental health services can be an uncertain and distressing event that can have serious ramifications for their recovery. Recognition of this across many countries and recent UK media interest in the dangers of mental health services failing young people has led practitioners to question the existing processes. This paper reviews the current theories and research into potential failings of services and encourages exploration for a deeper understanding of when and how care should be managed in the transition process for young people. Mental health nurses can play a vital role in this process and, by adopting the assumptions of this paradigm, look at transition from this unique perspective. By reviewing the current ideas related to age boundaries, service thresholds, service philosophy and service design, it is argued that the importance of the therapeutic relationship, the understanding of the cultural context of the young person and the placing of the young person in a position of autonomy and control should be central to any decision and process of transfer between two mental health services.

  5. Effects of Aging and Adult Development Education and Service Learning on Attitude, Anxiety, and Occupational Interest

    ERIC Educational Resources Information Center

    Boswell, Stefanie S.

    2015-01-01

    This study investigated the effect of a semester-long aging and adult development course that included an intergenerational, service-learning component on attitudes toward older adult men and women, aging anxiety, and interest in occupations that serve older adults among individuals training for careers in healthcare and social services. It also…

  6. 20 CFR 663.150 - What core services must be provided to adults and dislocated workers?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false What core services must be provided to adults... ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through the One-Stop...

  7. 20 CFR 663.150 - What core services must be provided to adults and dislocated workers?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What core services must be provided to adults... ADMINISTRATION, DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through the One-Stop Delivery System §...

  8. 20 CFR 663.150 - What core services must be provided to adults and dislocated workers?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false What core services must be provided to adults... ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through the One-Stop...

  9. 20 CFR 663.150 - What core services must be provided to adults and dislocated workers?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false What core services must be provided to adults... ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through the One-Stop...

  10. Directory of Adult Education Documentation and Information Services. Second Edition. IBEDATA Series.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Paris (France).

    This second, revised edition of the Directory of Adult Education Documentation and Information Services is a reference tool for those seeking information and documentation on adult education in other countries. In the first part 154 national adult education documentation services in sixty-five countries have been listed by country in alphabetical…

  11. Day-to-day variations in the amplitude of the soil temperature cycle and impact on adult eclosion timing of the onion fly

    NASA Astrophysics Data System (ADS)

    Tanaka, Kazuhiro; Watari, Yasuhiko

    2016-12-01

    The onion fly Delia antiqua advances its eclosion timing with decreasing temperature amplitude to compensate for a depth-dependent phase delay of the zeitgeber. To elucidate whether or not naturally occurring day-to-day variations in the amplitude of soil temperature cycle disturb this compensatory response, we monitored daily variations in the temperature amplitude in natural soils and evaluated the impact on adult eclosion timing. Our results indicated that both median and variance of the soil temperature amplitude become smaller as depth increases. Insertion of a larger temperature fluctuation into the thermoperiod with smaller temperature amplitude induced a stronger phase delay, while insertion of a smaller temperature fluctuation into the thermoperiod with larger temperature amplitude had a weaker phase-advancing effect. It is therefore expected that larger diurnal temperature fluctuations disturb the compensatory response, particularly if they occur at deeper locations, while smaller temperature fluctuations do so only at shallower locations. Under natural conditions, however, the probability of occurrence of smaller or larger temperature fluctuations in shallower or deeper soils, respectively, is relatively small. Thus, naturally occurring day-to-day variations in the temperature amplitude rarely disturb the compensatory response, thereby having a subtle or negligible impact on adult eclosion timing.

  12. 20 CFR 663.300 - What are training services for adults and dislocated workers?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are training services for adults and dislocated workers? 663.300 Section 663.300 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION... Training Services § 663.300 What are training services for adults and dislocated workers? Training...

  13. 20 CFR 663.300 - What are training services for adults and dislocated workers?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false What are training services for adults and dislocated workers? 663.300 Section 663.300 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION... INVESTMENT ACT Training Services § 663.300 What are training services for adults and dislocated...

  14. Piloting the older adult financial exploitation measure in adult safeguarding services.

    PubMed

    Phelan, A; Fealy, G; Downes, C

    2017-01-27

    Financial abuse is arguably the most complex form of elder abuse as it may occur remote to the older person and it is impacted by issues such as cultural values, perpetrator intent and family expectations. Financial abuse may not be recognised by either the older person or the perpetrator, thus, its prevention, early identification and amelioration are important. The (Irish) National Centre for the Protection of Older People undertook a study to determine the appropriateness of the Older Adult Financial Exploitation Measure for use by the national safeguarding older person services. Findings from a small pilot study involving 16 safeguarding staff's use of the Older Adult Financial Exploitation Measure with 52 community dwelling older people referred to their service demonstrate a higher suspicion of financial abuse as well as identifying multiple instances of possible financial exploitation in a single individual. Thus, the Older Adult Financial Exploitation Measure is considered appropriate to assist safeguarding personnel's assessment of older people related to a suspicion of financial abuse.

  15. Measuring Physical Activity with Hip Accelerometry among U.S. Older Adults: How Many Days Are Enough?

    PubMed Central

    Dale, William; Lauderdale, Diane S.; Waite, Linda

    2017-01-01

    Introduction Accelerometers are increasingly used in research. Four to 7 days of monitoring is preferred to estimate average activity but may be burdensome for older adults. We aimed to investigate: 1) 7-day accelerometry protocol adherence, 2) demographic predictors of adherence, 3) day of the week effect, and 4) average activity calculated from 7 versus fewer days among older adults. Methods We used the 2003–2006 older adult hip accelerometry data from the National Health and Nutrition Examination Survey (NHANES) sample. We determined proportions with 1–7 valid (10–20 hours) wear days and identified wear day correlates using ordinal logistic regression. We determined the day of week effect on 5 accelerometry measures (counts per minute, CPM; % sedentary behavior; % light-lifestyle activity; % moderate-vigorous activity, MVPA; total activity counts) using multivariate linear regression and compared averages estimated over 2 or 3 versus 7 days using correlations, linear regression, and Bland-Altman plots. Results Among 2,208 participants aged 65+, 85% of participants had ≥2 and 44% had 7 valid wear days. Increasing age (p = 0.01) and non-white race (p < 0.001) were associated with fewer days. Daily CPM, % MVPA, and total daily activity counts were similar Monday through Saturday, but significantly lower on Sundays (p < 0.001). Daily % sedentary behavior and % light-lifestyle activity were significantly different on Saturdays (p = 0.04–0.045) and Sundays (p < 0.001) compared to weekdays. Among participants with 7 valid days, 2 or 3 day averages were highly correlated with 7 day averages for all 5 accelerometry measures (2 versus 7 days: r = 0.90–0.93, 3 versus 7 days: r = 0.94–0.96). Conclusions Protocols of 2–3 days, adjusting for Sundays (average CPM, % moderate-vigorous activity, and average total daily activity counts) or weekends (% sedentary behavior and % light-lifestyle activity), give reliable estimates of older adult activity. PMID:28081249

  16. 20 CFR 663.150 - What core services must be provided to adults and dislocated workers?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through the One-Stop Delivery System § 663... through the One-Stop delivery system. (b) Followup services must be made available, as appropriate, for...

  17. Meal Replacement Beverage Twice a Day in Overweight and Obese Adults (MDRC2012-001)

    PubMed Central

    Frestedt, Joy L; Young, Lindsay R; Bell, Margie

    2012-01-01

    This open label, single arm, prospective, interventional, weight loss trial evaluated a meal replacement beverage (Right Size® Smoothie) used to replace breakfast and lunch each day for 12 weeks (7 clinic visits) as part of a calorie-restricted diet in overweight and obese adults. A total of 155 individuals were screened, 55 enrolled and 28 completed this 12 week study. Subjects were obese (mean weight: 206 pounds and BMI: 32.7 kg/m2) and the mean age was 40 years including 42 (76.4%) female and 13 (23.6%) male volunteers. The modified Intent to Treat and Completer groups lost an average of 10.6 and 13.8 pounds and reduced their average BMI by 1.7 and 2.2 kg/m2 respectively during this 12 week trial. The Per Protocol group lost 15.2 pounds and 2.4 kg/m2 and the Optimal Weight Loss group lost 18.5 pounds and 2.9 kg/m2. Using the Satiety Labeled Intensity Magnitude scale (SLIM) questionnaire, subjects reported feeling relatively hungry before they consumed the beverage, then feeling relatively full 15 minutes following the beverage with the sensation of some fullness lasting more than 2 hours and then feeling relatively hungry again at 3 hours after consuming the beverage. Study subjects reported significant improvements in physical functioning, general health, vitality and mental health as well as increased cognitive restraint of eating, reduced disinhibition and reduced hunger during the trial. The study beverages were well tolerated and no Serious Adverse Events (SAE) reported. This study suggests the study beverage aids in weight loss by helping to curb hunger during a reduced calorie diet program. PMID:23236298

  18. Meal Replacement Beverage Twice a Day in Overweight and Obese Adults (MDRC2012-001).

    PubMed

    Frestedt, Joy L; Young, Lindsay R; Bell, Margie

    2012-11-01

    This open label, single arm, prospective, interventional, weight loss trial evaluated a meal replacement beverage (Right Size(®) Smoothie) used to replace breakfast and lunch each day for 12 weeks (7 clinic visits) as part of a calorie-restricted diet in overweight and obese adults. A total of 155 individuals were screened, 55 enrolled and 28 completed this 12 week study. Subjects were obese (mean weight: 206 pounds and BMI: 32.7 kg/m(2)) and the mean age was 40 years including 42 (76.4%) female and 13 (23.6%) male volunteers. The modified Intent to Treat and Completer groups lost an average of 10.6 and 13.8 pounds and reduced their average BMI by 1.7 and 2.2 kg/m(2) respectively during this 12 week trial. The Per Protocol group lost 15.2 pounds and 2.4 kg/m(2) and the Optimal Weight Loss group lost 18.5 pounds and 2.9 kg/m(2). Using the Satiety Labeled Intensity Magnitude scale (SLIM) questionnaire, subjects reported feeling relatively hungry before they consumed the beverage, then feeling relatively full 15 minutes following the beverage with the sensation of some fullness lasting more than 2 hours and then feeling relatively hungry again at 3 hours after consuming the beverage. Study subjects reported significant improvements in physical functioning, general health, vitality and mental health as well as increased cognitive restraint of eating, reduced disinhibition and reduced hunger during the trial. The study beverages were well tolerated and no Serious Adverse Events (SAE) reported. This study suggests the study beverage aids in weight loss by helping to curb hunger during a reduced calorie diet program.

  19. Unplanned 30-Day Readmissions in a General Internal Medicine Hospitalist Service at a Comprehensive Cancer Center

    PubMed Central

    Manzano, Joanna-Grace M.; Gadiraju, Sahitya; Hiremath, Adarsh; Lin, Heather Yan; Farroni, Jeff; Halm, Josiah

    2015-01-01

    Purpose: Hospital readmissions are considered by the Centers for Medicare and Medicaid as a metric for quality of health care delivery. Robust data on the readmission profile of patients with cancer are currently insufficient to determine whether this measure is applicable to cancer hospitals as well. To address this knowledge gap, we estimated the unplanned readmission rate and identified factors influencing unplanned readmissions in a hospitalist service at a comprehensive cancer center. Methods: We retrospectively analyzed unplanned 30-day readmission of patients discharged from the General Internal Medicine Hospitalist Service at a comprehensive cancer center between April 1, 2012, and September 30, 2012. Multiple independent variables were studied using univariable and multivariable logistic regression models, with generalized estimating equations to identify risk factors associated with readmissions. Results: We observed a readmission rate of 22.6% in our cohort. The median time to unplanned readmission was 10 days. Unplanned readmission was more likely in patients with metastatic cancer and those with three or more comorbidities. Patients discharged to hospice were less likely to be readmitted (all P values < .01). Conclusion: We observed a high unplanned readmission rate among our population of patients with cancer. The risk factors identified appear to be related to severity of illness and open up opportunities for improving coordination with primary care physicians, oncologists, and other specialists to manage comorbidities, or perhaps transition appropriate patients to palliative care. Our findings will be instrumental for developing targeted interventions to help reduce readmissions at our hospital. Our data also provide direction for appropriate application of readmission quality measures in cancer hospitals. PMID:26152375

  20. Prevalence of Behavior Disorder and Disturbance to Family and Staff in a Sample of Adult Day Health Care Clients.

    ERIC Educational Resources Information Center

    Teresi, Jeanne A.; Holmes, Douglas; Dichter, Elizabeth; Koren, Mary Jane; Ramirez, Mildred; Fairchild, Susan

    1997-01-01

    Reports on the prevalence of behavior disorders in a sample of residents (N=360) in adult day health care programs. Findings indicate relatively high rates of behavior disorders. Most prevalent were the affective disorders (seeking reassurance, depression, crying) and verbal-vocal agitation. Differences between formal and informal caregivers'…

  1. Recruiting Older Adults into a Physical Activity Promotion Program: "Active Living Every Day" Offered in a Naturally Occurring Retirement Community

    ERIC Educational Resources Information Center

    Hildebrand, Mary; Neufeld, Peggy

    2009-01-01

    Purpose: This article explores recruitment strategies based on the transtheoretical model (TTM) with older adults living in a naturally occurring retirement community (NORC) to encourage enrollment in a physical activity promotion program, "Active Living Every Day" (ALED). Reasons for participation or nonparticipation are identified. Design and…

  2. 20 CFR 663.110 - What are the eligibility criteria for core services for adults in the adult and dislocated worker...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... services for adults in the adult and dislocated worker programs? 663.110 Section 663.110 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services...

  3. 78 FR 41716 - Hours of Service; Limited 90-Day Waiver From the 30-Minute Rest Break Requirement for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-11

    ... beginning of this notice. Long-Range Weather Forecasts The FMCSA reviewed information from the National Oceanic and Atmospheric Administration's National Weather Service (NOAA). The NOAA posts long-range... Federal Motor Carrier Safety Administration 49 CFR Part 395 Hours of Service; Limited 90-Day Waiver...

  4. 3 CFR 8501 - Proclamation 8501 of April 16, 2010. National Day of Service and Remembrance for Victims and...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Proclamation 8501 of April 16, 2010. National Day of Service and Remembrance for Victims and Survivors of Terrorism, 2010 8501 Proclamation 8501 Presidential... with appropriate ceremonies, activities, and acts of community service in memory of the victims...

  5. 25 CFR 36.82 - May behavioral health professional(s) provide services during the academic school day?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false May behavioral health professional(s) provide services...) provide services during the academic school day? Behavioral health professional(s) must average at least 75 percent of their work hours with students in their dormitories. These work hours must...

  6. Determining Factors for Utilization of Preventive Health Services among Adults with Disabilities in Taiwan

    ERIC Educational Resources Information Center

    Kung, Pei-Tseng; Tsai, Wen-Chen; Li, Ya-Hsin

    2012-01-01

    Taiwan has provided free health checks for adults since 1995. However, very little previous research has explored the use of preventive health services by physically and mentally disabled adults. The present study aimed to understand this use of preventive health services and the factors that influence it. Research participants included disabled…

  7. Mechanisms of Service-Delivery Systems of Adult Education in Non-University Institutions in Canada.

    ERIC Educational Resources Information Center

    Weva, Kabule W.

    A study was conducted to identify and describe the different mechanisms of adult education services provided by non-university institutions in Canada. Specifically, the study sought to determine which institutions were involved in adult education, which service-delivery modes were most widely used, current trends, and which institutions and…

  8. Perceptions of Biopsychosocial Services Needs among Older Adults with Severe Mental Illness: Met and Unmet Needs

    ERIC Educational Resources Information Center

    Cummings, Sherry M.; Cassie, Kimberly McClure

    2008-01-01

    This study sought to identify the psychiatric, physical, and social services needs experienced by older adults with severe mental illness (SMI) and to examine factors influencing their experience of need and service provision adequacy. Seventy-five older adults with SMI were recruited from a community mental health center to participate in the…

  9. Without Speaking, Youth Enters Adult Work Scene, Copes with Autism a Day at a Time

    ERIC Educational Resources Information Center

    Murphy, Patti

    2010-01-01

    This article presents the story of Chad Roberts of Canton, Georgia, who is proving himself a promising employee day by day. He works several jobs in increments of up to 90 minutes. Some days, he completes bulk mailings at a law firm. On others, he's at local restaurants stocking the wait staff stations with supplies. The community-based vocational…

  10. The Association Between Sleep and Physical Function Among Older Veterans in an Adult Day Health Care Program

    PubMed Central

    Song, Yeonsu; Dzierzewski, Joseph; Fung, Constance H.; Rodriguez, Juan C.; Jouldjian, Stella; Mitchell, Michael; Josephson, Karen R.; Alessi, Cathy A.; Martin, Jennifer L.

    2015-01-01

    OBJECTIVES To examine whether sleep disturbance is associated with poor physical function in older veterans in an adult day health care (ADHC) program. DESIGN Cross-sectional study. SETTING One ADHC program in a Veterans Affairs Ambulatory Care Center. PARTICIPANTS Older veterans (N = 50) who were enrolled in a randomized controlled trial of a sleep intervention program and provided complete baseline data. MEASUREMENTS Participant characteristics (e.g., age, depression, relationship to caregiver, pain, comorbidity) were collected using appropriate questionnaires. Physical function was measured using the total score of activities of daily living (ADLs) and instrumental ADLs (IADLs) from the Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire. Sleep was assessed subjectively (by the Pittsburgh Sleep Quality Index and the Insomnia Severity Index) and objectively (by wrist actigraphy). RESULTS As expected, participants required substantial assistance with ADLs and IADLs. A regression model showed that participant characteristics (i.e., marital status, use of sleep medication, comorbidity, and posttraumatic stress disorder) and living arrangement (i.e., living with a spouse and/or others) were significantly associated with poor physical function. Poorer objective sleep (i.e., total sleep time, total numbers of awakenings, and total wake time) was significantly associated with poor physical function, accounting for a significant proportion of the variance above and beyond participant characteristics. CONCLUSION Objective measures of nighttime sleep disturbance were associated with poor physical function among older veterans in an ADHC program. Further research is needed to determine whether interventions to improve sleep will delay functional decline in this vulnerable population. PMID:26200520

  11. Reference Services for the Adult Learner: Challenging Issues for the Traditional and Technological Era.

    ERIC Educational Resources Information Center

    Sarkodie-Mensah, Kwasi, Ed.

    This book offers approaches for teaching adult patrons how and where to find information in libraries and through information services. It includes 34 papers, organized in seven sections, expressing the views of faculty, adult students, and administrators as well as librarians on theories of educational psychology that explain how adults learn.…

  12. 76 FR 23479 - Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Young Adult

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-27

    ... (CHAMPUS); TRICARE Young Adult AGENCY: Office of the Secretary, DoD. ACTION: Interim final rule with... Defense Authorization Act for Fiscal Year 2011 (NDAA for FY11). It establishes the TRICARE Young Adult... age of 26 of uniformed services sponsors. The TRICARE Young ] Adult program is a premium-based...

  13. An Information Needs Profile of Israeli Older Adults, regarding the Law and Services

    ERIC Educational Resources Information Center

    Getz, Irith; Weissman, Gabriella

    2010-01-01

    Based on Nicholas' framework for assessing information needs, this research aims to construct a profile of both Israeli older adults and their information needs regarding laws and social services. Data were collected by questionnaires answered by 200 older adults, born in Europe, Asia and Africa, who attended social clubs for older adults. The…

  14. A Telephone Support Program for Adult Day Center Caregivers: Early Indications of Impact

    ERIC Educational Resources Information Center

    Gendron, Tracey; Pelco, Lynn E.; Pryor, Jennifer; Barsness, Sonya; Seward, Lynne

    2013-01-01

    The Virginia Commonwealth University/A Grace Place Caregiver Telephone Support Pilot Program was developed as a service-learning experience for graduate students to address the need for family caregiver support services. The Telephone Support Program was developed by the Virginia Commonwealth University Department of Gerontology, in collaboration…

  15. Safety and cost savings of an improved three-day rule for stool culture in hospitalised children and adults.

    PubMed

    Seyler, L; Lalvani, A; Collins, L; Goddard, L; Bowler, I C J W

    2007-10-01

    Stools sent for culture from patients after three days of hospitalisation have a low yield (<1%) for bacterial enteric pathogens (BEP), excluding Clostridium difficile, and are expensive to process. A 'three-day rule' for rejection of specimens has previously been validated in adults. We evaluated a three-day rule for paediatric stool samples by retrospective review of all stool culture results from 1995 to 2002. Excluding C. difficile, yield for BEP in samples sent within three days following admission was 97/3751 (2.59%) compared with 3/1511 (0.2%) in samples sent more than three days after admission. The criteria for culture would have been met if the rule had been applied for these three samples. We prospectively evaluated potential savings if the rule were applied for both children and adults over a two-month period in 2000. Savings were greater for adults than for children. Of 490 stools from children, 38 (7.8%) samples did not meet the criteria for culture and of 206 stools from adult patients, 64 (31%) did not meet the criteria for culture. We implemented the rule between 1 March 2003 and 31 March 2006. A total of 14 439 stool samples were received from inpatients requesting culture for BEP, excluding C. difficile. Of these, 5744 (39.8%) were rejected because the criteria for culture were not met. This was estimated as an annual saving of 11,848 pounds to the Trust laboratory. If extrapolated to all NHS Trusts, the potential savings could be in the order of 1.18 million pounds annually.

  16. Talking Therapy Services for Adult Survivors of Childhood Sexual Abuse (CSA) in Scotland: Perspectives of Service Users and Professionals

    ERIC Educational Resources Information Center

    Chouliara, Zoe; Karatzias, Thanos; Scott-Brien, Georgia; Macdonald, Anne; MacArthur, Juliet; Frazer, Norman

    2011-01-01

    This study aimed to elicit perceptions and experiences of talking therapy services for CSA survivors and professionals utilizing qualitative interviews and analyzing transcripts using Interpretative Phenomenological Analysis. Participants included 13 adult survivors and 31 professionals in statutory and voluntary services in Scotland. Main themes…

  17. Adult Education in the Service of the Rural Poor

    ERIC Educational Resources Information Center

    Mathur, V. S.

    1975-01-01

    The address, delivered at the 27th All India Adult Education Conference, summarizes demographic data on the rural poor, their economic and social situation, and discusses land reform, technology, employment opportunities, and adult education as ways to eliminate rural poverty. Adult education promotes leadership development and community…

  18. The 30-day prognosis of chronic-disease patients after contact with the out-of-hours service in primary healthcare

    PubMed Central

    Carlsen, Anders Helles; Moth, Grete; Christensen, Morten Bondo; Vestergaard, Mogens; Olesen, Frede; Vedsted, Peter

    2014-01-01

    Abstract Objective. Little is known about the prognosis of patients with chronic disease who contact the out-of-hours (OOH) service in primary care. The characteristics of contacts with the Danish out-of-hours service and daytime general practice, hospitalization, and death were studied during a 30-day follow-up period in patients with chronic heart diseases. Design. Cohort study. Setting and subjects. The study was based on data from 11 897 adults aged 18 + years from a Danish survey of OOH contacts, including information on consultation type. Reason for encounter (RFE) was categorized by OOH GPs at triage as either “exacerbation” or “new health problem”. Registry data were used to identify eligible patients, and the cohort was followed for 30 days after OOH contact through nationwide registries on healthcare use and mortality. Main outcome measures. The 30-day prognosis of chronic-disease patients after OOH contact. Results. Included patients with chronic disease had a higher risk of new OOH contact, daytime GP contact, and hospitalization than other patients during the 30-day follow-up period. OOH use was particularly high among patients with severe mental illness. A strong association was seen between chronic disease and risk of dying during follow-up. Conclusion. Patients with chronic disease used both daytime general practice and the out-of-hours service more often than others during the 30-day follow-up period; they were more often hospitalized and had higher risk of dying. The findings call for a proactive approach to future preventive day care and closer follow-up of this group, especially patients with psychiatric disease. PMID:25471829

  19. Cannabis Withdrawal, Posttreatment Abstinence, and Days to First Cannabis Use Among Emerging Adults in Substance Use Treatment: A Prospective Study

    PubMed Central

    Davis, Jordan P.; Smith, Douglas C.; Morphew, Jason W.; Lei, Xinrong; Zhang, Saijun

    2015-01-01

    Very little prospective research investigates how cannabis withdrawal is associated with treatment outcomes, and this work has not used the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) thresholds for cannabis withdrawal. The sample included 110 emerging adults entering outpatient substance use treatment who were heavy cannabis users with no other drug use and limited alcohol use. We used survival analyses to predict days to first use of cannabis and logistic regression to predict whether participants were abstinent and living in the community at 3 months. Those meeting criteria for cannabis withdrawal were more likely to return to use sooner than those not meeting criteria for cannabis withdrawal. However, the presence of cannabis withdrawal was not a significant predictor of 3-month abstinence. Emerging adults with DSM-5 cannabis withdrawal may have difficulty initiating abstinence in the days following their intake assessment, implying the need for strategies to mitigate their more rapid return to cannabis use. PMID:26877548

  20. Health Services Utilization between Older and Younger Homeless Adults.(author Abstract)

    ERIC Educational Resources Information Center

    Nakonezny, Paul A.; Ojeda, Michael

    2005-01-01

    Purpose: Our purpose in the current study was to examine the relationship between health services utilization delivered by means of the Homeless Outreach Medical Services (HOMES) program and health services utilization delivered by means of the Parkland emergency room and inpatient units among a sample of older and younger homeless adults being…

  1. 20 CFR 663.800 - What are supportive services for adults and dislocated workers?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false What are supportive services for adults and dislocated workers? 663.800 Section 663.800 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION... providers, must develop a policy on supportive services that ensures resource and service coordination...

  2. 78 FR 13394 - 30-Day Notice of Proposed Information Collection: Office of Language Services Contractor...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-27

    ... Notice of Proposed Information Collection: Office of Language Services Contractor Application Form ACTION... Language Services Contractor Application Form. OMB Control Number: 1405-0191. Type of Request: Extension of... U.S. Department of State, Office of Language Services, the information collected is used to...

  3. A day-centered approach to modeling cortisol: Diurnal cortisol profiles and their associations among U.S. adults

    PubMed Central

    Dmitrieva, Natalia O.; Almeida, David M.; Dmitrieva, Julia; Loken, Eric; Pieper, Carl F.

    2013-01-01

    Summary Diurnal cortisol is a marker of HPA-axis activity that may be one of the biological mechanisms linking stressors to age-related health declines. The current study identified day-centered profiles of diurnal cortisol among 1,101 adults living in the United States. Participants took part in up to four consecutive days of salivary cortisol collection, assessed at waking, 30 minutes post-waking, before lunch, and before bedtime. Growth Mixture Modeling with latent time basis was used to estimate common within-day trajectories of diurnal cortisol among 2,894 cortisol days. The 3-class solution provided the best model fit, showing that the majority of study days (73%) were characterized by a Normative cortisol pattern, with a robust cortisol awakening response (CAR), a steep negative diurnal slope, coupled with low awakening and bedtime levels. Relative to this profile, diurnal cortisol on the remainder of days appeared either Elevated throughout the day (20% of days) or Flattened (7% of days). Relative to the Normative trajectory, the Elevated trajectory was distinguished by a higher morning cortisol level, whereas the Flattened trajectory was characterized by a high bedtime level, with weaker CAR and diurnal slope parameters. Relative to the Normative profile, Elevated profile membership was associated with older age and cigarette smoking. Greater likelihood of the Flattened cortisol pattern was observed among participants who were older, male, smoked cigarettes, used medications that are known to affect cortisol output, and reported poorer health. The current study demonstrates the value of a day-centered Growth Mixture Modeling approach to the study of diurnal cortisol, showing that deviations from the classic robust rhythm of diurnal cortisol are associated with older age, male sex, use of medications previously shown to affect cortisol levels, poorer health behaviors, and poorer self-reported health. PMID:23770247

  4. Predictors of valued everyday occupations, empowerment and satisfaction in day centres: implications for services for persons with psychiatric disabilities.

    PubMed

    Eklund, Mona; Sandlund, Mikael

    2014-09-01

    This study addresses predictors of occupational value, empowerment and satisfaction with the rehabilitation received in day centres for people with psychiatric disabilities. These outcomes represent varying aspects of relevance for the day centre context and together create a manifold outcome picture. This was a longitudinal study with approval from the regional research vetting board. Self-report instruments were used, and the investigated predictors motivation for going to the day centre, occupational engagement, socio-demographic factors and self-reported diagnosis. Attendees (N = 108) at 8 day centres participated and filled in self-report questionnaires regarding the predictor and outcome variables. A baseline measurement and a 14-month follow-up composed the data. Occupational engagement at baseline could predict all three outcomes at the follow-up. Motivation for the day centre activities and not preferring work before attending the day centre were positive for satisfaction with the day centre. A low participation rate, although comparable with previous studies on the target group, was a limitation of this study. To conclude, both occupational engagement and motivation are factors that can be stimulated by the staff in day centres. Actions for how to accomplish that, and thereby also more positive outcomes of the day centre services, are proposed, such as a system of freedom of choice among day centres, and between day centres and supported employment.

  5. Autism spectrum disorder in adults: diagnosis, management, and health services development

    PubMed Central

    Murphy, Clodagh M; Wilson, C Ellie; Robertson, Dene M; Ecker, Christine; Daly, Eileen M; Hammond, Neil; Galanopoulos, Anastasios; Dud, Iulia; Murphy, Declan G; McAlonan, Grainne M

    2016-01-01

    Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by pervasive difficulties since early childhood across reciprocal social communication and restricted, repetitive interests and behaviors. Although early ASD research focused primarily on children, there is increasing recognition that ASD is a lifelong neurodevelopmental disorder. However, although health and education services for children with ASD are relatively well established, service provision for adults with ASD is in its infancy. There is a lack of health services research for adults with ASD, including identification of comorbid health difficulties, rigorous treatment trials (pharmacological and psychological), development of new pharmacotherapies, investigation of transition and aging across the lifespan, and consideration of sex differences and the views of people with ASD. This article reviews available evidence regarding the etiology, legislation, diagnosis, management, and service provision for adults with ASD and considers what is needed to support adults with ASD as they age. We conclude that health services research for adults with ASD is urgently warranted. In particular, research is required to better understand the needs of adults with ASD, including health, aging, service development, transition, treatment options across the lifespan, sex, and the views of people with ASD. Additionally, the outcomes of recent international legislative efforts to raise awareness of ASD and service provision for adults with ASD are to be determined. Future research is required to identify high-quality, evidence-based, and cost-effective models of care. Furthermore, future health services research is also required at the beginning and end of adulthood, including improved transition from youth to adult health care and increased understanding of aging and health in older adults with ASD. PMID:27462160

  6. 20 CFR 663.110 - What are the eligibility criteria for core services for adults in the adult and dislocated worker...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the eligibility criteria for core... the One-Stop Delivery System § 663.110 What are the eligibility criteria for core services for adults in the adult and dislocated worker programs? To be eligible to receive core services as an adult...

  7. Expanding Educational Services for Adults. OPTIONS. Publicity Kit.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. National Center for Research in Vocational Education.

    This publicity kit is intended to provide adult educators with materials for promoting and recruiting students into an adult education program designed according to the OPTIONS model (i.e., programs geared toward teaching the literacy, technical, and entrepreneurship skills that are necessary to adapt to changing labor market conditions resulting…

  8. Energy and macronutrient intake over the course of the day of German adults: A DEDIPAC-study.

    PubMed

    Wittig, Friederike; Hummel, Eva; Wenzler, Germaine; Heuer, Thorsten

    2017-03-16

    The aim of the study was to analyze the energy and macronutrient intake over the course of the day of selected population groups in Germany defined by sex, age, BMI, SES, and diet quality. The study was based on food consumption data from the German National Nutrition Survey II (2005-2007) assessed by two 4-day dietary weighing records of 662 women and men aged between 18 and 80 years. Energy and macronutrient intake were calculated using the German Nutrient Database 3.02 and summarized for the periods 'morning', 'midday', 'afternoon', 'evening', and 'night'. Generalized estimating equation models were used to examine differences in energy and macronutrient intake. For women and men, a three-main-meal pattern ('morning', 'midday', and 'evening') was observed, indicated as peaks in energy intake at 08:00 to 09:00, 13:00 and 19:00 o'clock. The distributions of carbohydrate, protein, and fat intake mirror the distribution of energy intake over the course of the day. The highest energy intake was found in the 'evening' period, especially in young adults, overweight persons, persons with a high SES, and men with a low diet quality. Women of the oldest age group showed a similar energy intake across the three-main-meals in contrast to young adults, who had lower peaks in the 'morning' and 'midday' periods as well as a shift to later meal times. Young adults seem to have a higher variability in energy intake and a less distinct meal pattern, while seniors have a more structured day. Because a high energy intake in the 'evening' period is associated with negative health-related factors, the distribution of energy intake should be considered by recommendations for a healthy nutritional behavior.

  9. Dientamoeba fragilis is more prevalent than Giardia duodenalis in children and adults attending a day care centre in Central Italy.

    PubMed

    Crotti, D; D'Annibale, M L; Fonzo, G; Lalle, M; Cacciò, S M; Pozio, E

    2005-06-01

    Giardia duodenalis is a well recognised enteropathogen, while Dientamoeba fragilis is rarely detected and consequently it is not recognised as an important human pathogen. In 2002-2003, a survey has been carried out on enteroparasites in faecal samples of outpatients attending a day care centre in the town of Perugia (Central Italy). To improve the detection level, at least three samples from each patient were collected at different days and within two hours from defecation. The coproparasitological examination has been carried out by direct microscopic examination, faecal concentration, and Giemsa and modified Ziehl-Nielsen stainings of faecal smears. The genotypes of Giardia duodenalis isolates were determined by PCR of the beta-giardin gene. Of 1,989 enrolled people (966 children, 1,023 adults), 165 persons (8.3%; 153 adults, 15.0%; 12 children, 1.2%), were positive for parasites, but only 1 12 adults (73.2% of those infected) and eight children (66.7% of those infected) harboured D. fragilis and G. duodenalis. Both the Assemblages A and B were detected in 18 G. duodenalis isolates examined at the beta-giardin gene. The higher prevalence of D. fragilis infections than that of G. duodenalis is probably related to the method used, a procedure, which is rarely followed in laboratories for the diagnosis of enteric parasites. These epidemiological data suggest that when faecal samples are examined after a period of time and without Giemsa staining, most D. fragilis infections goes undetected.

