Sample records for adult protective service

  1. National Adult Protective Services Association

    MedlinePlus

    ... What’s New with NAPSA? REPORT ABUSE, NEGLECT AND FINANCIAL EXPLOITATION OF VULNERABLE ADULTS! Need to make a report to adult protective services? Learn more about APS or visit our report page for state reporting numbers. Discharge Planning: Guidance for Adult Protective Services ...

  2. An Adult Protective Services' view of collaboration with Mental Health Services.

    PubMed

    Teaster, Pamela B; Stansbury, Kim L; Nerenberg, Lisa; Stanis, Patricia

    2009-10-01

    Mental Health Services (MHS) meet mental health needs of older adults through active, outpatient, community-based care. Adult Protective Services (APS) are involved with needs of older adults who have mental disability and mental illness. Adult Protective Services and MHS staff may to work together when they respond to the needs of victims and adults at risk for abuse, neglect, self-neglect, and exploitation. The purpose of this study was to understand effective APS-MHS collaborations (e.g., leadership, organizational culture, administration, and resources in predicting success). A survey that was sent to members of the National Adult Protective Services Association (NAPSA) revealed that both APS and MHS have strong commitments to protecting clients' rights and autonomy, but there appear to be differences between the two with regard to implementation, apparent in cases involving clients with diminished mental capacity who are at imminent risk, but who refuse help. Strengths of APS-MHS collaborations included improved communication and better service for at-risk clients.

  3. 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…

  4. 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:…

  5. 25 CFR 20.402 - When are protective services provided?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.402 When are protective services provided? Protective services are provided when children or adults: (a) Are deprived temporarily or permanently of needed supervision by responsible adults; (b) Are neglected, abused or exploited...

  6. An ecological systems examination of elder abuse: a week in the life of adult protective services.

    PubMed

    Wangmo, Tenzin; Teaster, Pamela B; Grace, James; Wong, Wilson; Mendiondo, Marta S; Blandford, Caitlin; Fisher, Steve; Fardo, David W

    2014-01-01

    Using Bronfenbrenner's ecological systems model, this study examined allegations of elder abuse made to Kentucky Adult Protective Services (APS) and the investigation that followed, in order to understand how APS addressed the needs of abused elders. Elder abuse allegations made to APS during the study week were collected using 3 study tools. Allegations and resulting investigations were analyzed. During the study week, APS received 1,002 calls alleging elder abuse. Of these, 483 were categorized as reports needing protective services, with 177 reports screened in for investigation and 167 actually investigated. Results describe characteristics of abuse calls, investigations, victims, perpetrators, and total investigation times. Substantiation ratio, recidivism, and whether investigation increased or decreased the risk of abuse were also assessed. An examination of APS casework through the lens of nested systems frames the study findings and discussion. Such an examination has the potential to improve the quality of services provided to older adults.

  7. Perceived Educational Needs and Preparation of Adult Protective Services Workers for Practice with End-of-Life Issues

    ERIC Educational Resources Information Center

    Csikai, Ellen L.; Durkin, Daniel W.

    2009-01-01

    As the number of older adults in the United States increases, so will the expected number of allegations of elder abuse. Adult protective services (APS) staff are likely to handle much more complex situations, and in growing numbers, due to the presence of chronic and life-limiting conditions of their clients. The APS workers, in this national…

  8. Developing an undue influence screening tool for Adult Protective Services.

    PubMed

    Quinn, Mary Joy; Nerenberg, Lisa; Navarro, Adria E; Wilber, Kathleen H

    2017-03-01

    The study purpose was to develop and pilot an undue influence screening tool for California's Adult Protective Services (APS) personnel based on the definition of undue influence enacted into California law January 1, 2014. Methods included four focus groups with APS providers (n = 33), piloting the preliminary tool by APS personnel (n = 15), and interviews with four elder abuse experts and two APS administrators. Social service literature-including existing undue influence models-was reviewed, as were existing screening and assessment tools. Using the information from these various sources, the California Undue Influence Screening Tool (CUIST) was developed. It can be applied to APS cases and potentially adapted for use by other professionals and for use in other states. Implementation of the tool into APS practice, policy, procedures, and training of personnel will depend on the initiative of APS management. Future work will need to address the reliability and validity of CUIST.

  9. A survey of georgia adult protective service staff: implications for older adult injury prevention and policy.

    PubMed

    Strasser, Sheryl M; Kerr, Judith; King, Patricia S; Payne, Brian; Beddington, Sarah; Pendrick, Danielle; Leyda, Elizabeth; McCarty, Frances

    2011-07-01

    The aging population is a rapidly growing demographic. Isolation and limited autonomy render many of the elderly vulnerable to abuse, neglect and exploitation. As the population grows, so does the need for Adult Protective Services (APS). This study was conducted to examine current knowledge of older adult protection laws in Georgia among APS staff and to identify training opportunities to better prepare the APS workforce in case detection and intervention. The Georgia State University Institute of Public Health faculty developed a primary survey in partnership with the Georgia Division of Aging Services' leadership to identify key training priority issues for APS caseworkers and investigators. A 47-item electronic questionnaire was delivered to all APS employees via work-issued email accounts. We conducted descriptive analyses, t-tests and chi-square analyses to determine APS employees' baseline knowledge of Georgia's elder abuse policies, laws and practices, as well as examine associations of age, ethnicity, and educational attainment with knowledge. We used a p-value of 0.05 and 95% confidence intervals to determine statistical significance of analyses performed. Ninety-two out of 175 APS staff responded to the survey (53% response rate). The majority of respondents were Caucasian (56%) women (92%). For over half the survey items, paired sample t-tests revealed significant differences between what APS staff reported as known and what APS staff members indicated they needed to know more about in terms of elder abuse and current policies. Chi-square tests revealed that non-Caucasians significantly preferred video conferencing as a training format (44% compared to 18%), [χ(2)(1) = 7.102, p < .008], whereas Caucasians preferred asynchronous online