  10. 77 FR 65927 - 60-Day Notice of Proposed Information Collection: Office of Language Services Contractor...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-31

    ... Notice of Proposed Information Collection: Office of Language Services Contractor Application Form ACTION...: LSApplications@state.gov . Mail: Department of State, Office of Language Services SA- 1, Fourteenth Floor, 2401 E....gov . SUPPLEMENTARY INFORMATION: Title of Information Collection: Office of Language...

  11. 78 FR 7436 - Request for Public Comment: 30-Day Proposed Information Collection: Indian Health Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-01

    ... providers under contract with the IHS. Affected Public: Patients, health and medical care providers or Tribal Governments. Type of Respondents: Health and medical care providers. Burden Hours: The table below... services provided; to process payments ] for health care services performed by such providers; and to...

  12. 77 FR 69865 - 60-Day Proposed Information Collection; Request for Public Comment: Indian Health Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-21

    ... care providers under contract with the IHS. Affected Public: Patients, health and medical care providers or Tribal Governments. Type of Respondents: Health and medical care providers. Burden Hours: The... validate services provided; to process payments for health care services performed by such providers;...

  13. 20 CFR 663.110 - What are the eligibility criteria for core services for adults in the adult and dislocated worker...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... services for adults in the adult and dislocated worker programs? 663.110 Section 663.110 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated...

  14. 20 CFR 663.110 - What are the eligibility criteria for core services for adults in the adult and dislocated worker...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... services for adults in the adult and dislocated worker programs? 663.110 Section 663.110 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated...

  15. 20 CFR 663.110 - What are the eligibility criteria for core services for adults in the adult and dislocated worker...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... services for adults in the adult and dislocated worker programs? 663.110 Section 663.110 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated...

  16. Geography of Service Delivery: On the Role of Mental Health Service Structure in Community Senior Services for Puerto Rican Older Adults

    ERIC Educational Resources Information Center

    Velez Ortiz, Daniel

    2009-01-01

    The main purpose of this study was to examine the role of mental health services structure in community senior centers and how it interacts with Puerto Rican older adults' historical, social, and cultural experiences to relate to their perceptions, awareness, and utilization of mental health services. The study was carried out within a concurrent…

  17. A Comparison of Quality of Life Outcomes for People with Intellectual Disabilities in Supported Employment, Day Services and Employment Enterprises

    ERIC Educational Resources Information Center

    Beyer, Stephen; Brown, Tony; Akandi, Rachel; Rapley, Mark

    2010-01-01

    Background: Policy objectives for people with intellectual disabilities include day service modernization and the promotion of paid employment and quality of life. Quality of life is under represented as an outcome measure in vocational research. This research compares subjective and objective quality of life, and quality of work environment for…

  18. The influence of time of day on static and dynamic postural control in normal adults.

    PubMed

    Kwon, Yong Hyun; Choi, Yong Won; Nam, Seok Hyun; Lee, Myoung Hee

    2014-03-01

    [Purpose] We attempted to determine whether static and dynamic postural control ability fluctuated depending on the influence of the time of day (9 am, 1 pm, and 5 pm), and at which time point postural balance performance was best in healthy individuals. [Subjects and Methods] Twenty-four healthy subjects participated in this study. The static and dynamic postural balance test was conducted during three sessions (i.e., at 9 am, 1 pm, and 5 pm) with a counterbalanced order for prevention of learning effects. As outcome measurements, AP distance, ML distance, and velocity moment were adopted in the static balance test, and the performance time and total distance were measured in the dynamic balance test. [Results] For the static postural balance test, COP distance was shorter and COP velocity was slower at 9 am compared with those at 1 and 5 pm. In particular, the COP distance at 9 am was statistically different from that at 13 pm. During the dynamic postural balance test, performance time and total distance were influenced by the time of day, as the best performance was observed in the morning. [Conclusion] This study found that static and dynamic postural balance abilities were greatest in the morning and worst at 1 pm. Understanding of the mechanism of the time-of-day effect on postural balance will be helpful for assessment and treatment of postural balance by physical therapists and in making desirable clinical decisions.

  19. Where Would You Turn for Help? Older Adults' Awareness of Community Support Services

    ERIC Educational Resources Information Center

    Denton, M.; Ploeg, J.; Tindale, J.; Hutchison, B.; Brazil, K.; Akhtar-Danesh, N.; Quinlan, M.; Lillie, J.; Plenderleith, J. Millen; Boos, L.

    2008-01-01

    Previous findings on older adults' awareness of community support services (CSSs) have been inconsistent and marred by acquiescence or over-claiming bias. To address this issue, this study used a series of 12 vignettes to describe common situations faced by older adults for which CSSs might be appropriate. In telephone interviews, 1,152 adults…

  20. Balance and Mobility Training for Older Adults: An Undergraduate Service-Learning Experience.

    ERIC Educational Resources Information Center

    Williams, Kathleen; Kovacs, Christopher

    2001-01-01

    Describes a service learning program aimed at improving balance and mobility in a group of older adults from an independent living center while giving college students (mainly exercise and sport science majors) an opportunity to interact with this population. The program has resulted in improved balance and mobility for the older adults and…

  1. Consumers' Perspectives on Effective Orientation and Mobility Services for Diabetic Adults Who Are Visually Impaired

    ERIC Educational Resources Information Center

    Griffin-Shirley, Nora; Kelley, Pat; Matlock, Dwayne; Page, Anita

    2006-01-01

    The authors interviewed and videotaped diabetic adults with visual impairments about their perceptions of orientation and mobility (O&M) services that they had received. The visual impairments of these middle-aged adults ranged from totally blind to low vision. The interview questions focused on demographic information about the interviewees, the…

  2. Specific allogeneic unresponsiveness in the adult host: present-day experimental models

    SciTech Connect

    Rapaport, F.T.; Bachvaroff, R.J.; Cronkite, E.; Chanana, A.; Sato, T.; Asari, H.; Waltzer, W.C.

    1982-01-01

    As part of a long-term intensive effort to apply the induction of adult allogensic unresponsiveness to the transplantation problem, two techniques to control the variability in the persistence of immunologically competent postthymic cells iin the treated host and/or the inoculum of autologous marrow returned to the host after irradiation are described. The first consisted of exposing the peripheral blood of prospective recipients to a 5-week course of extra-corporeal irradiation (ECIB), the other of exposing the stored autologous marrow scheduled to repopulate a given recipient to methyl-prednisolone (MPd) and DNase prior to renifusion into the recipient. Serial analysis of bone marrow cell samples at various intervals before and after treatment was undertaken. The significance of the disappearance of a particular population of nonnuclear cells from the samples, and the association of such disappearance with increased success in the induction of allogeneic unresponsiveness is discussed. (ACR)

  3. Day Care as a Social Service Strategy: 1890 to 1946. A Substantive Paper.

    ERIC Educational Resources Information Center

    Gray, Wendy

    The purpose of this paper is to examine the impact of the social work profession on day care delivery from 1890 to 1946, and to relate the outcomes of the investigation to some contemporary social policy issues. The first chapter discusses day care during the Progressive Era (1890 to 1918) while the second chapter explores the…

  4. Day Care Homes: A Pennsylvania Profile. Center for Human Services Development Report No. 18.

    ERIC Educational Resources Information Center

    Peters, Donald L.

    This report presents a preliminary profile of home day care in Pennsylvania. Information was gathered through extensive questionnaires and home observations which occurred during site visits to a geographically-representative sample of 162 licensed or approved day care homes. In the profile, comparisons are made between 146 homes which are…

  5. An Idiographic Examination of Day-to-Day Patterns of Substance Use Craving, Negative Affect, and Tobacco Use among Young Adults in Recovery

    ERIC Educational Resources Information Center

    Zheng, Yao; Wiebe, Richard P.; Cleveland, H. Harrington; Molenaar, Peter C. M.; Harris, Kitty S.

    2013-01-01

    Psychological constructs, such as negative affect and substance use cravings that closely predict relapse, show substantial intraindividual day-to-day variability. This intraindividual variability of relevant psychological states combined with the "one day at a time" nature of sustained abstinence warrant a day-to-day investigation of substance…

  6. Students' Motivations, Value, and Decision to Participate in Service-Learning at the National FFA Days of Service

    ERIC Educational Resources Information Center

    Roberts, Richie; Terry, Robert, Jr.; Brown, Nicholas R.; Ramsey, Jon W.

    2016-01-01

    As agricultural educators continue to seek methods of instruction to make learning impactful for students, service-learning has emerged as a desirable technique for meeting these educational objectives. A gap in the agricultural education literature exists, however, in terms of describing whether these learning experiences motivate students…

  7. 75 FR 20893 - National Day of Service and Remembrance for Victims and Survivors of Terrorism, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-21

    ... those who came to their aid--reaffirmed the strength of our Nation, and the human spirit. Terrorists... ceremonies, activities, and acts of community service in memory of the victims and survivors of...

  8. Using the Consumer Experience with Pharmacy Services Survey as a quality metric for ambulatory care pharmacies: older adults' perspectives

    PubMed Central

    Shiyanbola, Olayinka O; Mott, David A; Croes, Kenneth D

    2016-01-01

    Objectives To describe older adults' perceptions of evaluating and comparing pharmacies based on the Consumer Experience with Pharmacy Services Survey (CEPSS), describe older adults' perceived importance of the CEPSS and its specific domains, and explore older adults' perceptions of the influence of specific CEPSS domains in choosing/switching pharmacies. Design Focus group methodology was combined with the administration of a questionnaire. The focus groups explored participants' perceived importance of the CEPSS and their perception of using the CEPSS to choose and/or switch pharmacies. Then, using the questionnaire, participants rated their perceived importance of each CEPSS domain in evaluating a pharmacy, and the likelihood of using CEPSS to switch pharmacies if their current pharmacy had low ratings. Descriptive and thematic analyses were done. Setting 6 semistructured focus groups were conducted in a private meeting room in a Mid-Western state in the USA. Participants 60 English-speaking adults who were at least 65 years, and had filled a prescription at a retail pharmacy within 90 days. Results During the focus groups, the older adults perceived the CEPSS to have advantages and disadvantages in evaluating and comparing pharmacies. Older adults thought the CEPSS was important in choosing the best pharmacies and avoiding the worst pharmacies. The perceived influence of the CEPSS in switching pharmacies varied depending on the older adult's personal experience or trust of other consumers' experience. Questionnaire results showed that participants perceived health/medication-focused communication as very important or extremely important (n=47, 82.5%) in evaluating pharmacies and would be extremely likely (n=21, 36.8%) to switch pharmacies if their pharmacy had low ratings in this domain. Conclusions The older adults in this study are interested in using patient experiences as a quality metric for avoiding the worst pharmacies. Pharmacists' communication

  9. Teaching Young Adults with Disabilities through Service Learning

    ERIC Educational Resources Information Center

    Woodruff, Elizabeth A.; Sinelnikov, Oleg A.

    2015-01-01

    While many scholars agree that service learning is beneficial to both the student and the community, the research on service learning in the physical education setting is limited. However, there are courses that can be aligned with the professional preparation needs of students and the broader needs of the community. Drawing on theory which has…

  10. The effect of exercise intervention on frail elderly in need of care: half-day program in a senior day-care service facility specializing in functional training

    PubMed Central

    Sakamoto, Ryota; Miura, Yasushi

    2016-01-01

    [Purpose] This study investigated the long-term effect of a half-day exercise intervention program on health-related quality of life, life function, and physical function in frail elderly in need of care. The program was conducted at a senior day-care facility specializing in functional training. [Subjects and Methods] Subjects included 41 elderly in need of care who had visited the service facility for at least 1 year. Physical function and life function were evaluated at baseline, 6 months, and 12 months. Quality of life was evaluated with the Short Form-36 at baseline and 12 months. [Results] Improvements in balance, walking speed and endurance, complex performance abilities, self-efficacy during the activities, and the level and sphere of activity were observed at 6 months and maintained up to 12 months. Moreover, improvements in agility, activities of daily living, life function, and quality of life were also observed at 12 months. Improvements in muscle strength, walking ability, self-efficacy over an action, and activities of daily living were related to the improvement in quality of life. [Conclusion] The use of individualized exercise programs developed by physiotherapists led to improvements in activities of daily living and quality of life among elderly in need of care. PMID:27512243

  11. Involving Adult Service Users with Learning Disabilities in the Training of Speech and Language Therapy Students

    ERIC Educational Resources Information Center

    Harding, Celia

    2009-01-01

    This article describes a pilot project carried out at City University London, Department of Language and Communication Science, where adult service users with learning disabilities trained first-year speech and language therapy students. The training involved presentations by the service users on their involvement in interviewing support staff,…

  12. Behavioral Health Services Utilization among Older Adults Identified within a State Abuse Hotline Database

    ERIC Educational Resources Information Center

    Schonfeld, Lawrence; Larsen, Rebecca G.; Stiles, Paul G.

    2006-01-01

    Purpose: This study examined the extent to which older adults identified in a statewide abuse hotline registry utilized behavioral health services. This is important as mental health issues have been identified as a high priority for filling gaps in services for victims of mistreatment. Design and Methods: We compared Medicaid and Medicare claims…

  13. Understanding Patterns of Service Utilization among Informal Caregivers of Community Older Adults

    ERIC Educational Resources Information Center

    Hong, Song-Iee

    2010-01-01

    Purpose: The article seeks to identify patterns of service utilization among informal caregivers of frail older adults. In particular, the study examined determinants that explain heterogeneous variations in caregivers' service use patterns. Methods: Using a latent class analysis (LCA) on the 2004 National Long-Term Care Survey and Informal…

  14. A Community Development Approach to Service-Learning: Building Social Capital between Rural Youth and Adults

    ERIC Educational Resources Information Center

    Henness, Steven A.; Ball, Anna L.; Moncheski, MaryJo

    2013-01-01

    Using 4-H and FFA case study findings, this article explores how community service-learning supports the building of social capital between rural youth and adults and the positive effects on community viability. Key elements of practice form a community development approach to service-learning, which opens up doorways for youth to partner with…

  15. An Inventory of Skills and Attitudes Necessary for a Career in Human Services/Adult Care.

    ERIC Educational Resources Information Center

    Broadbent, William

    This document is an inventory of skills identified as necessary by professionals in the human services field specializing in adult care. It is intended as a mechanism whereby educators can compare that which they teach against what the human services industry feels is relevant. Introductory material discusses the process of the occupational…

  16. Adult ESOL Students and Service-Learning: Voices, Experiences, and Perspectives

    ERIC Educational Resources Information Center

    Bippus, Sharon L.; Eslami, Zohreh R.

    2013-01-01

    This multiple-case study examined the unique perspectives of six adult English for speakers of other languages (ESOL) students who participated as the givers of a service in a semester-long service learning community college ESOL course. Their ages ranged from 19 to 45 and they hailed from five different countries (Colombia, Mexico, South Korea,…

  17. 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…

  18. Factors Affecting the Involvement of Day Centre Care Staff in the Delivery of Physiotherapy to Adults with Intellectual Disabilities: An Exploratory Study in One London Borough

    ERIC Educational Resources Information Center

    Middleton, M. -J.; Kitchen, S. S.

    2008-01-01

    Background: Physiotherapists for adults with intellectual disabilities often work in day centres, relying on care staff to support programmes. This study investigates factors affecting physiotherapy delivery in 4 day centres in one London borough. Materials and Method: Semi-structured interviews were carried out with day centre care staff,…

  19. Psychometric Properties of 7- and 30-Day Versions of the PROMIS Emotional Distress Item Banks in an Australian Adult Sample.

    PubMed

    Batterham, Philip J; Sunderland, Matthew; Carragher, Natacha; Calear, Alison L

    2017-01-01

    This study aimed to examine the psychometric properties of the PROMIS depression, anxiety, and anger item banks in a large Australian population-based sample. The study tested for unidimensionality; evaluated invariance across age, gender, and education; assessed local independence; and tested item bank scores as an indicator for clinical criteria. In addition, equivalence of the 7-day time frame against an alternative 30-day time frame was assessed. A sample of 3,175 Australian adults were recruited into the study through online advertising. All three item banks showed strong evidence of unidimensionality and parsimony, with no items showing local dependence. All items were invariant across age, gender, and education. The item banks were accurate in detecting clinical criteria for major depressive disorder, generalized anxiety disorder, and panic disorder, although legacy measures designed for this purpose sometimes performed marginally better. Responses to the 30-day time frame were highly consistent with the original 7-day time frame. The study provided support for the validity of the PROMIS emotional distress item banks as measures of depression, anxiety, and anger in the Australian population, supporting the generalizability of the measures. The time frame chosen for assessing mental health outcomes using these item banks should be based on pragmatic considerations.

  20. Youth with special health care needs: transition to adult health care services.

    PubMed

    Oswald, Donald P; Gilles, Donna L; Cannady, Mariel S; Wenzel, Donna B; Willis, Janet H; Bodurtha, Joann N

    2013-12-01

    Transition to adult services for children and youth with special health care needs (CYSHCN) has emerged as an important event in the life course of individuals with disabilities. Issues that interfere with efficient transition to adult health care include the perspectives of stakeholders, age limits on pediatric service, complexity of health conditions, a lack of experienced healthcare professionals in the adult arena, and health care financing for chronic and complex conditions. The purposes of this study were to develop a definition of successful transition and to identify determinants that were associated with a successful transition. The 2007 Survey of Adult Transition and Health dataset was used to select variables to be considered for defining success and for identifying predictors of success. The results showed that a small percentage of young adults who participated in the 2007 survey had experienced a successful transition from their pediatric care.

  1. 77 FR 11558 - Request for Public Comment; 60-Day Proposed Information Collection: Indian Health Service; Loan...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-27

    ... for education expenses that meet program criteria and who are qualified and willing to serve at, often..., and the individual agrees to work at an IHS location and provide health services to American Indian... location according to vacancy rates for that fiscal year and also considers whether the location is in...

  2. Math In-Service Training for Adult Educators.

    ERIC Educational Resources Information Center

    Llorente, Juan Carlos; Porras, Marta; Martinez, Rosa

    In a series of mathematics education workshops in which teachers from adult basic education and vocational education worked together to design teaching situations on particular contents in mathematics in order to make explicit and bring into reflection the teaching strategies used by each group. The workshops constituted a common space of…

  3. 20 CFR 663.145 - What services are WIA title I adult and dislocated workers formula funds used to provide?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false What services are WIA title I adult and... TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through the...

  4. 20 CFR 663.145 - What services are WIA title I adult and dislocated workers formula funds used to provide?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What services are WIA title I adult and... TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through the One-Stop...

  5. 20 CFR 663.145 - What services are WIA title I adult and dislocated workers formula funds used to provide?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false What services are WIA title I adult and... TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through the...

  6. 20 CFR 663.145 - What services are WIA title I adult and dislocated workers formula funds used to provide?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false What services are WIA title I adult and... TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through the...

  7. Access to Adult Learning Opportunities. Tierra de Oportunidad Module 6. LAES: Latino Adult Education Services Project.

    ERIC Educational Resources Information Center

    Kissam, Ed; Dorsey, Holda

    This module, which may be used as the basis for a workshop or as a special topic unit in an adult basic education or English-as-a-Second-Language (ESL) course, focuses on access to adult learning opportunities. The following items are included: module overview; list of basic, thinking, interpersonal, information utilization, and other skills…

  8. 78 FR 79475 - 30-Day Notice of Proposed Information Collection: The Impact of Housing and Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-30

    ...HUD has submitted the proposed information collection requirement described below to the Office of Management and Budget (OMB) for review, in accordance with the Paperwork Reduction Act. The purpose of this notice is to allow for an additional 30 days of public...

  9. Services for young people with attention deficit/hyperactivity disorder transitioning from child to adult mental health services: a national survey of mental health trusts in England.

    PubMed

    Hall, Charlotte L; Newell, Karen; Taylor, John; Sayal, Kapil; Hollis, Chris

    2015-01-01

    Transition from child to adult mental health services is considered to be a difficult process, particularly for individuals with neurodevelopmental disorders such as attention deficit/hyperactivity disorder (ADHD). This article presents results from a national survey of 36 mental health National Health Service (NHS) trusts across England, the findings indicate a lack of accurate data on the number of young people with ADHD transitioning to, and being seen by, adult services. Less than half of the trusts had a specialist adult ADHD service and in only a third of the trusts were there specific commissioning arrangements for adult ADHD. Half of the trusts reported that young people with ADHD were prematurely discharged from child and adolescent mental health services (CAMHS) because there were no suitable adult services. There was also a lack of written transition protocols, care pathways, commissioned services for adults with ADHD and inadequate information sharing between services. The findings advocate the need to provide a better transition service underpinned by clear, structured guidelines and protocols, routine data collection and information sharing across child and adult services. An increase in the commission of specialist adult ADHD clinics is needed to ensure individuals have access to appropriate support and care.

  10. [Inter-Occupational Cooperation Levels in a Day Care Service and Its Subjects - From the Viewpoint of Multiple Occupations].

    PubMed

    Ugai, Chizuru; Hata, Kiyomi

    2016-12-01

    We clarified the role of cooperation of nursing personnel who work in day care services, to precede our examination of inter-occupational cooperation. The study results revealed that there were four cooperation levels. Subjects for the cooperation included:"difficulty in sharing information,"difficulty in understanding the whole picture,"difficulty in finding directions, "and"difficulty in dealing with emergency cases."The purpose of this study was to clarify the inter-occupational cooperation levels in a day care service and its subjects. We also conducted semi-structured interviews with 13 persons of differing occupations(other than nurses), and who worked in day-care services in A prefecture. As a result, it was revealed that there were three inter-occupational cooperation levels and its subjects included:"difficulty in sharing information" (which was answered the same as the nurses),"difficulty in sharing goals"(which were different among individual occupations), "lack of consistency in care,"necessity of learning because of insufficient knowledge,"and"hesitation to notify."

  11. Adult Services. Twenty-Eight Quick Recipes for Stretching Your Popular Adult Materials Budget.

    ERIC Educational Resources Information Center

    Baker, Sharon L., Ed.

    1995-01-01

    Describes methods for stretching a popular adult library materials budget. Highlights include prepurchase evaluation and selection; acquisitions; fund raising to support selection funds; distribution; weeding; promotion; and lobbying. (Author/AEF)

  12. Allocation of Rehabilitation Services for Older Adults in the Ontario Home Care System

    PubMed Central

    Armstrong, Joshua J.; Sims-Gould, Joanie

    2016-01-01

    Background: Physiotherapy and occupational therapy services can play a critical role in maintaining or improving the physical functioning, quality of life, and overall independence of older home care clients. Despite their importance, however, there is limited understanding of the factors that influence how rehabilitation services are allocated to older home care clients. The aim of this pilot study was to develop a preliminary understanding of the factors that influence decisions to allocate rehabilitation therapy services to older clients in the Ontario home care system, as perceived by three stakeholder groups. Methods: Semi-structured interviews were conducted with 10 key informants from three stakeholder groups: case managers, service providers, and health system policymakers. Results: Drivers of the allocation of occupational therapy and physiotherapy for older adults included functional needs and postoperative care. Participants identified challenges in providing home care rehabilitation to older adults, including impaired cognition and limited capacity in the home care system. Conclusions: Considering the changing demands for home care services, knowledge of current practices across the home care system can inform efforts to optimize rehabilitation services for the growing number of older adults. Further research is needed to advance the understanding of, and optimize rehabilitation service allocation to, older frail clients with multiple morbidities. Developing novel decision-support mechanisms and standardized clinical care pathways for older client populations may be beneficial. PMID:27904234

  13. Allocation of Rehabilitation Services for Older Adults in the Ontario Home Care System.

    PubMed

    Armstrong, Joshua J; Sims-Gould, Joanie; Stolee, Paul

    2016-01-01

    Background: Physiotherapy and occupational therapy services can play a critical role in maintaining or improving the physical functioning, quality of life, and overall independence of older home care clients. Despite their importance, however, there is limited understanding of the factors that influence how rehabilitation services are allocated to older home care clients. The aim of this pilot study was to develop a preliminary understanding of the factors that influence decisions to allocate rehabilitation therapy services to older clients in the Ontario home care system, as perceived by three stakeholder groups. Methods: Semi-structured interviews were conducted with 10 key informants from three stakeholder groups: case managers, service providers, and health system policymakers. Results: Drivers of the allocation of occupational therapy and physiotherapy for older adults included functional needs and postoperative care. Participants identified challenges in providing home care rehabilitation to older adults, including impaired cognition and limited capacity in the home care system. Conclusions: Considering the changing demands for home care services, knowledge of current practices across the home care system can inform efforts to optimize rehabilitation services for the growing number of older adults. Further research is needed to advance the understanding of, and optimize rehabilitation service allocation to, older frail clients with multiple morbidities. Developing novel decision-support mechanisms and standardized clinical care pathways for older client populations may be beneficial.

  14. Mental health care Monitor Older adults (MEMO): monitoring patient characteristics and outcome in Dutch mental health services for older adults.

    PubMed

    Veerbeek, Marjolein; Oude Voshaar, Richard; Depla, Marja; Pot, Anne Margriet

    2013-06-01

    Information on which older adults attend mental health care and whether they profit from the care they receive is important for policy-makers. To assess this information in daily practice, the "Mental health care Monitor Older adults" (MEMO) was developed in the Netherlands. The aim of this paper is to describe MEMO and the older adults who attend outpatient mental health care regarding their predisposing and enabling characteristics and need for care. In MEMO all patients referred to the division of old age psychiatry of the participating mental health care organisations are assessed at baseline and monitored at 4, 8 and 12-month follow-up. Primary outcomes are mental and social functioning, consumer satisfaction, and type of treatment provided (MEMO Basic). Over the years, MEMO Basic is repeated. In each cycle, additional information on specific patient groups is added (e.g. mood disorders). Data collection is supported by a web-based system for clinicians, including direct feedback to monitor patients throughout treatment. First results at baseline showed that the majority of patients that entered the division of old age psychiatry was female (69%), had low education (83%), lived alone (53%), was depressed (42%) and had a comorbid condition (82%). It seemed that older immigrants were not sufficiently reached. The current study is the first in the Netherlands to evaluate patient characteristics and outcome in mental health care provided for older adults in day-to-day practice. If MEMO works out successfully, the method should be extended to other target groups.

  15. Inequalities in the use of dental services among adults in inner South East London.

    PubMed

    Al-Haboubi, Mustafa; Klass, Charlotte; Jones, Kate; Bernabé, Eduardo; Gallagher, Jennifer E

    2013-06-01

    Improving access to National Health Service (NHS) dentistry is a public health issue that has been a focus for successive governments and policy makers in the UK. To inform this process, commissioners of services need to understand trends in service use and demands of the local population. This study explored inequalities in dental services use among adults in a socially deprived, ethnically diverse metropolitan area of London; satisfaction with services; and public views for improvement of services. Data from 695 adults were analysed for this study (56% of the eligible sample). Inequalities in dental services use and satisfaction with care according to sociodemographic factors were assessed in unadjusted and fully adjusted models. The proportion of participants who reported attending the dentist in the last 24 months was 69%, with inequalities according to social grade, ethnicity, sex and age but not according to borough of residence. The most common areas identified by respondents for service improvement were availability of dentists, affordability of care, and accommodation of services. Among those who visited the dentist in the last 24 months, 90% were satisfied with the quality of care provided. However, there were inequalities in satisfaction with care according to borough and reason for the last dental visit.

  16. Local Medicaid Home- and Community-Based Services Spending and Nursing Home Admissions of Younger Adults

    PubMed Central

    Keohane, Laura; Mor, Vincent

    2014-01-01

    We used fixed-effect models to examine the relationship between local spending on home- and community-based services (HCBSs) for cash-assisted Medicaid-only disabled (CAMOD) adults and younger adult admissions to nursing homes in the United States during 2001 through 2008, with control for facility and market characteristics and secular trends. We found that increased CAMOD Medicaid HCBS spending at the local level is associated with decreased admissions of younger adults to nursing homes. Our findings suggest that states’ efforts to expand HCBS for this population should continue. PMID:25211711

  17. Local Medicaid home- and community-based services spending and nursing home admissions of younger adults.

    PubMed

    Thomas, Kali S; Keohane, Laura; Mor, Vincent

    2014-11-01

    We used fixed-effect models to examine the relationship between local spending on home- and community-based services (HCBSs) for cash-assisted Medicaid-only disabled (CAMOD) adults and younger adult admissions to nursing homes in the United States during 2001 through 2008, with control for facility and market characteristics and secular trends. We found that increased CAMOD Medicaid HCBS spending at the local level is associated with decreased admissions of younger adults to nursing homes. Our findings suggest that states' efforts to expand HCBS for this population should continue.

  18. A Profile of Social Service Personnel in Title IV-A Day Care in Philadelphia, 1974-1975. Report No. 7646.

    ERIC Educational Resources Information Center

    Asano, Mildred M.

    This report, representing the first half of a comprehensive study, describes the personnel of the Social Services Component in Title IV-A Day Care in Philadelphia and discusses some of the functions and services provided by these personnel. Data were based on responses from 129 service workers in 38 agencies. Respondents reported information on 21…

  19. 7 CFR Appendix B to Subpart C of... - FSA-2510, Notice of Availability of Loan Servicing to Borrowers Who Are 90 Days Past Due

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false FSA-2510, Notice of Availability of Loan Servicing to Borrowers Who Are 90 Days Past Due B Appendix B to Subpart C of Part 766 Agriculture Regulations of the... LOAN SERVICING-SPECIAL Loan Servicing Programs Pt. 766, Subpt. C, App. B Appendix B to Subpart C...

  20. 7 CFR Appendix B to Subpart C of... - FSA-2510, Notice of Availability of Loan Servicing to Borrowers Who Are 90 Days Past Due

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 7 2011-01-01 2011-01-01 false FSA-2510, Notice of Availability of Loan Servicing to Borrowers Who Are 90 Days Past Due B Appendix B to Subpart C of Part 766 Agriculture Regulations of the... LOAN SERVICING-SPECIAL Loan Servicing Programs Pt. 766, Subpt. C, App. B Appendix B to Subpart C...

  1. Characterizing Older Adults' Involvement in Naturally Occurring Retirement Community (NORC) Supportive Service Programs.

    PubMed

    Greenfield, Emily A; Fedor, James P

    2015-01-01

    Naturally Occurring Retirement Community (NORC) Supportive Service Programs constitute one of the longest-standing models for age-friendly community initiatives. As a support-focused model, NORC programs typically offer a range of benefits--including direct services, group activities, and broader community development activities--that are intended to engage older adults with diverse needs, preferences, and interests. Moreover, NORC programs are designed to be used according to the needs of the particular participant engaging with them at a particular point in time. This range and flexibility of benefits indicate the importance of more systematically characterizing the ways in which older adults are involved with NORC programs. For this purpose, we used data from in-depth interviews with 35 residents across 6 NORC programs in New York City. Qualitative analysis revealed 6 ordered categories of involvement: (a) consciously no involvement; (b) involved, but not consciously; (c) relationship with staff only; (d) selectively involved with a strong sense of security; (e) NORC program leaders; and (f) dependence on the NORC program. Overall, results indicate how older adults' involvement in NORC programs can be characterized beyond their utilization of specific types of services and by their relationship with the program as a whole. Findings suggest the importance for outcomes research on NORC programs and related models to consider subgroup differences by involvement. Results also provide directions for theory development on engagement in voluntary programs, as well as for practice to enhance older adults' involvement in supportive service programs.

  2. New Research into General Psychiatric Services for Adults with Intellectual Disability and Mental Illness

    ERIC Educational Resources Information Center

    Chaplin, R.

    2009-01-01

    Background: There are a variety of models for the mental health care of adults with comorbid intellectual disability (ID) and mental illness. There has been a long-running debate as to whether this should be provided by general psychiatric or specialised ID services. A previous review concluded that there was no clear evidence to support either…

  3. Physical Therapists' Perceptions of Providing Services to Adults with Childhood-Onset Neuromotor Disabilities

    ERIC Educational Resources Information Center

    Compton-Griffith, Kelsi N.; Cicirello, Nancy A.; Turner, Anne

    2011-01-01

    Adults with childhood-onset neuromotor disabilities face problems accessing health care services. There are often challenges finding primary care providers or specialized providers, such as physical therapists, who are knowledgeable about neuromotor disabilities. The purpose of this study was to determine the perceptions of physical therapists…

  4. Informal Adult Learning and Emotion Work of Service Providers for Refugee Claimants

    ERIC Educational Resources Information Center

    Brigham, Susan M.; Baillie Abidi, Catherine; Tastsoglou, Evangelia; Lange, Elizabeth

    2015-01-01

    Like the immigrant clients they serve, service providers have been overlooked in adult education literature, yet their roles are crucial for addressing the serious concerns of refugees and refugee claimants who flee their home countries hoping to find safe refuge in another country.

  5. A Meta-Ethnographic Synthesis of Support Services for Adult Learners in Distance Learning Programs

    ERIC Educational Resources Information Center

    Tuquero, Jean M.

    2010-01-01

    This qualitative research study utilized Noblit and Hare's (1988) meta-ethnographic approach to synthesize findings of five dissertations that focused on distance learning support services for adult learners. Noblit and Hare's (1988) meta-ethnographic approach consists of seven phases. Each meta-ethnographic phase guided the identification process…

  6. Food Security in Older Adults: Community Service Provider Perceptions of Their Roles

    ERIC Educational Resources Information Center

    Keller, Heather H.; Dwyer, John J. M.; Edwards, Vicki; Senson, Christine; Edward, H. Gayle

    2007-01-01

    Food insecurity in older adults is influenced by financial constraints, functional disability, and isolation. Twenty-eight social- and community-service providers participated in four focus groups to report (a) perceptions and experiences with food insecurity in their older clients, (b) beliefs about their potential role(s) in promoting food…

  7. Service Providers' Perceptions of Active Ageing among Older Adults with Lifelong Intellectual Disabilities

    ERIC Educational Resources Information Center

    Buys, L.; Aird, R.; Miller, E.

    2012-01-01

    Background: Considerable attention is currently being directed towards both active ageing and the revising of standards for disability services within Australia and internationally. Yet, to date, no consideration appears to have been given to ways to promote active ageing among older adults with intellectual disabilities (IDs). Methods:…

  8. The Prevalence of Undiagnosed Geriatric Health Conditions among Adult Protective Service Clients

    ERIC Educational Resources Information Center

    Heath, John M.; Brown, Merle; Kobylarz, Fred A.; Castano, Susan

    2005-01-01

    Purpose: We sought to determine the prevalence of remediable health conditions from in-home geriatric assessments of referred adult protective service (APS) clients suffering elder mistreatment. Design and Methods: We used a retrospective cohort study of 211 APS clients (74% female; age, M = 77 years) in two central New Jersey counties. Results:…

  9. Unmet Healthcare and Social Services Needs of Older Canadian Adults with Developmental Disabilities

    ERIC Educational Resources Information Center

    Shooshtari, Shahin; Naghipur, Saba; Zhang, Jin

    2012-01-01

    The authors sought to create a demographic, socioeconomic, and health-related profile of older (40+) Canadian adults with developmental disabilities (DD) residing in their communities, and to enhance current knowledge of their unmet health and social support services needs. They provide a secondary analysis of cross-sectional data from the 2001…

  10. Examining Self-Protection Measures Guarding Adult Protective Services Social Workers against Compassion Fatigue

    ERIC Educational Resources Information Center

    Bourassa, Dara

    2012-01-01

    Little research has focused on the risk factors, effects, and experiences of compassion fatigue among gerontological social workers. This qualitative study explores the experiences and perspectives of nine Adult Protective Services (APS) social workers in relation to compassion fatigue. Results show that the APS social workers combined personal…

  11. Differential Outcomes for American College Students Engaged in Community Service-Learning Involving Youth and Adults

    ERIC Educational Resources Information Center

    Seider, Scott; Rabinowicz, Samantha; Gillmor, Susan

    2012-01-01

    The Serve Program at Ignatius University is a community service-learning program that combines academic study of philosophy with a yearlong field-based project at one of approximately 50 different sites. Half of these projects entail working with youth, while the other half entail working with adults. This mixed methods analysis found that college…

  12. Community-Based Supports and Services for Older Adults: A Primer for Clinicians

    PubMed Central

    Siegler, Eugenia L.; Lama, Sonam D.; Knight, Michael G.; Laureano, Evelyn; Reid, M. Carrington

    2015-01-01

    Although 20% of adults 60 years and older receive community-based supports and services (CBSS), clinicians may have little more than a vague awareness of what is available and which services may benefit their patients. As health care shifts toward more creative and holistic models of care, there are opportunities for CBSS staff and primary care clinicians to collaborate toward the goal of maintaining patients’ health and enabling them to remain safely in the community. This primer reviews the half-century history of these organizations in the United States, describes the most commonly used services, and explains how to access them. PMID:25729774

  13. Costs of providing dental services to adult mentally retarded: a preliminary report.

    PubMed Central

    Gotowka, T D; Johnson, E S; Gotowka, C J

    1982-01-01

    This study reports on the hourly costs of providing comprehensive dental services to mentally retarded adults in a hospital-based group dental practice. The analysis indicated average total hourly costs of $56.11 for dentist-provided services an $22.25 for dental hygienist-provided services. When compared to the revenues available for program maintenance, a net hourly deficit of $18.82 per dentist hour and $9.89 per dental hygienist hour resulted. The implications of this operating loss on the continued care of this patient population are discussed. PMID:6751105

  14. Assessing capacity for providing culturally competent services to LGBT older adults.

    PubMed

    Portz, Jennifer Dickman; Retrum, Jessica H; Wright, Leslie A; Boggs, Jennifer M; Wilkins, Shari; Grimm, Cathy; Gilchrist, Kay; Gozansky, Wendolyn S

    2014-01-01

    This qualitative, interview-based study assessed the cultural competence of health and social service providers to meet the needs of LGBT older adults in an urban neighborhood in Denver, Colorado, known to have a large LGBT community. Only 4 of the agencies were categorized as "high competency"; 12 were felt to be "seeking improvement" and 8 were considered "not aware." These results indicate significant gaps in cultural competency for the majority of service providers. Social workers are well-suited to lead efforts directed at improving service provision and care competencies for the older LGBT community.

  15. Competing values in serving older and vulnerable adults: adult protective services, mandated reporting, and domestic violence programs.

    PubMed

    Cramer, Elizabeth P; Brady, Shane R

    2013-01-01

    State mandatory reporting statutes may directly or indirectly list domestic violence programs as among those that are mandated reporters of cases of suspected abuse, neglect, or exploitation of older individuals and those with disabilities. Domestic violence programs, however, may not consider themselves to be mandated reporters, because the responsibility of reporting abuse may be contrary to their programmatic philosophy. In the Commonwealth of Virginia, the potential conflict between domestic violence programs and Adult Protective Services about the issue of mandated reporting has created tension between these organizations as each entity continues interpreting the issues and policies of mandated reporting through its own lens. The authors draw out some of the reasons for the conflict as well as make recommendations for improving relationships between the two organizations, which will ultimately benefit vulnerable adults who are experiencing abuse.

  16. Community-Based Juvenile Reentry Services: The Effects of Service Dosage on Juvenile and Adult Recidivism

    ERIC Educational Resources Information Center

    Abrams, Laura S.; Terry, Diane; Franke, Todd M.

    2011-01-01

    In this study the authors examined the influence of length of participation in a community-based reentry program on the odds of reconviction in the juvenile and adult criminal justice systems. A structured telephone survey of reentry program alumni was conducted with 75 transition-age (18-25 year-old) young men. Binary logistic regression analysis…

  17. Web-Browsing Competencies of Pre-Service Adult Facilitators: Implications for Curriculum Transformation and Distance Learning

    ERIC Educational Resources Information Center

    Theresa, Ofoegbu; Ugwu, Agboeze Matthias; Ihebuzoaju, Anyanwu Joy; Uche, Asogwa

    2013-01-01

    The study investigated the Web-browsing competencies of pre-service adult facilitators in the southeast geopolitical zone of Nigeria. Survey design was adopted for the study. The population consists of all pre-service adult facilitators in all the federal universities in the southeast geopolitical zone of Nigeria. Accidental sampling technique was…

  18. Survey on the use of health services by adult men: prevalence rates and associated factors1

    PubMed Central

    de Arruda, Guilherme Oliveira; Marcon, Sonia Silva

    2016-01-01

    Objective estimate the prevalence and identify factors associated with the use of health services by men between 20 and 59 years of age. Method population-based, cross-sectional domestic survey undertaken with 421 adult men, selected through systematic random sampling. The data were collected through a structured instrument and analyzed using descriptive and inferential statistics with multiple logistic regression. Results the prevalence rate of health service use during the three months before the interviews was 42.8%, being higher among unemployed men with a religious creed who used private hospitals more frequently, had been hospitalized in the previous 12 months and referred some disease. Conclusion the prevalence of health service use by adult men does not differ from other studies and was considered high. It shows to be related with the need for curative care, based on the associated factors found. PMID:27027680

  19. Transition to adult endocrine services: What is achievable? The diabetes perspective.

    PubMed

    White, Mary; O'Connell, Michele A; Cameron, Fergus J

    2015-06-01

    Transition is defined as the 'purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centred to adult-oriented health care systems' by Blum RW, (2002). The primary goal of transition is to ensure an uninterrupted process in healthcare delivery between the paediatric and adult settings; however, losses to follow up and decreased engagement with specialist services are common during this time. The current transition literature specifically pertaining to type 1 diabetes mellitus (T1DM) is often limited by incomplete data, the absence of control data and lack of follow up data spanning both the paediatric and adult years. This paper serves to review the current transition literature base, highlighting areas which warrant further study.

  20. Age Preferences: How Old Is "Too Old" for Selected Service Providers among Young, Middle-Aged, and Older Adults?

    ERIC Educational Resources Information Center

    Farney, Lori; Aday, Ronald H.; Breault, Kevin D.

    2006-01-01

    This study investigated age preferences for 11 different service providers and the age at which workers in these occupational roles were considered to be "too old" by three age groups: young (18-24), middle-aged (35-55), and older adults (65+). Results indicate that in comparison to middle-aged and older adults, young adults continue to have…

  1. The Relationship between Age, Gender, Historical Change, and Adults' Perceptions of Mental Health and Mental Health Services

    ERIC Educational Resources Information Center

    Currin, James B.; Hayslip, Bert, Jr.; Temple, Jeff R.

    2011-01-01

    The purpose of this study was to explore the impact of age, historical change, and gender on perceptions of mental health and mental health services. Using multidimensional measures to assess such perceptions among older adults (1977, 1991, 2000), and younger adults (1991, 2000), we expected that older adults would have less positive mental health…

  2. 20 CFR 663.115 - What are the eligibility criteria for core services for dislocated workers in the adult and...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... services for dislocated workers in the adult and dislocated worker programs? 663.115 Section 663.115 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and...

  3. 20 CFR 663.115 - What are the eligibility criteria for core services for dislocated workers in the adult and...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... services for dislocated workers in the adult and dislocated worker programs? 663.115 Section 663.115 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and...

  4. 20 CFR 663.115 - What are the eligibility criteria for core services for dislocated workers in the adult and...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... services for dislocated workers in the adult and dislocated worker programs? 663.115 Section 663.115 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker...

  5. 20 CFR 663.115 - What are the eligibility criteria for core services for dislocated workers in the adult and...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... services for dislocated workers in the adult and dislocated worker programs? 663.115 Section 663.115 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and...

  6. AECAP Guide for State Leaders: State and Local Coordination and Planning to Strengthen Adult Basic Education Services

    ERIC Educational Resources Information Center

    Alamprese, Judith A.; Gwaltney, Margaret K.

    2010-01-01

    The Adult Education Coordination and Planning (AECAP) guide is designed to assist state adult education staff in forming partnerships at the state level and facilitating coordination at the local level as a lever for expanding and improving the quality of adult basic education (ABE) and workforce development services. Coordination plays a critical…

  7. Transition into adult healthcare services in Scotland: findings from a study concerning service users at the Scottish Spina Bifida Association

    PubMed Central

    Wynd, Andrew HD; Carachi, Robert

    2014-01-01

    Background and Aims Literature on interventions that enable young people with spina bifida and/or hydrocephalus to have smooth transition, into adult healthcare services, stress the need for the process to start early and to include all family members. The study reported here was set to quantify and articulate the experiences of service users who are or due to be going through the transition process in Scotland today. Methods and Results Focus group sessions, in the North of Scotland and in the ‘Central Belt’, captured rich qualitative data. A survey, sent to eligible participants on the Spina Bifida National database, offered complimentary data source. Despite the fact that the number of returned questionnaires was low (n = 20), data analysis identified a number of core recurring themes. These include issues concerning Communications, Respect, Choice and Control. Findings suggest that there is a significant chasm between the political rhetoric and the reality faced by young people with spina bifida moving to adult healthcare services. Conclusion A possible way to facilitate successful transition of young people is using personal healthcare information as the locus for needed change. More research is needed to ascertain whether a ‘Person-Centred Record’, which is set to empower young people on their transition pathway, is an appropriate transition tool. PMID:25358489

  8. Postnatal day 7 ethanol treatment causes persistent reductions in adult mouse brain volume and cortical neurons with sex specific effects on neurogenesis.

    PubMed

    Coleman, Leon G; Oguz, Ipek; Lee, Joohwi; Styner, Martin; Crews, Fulton T

    2012-09-01

    Ethanol treatment on postnatal day seven (P7) causes robust brain cell death and is a model of late gestational alcohol exposure (Ikonomidou et al., 2000). To investigate the long-term effects of P7 ethanol treatment on adult brain, mice received either two doses of saline or ethanol on P7 (2.5 g/kg, s.c., 2 h apart) and were assessed as adults (P82) for brain volume (using postmortem MRI) and cellular architecture (using immunohistochemistry). Adult mice that received P7 ethanol had reduced MRI total brain volume (4%) with multiple brain regions being reduced in both males and females. Immunohistochemistry indicated reduced frontal cortical parvalbumin immunoreactive (PV + IR) interneurons (18-33%) and reduced Cux1+IR layer II pyramidal neurons (15%) in both sexes. Interestingly, markers of adult hippocampal neurogenesis differed between sexes, with only ethanol treated males showing increased doublecortin and Ki67 expression (52 and 57% respectively) in the dentate gyrus, consistent with increased neurogenesis compared to controls. These findings suggest that P7 ethanol treatment causes persistent reductions in adult brain volume and frontal cortical neurons in both males and females. Increased adult neurogenesis in males, but not females, is consistent with differential adaptive responses to P7 ethanol toxicity between the sexes. One day of ethanol exposure, e.g. P7, causes persistent adult brain dysmorphology.

  9. Development and dissemination of collaborative family-oriented services: the case of community/day residential care in Israel.

    PubMed

    Elizur, Yoel

    2012-03-01

    The initiation, development, and dissemination of family-oriented programs are a unifying thread that highlights family therapy's contribution to the fields of mental/physical health and social services. These demanding tasks require an ecosystemic vision, a supportive larger context, and a range of skills. This article delineates the evolution of community and day residential care in Israel by examining processes at different ecological levels: the formulation and implementation of national social policy, the follow-up of two family-oriented facilities, one of which thrived while the other eventually closed, and the residential care provided to 1 family with 3 children. The analysis of this multilevel data highlights 4 facilitating/obstructing factors that have had major impact on family-oriented programs: support by both national and local sociopolitical-professional administration, program's management autonomy, staff training, support and development, and effective facility leadership that establishes and nurtures family-oriented organizational structure and culture.

  10. A new measure for assessing executive function across a wide age range: children and adults find happy-sad more difficult than day-night.

    PubMed

    Lagattuta, Kristin Hansen; Sayfan, Liat; Monsour, Michael

    2011-05-01

    Two experiments examined 4- to 11-year-olds' and adults' performance (N = 350) on two variants of a Stroop-like card task: the day-night task (say 'day' when shown a moon and 'night' when shown a sun) and a new happy-sad task (say 'happy' for a sad face and 'sad' for a happy face). Experiment 1 featured colored cartoon drawings. In Experiment 2, the happy-sad task featured photographs, and pictures for both measures were gray scale. All age groups made more errors and took longer to respond to the happy-sad versus the day-night versions. Unlike the day-night task, the happy-sad task did not suffer from ceiling effects, even in adults. The happy-sad task provides a methodological advance for measuring executive function across a wide age range.

  11. A New Measure for Assessing Executive Function across a Wide Age Range: Children and Adults Find "Happy-Sad" More Difficult than "Day-Night"

    ERIC Educational Resources Information Center

    Lagattuta, Kristin Hansen; Sayfan, Liat; Monsour, Michael

    2011-01-01

    Two experiments examined 4- to 11-year-olds' and adults' performance (N = 350) on two variants of a Stroop-like card task: the "day-night task" (say "day" when shown a moon and "night" when shown a sun) and a new "happy-sad task" (say "happy" for a sad face and "sad" for a happy face). Experiment 1 featured colored cartoon drawings. In Experiment…

  12. Services in the Community for Adults with Psychosis and Intellectual Disabilities: A Delphi Consultation of Professionals' Views

    ERIC Educational Resources Information Center

    Hemmings, C. P.; Underwood, L. A.; Bouras, N.

    2009-01-01

    Background: There remains a severe lack of evidence on the effectiveness of community services for adults with psychosis and intellectual disabilities (ID). There has been little consensus even of what services should provide for this service user group. Method: A consultation of multidisciplinary professionals was carried out by using a…

  13. 20 CFR 663.145 - What services are WIA title I adult and dislocated workers formula funds used to provide?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through the One-Stop Delivery... to provide core, intensive and training services through the One-Stop delivery system. Local Boards... to provide the other services described in WIA section 134(e): (1) Discretionary One-Stop...

  14. Differences in sleep complaints in adults with varying levels of bed days residing in extended care facilities for chronic disease management.

    PubMed

    Fox, Mary T; Sidani, Souraya; Brooks, Dina

    2010-05-01

    This cohort study examined differences in perceived insomnia and daytime sleepiness in 67 adults residing in extended care facilities for chronic disease management who had varying levels of bed days. One bed day was defined as spending 24 hours in bed. Planned pairwise comparisons, using Bonferroni adjustment, were made between participants who spent 0 (n = 21), 2 to 4 (n = 23), and 5 to 7 (n = 23) days in bed during 1 week of monitoring. Participants who spent 5 to 7 days in bed had significantly greater insomnia than those who spent 2 to 4 days in bed. No group differences were found in daytime sleepiness. Based on the findings, nurses may assess subjective insomnia and explore sleep hygiene strategies, such as increasing time out of bed with patients who have high levels of 5 to 7 bed days.

  15. Caution! All data are not created equal: The hazards of using National Weather Service data for calculating accumulated degree days.

    PubMed

    Dabbs, Gretchen R

    2010-10-10

    An increasing number of anthropological decomposition studies are utilizing accumulated degree days (ADD) to quantify and estimate the post-mortem interval (PMI) at given decompositional stages, or the number of ADD required for certain events, such as tooth exfoliation, to occur. This study addresses the utility of retroactively applying temperature data from the closest National Weather Service (NWS) station to these calculations as prescribed in the past. Hourly temperature readings were collected for 154 days at a research site in Farmington, AR between June 30 and December 25, 2008. These were converted to average daily temperatures by calculating the mean of the 24 hourly values, following the NWS reporting procedure. These data were compared to comparable data from the Owl Creek and Drake Field NWS stations, the two closest to the research site, located 5.7 and 9.9km away, respectively. Paired samples t-tests between the research site and each of the NWS stations show significant differences between the average daily temperature data collected at the research station, and both Owl Creek (2.0°C, p<0.001) and Drake Field (0.6°C, p<0.001). When applied to a simulated recovery effort, the further NWS station also proved to represent the better model for the recovery site. Using a published equation for estimating post-mortem interval using ADD and total body decomposition scores (Megyesi et al., 2005 [1]), the Drake Field data produced estimates of PMI more closely mirroring those of the research site than did Owl Creek. This demonstrates that instead of automatically choosing the nearest NWS station, care must be taken when choosing an NWS station for retroactively gathering temperature data for application of PMI estimation techniques using accumulated degree days to ensure the station adequately reflects temperature conditions at the recovery site.

  16. Working With LGBT Baby Boomers and Older Adults: Factors That Signal a Welcoming Service Environment.

    PubMed

    Croghan, Catherine F; Moone, Rajean P; Olson, Andrea M

    2015-01-01

    Many providers recognize the importance of creating culturally competent services for lesbian, gay, bisexual, and transgender (LGBT) older adults. Although multiple resources list steps to make professional practices more LGBT-welcoming, these resources provide no empirical data to support their recommendations. LGBT older adults (N = 327) were asked to describe what signals that a provider is LGBT-welcoming. Six of the top 10 signals related to provider behavior and suggest the importance of staff training; the balance included display of signage and rainbow flags, use of inclusive language on forms and the presence of LGBT-identified staff. Results provide evidence-based recommendations for working with LGBT older adults.

  17. Comparison of GT3X accelerometer and Yamax pedometer steps/day in a free-living sample of overweight and obese adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The purpose of this study was to compare steps/day detected by the YAMAX SW-200 pedometer versus the Actigraph GT3X accelerometer in free-living adults. Daily YAMAX and GT3X steps were collected from a sample of 23 overweight and obese participants (78% female; age = 52.6 +/- 8.4 yr.; BMI = 31.0 +/-...

  18. Perceived Need for Home- and Community-Based Services: Experiences of Urban Chinese Older Adults With Functional Impairments.

    PubMed

    Li, Hong; Xu, Ling; Chi, Iris

    2017-01-01

    Guided by Cantor's social care model, this study identified individual, family, and social support factors that influence urban older adults' need for home- and community-based services, including medical and rehabilitation, instrumental care and support, and psychosocial services. The data were extracted from the Sample Survey on Aged Population in Urban/Rural China conducted by the China Research Center on Aging in 2006. Results from multiple logistic regression show that older adults' need for medical and rehabilitation services is significantly related to instrumental activities of daily living, depression, not having filial children, friend support networks, and having a confidant. Older adults' need for instrumental care and support is related to their educational attainment, financial strain, instrumental activities of daily living, not living with children, and friend support networks. Finally, older adults' need for psychosocial services is significantly related to educational attainment, depression, not being married, friend support networks, and having a confidant. Implications for social service development are discussed.

  19. Domestic violence screening and service acceptance among adult victims in a dependency court setting.

    PubMed

    Rivers, James E; Maze, Candice L; Hannah, Stefanie A; Lederman, Cindy S

    2007-01-01

    Many child welfare systems are unable to effectively identify and address co-occurring domestic violence and child maltreatment. In response, the Dependency Court Intervention Program for Family Violence implemented a protocol to identify indicators of domestic violence in families involved with child protection proceedings. This article highlights data that demonstrate the ability of an outreach and screening process to identify adult victims of domestic violence in dependency court and to offer them appropriate intervention services.

  20. Family Life and the Impact of Previous and Present Residential and Day Care Support for Children with Major Cognitive and Behavioural Challenges: A Dilemma for Services and Policy

    ERIC Educational Resources Information Center

    Brown, R. I.; Geider, S.; Primrose, A.; Jokinen, N. S.

    2011-01-01

    Introduction: Since the development of inclusion and integration, parents have increasingly become the major, and sometimes the only, carers of their children with disabilities. Many families speak of stress and frustration with service and community support, and some have turned to residential and specialised day care services to overcome…

  1. Cognitive Deterioration in Adults with Down Syndrome: Effects on the Individual, Caregivers, and Service Use.

    ERIC Educational Resources Information Center

    Oliver, Chris; Crayton, Lissa; Holland, Anthony; Hall, Scott

    2000-01-01

    Individuals with Down syndrome (n=49) were assigned to three groups: those showing cognitive deterioration, those comparable in age, and those not showing cognitive deterioration but younger. Those experiencing cognitive deterioration were less likely to receive day services, had more impoverished life experiences, and required more support.…

  2. Physical activity and health services utilization and costs among U.S. adults.

    PubMed

    Kang, Sung-Wan; Xiang, Xiaoling

    2017-03-01

    The objective of this study was to examine the relationship between physical activity and health services utilization and costs among adults aged 18 or older in the U.S. Data came from the Medical Expenditure Panel Survey-Household component from 2007 through 2011 (n=117,361). Regular physical activity was defined as spending half an hour or more in moderate or vigorous physical activity at least three times a week. The following categories of self-reported health services utilization and costs were examined: preventive, office-based, outpatient, inpatient, emergency department, home health, and prescription medicines. The association of physical activity and health services utilization and costs was estimated using two-part models. Adults who engaged in regular physical activity were more likely to use preventive (ORs ranged from 1.06 to 1.34, p<0.05) and office-based services (OR=1.05, 95% CI=1.01-1.10, p<0.05). Combining results from both parts of the two-part models, physically active adults incurred significantly lower utilization of inpatient (0.09 vs 0.12 visit per person), emergency room (0.18 vs 0.19 visit per person), home health care (1.21 vs 1.92 visit per person), and prescription medicines (12.66 vs 13.75 number of prescriptions per person) and spent $27 less per capita expenditures for office-based visits, $351 less for inpatient visits, and $52 less for home health care visits. Promoting regular physical activity may reduce health care costs through decreasing demand for secondary and tertiary care services.

  3. A systematic review of the predictors of health service utilisation by adults with mental disorders in the UK

    PubMed Central

    Twomey, Conal D; Baldwin, David S; Hopfe, Maren; Cieza, Alarcos

    2015-01-01

    Objectives To identify variables that predict health service utilisation (HSU) by adults with mental disorders in the UK, and to determine the evidence level for these predictors. Design A narrative synthesis of peer-reviewed studies published after the year 2000. The search was conducted using four databases (ie, PsycINFO, CINAHL Plus with full text, MEDLINE and EMBASE) and completed on 25 March 2014. Setting The majority of included studies were set in health services across primary, secondary, specialist and inpatient care. Some studies used data from household and postal surveys. Participants Included were UK-based studies that predicted HSU by adults with mental disorders. Participants had a range of mental disorders including psychotic disorders, personality disorders, depression, anxiety disorders, eating disorders and dementia. Primary outcome A wide range of HSU outcomes were examined, including general practitioner (GP) contacts, medication usage, psychiatrist contacts, psychotherapy attendances, inpatient days, accident and emergency admissions and ‘total HSU’. Results Taking into account study quality, 28 studies identified a range of variables with good preliminary evidence supporting their ability to predict HSU. Of these variables, comorbidity, personality disorder, age (heterogeneous age ranges), neurotic symptoms, female gender, a marital status of divorced, separated or widowed, non-white ethnicity, high previous HSU and activities of daily living, were associated with increased HSU. Moreover, good preliminary evidence was found for associations of accessing a primary care psychological treatment service and medication use with decreased HSU. Conclusions The findings can inform decisions about which variables might be used to derive mental health clusters in ‘payment by results’ systems in the UK. The findings also support the need to investigate whether combining broad diagnoses with care pathways is an effective method for mental health

  4. Becoming Aware of What You Know or Need to Know: Gathering Client and Context Characteristics in Day Services for Persons with Profound Intellectual and Multiple Disabilities

    ERIC Educational Resources Information Center

    Vlaskamp, C.; Hiemstra, S. J.; Wiersma, L. A.

    2007-01-01

    Persons with profound and multiple disabilities (PIMD) are dependent on staff to be sufficiently knowledgeable as to provide them with appropriate day services. One important determinant of the appropriateness and adequacy of a day support program is the level to which staff have detailed and specific knowledge about the functional abilities and…

  5. What prompts young adults in Ireland to attend health services for STI testing?

    PubMed Central

    2009-01-01

    Background In-depth understanding of the factors that prompt young adults to attend health services for sexually transmitted infection (STI) testing are needed to underpin sexual health programes. We conducted a qualitative study to identify and explore why young adults (18–29 years) in Ireland attended specialist and community health services for STI testing; the factors that supported/undermined their decisions to seek STI testing; and any factors that led to delay in seeking STI testing. Methods Semi-structured interviews with 30 adults (21 women, 9 men). Young adults were recruited from General Practice (GP) practices, Third Level College health services, Family Planning clinics and specialist STI treatment services for men who have sex with men (MSM). Interview questions examined why respondents decided to go for STI testing, whether they acted upon this desire immediately or decided to wait, and what they felt were important barriers/enablers to their health-seeking attempts. Interviews were thematically analyzed using standard qualitative techniques. Results Respondents sought STI testing for one of four reasons: they had reached a transitional moment in their lives (they were either about to stop using condoms with their sexual partner or were emerging from a period of their lives where they had a series of risky sexual relationships); they had had unprotected sex with a casual partner; they had symptoms of infection; and/or they were required to do so by their employer. Catalytic factors included media and government health promotion campaigns and knowing someone with an STI. However, many respondents delayed seeking testing. Reasons included respondents' concerns about stigma and that they would be judged by healthcare professionals, and feelings of invulnerability. Importantly, several respondents who waited up to four weeks to make an appointment after their initial decision to seek STI testing did not view this as delay. Conclusion Sexual health

  6. Provider views of harm reduction versus abstinence policies within homeless services for dually diagnosed adults.

    PubMed

    Henwood, Benjamin F; Padgett, Deborah K; Tiderington, Emmy

    2014-01-01

    Harm reduction is considered by many to be a legitimate alternative to abstinence-based services for dually diagnosed individuals, yet there is limited understanding of how varying approaches affect front-line practice within services for homeless adults. This paper examines how front-line providers working with individuals who have experienced homelessness, serious mental illness, and addiction view policies of harm reduction versus abstinence within two different approaches to homeless services: the traditional or "treatment first" approach that requires abstinence, and the more recent housing first approach that incorporates harm reduction. As part of a federally funded qualitative study, 129 in-depth interviews conducted with 41 providers were thematically analyzed to understand how providers view harm reduction versus abstinence approaches. Themes included the following: (a) harm reduction as a welcomed alternative, (b) working with ambiguity, and (c) accommodating abstinence. Drawing on recovery principles, the authors consider the broader implications of the findings for behavioral health care with this population.

  7. Type of insurance and use of preventive health services among older adults in Mexico

    PubMed Central

    Rivera-Hernandez, Maricruz; Galarraga, Omar

    2016-01-01

    Objectives The main purpose of this paper was to assess the differences between Seguro Popular (SP) and employer-based health insurance in the use of preventive services, including screening tests for diabetes, cholesterol, hypertension, cervical cancer and prostate cancer among older adults at more than a decade of health care reform in Mexico. Methods Logistic regression models were used with data from the Mexican Health and Nutrition Survey 2012. Results After adjusting for other factors influencing preventive service utilization, SP enrollees were more likely to use screening tests for diabetes, cholesterol, hypertension and cervical cancer than the uninsured; however, those in employment-based and private insurances had higher odds of using preventive care for most of these services, except Pap smears. Discussion Despite all the evidence that suggests that Seguro Popular has increased access to health insurance for the poor, inequalities in healthcare access still exist in Mexico. PMID:25804897

  8. Organisational simplification and secondary complexity in health services for adults with learning disabilities.

    PubMed

    Heyman, Bob; Swain, John; Gillman, Maureen

    2004-01-01

    This paper explores the role of complexity and simplification in the delivery of health care for adults with learning disabilities, drawing upon qualitative data obtained in a study carried out in NE England. It is argued that the requirement to manage complex health needs with limited resources causes service providers to simplify, standardise and routinise care. Simplified service models may work well enough for the majority of clients, but can impede recognition of the needs of those whose characteristics are not congruent with an adopted model. The data were analysed in relation to the core category, identified through thematic analysis, of secondary complexity arising from organisational simplification. Organisational simplification generates secondary complexity when operational routines designed to make health complexity manageable cannot accommodate the needs of non-standard service users. Associated themes, namely the social context of services, power and control, communication skills, expertise and service inclusiveness and evaluation are explored in relation to the core category. The concept of secondary complexity resulting from organisational simplification may partly explain seemingly irrational health service provider behaviour.

  9. Possibilities of ICT-supported services in the clinical management of older adults.

    PubMed

    Vollenbroek-Hutten, Miriam; Jansen-Kosterink, Stephanie; Tabak, Monique; Feletti, Luca Carlo; Zia, Gianluca; N'dja, Aurèle; Hermens, Hermie

    2017-02-01

    Services making use of information and communication technology (ICT) are of potential interest to face the challenges of our aging society. Aim of this article is to describe the possible field of application for ICT-supported services in the management of older adults, in particular those with functional impairment. The current status of ICT-supported services is described and examples of how these services can be implemented in everyday practice are given. Upcoming technical solutions and future directions are also addressed. An ICT-supported service is not only the technological tool, but its combination with clinical purposes for which it is used and the way it is implemented in everyday care. Patient's satisfaction with ICT-supported services is moderate to good. Actual use of patients is higher than those of professionals but very variable. Frequency of use is positively related to clinical outcome. ICT offers a variety of opportunities for the treatment and prevention of frailty and functional decline. Future challenges are related to the intelligence of the systems and making the technologies even more unobtrusive and intuitive.

  10. Effect of Indoor Temperature on Physical Performance in Older Adults during Days with Normal Temperature and Heat Waves

    PubMed Central

    Lindemann, Ulrich; Stotz, Anja; Beyer, Nina; Oksa, Juha; Skelton, Dawn A.; Becker, Clemens; Rapp, Kilian; Klenk, Jochen

    2017-01-01

    Indoor temperature is relevant with regard to mortality and heat-related self-perceived health problems. The aim of this study was to describe the association between indoor temperature and physical performance in older adults. Eighty-one older adults (84% women, mean age 80.9 years, standard deviation 6.53) were visited every four weeks from May to October 2015 and additionally during two heat waves in July and August 2015. Indoor temperature, habitual gait speed, chair-rise performance and balance were assessed. Baseline assessment of gait speed was used to create two subgroups (lower versus higher gait speed) based on frailty criteria. The strongest effect of increasing temperature on habitual gait speed was observed in the subgroup of adults with higher gait speed (−0.087 m/s per increase of 10 °C; 95% confidence interval (CI): −0.136; −0.038). The strongest effects on timed chair-rise and balance performance were observed in the subgroup of adults with lower gait speed (2.03 s per increase of 10 °C (95% CI: 0.79; 3.28) and −3.92 s per increase of 10 °C (95% CI: −7.31; −0.52), respectively). Comparing results of physical performance in absentia of a heat wave and during a heat wave, habitual gait speed was negatively affected by heat in the total group and subgroup of adults with higher gait speed, chair-rise performance was negatively affected in all groups and balance was not affected. The study provides arguments for exercise interventions in general for older adults, because a better physical fitness might alleviate impediments of physical capacity and might provide resources for adequate adaptation in older adults during heat stress. PMID:28216585

  11. One Facility's Experience Using the Community Readiness Model to Guide Services for Gay, Lesbian, Bisexual, and Transgender Older Adults

    ERIC Educational Resources Information Center

    Carlson, Laurie A.; Harper, Kelly S.

    2011-01-01

    Service provision to gay, lesbian, bisexual, and transgender (GLBT) older adults is a dynamic and sensitive area, requiring rigorous and extensive inquiry and action. Examining the readiness and assets of organizations serving GLBT older adults requires not only heart and sensitivity but also resources and a clear vision. The Community Readiness…

  12. Paid sick leave and preventive health care service use among U.S. working adults.

    PubMed

    DeRigne, LeaAnne; Stoddard-Dare, Patricia; Collins, Cyleste; Quinn, Linda

    2017-02-09

    Managing work and health care can be a struggle for many American workers. This paper explored the relationship between having paid sick leave and receiving preventive health care services, and hypothesized that those without paid sick leave would be less likely to obtain a range of preventive care services. In 2016, cross-sectional data from a sample of 13,545 adults aged 18-64 with current paid employment from the 2015 National Health Interview Survey (NHIS) were examined to determine the relationship between having paid sick leave and obtaining eight preventive care services including: (1) blood pressure check; (2) cholesterol check; (3) fasting blood sugar check; (4) having a flu shot; (5) having seen a doctor for a medical visit; (6) getting a Pap test; (7) getting a mammogram; (8) getting tested for colon cancer. Findings from multivariable logistic regressions, holding 10 demographic, work, income, and medical related variables stable, found respondents without paid sick leave were significantly less likely to report having used six of eight preventive health services in the last 12months. The significant findings remained robust even for workers who had reported having been previously told they had risk factors related to the preventive services. These findings support the idea that without access to paid sick leave, American workers risk foregoing preventive health care which could lead to the need for medical care at later stages of disease progression and at a higher cost for workers and the American health care system as a whole.

  13. Use of Public Oral Health Services by the Adult Population: A Multilevel Analysis

    PubMed Central

    2016-01-01

    Background It is important to assess context to explain inequalities in oral health, particularly with regard to the type of service used; thus, this study aimed to identify the social determinants of public dental service use by adults and to assess whether, beyond the level individual, existing inequalities are also expressed in the context in which individuals are embedded. Methods A multilevel analysis with three levels of aggregation of variables was performed. The individual variables were derived from the database of the SB Minas Gerais project—a survey of oral health status of the population of Minas Gerais, a state of the Brazilian Southeast region. The variable at the neighborhood level came from the Census of 2010. The variables at the municipal level were obtained from available public databases relating to oral health services. At the municipal level, the Human Development Index (HDI) variable was chosen to represent quality of life in the municipalities. Results In the final model, the following individual variables were associated with greater use of public dental services: lower income (PR = 1.98, 95% CI = 1.53; 2.58), higher number of residents at home (PR = 1.37, 95% CI = 1.11; 1.68) and higher number of teeth requiring treatment (PR = 1.49, 95% CI = 1.20; 1.84). With regard to context variables, a poorer infrastructure (PR = 0.62, 95% CI = 0.40; 0.96) leads to a lower use of public services. Conclusion The use of public services is associated with family income, how this income is divided in households, the need for treatment presented by the individual and the organization of the existing oral health service infrastructure in the municipality. PMID:26730714

  14. Community services' involvement in the discharge of older adults from hospital into the community

    PubMed Central

    Guerin, Michelle; Grimmer, Karen; Kumar, Saravana

    2013-01-01

    Background Community services are playing an increasing role in supporting older adults who are discharged from hospital with ongoing non-acute care needs. However, there is a paucity of information regarding how community services are involved in the discharge process of older individuals from hospital into the community. Methods Twenty-nine databases were searched from 1980 to 2012 (inclusive) for relevant primary published research, of any study design, as well as relevant unpublished work (e.g. clinical guidelines) which investigated community services' involvement in the discharge of older individuals from hospital into the community. Data analysis and quality appraisal (using McMaster critical appraisal tools) were undertaken predominately by the lead author. Data was synthesised qualitatively. Results Twelve papers were eligible for inclusion (five randomised controlled trials, four before and after studies and three controlled trials), involving a total of 8440 older adults (>65 years). These papers reported on a range of interventions. During data synthesis, descriptors were assigned to four emergent discharge methods: Virtual Interface Model, In-reach Interface Model, Out-reach Interface Model and Independent Interface Model. In each model, the findings were mixed in terms of health care and patient and carer outcomes. Conclusions It is plausible that each model identified in this systematic review has a role to play in successfully discharging different cohorts of older adults from hospital. Further research is required to identify appropriate population groups for various discharge models and to select suitable outcome measures to determine the effectiveness of these models, considering all stakeholders' involved. PMID:24179455

  15. Heavy consumption of dental services; a longitudinal cohort study among Finnish adults

    PubMed Central

    2013-01-01

    Background A reform to Dental Care legislation in 2002 abolished age limits restricting adults’ use of public dental services in Finland. In the Public Dental Service (PDS) unit of Espoo, the proportion of adult patients rose from 36% to 57%. The aim of this study was to investigate heavy use of dental services by adults and its determinants. Methods A longitudinal cohort study was undertaken based on a PDS patient register. Of all adults who attended the PDS in Espoo in 2004, those who had six or more visits (n=3,173) were assigned to the heavy user group and a comparison group of low users (n=22,820) had three or fewer dental visits. A sample of 320 patients was randomly selected from each group. Baseline information (year 2004) on age, sex, number and type of visit, oral health status and treatment provided was collected from treatment records. Each group was followed-up for five years and information on the number and types of visit was recorded for each year from 2005 to 2009. Results Most heavy users (61.6%) became low users and only 11.2% remained chronic heavy users. Most low users (91.0%) remained low users. For heavy users, the mean number of dental visits per year (3.0) during the follow-up period was significantly lower than initially in 2004 (8.3) (p<0.001) but 74.8% of heavy users had had emergency visits compared with 21.6% of the low users (p<0.001). A third (33%) of the visitors in each group had no proper examination and treatment planning during the 5-year follow-up period and two or more examinations were provided to fewer than half of the heavy (46.1%) or low (46.5%) users. The mean number of treating dentists was 5.7 for heavy users and 3.8 for low users (p<0.001). Conclusions Frequent emergency visits were characteristic of heavy users of dental services. Treatment planning was inadequate, probably partly due to the many dentists involved and too many patients requesting care. Better local management and continuous education are needed to

  16. Examining self-protection measures guarding Adult Protective Services social workers against compassion fatigue.

    PubMed

    Bourassa, Dara

    2012-06-01

    Little research has focused on the risk factors, effects, and experiences of compassion fatigue among gerontological social workers. This qualitative study explores the experiences and perspectives of nine Adult Protective Services (APS) social workers in relation to compassion fatigue. Results show that the APS social workers combined personal characteristics and professional factors to develop boundary-setting mechanisms that protected them from experiencing the deleterious symptoms and effects of compassion fatigue. Implications center around the elements needed to implement boundaries in order to maintain a separation between the work and home environment. Suggestions for future research are provided.

  17. Breaking up of prolonged sitting over three days sustains, but does not enhance, lowering of postprandial plasma glucose and insulin in overweight and obese adults.

    PubMed

    Larsen, Robyn N; Kingwell, Bronwyn A; Robinson, Carol; Hammond, Louise; Cerin, Ester; Shaw, Jonathan E; Healy, Genevieve N; Hamilton, Marc T; Owen, Neville; Dunstan, David W

    2015-07-01

    To compare the cumulative (3-day) effect of prolonged sitting on metabolic responses during a mixed meal tolerance test (MTT), with sitting that is regularly interrupted with brief bouts of light-intensity walking. Overweight/obese adults (n=19) were recruited for a randomized, 3-day, outpatient, cross-over trial involving: (1) 7-h days of uninterrupted sitting (SIT); and (2) 7-h days of sitting with light-intensity activity breaks [BREAKS; 2-min of treadmill walking (3.2 km/h) every 20 min (total: 17 breaks/day)]. On days 1 and 3, participants underwent a MTT (75 g of carbohydrate, 50 g of fat) and the incremental area under the curve (iAUC) was calculated from hourly blood samples. Generalized estimating equation (GEE) models were adjusted for gender, body mass index (BMI), energy intake, treatment order and pre-prandial values to determine effects of time, condition and time × condition. The glucose iAUC was 1.3 ± 0.5 and 1.5 ± 0.5 mmol·h·l(-1) (mean differences ± S.E.M.) higher in SIT compared with BREAKS on days 1 and 3 respectively (condition effect: P=0.001), with no effect of time (P=0.48) or time × condition (P=0.8). The insulin iAUC was also higher on both days in SIT (day 1: ∆151 ± 73, day 3: ∆91 ± 73 pmol·h·l(-1), P=0.01), with no effect of time (P=0.52) or time × condition (P=0.71). There was no between-treatment difference in triglycerides (triacylglycerols) iAUC. There were significant between-condition effects but no temporal change in metabolic responses to MTT, indicating that breaking up of sitting over 3 days sustains, but does not enhance, the lowering of postprandial glucose and insulin.

  18. Experts stress both wellness and amenity aspects of food and nutrition services in assisted living facilities for older adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There has been no consensus on best practices in food and nutrition services in assisted living facilities (ALFs) for older adults. We documented experts’ views on optimal food and nutrition services emphases in ALFs, and factors affecting their views. One hundred thirty-five national experts speci...

  19. Demographic Characteristics, Health Conditions, and Residential Service Use in Adults with Down Syndrome in 25 U.S. States

    ERIC Educational Resources Information Center

    Stancliffe, Roger J.; Lakin, K. Charlie; Larson, Sheryl A.; Engler, Joshua; Taub, Sarah; Fortune, Jon; Bershadsky, Julie

    2012-01-01

    This study describes service users with Down syndrome (N = 1,199) and a comparative sample with intellectual and developmental disabilities but not Down syndrome (N = 11,182), drawn from National Core Indicator surveys of adult service users in 25 U.S. states. Individuals with Down syndrome were younger than were individuals without Down syndrome.…

  20. Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services.

    PubMed

    Ewen, Heidi H; Washington, Tiffany R; Emerson, Kerstin G; Carswell, Andrew T; Smith, Matthew Lee

    2017-03-22

    Background: The majority of older adults prefer to remain in their homes, or to "age-in-place." To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults' residential environment is associated with their health status and HCBS utilization. Building upon the Person-Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs as well

  1. 45 CFR Appendix A to Part 96 - Uniform Definitions of Services

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... activities may include the cost of personnel, equipment, and food; assessment of nutritional and dietary..., or drug abuse. 5. Day Care Services—Adults Day care services for adults are those services or...-hour day. Component services or activities may include opportunity for social...

  2. 45 CFR Appendix A to Part 96 - Uniform Definitions of Services

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... activities may include the cost of personnel, equipment, and food; assessment of nutritional and dietary..., or drug abuse. 5. Day Care Services—Adults Day care services for adults are those services or...-hour day. Component services or activities may include opportunity for social...

  3. 45 CFR Appendix A to Part 96 - Uniform Definitions of Services

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... activities may include the cost of personnel, equipment, and food; assessment of nutritional and dietary..., or drug abuse. 5. Day Care Services—Adults Day care services for adults are those services or...-hour day. Component services or activities may include opportunity for social...

  4. The combined effect of sleep and time of day on emotion decoding from dynamic visual cues in older adults

    PubMed Central

    Tsokanaki, Paraskevi; Moraitou, Despina; Papantoniou, Georgia

    2016-01-01

    It is well known that night sleep is a decisive factor for the effective functioning of the human body and mind. In addition to the role of sleep, older adults report that they are “morning types” and that their cognitive and emotional abilities seem to be at a higher level in the morning hours. In this vein, this study is aimed at examining the effect of sleep combined with the “time of day” condition on a specific ability that is crucial for interpersonal communication, namely, emotion recognition, in older adults. Specifically, the study compared older adults’ performance in decoding emotions from ecologically valid, dynamic visual cues, in two conditions: “early in the morning and after night sleep”, and “in the afternoon and after many hours since night sleep”. An emotion recognition task was administered twice to 37 community-dwelling older adults. The results showed a statistically significant higher performance in the morning in decoding all emotions presented, compared to the afternoon condition. Pleasant surprise, sadness, and anxiety were revealed as the most difficult emotions to be recognized in the afternoon condition. PMID:27621639

  5. Health services access and use among older adults in North Carolina: urban vs rural residents.

    PubMed Central

    Blazer, D G; Landerman, L R; Fillenbaum, G; Horner, R

    1995-01-01

    OBJECTIVES. This study compared health service use and satisfaction with health care among older adults living in urban vs rural counties in North Carolina. METHODS. A stratified random sample of 4162 residents of one urban and four rural counties of North Carolina was surveyed to determine urban/rural variation in inpatient and outpatient health service use, continuity of care and satisfaction with care, and barriers (transportation, cost) to care. RESULTS. Inpatient and outpatient service use did not vary by residence in controlled analyses. Continuity of care was more frequent in rural counties. Transportation was not perceived as a barrier to health care more frequently in rural than in urban counties, but cost was a greater barrier to care among rural elderly people. CONCLUSIONS. In this sample, older persons living in rural counties within reasonable driving distance of urban counties with major medical centers used health services as frequently and were as satisfied with their health care as persons in urban counties. Cost of care, however, was a significant and persistent barrier among rural elderly people, despite Medicare coverage. PMID:7573622

  6. Determinants of Utilization of Eye Care Services in a Rural Adult Population of a Developing Country

    PubMed Central

    Olusanya, Bolutife A.; Ashaye, Adeyinka O.; Owoaje, Eme T.; Baiyeroju, Aderonke M.; Ajayi, Benedictus G.

    2016-01-01

    Purpose: To describe the factors that determine the utilization of eye care services in a rural community in South-Western Nigeria. Methods: A descriptive cross-sectional survey using a multistage sampling technique was conducted. The main outcome measure was self-reported previous consultation of an orthodox medical facility for eye care. Results: The study sample included 643 participants. Only 122 (19%) respondents had previously visited orthodox facilities in search of eye care and 24% of those with presenting visual acuity <6/18 had sought eye care. Characteristics associated with previous utilization of eye care services were age of =70 years (odds ratio [OR] ≥ 1.7, P = 0.02); male gender (OR = 1.5, P = 0.04); literacy (OR = 1.7, P = 0.007); and residing close to an eye care facility (OR = 2.8, P < 0.001). Blind respondents were three times more likely to seek eye care (P < 0.001). Regression analysis revealed that factors associated with increased likelihood of utilization of eye care services included age ≥70 years; literacy; residence close to an eye facility; being diabetic or hypertensive; history of ocular symptoms, and blindness. Conclusions: These findings suggest that a significant proportion (75%) of adults in the study area are not utilizing eye care services and that blindness is an important determinant of utilization of eye care services. Health education and awareness campaigns about the importance and benefits of seeking eye care early, and the provision of community-based eye care programs are essential to boost the uptake of eye care services in this community as well as other rural areas of West Africa. PMID:26957847

  7. Supplement for Adult Service Providers: A Curricular Approach To Support the Transition to Adulthood of Adolescents with Visual or Dual Sensory Impairments and Cognitive Disabilities.

    ERIC Educational Resources Information Center

    O'Neill, John; And Others

    This handbook supplement, for adult service providers, is part of a packet intended to aid educators, families, and adult service providers to facilitate the transition from school to adult life in the community for students with both cognitive disabilities and visual or dual sensory impairments. Emphasis is on preparation of students for adult…

  8. Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers

    PubMed Central

    Lee, Sungmin; Lee, Chanam; Rodiek, Susan

    2017-01-01

    Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS). Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 2011 to 2014 involving adults aged 65 and older in the city of San Antonio (TX, USA) were analyzed at the census tract level (n = 264). Negative binomial regression was used to identify significant census tract-based neighborhood environmental variables associated with the count of fall injuries in each census tract. Adjusting for exposure variable and the size of the census tract, neighborhoods with higher residential stability, captured as the percent of those who lived in the same house as the previous year were associated with decreased count of fall injuries. Neighborhoods with higher residential density and having a higher vacancy rate were associated with increased count of fall injuries. The study highlights the importance of stable and safe neighborhoods in reducing fall risks among older adults, which should be considered a prerequisite for promoting age-friendly environments. PMID:28208748

  9. 78 FR 69702 - 60-Day Notice of Proposed Information Collection: FHA-Insured Mortgage Loan Servicing for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-20

    ... for Performing Loans Including: Collection and Payment of Mortgage Insurance Premiums, Escrow Administration, Providing Loan Information and Customer Services, Assessment of Post Endorsement Fees and Charges... Service at (800) 877-8339. FOR FURTHER INFORMATION CONTACT: Ivery W. Himes, Director, Office of...

  10. Clinical outcome and predictors of adverse events of an enhanced older adult psychiatric liaison service: Rapid Assessment Interface and Discharge (Newport)

    PubMed Central

    Singh, Inderpal; Fernando, Priya; Griffin, Jane; Edwards, Chris; Williamson, Kathryn; Chance, Patrick

    2017-01-01

    Background Hospitals are currently admitting an increasing number of older people, and more than one-third could have an underlying mental health problem. The existing Older Adult Mental Health (OAMH) liaison service was increasingly unable to meet the escalating needs of older and frail patients. Therefore, the service was modernized and enhanced on an “invest-to-save” principle to provide a prompt holistic assessment for older adults with mental health problems. The objective of this study was a service evaluation to appraise clinical outcome, minimize the length of stay, and measure the predictors of adverse outcomes to streamline this enhanced service. Materials and methods Patient demographics, social care needs, comorbidity burden (Charlson comorbidity index, CCI), and functional status (Barthel index, BI) were recorded from November 2014 to February 2015. Frailty status (frailty index, FI) was measured by an index (Rockwood index) of accumulated deficits. The outcomes were compared with the previous OAMH liaison service data over the same period a year earlier. Results The new Rapid Assessment Interface and Discharge service assessed 339 patients compared to 179 by the previous liaison team over the 4-month period. Mean age was 82.18±8.04 years, with 60% women; preadmission BI was 14.96±4.35, and admission BI was 11.38±5.73 (P<0.001, paired t-test); mean CCI was 1.66±1.53, and mean FI was 0.34±0.99, and 80% were on polypharmacy. The direct discharges from front door were increased by 7%. The mean hospital stay reduced from 35 to 20 days in acute site and from 108 to 47 days in long-stay wards. The cost benefits were based on the mean reduction in hospital stay (41.8 days) and admission reduction (2.2 days), leading to a total annualized bed savings of 44 days. FI was the most highly significant factor between patient groups with a good and poor outcome (P=0.00003, independent groups t-test, t=−4.38, df 98). Conclusion Prompt mental health

  11. Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

    PubMed Central

    Ewen, Heidi H.; Washington, Tiffany R.; Emerson, Kerstin G.; Carswell, Andrew T.; Smith, Matthew Lee

    2017-01-01

    Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs

  12. Long-term care services and support systems for older adults: The role of technology.

    PubMed

    Czaja, Sara J

    2016-01-01

    The aging of the population, especially the increase in the "oldest old," is a remarkable achievement that presents both opportunities and challenges for policymakers, researchers, and society. Although many older adults enjoy relatively good health into their later years, many have one or more chronic conditions or diseases and need help with disease management activities or activities important to independent living. Technology is playing an increasingly important role in the health care arena and is becoming ubiquitous in health management activities. There are a variety of technology applications that can be used to enhance the mobility and quality of life of people who have limitations and help to foster the ability of those with chronic conditions to remain at home. Technology applications can also provide a central role in providing support to family caregivers in terms of enhancing access to information and community resources and connections to formal and informal support services. Monitoring technologies may also allow caregivers to check on the status or activities of their loved one while they are at work or at a distant location. Furthermore, telemedicine applications can aid the ability of care providers to monitor patients and deliver health services. The objective of this article is to highlight the potential role that technology can play in the provision of long-term support for older adults and their families. Challenges and barriers that currently limit the full potential of technology to be realized for these populations will also be discussed. Finally the role of psychological science toward maximizing the potential of technology applications in enhancing long term care and support services will be highlighted. (PsycINFO Database Record

  13. "I Have to Rest All the Time Because You Are Not Allowed to Play": Exploring Children's Perceptions of Autonomy during Sleep-Time in Long Day Care Services

    ERIC Educational Resources Information Center

    Nothard, Michaela; Irvine, Susan; Theobald, Maryanne; Staton, Sally; Pattinson, Cassandra; Thorpe, Karen

    2015-01-01

    Daytime sleep is a significant part of the daily routine for children attending early childhood education and care (ECEC) services in Australia and many other countries. The practice of sleep-time can account for a substantial portion of the day in ECEC and often involves a mandated sleep/rest period for all children, including older…

  14. Trauma-Informed Day Services for Individuals with Intellectual/Developmental Disabilities: Exploring Staff Understanding and Perception within an Innovative Programme

    ERIC Educational Resources Information Center

    Keesler, John M.

    2016-01-01

    Background: Trauma-informed care (TIC) is a systems-level philosophy of service delivery which integrates choice, collaboration, empowerment, safety and trust to create an organizational culture sensitive to trauma. This study explores staff understandings and perceptions within an innovative trauma-informed day program for individuals with…

  15. Illinois Department of Children and Family Services Text of Adopted Rules. Subchapter e: Requirements for Licensure. Part 407: Licensing Standards for Day Care Centers.

    ERIC Educational Resources Information Center

    Illinois State Dept. of Children and Family Services, Springfield.

    Reprinted in this document are day care center licensing standards adopted and codified, effective August 1983, by the Illinois Department of Children and Family Services and amended June 1984 and January 1985. Sections of the report concern purpose, definitions, effective date of standards, application for license and license renewal, provisions…

  16. Immunosuppression in early postnatal days induces persistent and allergen-specific immune tolerance to asthma in adult mice.

    PubMed

    Chen, Yan; Zhang, Jin; Lu, Yong; Wang, Libo

    2015-01-01

    Bronchial asthma is a chronic airway inflammatory condition with high morbidity, and effective treatments for asthma are limited. Allergen-specific immunotherapy can only induce peripheral immune tolerance and is not sustainable. Exploring new therapeutic strategies is of great clinical importance. Recombinant adenovirus (rAdV) was used as a vector to make cells expressing cytotoxic T lymphocyte-associated antigen-4-immunoglobulin (CTLA4Ig) a soluble CTLA4 immunoglobulin fusion protein. Dendritic cells (DCs) were modified using the rAdVs together with allergens. Then these modified DCs were transplanted to mice before allergen sensitization. The persistence and specificity of immune tolerance were evaluated in mice challenged with asthma allergens at 3 and 7 months. DCs modified by CTLA4Ig showed increased IL-10 secretion, decreased IL-12 secretion, and T cell stimulation in vitro. Mice treated with these DCs in the early neonatal period developed tolerance against the allergens that were used to induce asthma in the adult stage. Asthma symptoms, lung damage, airway reactivity, and inflammatory response all improved. Humoral immunity indices showed that this therapeutic strategy strongly suppressed mice immune responses and was maintained for as long as 7 months. Furthermore, allergen cross-sensitization and challenge experiments demonstrated that this immune tolerance was allergen-specific. Treatment with CTLA4Ig modified DCs in the early neonatal period, inducing persistent and allergen-specific immune tolerance to asthma in adult mice. Our results suggest that it may be possible to develop a vaccine for asthma.

  17. Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?

    PubMed

    Harris, Sion K; Aalsma, Matthew C; Weitzman, Elissa R; Garcia-Huidobro, Diego; Wong, Charlene; Hadland, Scott E; Santelli, John; Park, M Jane; Ozer, Elizabeth M

    2017-03-01

    We reviewed research regarding system- and visit-level strategies to enhance clinical preventive service delivery and quality for adolescents and young adults. Despite professional consensus on recommended services for adolescents, a strong evidence base for services for young adults, and improved financial access to services with the Affordable Care Act's provisions, receipt of preventive services remains suboptimal. Further research that builds off successful models of linking traditional and community clinics is needed to improve access to care for all youth. To optimize the clinical encounter, promising clinician-focused strategies to improve delivery of preventive services include screening and decision support tools, particularly when integrated into electronic medical record systems and supported by training and feedback. Although results have been mixed, interventions have moved beyond increasing service delivery to demonstrating behavior change. Research on emerging technology-such as gaming platforms, mobile phone applications, and wearable devices-suggests opportunities to expand clinicians' reach; however, existing research is based on limited clinical settings and populations. Improved monitoring systems and further research are needed to examine preventive services facilitators and ensure that interventions are effective across the range of clinical settings where youth receive preventive care, across multiple populations, including young adults, and for more vulnerable populations with less access to quality care.

  18. Recommendations for the transition of patients with ADHD from child to adult healthcare services: a consensus statement from the UK adult ADHD network.

    PubMed

    Young, Susan; Adamou, Marios; Asherson, Philip; Coghill, David; Colley, Bill; Gudjonsson, Gisli; Hollis, Chris; McCarthy, Jane; Müller, Ulrich; Paul, Moli; Pitts, Mark; Arif, Muhammad

    2016-08-26

    The aim of this consensus statement was to discuss transition of patients with ADHD from child to adult healthcare services, and formulate recommendations to facilitate successful transition. An expert workshop was convened in June 2012 by the UK Adult ADHD Network (UKAAN), attended by a multidisciplinary team of mental health professionals, allied professionals and patients. It was concluded that transitions must be planned through joint meetings involving referring/receiving services, patients and their families. Negotiation may be required to balance parental desire for continued involvement in their child's care, and the child's growing autonomy. Clear transition protocols can maintain standards of care, detailing relevant timeframes, responsibilities of agencies and preparing contingencies. Transition should be viewed as a process not an event, and should normally occur by the age of 18, however flexibility is required to accommodate individual needs. Transition is often poorly experienced, and adherence to clear recommendations is necessary to ensure effective transition and prevent drop-out from services.

  19. Outdoor PM2.5, Ambient Air Temperature, and Asthma Symptoms in the Past 14 Days among Adults with Active Asthma

    PubMed Central

    Mirabelli, Maria C.; Vaidyanathan, Ambarish; Flanders, W. Dana; Qin, Xiaoting; Garbe, Paul

    2016-01-01

    Background: Relationships between air quality and health are well-described, but little information is available about the joint associations between particulate air pollution, ambient temperature, and respiratory morbidity. Objectives: We evaluated associations between concentrations of particulate matter ≤ 2.5 μm in diameter (PM2.5) and exacerbation of existing asthma and modification of the associations by ambient air temperature. Methods: Data from 50,356 adult respondents to the Asthma Call-back Survey from 2006–2010 were linked by interview date and county of residence to estimates of daily averages of PM2.5 and maximum air temperature. Associations between 14-day average PM2.5 and the presence of any asthma symptoms during the 14 days leading up to and including the interview date were evaluated using binomial regression. We explored variation by air temperature using similar models, stratified into quintiles of the 14-day average maximum temperature. Results: Among adults with active asthma, 57.1% reported asthma symptoms within the past 14 days, and 14-day average PM2.5 ≥ 7.07 μg/m3 was associated with an estimated 4–5% higher asthma symptom prevalence. In the range of 4.00–7.06 μg/m3 of PM2.5, each 1-μg/m3 increase was associated with a 3.4% [95% confidence interval (CI): 1.1, 5.7] increase in symptom prevalence; across categories of temperature from 1.1 to 80.5°F, each 1-μg/m3 increase was associated with increased symptom prevalence (1.1–44.4°F: 7.9%; 44.5–58.6°F: 6.9%; 58.7–70.1°F: 2.9%; 70.2–80.5°F: 7.3%). Conclusions: These results suggest that each unit increase in PM2.5 may be associated with an increase in the prevalence of asthma symptoms, even at levels as low as 4.00–7.06 μg/m3. Citation: Mirabelli MC, Vaidyanathan A, Flanders WD, Qin X, Garbe P. 2016. Outdoor PM2.5, ambient air temperature, and asthma symptoms in the past 14 days among adults with active asthma. Environ Health Perspect 124:1882–1890;

  20. The Emergence of a Human Services Cooperative to Support Families and Young Adults with Disabilities: Implications for Disability Services and Supports

    ERIC Educational Resources Information Center

    Shogren, Karrie A.; Forber-Pratt, Anjali J.; Nittrouer, Christine; Aragon, Steven R.

    2013-01-01

    This paper documents the experiences of a group of parents who came together to form a human service cooperative in their local community to address the needs of their adult children with intellectual and developmental disabilities. Each parent felt that their child's needs were not (or could not be) met by existing providers. Parent leaders who…

  1. A Single Session of Low-Intensity Exercise Is Sufficient to Enhance Insulin Sensitivity Into the Next Day in Obese Adults

    PubMed Central

    Newsom, Sean A.; Everett, Allison C.; Hinko, Alexander; Horowitz, Jeffrey F.

    2013-01-01

    OBJECTIVE The purpose of this study was to determine the effect of a relatively modest session of exercise on insulin sensitivity and fatty acid uptake the next day in obese adults. RESEARCH DESIGN AND METHODS Eleven sedentary obese adults (male/female: 3/8; BMI 37 ± 1 kg/m2; peak oxygen uptake [VO2peak] 20 ± 1 mL/kg/min) completed three experimental trials. On two of these occasions, subjects exercised to expend 350 kcal in the afternoon. These two exercise trials were identical except for the exercise intensity (50% VO2peak [EX50] and 65% VO2peak [EX65]) and the duration of exercise necessary to expend 350 kcal (EX50 = ∼70 min; EX65 = ∼55 min). Subjects also completed a control trial (CON), without exercise. The next morning, we measured insulin sensitivity (hyperinsulinemic-euglycemic clamp) and whole-body fatty acid uptake (palmitate rate of disappearance from plasma [Rd]). RESULTS Exercise increased insulin sensitivity the next day, but whereas the 35% improvement after EX50 compared with CON was statistically significant (P = 0.01), the 20% improvement after EX65 was not (P = 0.17). Despite nearly identical values between CON and EX65 (P = 0.88), systemic fatty acid uptake was lower after EX50 compared with EX65 (P = 0.02), but not quite significant compared with CON (P = 0.07). Importantly, the change in fatty acid uptake after exercise compared with CON was negatively correlated with the change in insulin sensitivity for all trials (r = −0.60, P = 0.003). CONCLUSIONS A relatively modest single session of exercise in obese adults improved insulin sensitivity the next day, and a reduction in systemic fatty acid uptake in the several hours after exercise may be important for this effect. PMID:23757424

  2. Intoxication with Bourbon versus Vodka: Effects on Hangover, Sleep and Next-Day Neurocognitive Performance in Young Adults

    PubMed Central

    Rohsenow, Damaris J.; Howland, Jonathan; Arnedt, J. Todd; Almeida, Alissa B.; Greece, Jacey; Minsky, Sara; Kempler, Carrie S.; Sales, Suzanne

    2013-01-01

    Background This study assessed the effects of heavy drinking with high or low congener beverages on next-day neurocognitive performance, and the extent to which these effects were mediated by alcohol-related sleep disturbance or alcoholic beverage congeners, and correlated with the intensity of hangover. Methods Healthy heavy drinkers age 21–33 (n = 95) participated in two drinking nights after an acclimatization night. They drank to a mean of 0.11 g% BrAC on vodka or bourbon one night with matched placebo the other night, randomized for type and order. Polysomnography recordings were made overnight; self-report and neurocognitive measures were assessed the next morning. Results After alcohol, people had more hangover and more decrements in tests requiring both sustained attention and speed. Hangover correlated with poorer performance on these measures. Alcohol decreased sleep efficiency and REM sleep, and increased wake time and next-day sleepiness. Alcohol effects on sleep correlated with hangover but did not mediate the effects on performance. No effect of beverage congeners was found except on hangover severity, with people feeling worse after bourbon. Virtually no sex differences appeared. Conclusions Since drinking to this level affects complex cognitive abilities, safety could be affected, with implications for driving and for safety sensitive occupations. Congener content affects only how people feel the next day so does not increase risk. The sleep disrupting effects of alcohol did not account for the impaired performance so other mechanisms of effect need to be sought. Since hangover symptoms correlate with impaired performance, these might be contributing to the impairment. PMID:20028364

  3. Interactions of time of day and sleep with between-session habituation and extinction memory in young adult males.

    PubMed

    Pace-Schott, Edward F; Tracy, Lauren E; Rubin, Zoe; Mollica, Adrian G; Ellenbogen, Jeffrey M; Bianchi, Matt T; Milad, Mohammed R; Pitman, Roger K; Orr, Scott P

    2014-05-01

    Within-session habituation and extinction learning co-occur as do subsequent consolidation of habituation (i.e., between-session habituation) and extinction memory. We sought to determine whether, as we predicted: (1) between-session habituation is greater across a night of sleep versus a day awake; (2) time-of-day accounts for differences; (3) between-session habituation predicts consolidation of extinction memory; (4) sleep predicts between-session habituation and/or extinction memory. Participants (N = 28) completed 4-5 sessions alternating between mornings and evenings over 3 successive days (2 nights) with session 1 in either the morning (N = 13) or evening (N = 15). Twelve participants underwent laboratory polysomnography. During 4 sessions, participants completed a loud-tone habituation protocol, while skin conductance response (SCR), blink startle electromyography (EMG), heart-rate acceleration and heart-rate deceleration (HRD) were recorded. For sessions 1 and 2, between-session habituation of EMG, SCR and HRD was greater across sleep. SCR and HRD were generally lower in the morning. Between-session habituation of SCR for sessions 1 and 2 was positively related to intervening (first night) slow wave sleep. In the evening before night 2, participants also underwent fear conditioning and extinction learning phases of a second protocol. Extinction recall was tested the following morning. Extinction recall was predicted only by between-session habituation of SCR across the same night (second night) and by intervening REM. We conclude that: (1) sleep augments between-session habituation, as does morning testing; (2) extinction recall is predicted by concurrent between-session habituation; and (3) both phenomena may be influenced by sleep.

  4. Vancomycin MIC Does Not Predict 90-Day Mortality, Readmission, or Recurrence in a Prospective Cohort of Adults with Staphylococcus aureus Bacteremia

    PubMed Central

    Clemenzi-Allen, Angelo; Gahbauer, Alice; Deck, Daniel; Imp, Brandon; Vittinghoff, Eric; Chambers, Henry F.; Doernberg, Sarah

    2016-01-01

    Staphylococcus aureus bacteremia (SAB) is a tremendous health burden. Previous studies examining the association of vancomycin MIC and outcomes in patients with SAB have been inconclusive. This study evaluated the association between vancomycin MICs and 30- or 90-day mortality in individuals with SAB. This was a prospective cohort study of adults presenting from 2008 to 2013 with a first episode of SAB. Subjects were identified by an infection surveillance system. The main predictor was vancomycin MIC by MicroScan. The primary outcomes were death at 30 and 90 days, and secondary outcomes included recurrence, readmission, or a composite of death, recurrence, and readmission at 30 and 90 days. Covariates included methicillin susceptibility, demographics, illness severity, comorbidities, infectious source, and antibiotic use. Cox proportional-hazards models with propensity score adjustment were used to estimate 30- and 90-day outcomes. Of 429 unique first episodes of SAB, 11 were excluded, leaving 418 individuals for analysis. Eighty-three (19.9%) participants had a vancomycin MIC of 2 μg/ml. In the propensity-adjusted Cox model, a vancomycin MIC of 2 μg/ml compared to <2 μg/ml was not associated with a greater hazard of mortality or composite outcome of mortality, readmission, and recurrence at either 30 days (hazard ratios [HRs] of 0.86 [95% confidence interval {CI}, 0.41, 1.80] [P = 0.70] and 0.94 [95% CI, 0.55, 1.58] [P = 0.80], respectively) or 90 days (HRs of 0.91 [95% CI, 0.49, 1.69] [P = 0.77] and 0.69 [95% CI, 0.46, 1.04] [P = 0.08], respectively) after SAB diagnosis. In a prospective cohort of patients with SAB, vancomycin MIC was not associated with 30- or 90-day mortality or a composite of mortality, disease recurrence, or hospital readmission. PMID:27324762

  5. Survivorship services for adult cancer populations: a pan-Canadian guideline

    PubMed Central

    Howell, D.; Hack, T.F.; Oliver, T.K.; Chulak, T.; Mayo, S.; Aubin, M.; Chasen, M.; Earle, C.C.; Friedman, A.J.; Green, E.; Jones, G.W.; Jones, J.M.; Parkinson, M.; Payeur, N.; Sabiston, C.M.; Sinclair, S.

    2011-01-01

    Objective Our goal was to develop evidence-based recommendations for the organization and structure of cancer survivorship services, and best-care practices to optimize the health and well-being of post–primary treatment survivors. This review sought to determine the optimal organization and care delivery structure for cancer survivorship services, and the specific clinical practices and interventions that would improve or maximize the psychosocial health and overall well-being of adult cancer survivors. Data Sources We conducted a systematic search of the Inventory of Cancer Guidelines at the Canadian Partnership Against Cancer, the U.S. National Guideline Clearinghouse, the Canadian Medical Association InfoBase, medline (ovid: 1999 through November 2009), embase (ovid: 1999 through November 2009), Psychinfo (ovid: 1999 through November 2009), the Cochrane Library (ovid; Issue 1, 2009), and cinahl (ebsco: 1999 through December 2009). Reference lists of related papers and recent review articles were scanned for additional citations. Methods Articles were selected for inclusion as evidence in the systematic review if they reported on organizational system components for survivors of cancer, or on psychosocial or supportive care interventions HOWELL et al. designed for survivors of cancer. Articles were excluded from the systematic review if they focused only on pediatric cancer survivor populations or on populations that transitioned from pediatric cancer to adult services; if they addressed only pharmacologic interventions or diagnostic testing and follow-up of cancer survivors; if they were systematic reviews with inadequately described methods; if they were qualitative or descriptive studies; and if they were opinion papers, letters, or editorials. Data Extraction and Synthesis Evidence was selected and reviewed by three members of the Cancer Journey Survivorship Expert Panel (SM, TC, TKO). The resulting summary of the evidence was guided further and reviewed

  6. EMS-STARS: Emergency Medical Services "Superuser" Transport Associations: An Adult Retrospective Study.

    PubMed

    Hall, M Kennedy; Raven, Maria C; Hall, Jane; Yeh, Clement; Allen, Elaine; Rodriguez, Robert M; Tangherlini, Niels L; Sporer, Karl A; Brown, John F

    2015-01-01

    Abstract Objective. Emergency medical services (EMS) "superusers" -those who use EMS services at extremely high rates -have not been well characterized. Recent interest in the small group of individuals who account for a disproportionate share of health-care expenditures has led to research on frequent users of emergency departments and other health services, but little research has been done regarding those who use EMS services. To inform policy and intervention implementation, we undertook a descriptive analysis of EMS superusers in a large urban community. In this paper we compare EMS superusers to low, moderate, and high users to characterize factors contributing to EMS use. We also estimate the financial impact of EMS superusers. Methods. We conducted a retrospective cross-sectional study based on 1 year of data from an urban EMS system. Data for all EMS encounters with patients age ≥18 years were extracted from electronic records generated on scene by paramedics. We identified demographic and clinical variables associated with levels of EMS use. EMS users were characterized by the annual number of EMS encounters: low (1), moderate (2-4), high (5-14), and superusers (≥15). In addition, we performed a financial analysis using San Francisco Fire Department (SFFD) 2009 charge and reimbursement data. Results. A total of 31,462 adults generated 43,559 EMS ambulance encounters, which resulted in 39,107 transports (a 90% transport rate). Encounters for general medical reasons were common among moderate and high users and less frequent among superusers and low users, while alcohol use was exponentially correlated with encounter frequency. Superusers were significantly younger than moderate EMS users, and more likely to be male. The superuser group created a significantly higher financial burden/person than any other group, comprising 0.3% of the study population, but over 6% of annual EMS charges and reimbursements. Conclusions. In this retrospective study, adult

  7. Transition Services for DHH Adolescents and Young Adults With Disabilities: Challenges and Theoretical Frameworks.

    PubMed

    Luft, Pamela

    2015-01-01

    Deaf and hard of hearing (DHH) adolescents and young adults with disabilities (DWD) are a highly diverse group who may also demonstrate a range of functional limitations. These present unique challenges to professional efforts to provide high-quality transition services. Despite these issues, a majority of this population has cognitive abilities within the typical range, and therefore, their transition expectations should be commensurately high in comparison to those of their DHH peers. Research-based transition practices offer a range of interventions, and although none have been validated with DHH or DWD students, several provide important foundational learning opportunities. Yet their implementation will require modifications with programming and expertise beyond what is available in most school districts. Use of a multilevel, ecological framework and person-centered planning offers systematic strategies for increasing access to transition resources and supports to address these unique needs and lead to successful adulthood.

  8. 34 CFR 300.11 - Day; business day; school day.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Day; business day; school day. 300.11 Section 300.11 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION...

  9. 34 CFR 300.11 - Day; business day; school day.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Day; business day; school day. 300.11 Section 300.11 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION...

  10. 34 CFR 300.11 - Day; business day; school day.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Day; business day; school day. 300.11 Section 300.11 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION...

  11. Commissioning specialist diabetes services for adults with diabetes: summary of a Diabetes UK Task and Finish group report.

    PubMed

    Goenka, N; Turner, B; Vora, J

    2011-12-01

    The increasing prevalence of diabetes, the drive to develop community services for diabetes and the Quality and Outcomes Framework for diabetes have led to improvements in the management of diabetes in primary care settings, with services traditionally provided only in specialist care now provided for many patients with diabetes by non-specialists. Consequently, there is a need to redefine roles, responsibilities and components of a specialist diabetes service to provide for the needs of patients in the National Health Service (NHS) today. The delivery of diabetes care is complex and touches on almost every aspect of the health service. It is the responsibility of those working within commissioning and specialist provider roles to work together with people with diabetes to develop, organize and deliver a full range of integrated diabetes care services. The local delivery model agreed within the local diabetes network, comprising specialist teams, primary care teams, commissioners and people with diabetes, should determine how the diabetes specialist services are organizsed. It should identify the roles and responsibilities of provider organizations to ensure that the right person provides the right care, at the right time, and in the right place. We summarize a report entitled 'Commissioning Diabetes Specialist Services for Adults with Diabetes', which has been produced, as a 'Task and Finish' group activity within Diabetes UK, to assist managers, commissioners and healthcare professionals to provide advice on the structure, roles and components of specialist diabetes services for adults.

  12. 77 FR 43229 - Food and Nutrition Service

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-24

    ... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2012 Through June 30, 2013 AGENCY: Food and Nutrition Service... Program Development Branch, Child Nutrition Division, Food and Nutrition Service, U.S. Department...

  13. Views of Young People With Chronic Conditions on Transition From Pediatric to Adult Health Services

    PubMed Central

    Hislop, Jenni; Mason, Helen; Parr, Jeremy R.; Vale, Luke; Colver, Allan

    2017-01-01

    Purpose This study sought to identify and describe the views of young people with chronic conditions about the transition from pediatric to adult services. Methods Q methodology was used to identify young people’s views on transition. A set of 39 statements about transition was developed from an existing literature review and refined in consultation with local groups of young people. Statements were printed onto cards and a purposive sample of 44 young people with chronic health conditions was recruited, 41 remaining in the study. The young people were asked to sort the statement cards onto a Q-sort grid, according to their opinions from “strongly disagree” to “strongly agree.” Factor analysis was used to identify shared points of view (patterns of similarity between individual’s Q-sorts). Results Four distinct views on transition were identified from young people: (1) “a laid-back view of transition;” (2) “anxiety about transition;” (3) “wanting independence and autonomy during transition;” and (4) “valuing social interaction with family, peers, and professionals to assist transition.” Conclusions Successful transition is likely to be influenced by how young people view the process. Discussing and understanding young people’s views and preferences about transition should help clinicians and young people develop personalized planning for transition as a whole, and more specifically the point of transfer, leading to effective and efficient engagement with adult care. PMID:27287962

  14. Social determinants of older adults' awareness of community support services in Hamilton, Ontario.

    PubMed

    Tindale, J; Denton, M; Ploeg, J; Lillie, J; Hutchison, B; Brazil, K; Akhtar-Danesh, N; Plenderleith, J

    2011-11-01

    Community support services (CSSs) have been developed in Canada and other Western nations to enable persons coping with health or social issues to continue to live in the community. This study addresses the extent to which awareness of CSSs is structured by the social determinants of health. In a telephone interview conducted in February-March 2006, 1152 community-dwelling older adults (response rate 12.4%) from Hamilton, Ontario, Canada were made to read a series of four vignettes and were asked whether they were able to identify a CSS they may turn to in that situation. Across the four vignettes, 40% of participants did name a CSS as a possible source of assistance. Logistic regression was used to determine factors related to awareness of CSSs. Respondents most likely to have awareness of CSS include the middle-aged and higher-income groups. Being knowledgeable about where to look for information about CSSs, having social support and being a member of a club or voluntary organisations are also significant predictors of awareness of CSSs. Study results suggest that efforts be made to improve the level of awareness and access to CSSs among older adults by targeting their social networks as well as their health and social care providers.

  15. Evaluating the effects of diffused lavender in an adult day care center for patients with dementia in an effort to decrease behavioral issues: a pilot study

    PubMed Central

    Moorman Li, Robin; Gilbert, Brian; Orman, Anna; Aldridge, Petra; Leger-Krall, Sue; Anderson, Clare; Hincapie Castillo, Juan

    2017-01-01

    Abstract Objectives: To evaluate the effects of diffused lavender on the frequency of behavioral issues [BIs], defined as a composite of restlessness/wandering [RW], agitation [AGT], anger [ANG], and anxiety [ANX] in an adult day care center. Secondary objectives evaluate systematic differences on the frequency of BIs between age cohorts, gender, and individual behaviors. Design: Pre-post quasi-experimental study. Setting: Private nonprofit adult day care center for patients with dementia. Participants: Elderly patients older than 65 years of age with a clinical diagnosis of dementia, who require daytime monitoring. Intervention: Lavender aromatherapy twice a day for 20 min during a two-month period during active clinic days. Measurements: Behavioral issues were recorded using the behavior/intervention monthly flow record during the pre- and post-intervention periods. Results: There was no significant difference on frequency of BIs between pre-intervention and post-intervention periods (p = .06). There was a significant difference between pre-intervention and post-intervention total number of AGT occurrences (129 vs. 25; p value < .01). There was no significant difference between age cohorts for computed difference of RW, ANG, and ANX issues. There was a significant difference between age cohorts for computed difference of AGT (p value = .04) as the 70–85 age cohort showed less agitation compared to the 85–100 age cohort. Conclusion: The use of diffused lavender twice daily has shown to reduce the frequency of agitation in elderly patients with dementia, especially in the 70–85 age cohort. Though diffused lavender did not show statistical differences in the frequency of other behaviors (restlessness/wander, anger, anxiety), the study population may have been too small to find a difference. PMID:28265482

  16. THE ROLE OF THE HEALTH DEPARTMENT IN PROVIDING DAY CARE AND HEALTH SERVICES FOR CHILDREN OF MIGRANTS.

    ERIC Educational Resources Information Center

    SCHLOESSER, PATRICIA; AND OTHERS

    PLANNING AND ORGANIZATION, HEALTH SERVICES FOR CHILDREN, AND EVALUATION OF THE PROGRAM WERE PRESENTED. THE KANSAS BOARD OF HEALTH, THE DEPARTMENT OF SOCIAL WELFARE, THE KANSAS COUNCIL OF CHURCHES, AND THE KANSAS STATE UNIVERSITY CHILD DEVELOPMENT STAFF COMBINED RESOURCES TO CARRY OUT THE PROGRAM. THE TWO STATE AGENCIES PROVIDED THE HEALTH SERVICES…

  17. 75 FR 13441 - Hours of Service; Limited 90-Day Waiver for the Distribution of Anhydrous Ammonia in Agricultural...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-22

    ... the Distribution of Anhydrous Ammonia in Agricultural Operations AGENCY: Federal Motor Carrier Safety... Federal hours- of-service (HOS) regulations for the transportation of anhydrous ammonia from any...-LU) to certain motor carriers engaged in the distribution of anhydrous ammonia during the 2010...

  18. Funny things happen at the Grange: introducing comedy activities in day services to older people with dementia--innovative practice.

    PubMed

    Hafford-Letchfield, Trish

    2013-11-01

    This paper shares outcomes from the evaluation of a community project where comedy activities were introduced into a day centre for older people with dementia as a result of a partnership between the day centre, a local university and a specialist comedy provider. Four workshops were provided using improvisatory activities and comedy, as a medium to engage older people in reflecting on aspects of their care environment. The main output resulted in a 30 minute 'mockumentary' of the 'Her Majesty the Queen' visiting the day centre, in the form of a digital reusable learning object to be used by social work and mental health professionals. The evaluation demonstrated some additional outcomes for those involved and highlighted the benefits of laughter and fun in promoting a positive climate.

  19. Evaluation of in vivo genotoxicity by thioacetamide in a 28-day repeated-dose liver micronucleus assay using male young adult rats.

    PubMed

    Sui, Hajime; Matsumoto, Hirotaka; Wako, Yumi; Kawasako, Kazufumi

    2015-03-01

    The repeated-dose liver micronucleus (RDLMN) assay has the potential to detect liver carcinogens and can be integrated into general toxicological studies. In this study, thioacetamide (TAA) was tested in 14- and 28-day RDLMN assays to assess the performance of the assay. The test substance, TAA, was administered orally to 6-week-old male Crl:CD (SD) rats once daily for 14 or 28 days at a dosage of 5, 10 or 20mg/kg/day. Hepatocytes were collected approximately 24h after the last TAA administration, and the incidence of micronuclei was assessed. In this study, bone marrow micronucleus assays were also conducted in the same animals. The 14- and 28-day RDLMN assays indicated that none of the TAA dosages significantly increased the proportion of micronucleated hepatocytes. Bone marrow micronucleus assays with TAA also provided negative results. It is known that TAA is a liver carcinogen in mice and rats. In the previous genotoxic studies, the Ames test and the chromosomal aberration test using CHL/IU cells have yielded negative results [1-4]. The liver micronucleus assay using young adult rats singly dosed with TAA (75 and 150mg/kg) also produced negative results [5]. TAA gave positive results only in the mouse bone marrow micronucleus assays [6,7].

  20. The Impact of Day-Care Services on the Education of Secondary and Adult Students in Ohio.

    ERIC Educational Resources Information Center

    Hill, Ann Marie; Bragg, Debra D.

    The incidence of pregnancy among young teenagers has increased dramatically in the past several decades. Young single mothers are much more likely than others to leave school before graduation and to be unemployed and poor. This study was conducted to identify differences in completion, school attendance rates, and grades for secondary and adult…

  1. Interactive television for an urban adult mental health service: the Guy's Psychiatric Intensive Care Unit Telepsychiatry Project.

    PubMed

    Haslam, R; McLaren, P

    2000-01-01

    We carried out a feasibility study of an interactive television (IATV) system to enhance the provision of psychiatric intensive care services to a remote adult acute psychiatric ward in the same National Health Service mental health trust. The system used videoconferencing equipment connected by ISDN at 128 kbit/s. The system was used for patient referral, assessment and monitoring by staff at the remote site 8 km away.

  2. Adult-Derived Human Liver Stem/Progenitor Cells Infused 3 Days Postsurgery Improve Liver Regeneration in a Mouse Model of Extended Hepatectomy.

    PubMed

    Herrero, Astrid; Prigent, Julie; Lombard, Catherine; Rosseels, Valérie; Daujat-Chavanieu, Martine; Breckpot, Karine; Najimi, Mustapha; Deblandre, Gisèle; Sokal, Etienne M

    2017-02-16

    There is growing evidence that cell therapy constitutes a promising strategy for liver regenerative medicine. In the setting of hepatic cancer treatments, cell therapy could prove a useful therapeutic approach for managing the acute liver failure that occurs following extended hepatectomy. In this study, we examined the influence of delivering adult-derived human liver stem/progenitor cells (ADHLSCs) at two different early time points in an immunodeficient mouse model (Rag2-/-IL2Rγ-/-) that had undergone a 70% hepatectomy procedure. The hepatic mesenchymal cells were intrasplenically infused either immediately after surgery (n = 26) or following a critical 3-day period (n = 26). We evaluated the cells' capacity to engraft at day 1 and day 7 following transplantation by means of human Alu qPCR quantification, along with histological assessment of human albumin and α-smooth muscle actin. In addition, cell proliferation (anti-mouse and human Ki-67 staining) and murine liver weight were measured in order to evaluate liver regeneration. At day 1 posttransplantation, the ratio of human to mouse cells was similar in both groups, whereas 1 week posttransplantation this ratio was significantly improved (p < 0.016) in mice receiving ADHLSC injection at day 3 posthepatectomy (1.7%), compared to those injected at the time of surgery (1%). On the basis of liver weight, mouse liver regeneration was more extensive 1 week posttransplantation in mice transplanted with ADHLSCs (+65.3%) compared to that of mice from the sham vehicle group (+42.7%). In conclusion, infusing ADHLSCs 3 days after extensive hepatectomy improves the cell engraftment and murine hepatic tissue regeneration, thereby confirming that ADHLSCs could be a promising cell source for liver cell therapy and hepatic tissue repair.

  3. The Effects of Service-Learning on College Students’ Attitudes Toward Older Adults

    PubMed Central

    Augustin, Frankline; Freshman, Brenda

    2016-01-01

    The current U.S. healthcare workforce shortage is at crisis levels for providers who specialize in elder care (Harahan, 2011; Kovner, Mezey, & Harrington, 2002). Barriers such as ageism, lack of awareness of the need for workers, and lack of contact with seniors can impact the career choice of young professionals (Gross & Eshbaugh, 2011; Hutchison, Fox, Laas, Matharu, & Urzi, 2010; Lun, 2012). To explore ways to increase the number of students who pursue gerontology and to expand the elder care workforce, the researchers conducted a qualitative content analysis on the impact of service-learning in senior care facilities on students’ attitudes toward older adults. Students with senior contact reported increases in positive perceptions of seniors, discovered their own ageist stereotypes, and developed an interest in a career in elder care. Twenty-one months after the service-learning experience, students were surveyed again with their responses indicating continued positive attitude changes along with professional development demonstrating beneficial long-term effects from the experience. PMID:26679428

  4. Access to oral health care services among adults with learning disabilities: a scoping review

    PubMed Central

    Naseem, Mustafa; Shah, Altaf H; Khiyani, Muhammad Faheem; Khurshid, Zohaib; Zafar, Muhammad Sohail; Gulzar, Shabnam; AlJameel, AlBandary H.; Khalil, Hesham S.

    2016-01-01

    Summary Background The prevalence of oral diseases including dental caries and periodontal conditions is remarkably higher in people with disabilities. The provision of accessible oral health services for people with learning disabilities may be challenging. Objectives The objectives of the review were to identify barriers in accessing oral health care that persists within society, enabling or disabling people with learning disabilities. Methods Using the Arksey O’Malley framework, a scoping review was conducted on PubMed/Medline, OVIDSP, and EMBASE. Studies were evaluated and short-listed based on the inclusion criteria, which consisted of: (1) study participants or population with learning disabilities, (2) aged 16 years or over, (3) reporting on access to oral health services, (4) published in the English language. Those that justified the inclusion criteria were carefully chosen after a blind peer-reviewed process when relevance and quality were debated. Results Nine studies were eventually included from searches. Tabulation of data was done under the heading of study type, outcomes, the year of publication and patient selection. The majority of studies provided a biomedical overview of access for adults with learning disabilities. Conclusions The concept of access for people with disability is still ill-defined and obscure. Access to oral health care and needs of people with learning disabilities are complex and multi-facet. PMID:28149451

  5. The reliability of the quantitative timed up and go test (QTUG) measured over five consecutive days under single and dual-task conditions in community dwelling older adults.

    PubMed

    Smith, Erin; Walsh, Lorcan; Doyle, Julie; Greene, Barry; Blake, Catherine

    2016-01-01

    The timed up and go (TUG) test is a commonly used assessment in older people with variations including the addition of a motor or cognitive dual-task, however in high functioning older adults it is more difficult to assess change. The quantified TUG (QTUG) uses inertial sensors to detect test and gait parameters during the test. If it is to be used in the longitudinal assessment of older adults, it is important that we know which parameters are reliable and under which conditions. This study aims to examine the relative reliability of the QTUG over five consecutive days under single, motor and cognitive dual-task conditions. Twelve community dwelling older adults (10 females, mean age 74.17 (3.88)) performed the QTUG under three conditions for five consecutive days. The relative reliability of each of the gait parameters was assessed using intra-class correlation coefficient (ICC 3,1) and standard error of measurement (SEM). Five of the measures demonstrated excellent reliability (ICC>0.70) under all three conditions (time to complete test, walk time, number of gait cycles, number of steps and return from turn time). Measures of variability and turn derived parameters demonstrated weak reliability under all three conditions (ICC=0.05-0.49). For the most reliable parameters under single-task conditions, the addition of a cognitive task resulted in a reduction in reliability suggesting caution when interpreting results under these conditions. Certain sensor derived parameters during the QTUG test may provide an additional resource in the longitudinal assessment of older people and earlier identification of falls risk.

  6. 76 FR 17734 - 30-Day Notice of Proposed Information Collection: Form DS-1998E, Foreign Service Officer Test...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-30

    .... Originating Office: Human Resources, HR/REE/BEX. Form Number: DS-1998E. Respondents: Registrants for the... information collection request to the Office of Management and Budget (OMB) for ] approval in accordance with... Office of Management and Budget (OMB) for up to 30 days from March 30, 2011. ADDRESSES: Direct...

  7. Parent Choice of Day Care Services: A Statistical Study of the Amount and Type of Care Used.

    ERIC Educational Resources Information Center

    Moore, John C., Jr.

    Selected findings and policy implications from a statistical study of the amount and type of day care used by a national sample of parents are presented in this paper. For the analysis of hours used, the sample consisted of families (n=2,149) reporting use of at least one hour of care per week for whom complete data sets were available. For…

  8. Day to Day

    ERIC Educational Resources Information Center

    Jurecki, Dennis

    2006-01-01

    A clean, healthy and safe school provides students, faculty and staff with an environment conducive to learning and working. However, budget and staff reductions can lead to substandard cleaning practices and unsanitary conditions. Some school facility managers have been making the switch to a day-schedule to reduce security and energy costs, and…

  9. Rationale for periodic reporting on the use of adult clinical preventive services of public health priority--United States.

    PubMed

    Coates, Ralph J; Yoon, Paula W; Zaza, Stephanie; Ogden, Lydia; Thacker, Stephen B

    2012-06-15

    This supplement introduces a CDC initiative to monitor and report periodically on the use of a set of selected clinical preventive services in the U.S. adult population in the context of recent national initiatives to improve access to and use of such services. Increasing the use of these services has the potential to lead to substantial reductions in the burden of illness, death, and disability and to lower treatment costs. The majority of clinical preventive services are provided by the health-care sector, and public health agencies play important roles in helping to support increases in the use of these services (e.g., by identifying and implementing policies that are effective in increasing use of the services and by collaborating with stakeholders to conduct programs to improve use). Recent health reform initiatives, including efforts to increase the accessibility and affordability of preventive services, fund community prevention programs, and improve the use of health information technologies, offer opportunities to enhance use of preventive services. This supplement provides baseline information on a set of selected clinical preventive services before implementation of these recent reforms and discusses opportunities to increase the use of such services. This information can help public health practitioners collaborate with other stakeholders that have key roles to play in improving public health (e.g., employers, health plans, health professionals, and voluntary associations), understand the potential benefits of the recommended services, address the problem of underuse, and identify opportunities to apply effective strategies to improve use and foster accountability among stakeholders.

  10. Neighbourhood Deprivation, Health Inequalities and Service Access by Adults with Intellectual Disabilities: A Cross-Sectional Study

    ERIC Educational Resources Information Center

    Cooper, S. A.; McConnachie, A.; Allan, L. M.; Melville, C.; Smiley, E.; Morrison, J.

    2011-01-01

    Background: Adults with intellectual disabilities (IDs) experience health inequalities and are more likely to live in deprived areas. The aim of this study was to determine whether the extent of deprivation of the area a person lives in affects their access to services, hence contributing to health inequalities. Method: A cross-sectional study…

  11. Developing Cultural Competency in Adult Pre-Service Teachers Helps Diverse Learners: Graduates' Perspectives in the United States of America

    ERIC Educational Resources Information Center

    Lonnquist, Peg; RB-Banks, Yvonne; Huber, Katie

    2009-01-01

    This study reports the results of an electronic survey and two focus groups that included former Master of Arts in Teaching (MAT), students who took a required multicultural education course. As instructors in a pre-service teaching program for adult learners, we used a matrix of relevant materials to promote cultural competency within the…

  12. A Survey of Library Services to Children and Young Adults in Selected Developing Countries in Africa and Asia.

    ERIC Educational Resources Information Center

    Craver, Kathleen W.

    1985-01-01

    Review of developments in children and young adult library services since 1979 discusses three factors that complicate methods used to combat illiteracy problem: population growth, language, and undeveloped readership. Countries studied are Libya, Kenya, Tanzania, Angola, Zambia, Zimbabwe, Ghana, Nigeria, Gambia, Thailand, Singapore, Philippines,…

  13. Group Training of Applied Behavior Analysis (ABA) Knowledge Competencies to Community-Based Service Providers for Adults with Developmental Disabilities

    ERIC Educational Resources Information Center

    Luiselli, James K.; St. Amand, CarrieAnne; MaGee, Christine; Sperry, James M.

    2008-01-01

    We describe a training program to teach applied behavior analysis (ABA) knowledge competencies to paraprofessional staff (N = 47) at a habilitation services agency for adults with developmental disabilities. Before and following training, staff completed assessment of knowledge tests for three content areas: basic learning principles,…

  14. In-Service Training for Staffs of Group Homes and Work Activity Centers Serving Developmentally Disabled Adults

    ERIC Educational Resources Information Center

    Gage, Mary Ann; Fredericks, H. D. Bud; Johnson-Dorn, Nancy; Lindley-Southard, Barbara

    2009-01-01

    Results are reported for 3 years of in-service training provided to managers and direct care personnel employed in community, residential, and vocational programs for developmentally disabled adults. The data demonstrate the efficacy of the training model in that 1015 (97%) of 1080 training objectives attempted were completed by the trainees at…

  15. Using Information To Improve Services to Minnesota Youth with Disabilities in Transition from School to Adult Life.

    ERIC Educational Resources Information Center

    Thompson, James R.

    This report summarizes the discussion and recommendations of a symposium which focused on issues addressing the collection, sharing, and use of information to improve transition services and supports to youth and young adults with disabilities. Participants included representatives from state agencies, advocates, family members, and Community…

  16. Water Intake in a Sample of Greek Adults Evaluated with the Water Balance Questionnaire (WBQ) and a Seven-Day Diary

    PubMed Central

    Athanasatou, Adelais; Malisova, Olga; Kandyliari, Aikaterini; Kapsokefalou, Maria

    2016-01-01

    Awareness on the importance of hydration in health has created an unequivocal need to enrich knowledge on water intake of the general population and on the contribution of beverages to total water intake. We evaluated in the past water intake in a sample of Greek adults using two approaches. In study A, volunteers completed the Water Balance Questionnaire (WBQ), a food frequency questionnaire, designed to evaluate water intake (n = 1092; 48.1% males; 43 ± 18 years). In study B, a different population of volunteers recorded water, beverage, and food intake in seven-day diaries (n = 178; 51.1% males; 37 ± 12 years). Herein, data were reanalyzed with the objective to reveal the contribution of beverages in total water intake with these different methodologies. Beverage recording was grouped in the following categories: Hot beverages; milk; fruit and vegetable juices; caloric soft drinks; diet soft drinks; alcoholic drinks; other beverages; and water. Total water intake and water intake from beverages was 3254 (SE 43) mL/day and 2551 (SE 39) mL/day in study A; and 2349 (SE 59) mL/day and 1832 (SE 56) mL/day in study B. In both studies water had the highest contribution to total water intake, approximately 50% of total water intake, followed by hot beverages (10% of total water intake) and milk (5% of total water intake). These two approaches contribute information on water intake in Greece and highlight the contribution of different beverages; moreover, they point out differences in results obtained from different methodologies attributed to limitations in their use. PMID:27626443

  17. Actual use of and satisfaction associated with rollators and "shopping carts" among frail elderly Japanese people using day-service facilities.

    PubMed

    Kitajima, Eiji; Moriuchi, Takefumi; Iso, Naoki; Sagari, Akira; Kikuchi, Yasuyuki; Higashi, Toshio

    2016-04-06

    Purpose This study aimed at clarifying the actual use of and satisfaction with rollators and "shopping carts" (wheeled walkers with storage) among frail elderly people, who were certified by a long-term care insurance system as users of facilities that provide day-service nursing care and rehabilitation. Methods We identified 1247 frail elderly people who used day-service facilities, and evaluated their actual use of, and satisfaction with, rollators and shopping carts. Results Forty-four (3.5%) individuals used rollators, and 53 (4.3%) used shopping carts. The shopping cart group contained more individuals who were certified as care level 1 (26.4%), than the rollator group (20.5%), and 52.8% of the shopping cart group was certified as care levels 1-3. The scores for "repairs and services" and "follow-up" from the Quebec User Evaluation of Satisfaction with assistive Technology second version (QUEST 2.0) survey were significantly higher in the rollator group than in the shopping cart group. Conclusions The QUEST 2.0 scores revealed that shopping cart users exhibit insufficient "repairs and services" and "follow-up" scores. As frail elderly people with poor care status accounted for >50% of the shopping cart group, these individuals urgently need walking aids that are tailored to their care status. Implications for Rehabilitation We conclude that walking aid fitting must be tailored to each persons care status, and suggest that a system should be established to allow occupational or physical therapists to provide this fitting Moreover, our analysis of the QUEST2.0 service scores revealed that repairs, services, and follow-up are insufficient to meet the needs of shopping cart users.

  18. Initiation of Addiction Treatment and Access to Services: Young Adults' Accounts of Their Help-Seeking Experiences.

    PubMed

    Wagner, Vincent; Bertrand, Karine; Flores-Aranda, Jorge; Acier, Didier; Brunelle, Natacha; Landry, Michel; Brochu, Serge

    2016-12-04

    Substance addiction in young adults is particularly problematic. Yet, much remain at stake in understanding the specifics of this population's access to services. The objective of this study is to explore young adults' initiation of substance misuse treatment. Our study sample was composed of 35 individuals aged 18 to 30 with problematic psychoactive substance use who have been identified in criminal courts, hospital emergency departments, and Health and Social Services Centers in Québec (Canada). A thematic analysis was performed on the 62 semi-structured interviews conducted with participants. Three components emerged. First, personal elements-expectations, individual motivations, perceptions of use, and capacity to control it-influence initiation of substance misuse treatment. Second, family and peers have noticeable influences. Finally, system characteristics and prior care experiences also shape the process. Consideration should be given to tailor interventions that can reach young adults and encourage them to initiate appropriate care.

  19. Predicting 30- to 120-Day Readmission Risk among Medicare Fee-for-Service Patients Using Nonmedical Workers and Mobile Technology

    PubMed Central

    Ostrovsky, Andrey; O'Connor, Lori; Marshall, Olivia; Angelo, Amanda; Barrett, Kelsy; Majeski, Emily; Handrus, Maxwell; Levy, Jeffrey

    2016-01-01

    Objective Hospital readmissions are a large source of wasteful healthcare spending, and current care transition models are too expensive to be sustainable. One way to circumvent cost-prohibitive care transition programs is complement nurse-staffed care transition programs with those staffed by less expensive nonmedical workers. A major barrier to utilizing nonmedical workers is determining the appropriate time to escalate care to a clinician with a wider scope of practice. The objective of this study is to show how mobile technology can use the observations of nonmedical workers to stratify patients on the basis of their hospital readmission risk. Materials and Methods An area agency on aging in Massachusetts implemented a quality improvement project with the aim of reducing 30-day hospital readmission rates using a modified care transition intervention supported by mobile predictive analytics technology. Proprietary readmission risk prediction algorithms were used to predict 30-, 60-, 90-, and 120-day readmission risk. Results The risk score derived from the nonmedical workers' observations had a significant association with 30-day readmission rate with an odds ratio (OR) of 1.12 (95 percent confidence interval [CI], 1 .09–1.15) compared to an OR of 1.25 (95 percent CI, 1.19–1.32) for the risk score using nurse observations. Risk scores using nurse interpretation of nonmedical workers' observations show that patients in the high-risk category had significantly higher readmission rates than patients in the baseline-risk and mild-risk categories at 30, 60, 90, and 120 days after discharge. Of the 1,064 elevated-risk alerts that were triaged, 1,049 (98.6 percent) involved the nurse care manager, 804 (75.6 percent) involved the patient, 768 (72.2 percent) involved the health coach, 461 (43.3 percent) involved skilled nursing, and 235 (22.1 percent) involved the outpatient physician in the coordination of care in response to the alert. Discussion The predictive

  20. Anxiety sensitivity in relation to quit day dropout among adult daily smokers recruited to participate in a self-guided cessation attempt.

    PubMed

    Langdon, Kirsten J; Farris, Samantha G; Hogan, Julianna B D; Grover, Kristin W; Zvolensky, Michael J

    2016-07-01

    Anxiety sensitivity (AS; fear of anxiety and internal sensations) has been implicated in a variety of aspects of smoking, including difficulties achieving and maintaining abstinence during tobacco cessation. However, research has yet to evaluate whether AS impacts premature termination of initiating a quit attempt. Therefore, the aim of the present investigation was to explore the extent to which AS was associated with tobacco cessation dropout, as indexed by attendance on the scheduled quit day visit. Participants included 84 adult daily cigarette smokers (61.7% male; Mage=34.6years, SD=13.9), who were recruited to participate in a self-guided quit attempt (an attempt to quit smoking without professional or pharmacological aid). Results indicated that after controlling for the effects of participant sex, race, current (past month) psychological disorder, cigarettes smoked per day, number of years as a regular smoker, and pre-quit levels of motivation to quit, AS significantly predicted increased odds of study dropout prior to attending the scheduled quit day. These findings suggest that AS may be a mechanism involved with challenges in the initiation of quitting.

  1. 45 CFR Appendix A to Part 96 - Uniform Definitions of Services

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., or drug abuse. 5. Day Care Services—Adults Day care services for adults are those services or.... Component services and activities may include diagnosis and psychological evaluation; alcohol and drug... of personal and family counseling methods, methadone treatment for opiate abusers, or...

  2. Adult Career Counseling Center Nineteenth Annual Report, September 2001-June 2002. Computer-Assisted Career Guidance Systems and Career Counseling Services.

    ERIC Educational Resources Information Center

    Goodman, Jane; Anderson, Mary; Flatter, Brian; Harvey, Jennifer; McCarthy, Kelly; Yousif, Newjen

    The year 2001-02 marks the Adult Career Counseling Center's (ACCC's) nineteenth year of service, during which career advisors saw 102 community clients for over 300 hours of counseling. ACCC provides advising services at no charge for adults who are seeking guidance with career-related issues, including career exploration and planning. The…

  3. Adult Career Counseling Center Eighteenth Annual Report, September 2000-June 2001. Computer-Assisted Career Guidance Systems and Career Counseling Services.

    ERIC Educational Resources Information Center

    Goodman, Jane; Flatter, Brian; Helms, Catherine; Neik, Reetu; Quinn, Kelly

    During its 18 years of service, the Adult Career Counseling Center (ACCC) at Oakland University in Oakland, California, has provided career exploration and planning opportunities to more than 11,000 community adults at no charge. The following were among ACCC's activities in 2000-2001: (1) assisted clients in using the DISCOVER for Adults and…

  4. Mediating effect of Adult Day Health Care (ADHC) and family network on Quality of Life among low-income older Korean immigrants.

    PubMed

    Kim, Bum Jung

    2014-05-01

    The purpose of this study is to examine the direct and indirect effects of Adult Day Health Care (ADHC) and family network on Quality of Life (QOL) for low-income older Korean immigrants in Los Angeles County, CA. A cross-sectional survey of low-income older Korean immigrants who use ADHC programs was conducted. Self-reported measures included sociocultural characteristics, acculturation, cognitive function, family network, utilization of ADHC, and QOL. The study found that for QOL, two variables had only direct effects: years in ADHC and acculturation. Family network was directly associated with QOL and indirectly associated with it through the variable "years in ADHC." Our findings indicate that a strong family network is positively associated with more years of attendance in ADHC, and with higher QOL scores. Thus, policy makers and practitioners should be aware of the positive association among social networks, attendance in ADHC, and higher QOL among low-income older Korean immigrants.

  5. Post-abortion care services for youth and adult clients in Kenya: a comparison of services, client satisfaction and provider attitudes.

    PubMed

    Evens, Emily; Otieno-Masaba, Rose; Eichleay, Margaret; McCarraher, Donna; Hainsworth, Gwyn; Lane, Cate; Makumi, Margaret; Onduso, Pamela

    2014-01-01

    Unsafe abortion accounts for 35% of maternal mortality in Kenya. Post-abortion care (PAC) reduces maternal death and provides an opportunity to prevent unwanted pregnancies. Few studies have documented how the receipt of PAC services varies by client age. In this study, descriptive data were collected from clients, providers and eight health facilities in Kenya's Central and Nairobi provinces to examine receipt of PAC services by client age, client satisfaction and provider attitudes. Delivery of PAC treatment, pain management, HIV and STI services and violence screening did not vary by age. However, fewer youth between the ages of 15 and 24 received a contraceptive method compared with adult clients (35% versus 48%; p=0.02). Forty-nine per cent of youth reported not using a family planning method due to fears of infertility, side-effects or lack of knowledge compared with 22% of adults. Additional efforts are needed in Kenya to bolster the family planning services that young PAC clients receive and increase the uptake of contraception.

  6. Parents in transition: Experiences of parents of young people with a liver transplant transferring to adult services.

    PubMed

    Wright, J; Elwell, L; McDonagh, J E; Kelly, D A; Wray, J

    2017-02-01

    Predictors of successful transition from pediatric to adult services include ability to self-manage and engage with healthcare services. Parents have a key role in healthcare management throughout childhood and adolescence including encouraging development of self-management skills in their children. Transition to adult services can be challenging for parents and young people, yet parents' views regarding transition remain largely unexplored. Nine parents of pediatric liver transplant recipients (15.2-25.1 yr) participated in semistructured interviews. Interviews were analyzed using IPA. Analysis revealed three key themes: "emotional impact of transplantation," "protection vs. independence," and "ending relationships and changing roles." Parents expressed the dichotomous nature of the desire to promote independence in their child while still maintaining control and protection, and discussed how changing roles and relationships were difficult to navigate. Parents are important facilitators of young people's development of self-management skills for successful transfer to adult services. Parents should be supported to move from a "managerial" to a "supervisory" role during transition to help young people engage independently with the healthcare team. Findings support the development of interventions for parents to emphasize their role in transition and guide the transfer of self-management skills from parent to young person.

  7. Not All Large Customers are Made Alike: Disaggregating Response toDefault-Service Day-Ahead Market Pricing

    SciTech Connect

    Hopper, Nicole; Goldman, Charles; Neenan, Bernie

    2006-05-12

    For decades, policymakers and program designers have gone onthe assumption that large customers, particularly industrial facilities,are the best candidates for realtime pricing (RTP). This assumption isbased partly on practical considerations (large customers can providepotentially large load reductions) but also on the premise thatbusinesses focused on production cost minimization are most likely toparticipate and respond to opportunities for bill savings. Yet fewstudies have examined the actual price response of large industrial andcommercial customers in a disaggregated fashion, nor have factors such asthe impacts of demand response (DR) enabling technologies, simultaneousemergency DR program participation and price response barriers been fullyelucidated. This second-phase case study of Niagara Mohawk PowerCorporation (NMPC)'s large customer RTP tariff addresses theseinformation needs. The results demonstrate the extreme diversity of largecustomers' response to hourly varying prices. While two-thirdsexhibitsome price response, about 20 percent of customers provide 75-80 percentof the aggregate load reductions. Manufacturing customers are mostprice-responsive as a group, followed by government/education customers,while other sectors are largely unresponsive. However, individualcustomer response varies widely. Currently, enabling technologies do notappear to enhance hourly price response; customers report using them forother purposes. The New York Independent System Operator (NYISO)'semergency DR programs enhance price response, in part by signaling tocustomers that day-ahead prices are high. In sum, large customers docurrently provide moderate price response, but there is significant roomfor improvement through targeted programs that help customers develop andimplement automated load-response strategies.

  8. Old Myths and New Realities: Restructuring Student Services for Adult Learners.

    ERIC Educational Resources Information Center

    Brodzinski, Frederick R.

    Trends in the enrollment of adult students in higher education are examined, and some inappropriate policies and procedures presently in effect at colleges and universities that are obstacles to adult learners are discussed. The demographic picture of the adult student population is presented as are projections for the general population and…

  9. The CABES (Clare Adult Basic Education Service) Framework as a Tool for Teaching and Learning

    ERIC Educational Resources Information Center

    Greene, Moira

    2015-01-01

    This article describes a Framework that can be used to help bridge the gap between theory and practice in adult learning. The Framework promotes practice informed by three strands important to adult literacy work: social theories of literacy, social-constructivist learning theory and principles of adult learning. The Framework shows how five key…

  10. HIV-positive nigerian adults harbor significantly higher serum lumefantrine levels than HIV-negative individuals seven days after treatment for Plasmodium falciparum infection.

    PubMed

    Chijioke-Nwauche, Ifeyinwa; van Wyk, Albert; Nwauche, Chijioke; Beshir, Khalid B; Kaur, Harparkash; Sutherland, Colin J

    2013-09-01

    Management of coinfection with malaria and HIV is a major challenge to public health in developing countries, and yet potential drug-drug interactions between antimalarial and antiviral regimens have not been adequately investigated in people with both infections. Each of the constituent components of artemether-lumefantrine, the first-line regimen for malaria treatment in Nigeria, and nevirapine, a major component of highly active antiretroviral therapy, are drugs metabolized by the cytochrome P450 3A4 isoenzyme system, which is also known to be induced by nevirapine. We examined potential interactions between lumefantrine and nevirapine in 68 HIV-positive adults, all of whom were diagnosed with asymptomatic Plasmodium falciparum infections by microscopy. Post hoc PCR analysis confirmed the presence of P. falciparum in only a minority of participants. Day 7 capillary blood levels of lumefantrine were significantly higher in HIV-positive participants than in 99 HIV-negative controls (P = 0.0011). Associations between day 7 levels of lumefantrine and risk of persistent parasitemia could not be evaluated due to inadequate power. Further investigations of the impact of nevirapine on in vivo malaria treatment outcomes in HIV-infected patients are thus needed.

  11. Insolation data manual: long-term monthly averages of solar radiation, temperature, degree-days and global anti K/sub T/ for 248 national weather service stations

    SciTech Connect

    Knapp, C L; Stoffel, T L; Whitaker, S D

    1980-10-01

    Monthly averaged data is presented which describes the availability of solar radiation at 248 National Weather Service stations. Monthly and annual average daily insolation and temperature values have been computed from a base of 24 to 25 years of data. Average daily maximum, minimum, and monthly temperatures are provided for most locations in both Celsius and Fahrenheit. Heating and cooling degree-days were computed relative to a base of 18.3/sup 0/C (65/sup 0/F). For each station, global anti K/sub T/ (cloudiness index) were calculated on a monthly and annual basis. (MHR)

  12. Effects of different degrees of insulin resistance on endothelial function in obese adults undergoing alternate day fasting.

    PubMed

    Hoddy, Kristin K; Bhutani, Surabhi; Phillips, Shane A; Varady, Krista A

    2016-10-27

    BACKGROUND: Obesity can have deleterious effects on insulin sensitivity leading to endothelial dysfunction. Whether alternate day fasting (ADF) can ameliorate insulin sensitivity in a way that improves endothelial function remains unknown. OBJECTIVE: This study examined the impact of ADF on endothelium dependent flow mediated dilation (FMD) in obese subjects with different degrees of insulin resistance. METHODS: Obese non-diabetic adults (n = 54) participated in an 8-week ADF protocol (25% energy intake "fast day", alternated with ad libitum intake "feast day"). Subjects were divided into tertiles according to degree of insulin resistance based on HOMA-IR (Homeostatic model assessment-Insulin resistance): tertile 1 (0.8-2.4), tertile 2 (2.5-3.6), tertile 3 (3.7-12.4). RESULTS: Body weight decreased (P < 0.001) by 4% in each tertile. Fat mass, lean mass, and visceral fat mass also decreased (P < 0.001) similarly in each tertile. After 8 weeks of ADF, FMD and adiponectin differed (P < 0.05) between tertile 1 (3±0%; 26±23%) versus tertile 3 (-3±0%; -13±10%). Changes in leptin did not differ between tertiles (tertile 1: -23±7%; tertile 2: -20±7%; tertile 3: -9±7%). Fasting glucose did not change in any tertile. Fasting insulin and HOMA-IR differed (P < 0.05) between tertile 1 (10±11%; 11±11%) versus tertile 3 (-27±8%; -30±9%). Plasma lipids, blood pressure and heart rate did not change in any tertile. CONCLUSION: Our data suggest that ADF may be effective for decreasing insulin resistance in insulin resistant subjects, but these changes have no effect on endothelial function.

  13. Header: Do adult DTC programs prevent child maltreatment? Parental criminal justice involvement and children’s involvement with child protective services: Do adult drug treatment courts prevent child maltreatment?

    PubMed Central

    Eldred, Lindsey M.; Sloan, Frank A.; Evans, Kelly E.

    2016-01-01

    Background In light of evidence showing reduced criminal recidivism and cost savings, adult drug treatment courts have grown in popularity. However, the potential spillover benefits to family members are understudied. Objectives To examine: 1) the overlap between parents who were convicted of a substance-related offense and their children’s involvement with child protective services (CPS); and 2) whether parental participation in an adult drug treatment court program reduces children’s risk for CPS involvement. Methods Administrative data from North Carolina courts, birth records, and social services were linked at the child level. First, children of parents convicted of a substance-related offense were matched to (a) children of parents convicted of a non-substance-related offense and (b) those not convicted of any offense. Second, we compared children of parents who completed a DTC program with children of parents who were referred but did not enroll, who enrolled for <90 days but did not complete, and who enrolled for 90+ days but did not complete. Multivariate logistic regression was used to model group differences in the odds of being reported to CPS in the one to three years following parental criminal conviction or, alternatively, being referred to a DTC program. Results Children of parents convicted of a substance-related offense were at greater risk of CPS involvement than children whose parents were not convicted of any charge, but DTC participation did not mitigate this risk. Conclusion/Importance The role of specialty courts as a strategy for reducing children’s risk of maltreatment should be further explored. PMID:26789656

  14. Prevalence of co-occurring alcohol and other drug use in an Australian older adult mental health service.

    PubMed

    Searby, Adam; Maude, Phil; McGrath, Ian

    2016-04-01

    Co-occurring mental illness and substance use disorder, known as dual diagnosis, is a significant challenge to mental health services. Few older adult specific alcohol and other drug treatment services exist, meaning older adult mental health services may become the default treatment option for many. Evidence suggests that dual diagnosis leads to substandard treatment outcomes, including higher rates of psychiatric relapse, higher costs of care and poorer treatment engagement. This paper explores the prevalence of co-occurring alcohol and other drug (AOD) use in an older adult community mental health service in inner Melbourne, Australia. This aim was accomplished by using a retrospective file audit of clinical intake assessments (n = 593) performed on consumers presenting to the service over a two-year period, June 2012-2014. Of consumers presenting to the service, 15.5% (n = 92) were assessed by clinicians as having co-occurring AOD use. Depression predominated in the dual diagnosis group as the primary mental health disorder. Dual diagnosis consumers in this sample were statistically more likely to be male and younger than their non-dual diagnosis counterparts. A limitation of this audit was the lack of implementation of screening tools, leaving assessment to clinical judgement or the interest of the clinician. This may also explain the discrepancy between the results of this study and previous work. Although appearing to be a relatively small percentage of assessments, the results accounted for 92 individuals with complex mental health, AOD and medical issues. Poor screening procedures in a population that is traditionally difficult to assess need to be rectified to meet the future challenges inherent in the ageing baby boomer generation, changing drug use trends and extended lifespans through harm reduction initiatives and medical advancements.

  15. Working with LGBT older adults: an assessment of employee training practices, needs, and preferences of senior service organizations in Minnesota.

    PubMed

    Moone, Rajean P; Cagle, John G; Croghan, Catherine F; Smith, Jennifer

    2014-01-01

    As the population ages and LGBT older adults become more visible among senior service providers, the need for cultural competency training will grow. Although this training is a relatively new phenomenon, curricula exist. These are generally in person for 2- to 8-hr durations. Training to Serve embarked on a study to investigate preferences in cultural competency format and duration. One-hundred and eighty-four Minnesota service providers participated in the online survey. The majority (90%) were interested in participating in LGBT cultural competency training. Results suggest a preference for shorter duration and online formats. Implications for curricula development and future research are included.

  16. Food Avoidance and Food Modification Practices of Older Rural Adults: Association With Oral Health Status and Implications for Service Provision

    PubMed Central

    Quandt, Sara A.; Chen, Haiying; Bell, Ronny A.; Savoca, Margaret R.; Anderson, Andrea M.; Leng, Xiaoyan; Kohrman, Teresa; Gilbert, Gregg H.; Arcury, Thomas A.

    2010-01-01

    Purpose: Dietary variation is important for health maintenance and disease prevention among older adults. However, oral health deficits impair ability to bite and chew foods. This study examines the association between oral health and foods avoided or modified in a multiethnic rural population of older adults. It considers implications for nutrition and medical service provision to this population. Design and Methods: In-home interviews and oral examinations were conducted with 635 adults in rural North Carolina counties with substantial African American and American Indian populations. Avoidance and modification data were obtained for foods representing different dental challenges and dietary contributions. Data were weighted to census data for ethnicity and sex. Bivariate analyses of oral health measures and foods avoided used chi-square and logistic regression tests. Multivariable analyses used proportional odds or nominal regression models. Results: Whole fruits and raw vegetables were the most commonly avoided foods; substantial proportions of older adults also avoided meats, cooked vegetables, and other foods. Food avoidance was significantly associated with self-rated oral health, periodontal disease, bleeding gums, dry mouth, having dentures, and having fewer anterior and posterior occlusal contacts. Associations persisted when controlling for demographic and socioeconomic status indicators. From 24% to 68% of participants reported modifying specific fruits, vegetables, and meats. Modifying harder foods was related to location of teeth and periodontal disease and softer foods to oral pain and dry mouth. Implications: Food services for older adults should consider their oral health status. Policy changes are needed to provide oral health care in benefits for older adults. PMID:19574543

  17. Continuity of care from child and adolescent to adult mental health services: evidence from a regional survey in Northern Italy.

    PubMed

    Stagi, Paolo; Galeotti, Simona; Mimmi, Stefano; Starace, Fabrizio; Castagnini, Augusto C

    2015-12-01

    To examine clinical and demographic factors associated with continuity of care from child-adolescent (CAMHS) to adult mental health services (AMHS), we undertook a record-linkage study to the Adult Mental Health Information System including all those 16 years old and over who were listed between 2010 and 2013 in the Child and Adolescent Neuropsychiatry Information System in Emilia-Romagna, an Italian region of nearly 4.5 million residents. From a cohort of 8239 adolescents attending CAMHS (population at risk about 144,000), 821 (19.4 %) moved to AMHS, excluding cases with specific developmental disorders, whose conditions were not managed by adult psychiatrists, and those with mental retardation who attended usually social services. Young people referred for treatment to AMHS were more likely to receive a discharge diagnosis of schizophrenia and related disorders (Odds Ratio [OR] 3.92; 95 % confidence interval [CI] 2.17-7.08), personality disorders (OR 2.69; 95 % CI 1.89-3.83), and pervasive developmental disorders (OR 2.13; 95 % CI 1.51-2.99). Further factors predicting transfer to AMHS were not living with parents, inpatient psychiatric admission, and being on medication in the previous 24 months. These findings suggest that a relatively small number of adolescents moved to AMHS and are likely to reflect the configuration of local mental health services and alternative care available, mainly for those with less-severe mental disorders.

  18. Hennepin County Grant Purchase of Child Day Care through a Voucher System: An Evaluation and Use of Technology (Transfer and Technical Assistance to Enhance Service Delivery (with Exeuctive Summary). Final Report.

    ERIC Educational Resources Information Center

    Scoll, Barbara; Engstrom, Roger

    In January of 1982, the Hennepin County Community Services Department began implementing a day care voucher system which allowed day care clients to place their children in any licensed day care home or center that was willing to contract with Hennepin County. In October of the same year, Hennepin County was awarded a grant by the Department of…

  19. Service utilization among older adults with HIV: the joint association of sexual identity and gender.

    PubMed

    Brennan-Ing, Mark; Seidel, Liz; London, Andrew S; Cahill, Sean; Karpiak, Stephen E

    2014-01-01

    This study examines the association of sexual identity and gender among older clients with HIV at an AIDS service organization using the Andersen Model. Data confirm those aging with HIV exhibit high rates of age-associated illnesses 10 to 20 years before expected. They have fragile social networks that cannot supply the informal supports needed. This aging population will need to increasingly access community-based services. Sexual identity and gender were weak covariates of service utilization. Although heterosexual men used more services, utilization was largely predicted by service needs and the use of case management. Implications for service delivery and policy are discussed.

  20. Strongyloides ratti: transplantation of adults recovered from the small intestine at different days after infection into the colon of naive and infection-primed Wistar rats, and the effect of antioxidant treatment on large intestinal parasitism.

    PubMed

    Shintoku, Y; Takagi, H; Kadosaka, T; Nagaoka, F; Kondo, S; Itoh, M; Honda, S; Kimura, E

    2011-07-01

    Strongyloides ratti (Nagoya strain) is unique in that a portion of adults parasitizing the small intestine withstands 'worm expulsion', which starts at around day 8 post-infection (p.i.) by host immunity, and establishes in the large intestine after day 19 p.i. To investigate the mechanism, adults obtained from the small intestine at day 7 or 19 p.i. were transplanted into the colon of infection-primed immune rats. Adults obtained at day 7 p.i. were rejected quickly, whereas those obtained at day 19 p.i. could establish infection. Moreover, the body length and the number of intrauterine eggs increased in the large intestine. In a separate experiment, large intestinal parasitism was abolished by the treatment of host rats with an anti-oxidant, butylated hydroxyanisole. These results indicate that small intestinal adults between days 7 and 19 p.i. acquired the ability to parasitize the large intestine of immune rats, and that free radicals produced by the host may have played a significant role in the process.

  1. Referral Trends in Mental Health Services for Adults with Intellectual Disability and Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Tsakanikos, Elias; Sturmey, Peter; Costello, Helen; Holt, Geraldine; Bouras, Nick

    2007-01-01

    Researchers have paid increasing attention to mental health issues in adults with autism spectrum disorders (ASDs) over the last decades. However, little is known about how rates of clinical referrals, types of mental health diagnoses and treatment in adults with ASDs and intellectual disability have changed. We examined patterns of change in…

  2. Federal Support for Adult Education: 1969 Directory of Programs and Services.

    ERIC Educational Resources Information Center

    Adult Education Association of U.S.A., Washington, DC.

    This directory lists the agencies of the Federal Government that support or are engaged in adult or continuing education. It consists chiefly of capsule descriptions of programs administered by those agencies that provide support or resources of various kinds for the field of adult education. Furthermore, it provides information about agencies not…

  3. Factors Affecting Burnout when Caring for Older Adults Needing Long Term Care Services in Korea

    ERIC Educational Resources Information Center

    Won, Seojin; Song, Inuk

    2012-01-01

    The purpose of this study was to address factors related to caregiver burnout as a result of caring for an older adult with a chronic disease. Characteristics of care recipients and caregivers as well as social support were included to identify the relationships with caregiver burnout. The analysis was based on a sample of 334 older adults and…

  4. Developing a Curriculum in Response to Change. OPTIONS. Expanding Educational Services for Adults.

    ERIC Educational Resources Information Center

    Samuelson, Judith A.; And Others

    This guide is intended to assist adult educators in designing and adapting curricula to conform to technological changes in the workplace and to meet the learning needs of adults. The first part deals with the changing workplace and its effect on postsecondary education and with developing programs that respond to change (responses to…

  5. Formulating a Serious-Games Design Project for Adult Offenders with the Probation Service

    ERIC Educational Resources Information Center

    Bates, Matthew Ian; Brown, David; Cranton, Wayne; Lewis, James

    2011-01-01

    This paper documents an investigation evaluating if adult offenders can benefit from a facilitated serious-games design project as part of their probation program. Research has observed a participatory design group of adult offenders working with their probation managers and a PhD researcher to create a new serious-game for use by the probation…

  6. Characteristics of Adult Students Transitioning to a Traditional University and Perceptions of Student Services

    ERIC Educational Resources Information Center

    Rollins, Dani J.

    2012-01-01

    Limited research is devoted to the transitional process of adult students to the traditional university environment. Considering the incredible numbers of adults projected to return to higher education and/or entering a college or university program for the first time, it behooves institutions of higher learning to invest in the success of adult…

  7. Understanding Mealtime Changes for Adults with Cerebral Palsy and the Implications for Support Services

    ERIC Educational Resources Information Center

    Balandin, Susan; Hemsley, Bronwyn; Hanley, Leah; Sheppard, Justine Joan

    2009-01-01

    Background: Changes in the swallowing capabilities of adults with cerebral palsy as they age may impact on their health, safety, and well-being. Method: Thirty-two adults with cerebral palsy aged between 30 and 69 years participated in in-depth interviews about their experiences of changes in their swallowing and related management of their…

  8. Tierra de Oportunidad Implementation Handbook. LAES: Latino Adult Education Services Project.

    ERIC Educational Resources Information Center

    Kissam, Ed; Dorsey, Holda

    This handbook is intended to help administrators and instructors of adult basic education and English-as-a-Second-Language programs use the 30 Tierra de Oportunidad (Land of Opportunity) instructional modules, which address four strands or clusters relating to the different major domains in which adults function: work life, family life, community,…

  9. Five-day, low-level laser therapy for sports-related lower extremity periostitis in adult men: a randomized, controlled trial.

    PubMed

    Chang, Cheng-Chiang; Ku, Chih-Hung; Hsu, Wei-Chun; Hu, Yu-An; Shyu, Jia-Fwu; Chang, Shin-Tsu

    2014-07-01

    Periostitis in the lower leg caused by overexercise is a universal problem in athletes and runners. The purpose of this study was to observe the functional improvement of the lower limbs upon rehabilitation low-level laser therapy (LLLT). All medical data were gathered from enrolled adults with sports-related lower leg pain. A total of 54 patients underwent triple-phase bone scans using skeletal nuclear scintigraphy, which confirmed periostitis in their lower limbs. The patients were then randomly divided into two groups: one group received laser therapy (N = 29) and the other group (N = 25) received an equivalent placebo treatment (a drug or physical therapy). Treatment protocol commenced with rehabilitation intervention and LLLT was performed three times daily for 5 days at a dosage of 1.4 J/cm(2). A Likert-type pain scale was used to evaluate the severity of pain. Balance function, including postural stability testing (PST) and limits of stability (LOS), was also performed to evaluate the function outcome. Patients experienced a significant improvement in pain by day 2 or day 5 after starting LLLT, but here was no significant difference in pain scale between the measurements before (baseline) and after LLLT. Comparing the PST, the group differences of dynamic vs. static testings ranged from -18.54 to -50.22 (compared 12, 8, 4, 3, 2, 1 to 0, all p < 0.0001), and the PST after LLLT were 3.73 units (p = 0.0258) lower than those of before LLLT. Comparing the LOS, the group differences of dynamic vs. static testing were similar to those in PST, and the relationship between LOS and groups only varied with the direction control during dynamic testing in direction at backward/right vs. right (p < 0.0001). LLLT had a positive effect on proprioception in patients with lower limb periostitis. Larger, better controlled studies are needed to determine what specific effects LLLT has on the function of proprioception.

  10. Does Service Learning Promote Adult Development? Theoretical Perspectives and Directions for Research

    ERIC Educational Resources Information Center

    Smith, M. Cecil

    2008-01-01

    Service learning is one of the most pervasive education innovations of the past generation and has demonstrated much success in connecting schooling with community service. Service learning is designed to be integrated into, and enhance, the academic curriculum. It is believed, and there is growing evidence to show, that participation in service…

  11. Maghrebi minors as translators in health services in Tarragona (Spain): a qualitative study of the discourse of the Maghrebi adults

    PubMed Central

    2014-01-01

    Background In the province of Tarragona (Spain), 24% of immigrants come from countries in the Maghreb. 40% of Maghrebis residing in Spain say their linguistic command of Spanish is inadequate, which could hinder their relationship with healthcare professionals. The use of minors as translators by health services is a fairly common practice. The suitability of using children as translators has been questioned, although there has been little specific research on the subject and most has been from the perspective of professionals. The aim of this study was to qualitatively analyze the discourse of Maghrebi adults to the use of Maghrebi minors as translators in the health services. Methods A qualitative study using 12 in-depth interviews and 10 focus groups with Maghrebi adults living in Tarragona. The scope of the study was primary healthcare and hospital services in the area. A content analysis was performed using open coding. Results The practice studied is attributed to a lack of funding for translation resources, and prioritization of adults’ work over children’s education. It is seen as a convenient solution to the community’s communication problems, although it is considered unreliable and detrimental to the rights of the child. The attitudes of healthcare professionals to the phenomenon studied varies from acceptance without any ethical concerns to concern about its effects on the child. The solutions proposed are the organization of translation resources with a proactive approach which are adapted to real needs, and a change in the focus of language training activities for the adults in the community. Conclusions It is necessary to reconcile access to healthcare for Maghrebi adults with the rights of children who act as translators in the healthcare context. This requires coordination between health and educational institutions, changes in the organization and provision of translation resources, and a guarantee that immigrants have employment rights

  12. Risk factors for hospital admission in the 28 days following a community-acquired pneumonia diagnosis in older adults, and their contribution to increasing hospitalisation rates over time: a cohort study

    PubMed Central

    Millett, Elizabeth R C; De Stavola, Bianca L; Smeeth, Liam; Thomas, Sara L

    2015-01-01

    Objectives To determine factors associated with hospitalisation after community-acquired pneumonia (CAP) among older adults in England, and to investigate how these factors have contributed to increasing hospitalisations over time. Design Cohort study. Setting Primary and secondary care in England. Population 39 211 individuals from the Clinical Practice Research Datalink, who were eligible for linkage to Hospital Episode Statistics and mortality data, were aged ≥65 and had at least 1 CAP episode between April 1998 and March 2011. Main outcome measures The association between hospitalisation within 28 days of CAP diagnosis (a ‘post-CAP’ hospitalisation) and a wide range of comorbidities, frailty factors, medications and vaccinations. We examined the role of these factors in post-CAP hospitalisation trends. We also looked at trends in post-CAP mortality and length of hospitalisation over the study period. Results 14 comorbidities, 5 frailty factors and 4 medications/vaccinations were associated with hospitalisation (of 18, 12 and 7 considered, respectively). Factors such as chronic lung disease, severe renal disease and diabetes were associated with increased likelihood of hospitalisation, whereas factors such as recent influenza vaccination and a recent antibiotic prescription decreased the odds of hospitalisation. Despite adjusting for these and other factors, the average predicted probability of hospitalisation after CAP rose markedly from 57% (1998–2000) to 86% (2009–2010). Duration of hospitalisation and 28-day mortality decreased over the study period. Conclusions The risk factors we describe enable identification of patients at increased likelihood of post-CAP hospitalisation and thus in need of proactive case management. Our analyses also provide evidence that while comorbidities and frailty factors contributed to increasing post-CAP hospitalisations in recent years, the trend appears to be largely driven by changes in service provision and

  13. Effects of a 10-Day Intensive Health Promotion Program Combining Diet and Physical Activity on Body Composition, Physical Fitness, and Blood Factors of Young Adults: A Randomized Pilot Study.

    PubMed

    Lee, Kyoung Soon; Lee, Jae Koo; Yeun, Young Ran

    2017-04-11

    BACKGROUND A lifestyle characterized by poor eating habits and physical inactivity is a risk factor for multiple lifestyle diseases in young adults. This study assessed the effects of implementing an intensive 10-day health promotion program combining diet and physical activities on body composition, physical fitness, and biochemical parameters of young adults. MATERIAL AND METHODS In this randomized pilot study, 30 female undergraduate students were randomly allocated to an intervention and a control group. The health promotion program consisted of unlimited amounts of vegetarian food; aerobic, flexibility, and strength exercises (3 hours/day); lectures on health (3 hours/day); massage practice (2 hours/day); and healthy cooking practice (1 hour/day). The effects of the intervention were analyzed using the Mann-Whitney U test and the Wilcoxon signed-rank test. RESULTS The intensive 10-day health promotion program significantly reduced body weight, body mass index, triglyceride, total cholesterol, low-density lipoprotein cholesterol, blood glucose, and the homeostasis model assessment of insulin resistance. At the same time, participants demonstrated increased back muscle, leg muscle, and grip strength; waist and shoulder flexibility; balance; and cardiorespiratory endurance. CONCLUSIONS The intensive 10-day health promotion program is a viable intervention for improving body composition, physical fitness, glycemic control, and blood lipid levels in young adults.

  14. 38 CFR 52.130 - Nursing services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Nursing services. 52.130... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.130 Nursing services. The program management must provide an organized nursing service with a sufficient number of qualified nursing...

  15. 38 CFR 52.130 - Nursing services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Nursing services. 52.130... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.130 Nursing services. The program management must provide an organized nursing service with a sufficient number of qualified nursing...

  16. 38 CFR 52.130 - Nursing services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Nursing services. 52.130... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.130 Nursing services. The program management must provide an organized nursing service with a sufficient number of qualified nursing...

  17. 38 CFR 52.130 - Nursing services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Nursing services. 52.130... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.130 Nursing services. The program management must provide an organized nursing service with a sufficient number of qualified nursing...

  18. Maturing out, natural recovery, and dual diagnosis: What are the implications for older adult mental health services?

    PubMed

    Searby, Adam; Maude, Phil; McGrath, Ian

    2015-12-01

    In 1962, Charles Winick proposed that addiction was a self-limiting process, whereby individuals stopped using substances once the stresses of life transitions ceased. The notion of maturing out, as labelled by Winick, often forms the basis of the natural recovery movement in alcohol and other drug (AOD) research, aiding the notion that older individuals either cease their substance use or fall victim to the higher mortality rates prevalent in substance-using populations. As more consumers present to adult mental health treatment settings with co-occurring substance use disorders, the idea that individuals will simply cease using AOD is outdated. Given the future challenges of an ageing population, it is prudent to explore those who fail to mature out of substance use, as well as challenge the notion that older adult mental health services rarely encounter substance-using individuals. The present study explores Winick's research in the context of an ageing population and older adult mental health services. It also ponders the proposition put forth in subsequent research that older individuals with lifelong substance use switch to substances that are easier to obtain and better tolerated by their ageing bodies.

  19. Respite Care as a Community Care Service: Factors Associated with the Effects on Family Carers of Adults with Intellectual Disability in Taiwan

    ERIC Educational Resources Information Center

    Chou, Yueh-Ching; Tzou, Ping-Yi; Pu, Cheng-Yun; Kroger, Teppo; Lee, Wan-Ping

    2008-01-01

    Background: This study examines the effects and associated factors of respite care, which was legislated as a community service for adults with an intellectual disability (ID) in Taiwan in 1997. Method: A total of 116 family carers who live with an adult with ID and have utilised the respite care program were surveyed using standardised measures.…

  20. Phoenix Union High School District #210 Adult Academy Evaluation Report, 1980-81. Research Services Report No. 33:08:80/81:010.

    ERIC Educational Resources Information Center

    Norris, Carol A.; Wheeler, Linda

    The Adult Reading Academy, a federally-funded service of the Phoenix Union High School District, serves native- and foreign-born adult students who are deficient in the basic skills of reading, writing, arithmetic, and oral communication. In 1980/81, the program served 476 students at 17 sites. Approximately 24 percent of the clients served were…

  1. Adult Career Counseling Center Seventeenth Annual Report, September 1999-June 2000. Computer-Assisted Career Guidance Systems and Career Counseling Services.

    ERIC Educational Resources Information Center

    Frick, Brian, Ed.; Naik, Reetu, Ed.; Quinn, Kelly, Ed.; Rancour, Paulette, Ed.

    For 17 years, the Adult Career Counseling Center (ACCC) at Oakland University in Rochester, Michigan, has provided computer-assisted career guidance systems and career counseling services to a culturally diverse clientele of more than 11,000 adults living in the local community. The ACCC's goals are as follows: (1) provide career exploration and…

  2. Computer-Assisted Career Guidance Systems and Career Counseling Services. Eleventh Annual Report [of the] Oakland University Adult Career Counseling Center: September 1993-June 1994.

    ERIC Educational Resources Information Center

    Splete, Howard

    This report profiles the Adult Career Counseling Center (ACCC) at Oakland University, Michigan. Conceived in 1982, the Center provides services for adults seeking career guidance. The ACCC supplies career information, counseling, advice in preparation and interviewing skills, and referral information, all at no charge. The ACCC employed computers…

  3. Effects of different degrees of insulin resistance on endothelial function in obese adults undergoing alternate day fasting

    PubMed Central

    Hoddy, Kristin K.; Bhutani, Surabhi; Phillips, Shane A.; Varady, Krista A.

    2016-01-01

    BACKGROUND: Obesity can have deleterious effects on insulin sensitivity leading to endothelial dysfunction. Whether alternate day fasting (ADF) can ameliorate insulin sensitivity in a way that improves endothelial function remains unknown. OBJECTIVE: This study examined the impact of ADF on endothelium dependent flow mediated dilation (FMD) in obese subjects with different degrees of insulin resistance. METHODS: Obese non-diabetic adults (n = 54) participated in an 8-week ADF protocol (25% energy intake “fast day”, alternated with ad libitum intake “feast day”). Subjects were divided into tertiles according to degree of insulin resistance based on HOMA-IR (Homeostatic model assessment-Insulin resistance): tertile 1 (0.8–2.4), tertile 2 (2.5–3.6), tertile 3 (3.7–12.4). RESULTS: Body weight decreased (P < 0.001) by 4% in each tertile. Fat mass, lean mass, and visceral fat mass also decreased (P < 0.001) similarly in each tertile. After 8 weeks of ADF, FMD and adiponectin differed (P < 0.05) between tertile 1 (3±0%; 26±23%) versus tertile 3 (–3±0%; –13±10%). Changes in leptin did not differ between tertiles (tertile 1: –23±7%; tertile 2: –20±7%; tertile 3: –9±7%). Fasting glucose did not change in any tertile. Fasting insulin and HOMA-IR differed (P < 0.05) between tertile 1 (10±11%; 11±11%) versus tertile 3 (–27±8%; –30±9%). Plasma lipids, blood pressure and heart rate did not change in any tertile. CONCLUSION: Our data suggest that ADF may be effective for decreasing insulin resistance in insulin resistant subjects, but these changes have no effect on endothelial function. PMID:28035343

  4. Behaviour management problems as predictors of psychotropic medication and use of psychiatric services in adults with autism.

    PubMed

    Tsakanikos, Elias; Costello, Helen; Holt, Geraldine; Sturmey, Peter; Bouras, Nick

    2007-07-01

    We examined behaviour management problems as predictors of psychotropic medication, use of psychiatric consultation and in-patient admission in a group of 66 adults with pervasive developmental disorder (PDD) and intellectual disability (ID) and 99 controls matched in age, gender and level of ID. Overall, people with PDD had higher rates of most DAS behaviour problems and more frequent use of anti-psychotics than matched controls. Logistic regression analyses showed that physical aggression and problems such as pestering staff independently predicted use of anti-psychotics. Physical aggression and overactivity predicted further involvement of psychiatric services. PDD diagnosis predicted admission to an in-patient unit. The results suggest that externalizing problem behaviours in adults with autism can predict type of treatment intervention.

  5. Use of Hospital-based Services among Young Adults with Behavioral Health Diagnoses Before and After Health Insurance Expansions

    PubMed Central

    Golberstein, Ezra; Zaha, Rebecca; Greenfield, Shelly F.; Beardslee, William R.; Busch, Susan H.

    2014-01-01

    Importance Young adults have high levels of behavioral health needs but often lack health insurance. Recent health reforms have increased coverage, but it is unclear how use of hospital-based care changed after expanding insurance. Objective To evaluate the association between health insurance coverage expansions and use of hospital-based care among young adults with behavioral health diagnoses. Design Quasi-experimental analyses of hospital inpatient and emergency department use from 2003–2009 based on hospital discharge data, comparing differential changes in service use among young adults with behavioral health diagnoses in Massachusetts versus other states before and after Massachusetts’ 2006 health reform. Setting Hospital inpatient departments in the U.S. and emergency departments in Massachusetts and Maryland. Participants Population-based sample of inpatient admissions (n=12,821,746 across 7 years) nationwide and emergency department visits (n=6,756,303 across 7 years) from Maryland and Massachusetts for 12 to 25 year olds. Main Outcomes and Measures Inpatient admission rates per 1000 population for primary diagnosis of any behavioral health disorder, by diagnosis; emergency department visit rates per 1000 population by behavioral health diagnosis; and insurance coverage for discharges. Results After 2006, uninsurance among 19 to 25 year olds in Massachusetts fell from 26% to 10% (16 percentage points; 95% CI, 13–20). Young adults experienced relative declines in inpatient admission rates of 2.0 per 1000 for primary diagnoses of any behavioral health disorder (95% CI, 0.88–3.1), 0.38 for depression (95% CI, 0.18–0.58), and 1.3 for substance use disorder (95% CI, 0.68–1.8). The rise in emergency department visits with any behavioral health diagnosis after 2006 was lower among young adults in Massachusetts compared to Maryland (16.5 per 1000; 95% CI, 11.4–21.6). Among young adults in Massachusetts, the percent of behavioral health discharges

  6. Perceptions of Early Intervention Services: Adolescent and Adult Mothers in Two States

    ERIC Educational Resources Information Center

    Thompson, Stacy D.; Bruns, Deborah A.

    2013-01-01

    Early intervention (EI) provides critical services to families with young children who have diagnosed disabilities, developmental delays, or who are at-risk for developmental delays. Very little is known about the experiences of adolescent mothers who have children who qualify for EI services. The authors investigated the perceptions of adolescent…

  7. High School Community Service as a Predictor of Adult Voting and Volunteering

    ERIC Educational Resources Information Center

    Hart, Daniel; Donnelly, Thomas M.; Youniss, James; Atkins, Robert

    2007-01-01

    The influences of high school community service participation, extracurricular involvement, and civic knowledge on voting and volunteering in early adulthood were examined using the National Educational Longitudinal Study. The major finding in this study is that both voluntary and school-required community service in high school were strong…

  8. The Views of People Who Care for Adults with Down's Syndrome and Dementia: A Service Evaluation

    ERIC Educational Resources Information Center

    Furniss, Kate Atkins; Loverseed, Annie; Lippold, Tessa; Dodd, Karen

    2012-01-01

    It is well established that people with Down's syndrome are more likely to develop dementia than other people and that onset of dementia is likely to occur earlier at an earlier age. The article reports on a specialist service for people with Down's syndrome and dementia. The service has offered dementia screening and assessment to people with…

  9. Building Partnerships for Service-Learning. The Jossey-Bass Higher and Adult Education Series.

    ERIC Educational Resources Information Center

    Jacoby, Barbara

    The chapters in this collection contain information, exemplary models, and practical tools to make service-learning succeed. The chapters are: (1) "Fundamentals of Service-Learning Partnerships" (Barbara Jacoby); (2) "Developing a Theory and Practice of Campus-Community Partnerships" (Sandra Enos and Keith Morton); (3) "Assessment as a Means of…

  10. PBS Develops Institution-Neutral Online Services for Non-Traditional Adult Learners.

    ERIC Educational Resources Information Center

    Reese, Christopher

    As the IMS interoperability standards roll closer to widespread usability, the Public Broadcasting Service (PBS) and the United States Department of Labor (DOL) have formed an articulated partnership to develop a Web-based project. This interactive project places institution-neutral student services for non-traditional distance learners on the…

  11. The In-Service Training of Adult Literacy, Numeracy and English for Speakers of Other Languages Teachers in England; the Challenges of a "Standards-Led Model"

    ERIC Educational Resources Information Center

    Lucas, Norman

    2007-01-01

    Drawing upon two research projects, this paper analyses changes affecting the in-service training of adult literacy, numeracy and teachers of English for Speakers of Other Languages in England. There are many issues raised in this paper, particularly how in-service teacher education programmes in England can meet the diversity of learner need, how…

  12. Older Adults and Emerging Digital Service Delivery: A Mixed Methods Study on Information and Communications Technology Use, Skills, and Attitudes.

    PubMed

    Siren, Anu; Knudsen, Sine Grønborg

    2017-01-01

    Based on data from a survey (n = 3291) and 14 qualitative interviews among Danish older adults, this study investigated the use of, and attitudes toward, information communications technology (ICT) and the digital delivery of public services. While age, gender, and socioeconomic status were associated with use of ICT, these determinants lost their explanatory power when we controlled for attitudes and experiences. We identified three segments that differed in their use of ICT and attitudes toward digital service delivery. As nonuse of ICT often results from the lack of willingness to use it rather than from material or cognitive deficiencies, policy measures for bridging the digital divide should focus on skills and confidence rather than on access or ability.

  13. An examination of the relationships between service use and alternative measures of obesity among community-dwelling adults in Ireland.

    PubMed

    Doherty, Edel; Queally, Michelle; O'Neill, Ciaran

    2015-12-01

    Obesity has received increased attention arising from its increasing prevalence and the implications of obesity-related problems for society and the wider economy. To estimate healthcare and non-healthcare obesity impacts, many studies rely on body mass index (BMI) as a measure of obesity. However BMI is considered to be a noisy measure of total body fat that unlike some other measures does not capture fat distribution. This study uses one such measure, the waist-to-hip ratio, as both an alternative and in conjunction with BMI in the estimation of the relationship between adiposity and health service use. The article uses data from a large-scale study of older adults living in Ireland (the Tilda data set). The findings indicate that studies that include both measures of general and central adiposity may provide a more comprehensive characterisation of the relationship between healthcare service use and adiposity.

  14. Young adult cancer services in the UK: the journey to a national network.

    PubMed

    Carr, Robert; Whiteson, Myrna; Edwards, Melinda; Morgan, Sue

    2013-06-01

    The past decade has seen the development of a network of specialist teenage and young adult cancer centres across the UK. These provide expertise in treatment across the spectrum of malignancies that occur in young adults, supported by multi-disciplinary teams that are able to provide the psycho-social support so necessary for this age group, and in a hospital environment that encourages social interaction while delivering expert medical care. The development of teenage and young adult (TYA) cancer as a specialty gained establishment backing in 2005, through NICE guidance which mandated that all 16- to 24-year-olds should be referred to specialist TYA cancer centres. The foundation of this achievement was set by a handful of committed individuals and the Teenage Cancer Trust, a charity that has acted as patient advocate and political pressure group, and that has brought to public attention the need for change while providing support for specialist staff and hospitals.

  15. Meeting the Needs of Older Adult Refugee Populations With Home Health Services.

    PubMed

    Miner, Sarah M; Liebel, Dianne; Wilde, Mary H; Carroll, Jennifer K; Zicari, Elizabeth; Chalupa, Stephanie

    2015-12-27

    The United States resettles close to 70,000 refugees each year more than any other country in the world. Adult refugees are at risk for negative health outcomes and inefficient health resource use, and meeting the multiple health needs of this vulnerable population is a challenge. The purpose of this study was to assess the impact of a home health care (HHC) pilot project on meeting the needs of older adult refugee patients. A retrospective chart review of 40 refugee adult patients who participated in an HHC pilot was done to analyze their health outcomes using OASIS-C data. Participants' pain level, anxiety level, medication management, and activities of daily living management all significantly improved over the course of their HHC episode. Results of this study indicate that HHC has great potential to improve the health of vulnerable refugee populations and assist the families involved in their care.

  16. Can I have a beer, please? A study of alcohol service to young adults on licensed premises in Stockholm.

    PubMed

    Wallin, Eva; Andreásson, Sven

    2004-12-01

    This study evaluated the effects of a community alcohol prevention program on the frequency of alcohol service to young adults at licensed premises in Stockholm, Sweden. We used a pretest (1996)-posttests (1998 and 2001) design with intervention and control areas. The multicomponent intervention combines training of serving staff in responsible beverage service, policy initiatives, and enforcement of existing alcohol regulations. Adolescents 18 years old (the legal drinking age on licensed premises in Sweden), but younger looking according to an expert panel, visited licensed premises in pairs, where each adolescent ordered a beer. At baseline in 1996, the adolescents made 600 attempts to order. At follow-up in 1998, the number of attempts to order was 252, and at the second follow-up in 2001, the adolescents made 238 attempts. We found no statistically significant differences between the intervention and control areas. Overall, the frequency of alcohol service to adolescents on licensed premises in these areas of Stockholm decreased significantly over time, from 45 to 41 and to 32%, in 1996, 1998, and 2001, respectively. The decrease in alcohol service in 2001 was statistically significant compared to the baseline in 1996. One explanation for this improvement could be more effective enforcement of existing alcohol laws in both the intervention and control areas. We also found that licensed premises that used doormen to screen potential customers were less likely to sell to minors.

  17. Development of a first-contact protocol to guide assessment of adult patients in rehabilitation services networks

    PubMed Central

    Souza, Mariana A. P.; Ferreira, Fabiane R.; César, Cibele C.; Furtado, Sheyla R. C.; Coster, Wendy J.; Mancini, Marisa C.; Sampaio, Rosana F.

    2016-01-01

    Objective: This paper describes the development of the Protocol for Identification of Problems for Rehabilitation (PLPR), a tool to standardize collection of functional information based on the International Classification of Functioning, Disability and Health (ICF). Development of the protocol: The PLPR was developed for use during the initial contact with adult patients within a public network of rehabilitation services. Steps to develop the protocol included: survey of the ICF codes most used by clinical professionals; compilation of data from functional instruments; development and pilot testing of a preliminary version in the service settings; discussion with professionals and development of the final version. The final version includes: user identification; social and health information; brief functional description (BFD); summary of the BFD; and PLPR results. Further testing of the final version will be conducted. Conclusions: The protocol standardizes the first contact between the user and the rehabilitation service. Systematic use of the protocol could also help to create a functional database that would allow comparisons between rehabilitation services and countries over time. PMID:26786075

  18. Supervisors and Teamwork. Tierra de Oportunidad Module 24. LAES: Latino Adult Education Services Project.

    ERIC Educational Resources Information Center

    Kissam, Ed; Dorsey, Holda

    This module, which may be used as the basis for a workshop or as a special topic unit in adult basic education or English-as-a-Second-Language (ESL) courses, discusses supervisors and teamwork. It is designed to teach about differences between supervision in different kinds of workplaces; getting along and ahead with mainstream supervisors; and…

  19. The Use of Psychotropic Medication with Adults with Learning Disabilities: Survey Findings and Implications for Services

    ERIC Educational Resources Information Center

    Chapman, Melanie; Gledhill, Paul; Jones, Phillip; Burton, Mark; Soni, Saroj

    2006-01-01

    This paper describes the findings of a survey into prescribing of psychotropic medication with adults with learning disabilities in a British city. A self-completion questionnaire was sent to staff in dispersed housing and community learning disability teams to gather information about the number of people prescribed psychoactive medication, the…

  20. Teenagers' Access to Higher Education. Tierra de Oportunidad Module 7. LAES: Latino Adult Education Services Project.

    ERIC Educational Resources Information Center

    Kissam, Ed; Dorsey, Holda

    This module, which may be used as the basis for a workshop or as a special topic unit in adult basic education or English-as-a-Second-Language (ESL) courses, focuses on teenagers' access to higher education. The following items are included: module overview; list of basic, thinking, interpersonal, information utilization, and other skills…

  1. Men's Changing Roles. Tierra de Oportunidad Module 27. LAES: Latino Adult Education Services Project.

    ERIC Educational Resources Information Center

    Kissam, Ed; Dorsey, Holda

    This module, which may be used as the basis for a workshop or as a special topic unit in adult basic education or English-as-a-Second-Language (ESL) courses, discusses men's changing roles. It is designed to provide a framework for exploring how differences in language, laws, and ways for participating in the community and differences in the way…

  2. Analyzing and Debating Issues. Tierra de Oportunidad Module 18. LAES: Latino Adult Education Services Project.

    ERIC Educational Resources Information Center

    Kissam, Ed; Dorsey, Holda

    This module, which may be used as the basis for a workshop or as a special topic unit in adult basic education or English-as-a-Second-Language (ESL) courses, focuses on how to evaluate the facts, opinions, and positions on social issues held by family and friends, neighbors, authority figures, and the media. Topics covered include the following:…

  3. Recruiting Disadvantaged Adults. Public Library Training Institutes Library Service Guide No. 12.

    ERIC Educational Resources Information Center

    Eyster, George W.

    Disadvantaged adults who need the information a library can provide include those who are poor, in the minority, aging, institutionalized, or handicapped. Methods used to recruit these potential patrons may include the media, mailings, exhibits, posters and billboards, personal contact, classes, bookmobiles, speakers, and advisory committees. Some…

  4. Preferences for the provision of whole genome sequencing services among young adults

    PubMed Central

    Elliott, Kailyn R.

    2017-01-01

    Objectives As whole genome sequencing (WGS) becomes increasingly available, clinicians will be faced with conveying complex information to individuals at different stages in life. The purpose of this study is to characterize the views of young adults toward obtaining WGS, learning different types of genomic information, and having choice about which results are disclosed. Methods A mixed-methods descriptive study was conducted with a diverse group of 18 and 19-years-olds (N = 145). Participants watched an informational video about WGS and then completed an online survey. Results Participants held a positive attitude toward obtaining WGS and learning about a range of health conditions and traits. Increased interest in learning WGS information was significantly associated with anticipated capacity to handle the emotional consequences if a serious risk was found (β = 0.13, P = .04). Young adults wanted the ability to choose what types of genomic risk information would be returned and expressed decreased willingness to undergo WGS if clinicians made these decisions (t(138) = -7.14, P <.01). Qualitative analysis showed that young adults emphasized procedural factors in WGS decision-making and that perceived health benefits of WGS had a substantial role in testing preferences and anticipated usage of WGS results. Conclusions Clinicians are likely to encounter enthusiasm for obtaining WGS results among young adults and may need to develop strategies for ensuring that this preference is adequately informed. PMID:28334023

  5. Dealing with Taxes. Tierra de Oportunidad Module 17. LAES: Latino Adult Education Services Project.

    ERIC Educational Resources Information Center

    Kissam, Ed; Dorsey, Holda

    This module, which may be used as the basis for a workshop or as a special topic unit in adult basic education or English-as-a-Second-Language (ESL) courses, addresses how to file and pay federal income taxes. Topics covered include the following: defining tax-related vocabulary; analyzing tax credits and selecting the most appropriate ones;…

  6. Epidemiology of Epilepsy in Older Adults with an Intellectual Disability in Ireland: Associations and Service Implications

    ERIC Educational Resources Information Center

    McCarron, Mary; O'Dwyer, Marie; Burke, Eilish; McGlinchey, Eimear; McCallion, Philip

    2014-01-01

    There are limited studies on the prevalence of epilepsy and co-morbid conditions in older adults with an ID. To begin to address this prevalence of epilepsy was estimated for participants in the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing. Associations with demographic variables and co morbid health conditions were…

  7. Older Adults With Intellectual Disability in Residential Care Centers in Israel: Health Status and Service Utilization

    ERIC Educational Resources Information Center

    Merrick, Joav; Davidson, Philip W.; Morad, Mohammed; Janicki, Matthew P.; Wexler, Orren; Henderson, C. Michael

    2004-01-01

    To determine their health status, we studied 2,282 Israeli adults with intellectual disability who were at least 40 years of age and lived in residential care. Results showed that age is a significant factor in health status. The frequency of different disease categories (e.g., cardiovascular disease, cancer, and sensory impairments) increased…

  8. Support Systems for Injured Workers. Tierra de Oportunidad Module 5. LAES: Latino Adult Education Services Project.

    ERIC Educational Resources Information Center

    Kissam, Ed; Dorsey, Holda

    This module, which may be used as the basis for a workshop or as a special topic unit in an adult basic education or English-as-a-Second-Language (ESL) course, focuses on support systems for injured workers. The following items are included: module overview; list of basic, thinking, interpersonal, information utilization, and other skills…

  9. Unemployment Insurance. Tierra de Oportunidad Module 3. LAES: Latino Adult Education Services Project.

    ERIC Educational Resources Information Center

    Kissam, Ed; Dorsey, Holda

    This module, which may be used as the basis for a workshop or as a special topic unit in an adult basic education or English-as-a-Second-Language (ESL) course, focuses on the Unemployment Insurance (UI) system. The following items are included: module overview; list of basic, thinking, interpersonal, information utilization, and other skills…

  10. Women's Work Issues. Tierra de Oportunidad Module 2. LAES: Latino Adult Education Services Project.

    ERIC Educational Resources Information Center

    Kissam, Ed; Dorsey, Holda

    This module, which may be used as the basis for a workshop or as a special topic unit in an adult basic education or English-as-a-Second-Language (ESL) course, focuses on the problems faced by immigrant women in their work lives and legal provisions to protect employed women. The following items are included: module overview; list of basic,…

  11. Making Choices about Jobs. Tierra de Oportunidad Module 1. LAES: Latino Adult Education Services Project.

    ERIC Educational Resources Information Center

    Kissam, Ed; Dorsey, Holda

    This module, which may be used as the basis for a workshop or as a special topic unit in an adult basic education or English-as-a-Second-Language (ESL) course, focuses on building the basic decision skills workers need to choose among potential jobs. The following items are included: overview of the module; list of basic, thinking, interpersonal,…

  12. An international review of the patterns and determinants of health service utilisation by adult cancer survivors

    PubMed Central

    2012-01-01

    Background There is a need to review factors related to health service utilisation by the increasing number of cancer survivors in order to inform care planning and the organisation and delivery of services. Methods Studies were identified via systematic searches of Medline, PsycINFO, CINAHL, Social Science Citation Index and the SEER-MEDICARE library. Methodological quality was assessed using STROBE; and the Andersen Behavioural Model was used as a framework to structure, organise and analyse the results of the review. Results Younger, white cancer survivors were most likely to receive follow-up screening, preventive care, visit their physician, utilise professional mental health services and least likely to be hospitalised. Utilisation rates of other health professionals such as physiotherapists were low. Only studies of health service use conducted in the USA investigated the role of type of health insurance and ethnicity. There appeared to be disparate service use among US samples in terms of ethnicity and socio-demographic status, regardless of type of health insurance provision s- this may be explained by underlying differences in health-seeking behaviours. Overall, use of follow-up care appeared to be lower than expected and barriers existed for particular groups of cancer survivors. Conclusions Studies focussed on the use of a specific type of service rather than adopting a whole-system approach and future health services research should address this shortcoming. Overall, there is a need to improve access to care for all cancer survivors. Studies were predominantly US-based focussing mainly on breast or colorectal cancer. Thus, the generalisability of findings to other health-care systems and cancer sites is unclear. The Andersen Behavioural Model provided an appropriate framework for studying and understanding health service use among cancer survivors. The active involvement of physicians and use of personalised care plans are required in order to ensure

  13. The education and training needs of qualified mental health nurses working in acute adult mental health services.

    PubMed

    Jones, Julia; Lowe, Trevor

    2003-11-01

    This paper presents findings from a research study that investigated the education and training needs of qualified mental health nurses who work in acute adult mental health services in the UK. The study aimed to address a key knowledge 'gap' highlighted by recent Department of Health reports () that suggest that little is known regarding the education and training expectations, priorities and needs of mental health nurses who work in acute adult mental health services. This study aimed to identify (i) what type of post-registration education and training mental health nurses working in acute settings need; (ii) how the nurses want education and training to be delivered; and (iii) what qualifications and accreditation the nurses want to receive? The research consisted of two methods: focus groups and a questionnaire survey. This paper reports on the findings from the questionnaire survey. The results of the survey demonstrate that there is a real need for post-registration education and training for this group of nurses; to equip them with the relevant knowledge and skills to nurse people in the acute phase of their mental illness in acute inpatient settings.

  14. Mind how you cross the gap! Outcomes for young people who failed to make the transition from child to adult services: the TRACK study

    PubMed Central

    Islam, Zoebia; Ford, Tamsin; Kramer, Tami; Paul, Moli; Parsons, Helen; Harley, Katherine; Weaver, Tim; McLaren, Susan; Singh, Swaran P.

    2016-01-01

    Aims and method The Transitions of Care from Child and Adolescent Mental Health Services to Adult Mental Health Services (TRACK) study was a multistage, multicentre study of adolescents' transitions between child and adult mental health services undertaken in England. We conducted a secondary analysis of the TRACK study data to investigate healthcare provision for young people (n = 64) with ongoing mental health needs, who were not transferred from child and adolescent mental health services (CAMHS) to adult mental health services mental health services (AMHS). Results The most common outcomes were discharge to a general practitioner (GP; n = 29) and ongoing care with CAMHS (n = 13), with little indication of use of third-sector organisations. Most of these young people had emotional/neurotic disorders (n = 31, 48.4%) and neurodevelopmental disorders (n = 15, 23.4%). Clinical implications GPs and CAMHS are left with the responsibility for the continuing care of young people for whom no adult mental health service could be identified. GPs may not be able to offer the skilled ongoing care that these young people need. Equally, the inability to move them decreases the capacity of CAMHS to respond to new referrals and may leave some young people with only minimal support. PMID:27280035

  15. The effects of adults' affective expression and direction of visual gaze on 12-month-olds' visual preferences for an object following a 5-minute, 1-day, or 1-month delay.

    PubMed

    Flom, Ross; Johnson, Sarah

    2011-03-01

    Between 12- and 14 months of age infants begin to use another's direction of gaze and affective expression in learning about various objects and events. What is not well understood is how long infants' behaviour towards a previously unfamiliar object continues to be influenced following their participation in circumstances of social referencing. In this experiment, we examined infants' sensitivity to an adult's direction of gaze and their visual preference for one of two objects following a 5-min, 1-day, or 1-month delay. Ninety-six 12-month-olds participated. For half of the infants during habituation (i.e., familiarization), the adults' direction of gaze was directed towards an unfamiliar object (look condition). For the remaining half of the infants during habituation, the adults' direction of gaze was directed away from the unfamiliar object (look-away condition). All infants were habituated to two events. One event consisted of an adult looking towards (look condition) or away from (look-away condition) an object while facially and vocally conveying a positive affective expression. The second event consisted of the same adult looking towards or away from a different object while conveying a disgusted affective expression. Following the habituation phase and a 5-min, 1-day, or 1-month delay, infants' visual preference was assessed. During the visual preference phase, infants saw the two objects side by side where the adult conveying the affective expression was not visible. Results of the visual preference phase indicate that infants in the look condition showed a significant preference for object previously paired with the positive affect following a 5-min and 1-day delay. No significant visual preference was found in the look condition following a 1-month delay. No significant preferences were found at any retention interval in the look-away condition. Results are discussed in terms of early learning, social referencing, and early memory.

  16. Integrating criminal justice, community healthcare, and support services for adults with severe mental disorders.

    PubMed

    Weisman, R L; Lamberti, J S; Price, N

    2004-01-01

    Persons with severe mental disorders are overrepresented in our nation's jails and prisons. Factors including cooccurring substance use disorders, homelessness, and lack of access to community services have contributed to this problem, as have gaps between criminal justice, healthcare, and community support systems. In order to address these issues, Project Link was developed by the University of Rochester Department of Psychiatry in collaboration with five local community agencies. Project Link is designed to prevent involvement of individuals with severe mental illness from entering the criminal justice system. While many models of diversion programs exist, they are all dependent on access to appropriate community-based services. This paper will describe the steps that Project Link has taken towards integrating criminal justice, healthcare, and community support services for individuals with severe mental disorders involved in the criminal justice system.

  17. New patterns of community care: coordinated services for dually diagnosed adults in North Carolina.

    PubMed

    Polgar, M F; Johnsen, M C; Starrett, B E; Fried, B J; Morrissey, J P

    2000-01-01

    North Carolina has developed coordinated care systems for people dually diagnosed with both a mental retardation and a different major mental illness. In response to a class action lawsuit, the state has become a leader in treatment of this form of dual diagnosis. Systems of care for this "Thomas S class" operate in each of 41 area programs for mental health, developmental disabilities, and substance abuse. Networks of care among leaders in mental health and developmental disability promote the coordination of health, housing, social, and vocational services. A survey of 100 area program leaders finds extensive cooperation and a variety of services provided and contracted for, both within and beyond each area program, particularly among developmental disability specialists. Cooperation among leaders is associated with service variety and inter-organizational linkages. The extent of relationships among provider organizations is associated with better access to care. Best practice includes a single portal of entry and inter-agency councils.

  18. Pattern of health services utilization by adults of the Pelotas birth cohort from 1982 to 2004-5, Southern Brazil

    PubMed Central

    Dias-da-Costa, Juvenal S; Gigante, Denise P; Horta, Bernardo L; Barros, Fernando C; Victora, Cesar G

    2009-01-01

    OBJECTIVE To describe the pattern of health services utilization by young adults. METHODS Longitudinal study in Pelotas (Southern Brazil), in which the individuals were identified at birth in 1982 and followed up until 23 years of age. The outcome was defined by information collected about visits to health professionals that were attended in the year before the interview, between 2004 and 2005. The places where the visits occurred were categorized as public, private or belonging to health plan systems. Descriptive analyses were carried out for utilization and type of health service. Poisson Regression was employed in the adjusted analysis. RESULTS Of the interviewees, 72.0% visited health professionals in the year before the interview; 86.2% (95% CI 84.7;87.7) of the women and 59.3% (95% CI 57.3;61.3) of the men. Even when gynecological visits were excluded, the women still attended more visits than the men, 68.4% (95% CI 66.4;70.4). Health services utilization was more frequent among interviewees of better socioeconomic level. A difference of lower use in relation to non-white skin color was observed only among male youths. There were differences regarding the type of professional visited by men and women and also according to family income. Men and women used more frequently the public system, the health plan system and, in a smaller proportion, the private system. CONCLUSIONS The socioeconomic situation influenced the utilization and the type of health service, with men and women classified as “poor at the moment”, which indicates lower utilization of services. Such socioeconomic differences may indicate difficulties in the access to the health system. PMID:19142345

  19. Use of Physician Services by Older Adults: 1991/1992 to 2000/2001

    ERIC Educational Resources Information Center

    Watson, Diane E.; Heppner, Petra; Reid, Robert; Bogdanovic, Bogdan; Roos, Noralou P.

    2005-01-01

    Canadians have expressed concern that access to family physicians (FP) has declined. Anonymized physician services data for 1991/1992 to 2000/2001 were used to evaluate changes in supply and age-specific rates of use of FPs and specialists in Winnipeg, Manitoba. Physician-to-population ratios declined 7.5 per cent, FP-to-population ratios declined…

  20. Outcomes and Costs of Residential Services for Adults with Intellectual Disabilities in Taiwan: A Comparative Evaluation

    ERIC Educational Resources Information Center

    Chou, Yueh-Ching; Lin, Li-Chan; Pu, Cheng-Yun; Lee, Wan-Ping; Chang, Shu-Chuan

    2008-01-01

    Background: The disability policy in Taiwan has traditionally emphasized residential care in large institutions and, more recently, medium-sized group homes. This paper compares the relative costs, services provided and outcomes between the traditional institutions, medium-sized group homes and new small-scale community living units that were…

  1. Engaged Teaching and Learning with Adult Karen Refugees in a Service-Learning Site

    ERIC Educational Resources Information Center

    Smolen, Lynn Atkinson; Zhang, Wei; Detwiler, Stephen

    2013-01-01

    This article describes a case study of a service-learning project connected to a TESOL (teaching English to speakers of other languages) teacher preparation program. The case study explored the teacher candidates' experiences teaching English to Karen refugees from Myanmar (Burma) in a midwestern city in the United States. The teacher candidates'…

  2. Perceived barriers and facilitators of mental health service utilization in adult trauma survivors: A systematic review.

    PubMed

    Kantor, Viktoria; Knefel, Matthias; Lueger-Schuster, Brigitte

    2017-03-01

    Many trauma survivors seem to be reluctant to seek professional help. The aim of the current review was to synthesize relevant literature, and to systematically classify trauma survivors' perceived barriers and facilitators regarding mental health service utilization. The systematic search identified 19 studies addressing military personnel and 17 studies with trauma survivors of the general population. The data analysis revealed that the most prominent barriers included concerns related to stigma, shame and rejection, low mental health literacy, lack of knowledge and treatment-related doubts, fear of negative social consequences, limited resources, time, and expenses. Perceived facilitators lack attention in research, but can be influential in understanding mental health service use. Another prominent finding was that trauma survivors face specific trauma-related barriers to mental health service use, especially concerns about re-experiencing the traumatic events. Many trauma survivors avoid traumatic reminders and are therefore concerned about dealing with certain memories in treatment. These perceived barriers and facilitators were discussed regarding future research and practical implications in order to facilitate mental health service use among trauma survivors.

  3. Beyond Classroom Borders: Incorporating Collaborative Service Learning for the Adult Student

    ERIC Educational Resources Information Center

    Kelly, Millicent J.

    2013-01-01

    This article provides an overview of collaborative service learning activities as they are incorporated into university curricula designed for the nontraditional student. The basic tenets of the concept of "andragogy" are briefly reviewed to emphasize the special considerations that need to be addressed to ensure the successful inclusion of…

  4. Service Content as a Determinant of Homeless Adults' Perceptions of Program Efficacy

    ERIC Educational Resources Information Center

    Sosin, Michael; George, Christine; Grossman, Susan

    2012-01-01

    This work analyzes the relationship between the services clients receive in treatment programs and client ratings of program efficacy. It relies on data from a random sample of clients served by Chicago's homelessness system (N = 554). Regressions utilizing that data suggest that ratings of program efficacy are positively predicted by program…

  5. An Experiment in Service Learning: Pairing Students with Older Adults in a Lifespan Development Course.

    ERIC Educational Resources Information Center

    Schumann, Mary F.

    2001-01-01

    Describes the author's psychology class, in which she required students to do service work with a resident in a nursing home. Reports that students met for a minimum of eight hours with the resident and wrote both a history of the person and a reflection on the project. States that half of the students decided to continue volunteering after the…

  6. Dinosaur Day!

    ERIC Educational Resources Information Center

    Nakamura, Sandra; Baptiste, H. Prentice

    2006-01-01

    In this article, the authors describe how they capitalized on their first-grade students' love of dinosaurs by hosting a fun-filled Dinosaur Day in their classroom. On Dinosaur Day, students rotated through four dinosaur-related learning stations that integrated science content with art, language arts, math, and history in a fun and time-efficient…

  7. CEMI Days

    SciTech Connect

    2015-07-01

    CEMI Days are an important channel of engagement between DOE and the manufacturing industry to identify challenges and opportunities for increasing U.S. manufacturing competitiveness. CEMI Days that are held at manufacturing companies’ facilities can include tours of R&D operations or other points of interest determined by the host company.

  8. Design and Recruitment for a Randomized Controlled Trial of Problem Solving Therapy to Prevent Depression among Older Adults with Need for Supportive Services

    PubMed Central

    Albert, Steven M.; King, Jennifer; Dew, Mary Amanda; Begley, Amy; Anderson, Stewart; Karp, Jordan; Gildengers, Ari; Butters, Meryl; Reynolds, Charles F.

    2015-01-01

    Background Addressing subthreshold depression (indicated prevention) as well as vulnerabilities that increase the risk of major depression or anxiety disorders (selective prevention) is important for protecting mental health in old age. The Depression-Agency Based Collaborative is a prevention trial involving older adults recruited from aging services sites (home care agencies, senior housing senior centers) who meet criteria for subthreshold depression and disability. Objective To examine (i) the effectiveness of partnerships with aging services sites for recruiting at-risk older adults, (ii) the quality of recruitment and acceptability of the Dep-ABC assessment and intervention, and (iii) the baseline status of participants. Methods Dep-ABC is a single-blind randomized controlled prevention trial set in aging services settings but with centralized screening, randomization, in-home assessments, and follow-up. Its intervention arm involves 6–8 sessions of problem-solving therapy, in which older adults aged 60+ learn to break down problems that affect wellbeing and develop strategies to address them. We examined participation rates to assess quality of recruitment across sites and level of disability according to service use. Results Dep-ABC randomized 104 participants, 68.4% of eligible older adults. Screening using self-reported disability successfully netted a sample in which 74% received home care agency services, with remaining participants similarly impaired in structured self-reports of impairment and on observed performance tests. Conclusions Direct outreach to aging services providers is an effective way to identify older adults with service needs at high risk of major depression. Problem solving therapy is acceptable to this population and can be added to current services. PMID:26706911

  9. Preventing Youth from Falling Through the Cracks Between Child/Adolescent and Adult Mental Health Services: A Systematic Review of Models of Care.

    PubMed

    Nguyen, Tram; Embrett, Mark G; Barr, Neil G; Mulvale, Gillian M; Vania, Diana K; Randall, Glen E; DiRezze, Briano

    2017-02-20

    Optimizing the transition between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) is a priority for healthcare systems. The purpose of this systematic review is to: (1) identify and compare models of care that may be used to facilitate the transition from CAMHS to AMHS; and (2) discuss trends and implications to inform future research and practice. Results identified three models of care which move beyond healthcare services and incorporate a broader range of services that better meet the dynamic needs of transition-aged youth. Joint working among providers, coupled with individualized approaches, is essential to facilitating continuity of care.

  10. An analysis of structural relationship among achievement motive on social participation, purpose in life, and role expectations among community dwelling elderly attending day services

    PubMed Central

    Kyougoku, Makoto

    2016-01-01

    Background. Achievement motive is defined as the intention to achieve one’s goals. Achievement motive is assumed to promote clients to choices and actions toward their valuable goal, so it is an important consideration in rehabilitation. Purpose. The purpose of this study is to demonstrate the structural relationship among achievement motive on purpose in life, social participation, and role expectation of community-dwelling elderly people. Methods. Participants were community-dwelling elderly people in day-service centers. A total of 281 participants (male: 127, female: 154) answered the self-administered questionnaire in cross-sectional research. The questionnaire was comprised of demographic data and scales that evaluated achievement motive, social participation, purpose in life, and role expectation. We studied the structural relationship established by our hypothesized model via a structural equation modeling approach. Results. We checked the standardized path coefficients and the modification indices; the modified model’s statistics were a good fit: CFI = 0.984, TLI = 0.983, RMSEA = 0.050, 90% CI [0.044–0.055]. Achievement motive had a significantly direct effect on purpose in life (direct effect = 0.445, p value < 0.001), a significantly indirect effect on purpose in life via social participation or role expectation (indirect effect = 0.170, p value < 0.001) and a total effect on purpose in life (total effect = 0.615). Discussion. This result suggests that enhancing the intention to achieve one’s goals enables participants to feel a spirit of challenge with a purpose and a sense of fulfillment in their daily lives. PMID:26835188

  11. An analysis of structural relationship among achievement motive on social participation, purpose in life, and role expectations among community dwelling elderly attending day services.

    PubMed

    Sano, Nobuyuki; Kyougoku, Makoto

    2016-01-01

    Background. Achievement motive is defined as the intention to achieve one's goals. Achievement motive is assumed to promote clients to choices and actions toward their valuable goal, so it is an important consideration in rehabilitation. Purpose. The purpose of this study is to demonstrate the structural relationship among achievement motive on purpose in life, social participation, and role expectation of community-dwelling elderly people. Methods. Participants were community-dwelling elderly people in day-service centers. A total of 281 participants (male: 127, female: 154) answered the self-administered questionnaire in cross-sectional research. The questionnaire was comprised of demographic data and scales that evaluated achievement motive, social participation, purpose in life, and role expectation. We studied the structural relationship established by our hypothesized model via a structural equation modeling approach. Results. We checked the standardized path coefficients and the modification indices; the modified model's statistics were a good fit: CFI = 0.984, TLI = 0.983, RMSEA = 0.050, 90% CI [0.044-0.055]. Achievement motive had a significantly direct effect on purpose in life (direct effect = 0.445, p value < 0.001), a significantly indirect effect on purpose in life via social participation or role expectation (indirect effect = 0.170, p value < 0.001) and a total effect on purpose in life (total effect = 0.615). Discussion. This result suggests that enhancing the intention to achieve one's goals enables participants to feel a spirit of challenge with a purpose and a sense of fulfillment in their daily lives.

  12. [Effects of lindane upon the reproductive function in four generations running in the quail. Studies of gonads and müllerian tract in embryos, one day chicken and adults (author's transl)].

    PubMed

    Lutz-Ostertag, Y

    1981-01-01

    The effect of lindane commercial solution spraying on quail eggs is studied in four generations running issued from a single parental strain. Observations have been made on fourteen-day embryos, one-day chicken and also two-or eight-month adults quail. The results lead to conclude that pathogenous effects of lindane on gonads and müllerian tract are slowly annuled through successive generations when the experimental procedure consists in treating only the parental eggs. Conversely, following pesticide administration repeated at every generation, the action becomes cumulative and the ratio of aberrations increases. In ovarian and testicular tissues there are cyto-histopathological modifications. Many gonocytes are abnormal and cannot divide. Some of these cells degenerate at the meiotic prophase. Egg production and fertility in adults depend on these phenomenons.

  13. Are the dental health needs of adults with illegal drug dependence being met by current service provision in the United Kingdom?: a literature review.

    PubMed

    Hewson, Victoria; Wray, Jane

    2012-10-01

    This literature review outlines the current issues and debates relating to the dental health of adults with drug dependence. The dental health of adults with illegal drug dependence (IDD) continues to be under debate throughout dental practice, and the most appropriate model of care suitable to meet the high complex needs of this client group remains uncertain. The study aims to review and critically analyze available research relating to the oral health effects of illegal drug misuse and the dental health needs and status of adults with drug dependence. Second, it aims to identify and critically evaluate current models of dental service/care delivery, including relevant best practice guidance and potential barriers to dental access for adults with IDD. The available literature pertaining to dental health and adults with drug dependence are systematically reviewed and critically analyzed and evaluated in order to execute a rigorous investigation. The oral effects along with general medical complications associated with IDD are increasingly being recognized. There are substantive negative effects of IDD on oral health, particularly for those with opioid dependence; therefore, these clients have high complex dental needs and low use of dental services. Adults with drug dependence comprise a group with special dental needs and therefore need greater access to dental care than most people due to their high level of need. A high awareness of the implications for oral health care for adults with drug dependence is essential. Dental professionals have a key role in supporting the rehabilitation of these patients from potentially severe or fatal addictions. There is a distinct lack of national policy and guidance relating specifically to adults with drug dependence, and therefore, problems persist. Key findings and recommendations are presented to enhance the development of dental services for adults with IDD.

  14. The role of social isolation of elders in recidivism of self-neglect cases at San Francisco Adult Protective Services.

    PubMed

    Spensley, Catherine

    2008-01-01

    This study examined the relationship between social isolation of elders and recidivism of self-neglect cases at San Francisco Adult Protective Services. Of secondary interest was an examination of other risk factors: mental health concerns, cognitive deficits, and substance/alcohol abuse. A secondary chart review was conducted on 704 elder clients with confirmed cases of self-neglect in 2004. Bivariate and multivariate analyses showed a positive relationship between substance/ alcohol abuse and recidivism, and a negative relationship between cognitive decline and recidivism. No significant relationships were found for social isolation or mental health concerns and recidivism. This study supports previous research suggesting significant relationships between substance abuse and self-neglect, further demonstrating a need for more substance/alcohol abuse programs for elders.

  15. Multidimensional Measurement Within Adult Protective Services: Design and Initial Testing of the Tool for Risk, Interventions, and Outcomes

    PubMed Central

    Sommerfeld, David H.; Henderson, Linda B.; Snider, Marcy A.; Aarons, Gregory A.

    2014-01-01

    This study describes the development, field utility, reliability, and validity of the multidimensional Tool for Risk, Interventions, and Outcomes (TRIO) for use in Adult Protective Services (APS). The TRIO is designed to facilitate consistent APS practice and collect data related to multiple dimensions of typical interactions with APS clients, including the investigation and assessment of risks, the provision of APS interventions, and associated health and safety outcomes. Initial tests of the TRIO indicated high field utility, social worker “relevance and buy-in,” and inter-rater reliability. TRIO concurrent validity was demonstrated via appropriate patterns of TRIO item differentiation based on the type of observed confirmed abuse or neglect; and predictive validity was demonstrated by prediction of the risk of actual APS recurrence. The TRIO is a promising new tool that can help meet the challenges of providing and documenting effective APS practices and identifying those at high risk for future APS recurrence. PMID:24848994

  16. Career Day

    NASA Video Gallery

    NASA's 2013 Career Days was a joint collaboration between NASA Langley and the Newport News Shipbuilding where 600 high school students from Virginia took on two design challenges -- designing a ca...

  17. Two Worlds of Day Care: The Practitioner and the Researcher = Deux Mondes des Services de Garderie: La Pratique et la Recherche.

    ERIC Educational Resources Information Center

    Pence, Alan R.

    This brief essay, presented in parallel English and French versions, highlights the process by which day care practice and day care research have begun to overlap. First, the development of day care research in North America is presented in a "generational" model. It is argued that a shift has occurred from general child care…

  18. Association between helicopter with physician versus ground emergency medical services and survival of adults with major trauma in Japan

    PubMed Central

    2014-01-01

    Introduction Helicopter emergency medical services with a physician (HEMS) has been provided in Japan since 2001. However, HEMS and its possible effect on outcomes for severe trauma patients have still been debated as helicopter services require expensive and limited resources. Our aim was to analyze the association between the use of helicopters with a physician versus ground services and survival among adults with serious traumatic injuries. Methods This multicenter prospective observational study involved 24,293 patients. All patients were older than 15 years of age, had sustained blunt or penetrating trauma and had an Injury Severity Score (ISS) higher than 15. All of the patient data were recorded between 2004 and 2011 in the Japan Trauma Data Bank, which includes data from 114 major emergency hospitals in Japan. The primary outcome was survival to discharge from hospitals. The intervention was either transport by helicopter with a physician or ground emergency services. Results A total of 2,090 patients in the sample were transported by helicopter, and 22,203 were transported by ground. Overall, 546 patients (26.1%) transported by helicopter died compared to 5,765 patients (26.0%) transported by ground emergency services. Patients transported by helicopter had higher ISSs than those transported by ground. In multivariable logistic regression, helicopter transport had an odds ratio (OR) for survival to discharge of 1.277 (95% confidence interval (CI), 1.049 to 1.556) after adjusting for age, sex, mechanism of injury, type of trauma, initial vital signs (including systolic blood pressure, heart rate and respiratory rate), ISS and prehospital treatment (including intubation, airway protection maneuver and intravenous fluid). In the propensity score–matched cohort, helicopter transport was associated with improved odds of survival compared to ground transport (OR, 1.446; 95% CI, 1.220 to 1.714). In conditional logistic regression, after adjusting for

  19. [Mental health of children, adolescents and young adults--part 1: prevalence, illness persistence, adversities, service use, treatment delay and consequences].

    PubMed

    Lambert, M; Bock, T; Naber, D; Löwe, B; Schulte-Markwort, M; Schäfer, I; Gumz, A; Degkwitz, P; Schulte, B; König, H H; Konnopka, A; Bauer, M; Bechdolf, A; Correll, C; Juckel, G; Klosterkötter, J; Leopold, K; Pfennig, A; Karow, A

    2013-11-01

    Numerous birth-control studies, epidemiological studies, and observational studies have investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use by children, adolescents and young adults is low, even lower than for adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for a poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the interface of child and adolescent and adult psychiatry. Emerging studies show that these health-care structures are effective and efficient. Part 1 of the present review summarises the current state of mental health in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, and treatment delay with consequences.

  20. Lost in transition: child to adult cancer services for young people.

    PubMed

    McInally, Wendy

    Cancer nursing care across the UK has dramatically improved for children and young people with cancer over the past 20 years (Department of Health, 2007). Around 70% of young people diagnosed with cancer survive into adulthood, albeit with long-term health complications (Scottish Government, 2012). This raises the contemporary concern of how best to transition these patients to an adult-focused care regime (National Cancer Survivorship Initiative, 2012). With support from a Florence Nightingale Foundation Travel Scholarship in 2012, this study compared the various transition models currently in use across the UK, Finland and the USA with a clear focus on individual patient choice, staff education and preparation to care for this group of patients and their families. The findings revealed wide discrepancy in current nursing practices across the globe. This article presents a series of findings and recommendations to improve further the overall cancer experience for young people living with and beyond a cancer diagnosis.

  1. Implementation of Medicaid Managed Long-Term Services and Supports for Adults With Intellectual and/or Developmental Disabilities in Kansas.

    PubMed

    Williamson, Heather J; Perkins, Elizabeth A; Levin, Bruce L; Baldwin, Julie A; Lulinski, Amie; Armstrong, Mary I; Massey, Oliver T

    2017-04-01

    Many adults with intellectual and/or developmental disabilities (IDD) can access health and long-term services and supports (LTSS) through Medicaid. States are reforming their Medicaid LTSS programs from a fee-for-service model to a Medicaid managed LTSS (MLTSS) approach, anticipating improved quality of care and reduced costs, although there is limited evidence of MLTSS effectiveness. This study's objective was to contribute to the growing MLTSS research literature by describing MLTSS implementation in Kansas for adults with IDD. Thirty-one stakeholders completed in-depth semi-structured interviews, representing state or regional groups, service coordination providers, and family caregivers. Findings identify key aspects of the Centers for Medicare and Medicaid Services' new MLTSS regulations in the design and implementation of MLTSS programs.

  2. Learning and Change in the Adult Years: A Developmental Perspective. First Edition. Jossey-Bass Higher and Adult Education Series. Jossey-Bass Social and Behavioral Service Series.

    ERIC Educational Resources Information Center

    Tennant, Mark; Pogson, Philip

    Aimed at adult education practitioners engaged in graduate study, this book draws on the field of developmental psychology to provide new insights into the critical connections between experience and learning in adult education and training. Chapter 1 introduces the role of psychological development in adult learning, investment of "self" in…

  3. Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers

    PubMed Central

    Gomes, Barbara; Calanzani, Natalia; Curiale, Vito; McCrone, Paul; Higginson, Irene J

    2013-01-01

    Background Extensive evidence shows that well over 50% of people prefer to be cared for and to die at home provided circumstances allow choice. Despite best efforts and policies, one-third or less of all deaths take place at home in many countries of the world. Objectives 1. To quantify the effect of home palliative care services for adult patients with advanced illness and their family caregivers on patients' odds of dying at home; 2. to examine the clinical effectiveness of home palliative care services on other outcomes for patients and their caregivers such as symptom control, quality of life, caregiver distress and satisfaction with care; 3. to compare the resource use and costs associated with these services; 4. to critically appraise and summarise the current evidence on cost-effectiveness. Search methods We searched 12 electronic databases up to November 2012. We checked the reference lists of all included studies, 49 relevant systematic reviews, four key textbooks and recent conference abstracts. We contacted 17 experts and researchers for unpublished data. Selection criteria We included randomised controlled trials (RCTs), controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series (ITSs) evaluating the impact of home palliative care services on outcomes for adults with advanced illness or their family caregivers, or both. Data collection and analysis One review author assessed the identified titles and abstracts. Two independent reviewers performed assessment of all potentially relevant studies, data extraction and assessment of methodological quality. We carried out meta-analysis where appropriate and calculated numbers needed to treat to benefit (NNTBs) for the primary outcome (death at home). Main results We identified 23 studies (16 RCTs, 6 of high quality), including 37,561 participants and 4042 family caregivers, largely with advanced cancer but also congestive heart failure (CHF), chronic obstructive

  4. Factors Contributing to the Utilization of Adult Mental Health Services in Children and Adolescents Diagnosed with Hyperkinetic Disorder

    PubMed Central

    Blasco-Fontecilla, Hilario; Carballo, Juan J.; Garcia-Nieto, Rebeca; Lopez-Castroman, Jorge; Alegria, Analucia A.; Basurte-Villamor, Ignacio; Sevilla-Vicente, Juncal; Navarro-Jimenez, Rocio; Legido-Gil, Teresa; Morant-Ginestar, Consuelo; Jimenez-Arriero, Miguel Angel; Saiz-Ruiz, Jeronimo; Baca-Garcia, Enrique

    2012-01-01

    Objectives. To examine whether age of First diagnosis, gender, psychiatric comorbidity, and treatment modalities (pharmacotherapy or psychotherapy) at Child and Adolescent Mental Health Services (CAMHS) moderate the risk of Adult Mental Health Services (AMHS) utilization in patients diagnosed with hyperkinetic disorder at CAMHS. Methods. Data were derived from the Madrid Psychiatric Cumulative Register Study. The target population comprised 32,183 patients who had 3 or more visits at CAMHS. Kaplan-Meier curves were used to assess survival data. A series of logistic regression analyses were performed to study the role of age of diagnosis, gender, psychiatric comorbidity, and treatment modalities. Results. 7.1% of patients presented with hyperkinetic disorder at CAMHS. Compared to preschool children, children and adolescents first diagnosed with hyperkinetic disorder at CAMHS were more likely to use AMHS. Female gender and comorbidity with affective disorders, schizophrenia, schizotypal and delusional disorders increased the risk of use of AMHS. Pharmacological or combined treatment of hyperkinetic disorder diagnosed at CAMHS was associated with increased risk of use at AMHS. Conclusions. Older age of first diagnosis, female gender, psychiatric comorbidity, and pharmacological treatment at CAMHS are markers of risk for the transition from CAMHS to AMHS in patients with hyperkinetic disorder diagnosed at CAMHS. PMID:22654608

  5. The Senior Community Service Employment Program: The First 25 Years.

    ERIC Educational Resources Information Center

    Salisbury, Karen, Ed.

    The Senior Community Service Employment Program (SCSEP) provides subsidized, part-time employment to low-income persons age 55 and older. Participants work an average of 20 hours a week and are employed in a wide variety of community service activities and facilities, including home health care, adult day care, and nutritional services. The 11…

  6. Intensive Group Learning and On-Site Services to Improve Sexual and Reproductive Health Among Young Adults in Liberia: A Randomized Evaluation of HealthyActions

    PubMed Central

    Firestone, Rebecca; Moorsmith, Reid; James, Simon; Urey, Marilyn; Greifinger, Rena; Lloyd, Danielle; Hartenberger-Toby, Lisa; Gausman, Jewel; Sanoe, Musa

    2016-01-01

    ABSTRACT Introduction: Young Liberians, particularly undereducated young adults, face substantial sexual and reproductive health (SRH) challenges, with low uptake of contraceptive methods, high rates of unintended pregnancy, and low levels of knowledge about HIV status. The purpose of this study was to assess the impact of a 6-day intensive group learning intervention combined with on-site SRH services (called HealthyActions) among out-of-school young adults, implemented through an existing alternative education program, on uptake of contraception and HIV testing and counseling (HTC). Methods: The intervention was implemented among young women and men ages 15–35 who were enrolled in alternative basic education learning sites in 5 counties of Liberia. We conducted a randomized evaluation to assess program impact. Baseline data were collected in January–March 2014, and endline data in June–July 2014. Key outcomes of condom use, contraceptive use, and HTC were estimated with difference-in-difference models using fixed effects. All analyses were conducted in Stata 13. Results: We assessed outcomes for 1,157 learners at baseline and 1,052 learners at endline, across 29 treatment and 26 control sites. After adjusting for potential confounders, learners in the HealthyActions intervention group were 12% less likely to report never using a condom with a regular partner over the last month compared with the control group (P = .02). Female learners who received HealthyActions were 13% more likely to use any form of modern contraception compared with learners in control sites (P<.001), with the greatest increase in the use of contraceptive implants. Learners in HealthyActions sites were 45% more likely to have received HTC (P<.001). Conclusion: Providing intensive group learning in a supportive environment coupled with on-site health services improved SRH outcomes among participating learners. The focus of HealthyActions on participatory learning for low

  7. A Community-Based, Technology-Supported Health Service for Detecting and Preventing Frailty among Older Adults: A Participatory Design Development Process.

    PubMed

    van Velsen, Lex; Illario, Maddalena; Jansen-Kosterink, Stephanie; Crola, Catherine; Di Somma, Carolina; Colao, Annamaria; Vollenbroek-Hutten, Miriam

    2015-01-01

    Frailty is a multifaceted condition that affects many older adults and marks decline on areas such as cognition, physical condition, and nutritional status. Frail individuals are at increased risk for the development of disability, dementia, and falls. There are hardly any health services that enable the identification of prefrail individuals and that focus on prevention of further functional decline. In this paper, we discuss the development of a community-based, technology-supported health service for detecting prefrailty and preventing frailty and further functional decline via participatory design with a wide range of stakeholders. The result is an innovative service model in which an online platform supports the integration of traditional services with novel, Information Communication Technology supported tools. This service is capable of supporting the different phases of screening and offers training services, by also integrating them with community-based services. The service model can be used as a basis for developing similar services within a wide range of healthcare systems. We present the service model, the general functioning of the technology platform, and the different ways in which screening for and prevention of frailty has been localized. Finally, we reflect on the added value of participatory design for creating such health services.

  8. A Community-Based, Technology-Supported Health Service for Detecting and Preventing Frailty among Older Adults: A Participatory Design Development Process

    PubMed Central

    van Velsen, Lex; Illario, Maddalena; Jansen-Kosterink, Stephanie; Crola, Catherine; Di Somma, Carolina; Colao, Annamaria; Vollenbroek-Hutten, Miriam

    2015-01-01

    Frailty is a multifaceted condition that affects many older adults and marks decline on areas such as cognition, physical condition, and nutritional status. Frail individuals are at increased risk for the development of disability, dementia, and falls. There are hardly any health services that enable the identification of prefrail individuals and that focus on prevention of further functional decline. In this paper, we discuss the development of a community-based, technology-supported health service for detecting prefrailty and preventing frailty and further functional decline via participatory design with a wide range of stakeholders. The result is an innovative service model in which an online platform supports the integration of traditional services with novel, Information Communication Technology supported tools. This service is capable of supporting the different phases of screening and offers training services, by also integrating them with community-based services. The service model can be used as a basis for developing similar services within a wide range of healthcare systems. We present the service model, the general functioning of the technology platform, and the different ways in which screening for and prevention of frailty has been localized. Finally, we reflect on the added value of participatory design for creating such health services. PMID:26346580

  9. Capitol Day

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Stennis Space Center Director Gene Goldman visits with Mississippi Gov. Haley Barbour during NASA Day at the Capitol activities on Feb. 19. During the visit, Goldman presented the governor with a model of the J-2X rocket engine currently in development. Stennis engineers did early component testing for the new engine.

  10. Inspire Day

    ERIC Educational Resources Information Center

    Bohach, Barbara M.; Meade, Birgitta

    2014-01-01

    The authors collaborated on hosting a "Spring Inspire Day." planned and delivered by preservice elementary teachers as a social studies/science methods project. Projects that have authentic application opportunities can make learning meaningful for prospective teachers as well as elementary students. With the impetus for an integrated…

  11. Developing a Network of Adult Learning Documentation and Information Services. Directory of Members = Repertoire des Membres = Directorio de los Miembros = Mitgliederverzeichnis.

    ERIC Educational Resources Information Center

    Giere, Ursula

    This directory contains profiles of 89 adult education documentation and information services worldwide that are interested in international cooperation and networking. The foreword and executive summary are in English, French, Spanish, and German. These are followed by a discussion of the survey that collected information contained in the…

  12. The Development of Individualized Supportive Services for Physically and Sensorially Limited Adults at a Post-Secondary Area Vocational School. Final Report. January 1975-June 1977.

    ERIC Educational Resources Information Center

    Kelley, Catherine H.

    A project was conducted to develop and implement a coordinated program of supportive services for the physically and sensorially limited adult at the postsecondary level. Phase I consisted of removing architectural barriers, establishing an advisory committee, staffing the project, preparing the budget, and purchasing needed equipment. During…

  13. Survey of the Target Audience for the Adult Learning Program Service (ALPS), with a Review of Pertinent Research Studies. A Report to the Corporation for Public Broadcasting.

    ERIC Educational Resources Information Center

    Center for Urban Education, New York, NY.

    To provide information on the target audience for the Adult Learning Program Service (ALPS), a television series being developed by the Corporation for Public Broadcasting, interviews were conducted with a small national sample of potential viewers. The main focus of the study was an examination of the social-psychological aspects of a decision…

  14. Share Your Experience and I'll Lend You My Ear: Older Adult Outcomes of an Intergenerational Service-Learning Experience

    ERIC Educational Resources Information Center

    Zucchero, Renee A.

    2010-01-01

    Intergenerational service learning is frequently used in gerontology courses. However, research usually focuses on the experience of the younger (e.g., children, youth, adolescents, students) rather than older participants, or older adults who are in poor health. Using a focus group methodology, this study explored the experience of active older…

  15. Knowledge, Attitudes and Behaviors of Older Adults and College Students Participating in Recycling Mentors, a Service-Learning, Environmental Health Education Program

    ERIC Educational Resources Information Center

    D'Abundo, Michelle Lee; Fugate-Whitlock, Elizabeth; Fiala, Kelly Ann; Covan, Eleanor Krassen

    2013-01-01

    Purpose: The purpose of this research was to assess the knowledge, attitudes and practices of both students and older adults that participated in a service-learning, environmental health education program called Recycling Mentors (RM). Methods: Surveys were conducted before and after participation in RM. Quantitative data were analyzed using SPSS.…

  16. Cohesion to the Group and Its Association with Attendance and Early Treatment Response in an Adult Day-Hospital Program for Eating Disorders: A Preliminary Clinical Investigation

    ERIC Educational Resources Information Center

    Crino, Natalie; Djokvucic, Ivana

    2010-01-01

    Treatment outcome studies demonstrate that day-hospital programs are effective in the treatment of eating disorders. Few descriptions are available on the specifics of treatment, particularly the process of therapy. The group therapy modality is thought to provide important therapeutic benefits. The present study aimed to examine the association…

  17. Service-Learning at Dementia Care Programs: An Orientation and Training Program

    ERIC Educational Resources Information Center

    Lambert-Shute, Jennifer J.; Jarrott, Shannon E.; Fruhauf, Christine A.

    2004-01-01

    The present paper describes a project that addresses the unique challenge service-learners face at dementia care programs. The project was conducted in conjunction with two courses on aging that offer students a service-learning (S-L) option at a university adult day service (ADS) program that accepts service-learners from these courses. The…

  18. Effective process or dangerous precipice: qualitative comparative embedded case study with young people with epilepsy and their parents during transition from children’s to adult services

    PubMed Central

    2013-01-01

    Background Transition from children’s to adult epilepsy services is known to be challenging. Some young people partially or completely disengage from contact with services, thereby risking their health and wellbeing. We conducted a mixed-method systematic review that showed current epilepsy transition models enabling information exchange and developing self-care skills were not working well. We used synthesised evidence to develop a theoretical framework to inform this qualitative study. The aim was to address a critical research gap by exploring communication, information needs, and experiences of knowledge exchange in clinical settings by young people and their parents, during transition from children’s to adult epilepsy services. Method Qualitative comparative embedded Case study with 2 'transition’ cases (epilepsy services) in two hospitals. Fifty-eight participants: 30 young people (13–19 years) and 28 parents were interviewed in-depth (individual or focus group). Clinical documents/guidelines were collated. 'Framework’ thematic analysis was used. The theoretical framework was tested using themes, pattern matching and replication logic. Theory-based evaluation methods were used to understand how and why different models of service delivery worked. Results A joint epilepsy clinic for young people 14–17 years coordinated by children’s and adult services was more likely to influence young people’s behaviour by facilitating more positive engagement with adult healthcare professionals and retention of epilepsy-related self-care information. Critical success factors were continuity of care, on-going and consistent age-appropriate and person centred communication and repeated information exchange. Three young people who experienced a single handover clinic disengaged from services. Psychosocial care was generally inadequate and healthcare professionals lacked awareness of memory impairment. Parents lacked knowledge, skills and support to enable their

  19. An Assessment Inventory for the Day Care Child. Volume II: Field Evaluation and Preliminary Findings. Center for Human Services Development, Report No. 25.

    ERIC Educational Resources Information Center

    Kirchner, Elizabeth P.

    This is the second of a two volume report of a Day Care Inventory. The author presents an evaluation of the Inventory and make recommendations for changes, deletions and additions so that more satisfactory measures will be available for use in the study of the impact of day care on child development. The evaluations are based upon the findings…

  20. Retirement or Just a Change of Pace: An Australian National Survey of Disability Day Services Used by Older People with Disabilities

    ERIC Educational Resources Information Center

    Bigby, Christine; Balandin, Susan; Fyffe, Chris; McCubbery, Jeffrey; Gordon, Meg

    2004-01-01

    The increasing number of people with disabilities surviving to old age raises questions regarding the type of day support programs necessary to meet their needs. In this paper the results of a national survey of specialist disability day programs used by older 2 Definitions of old age selected by researchers should reflect differences in culture…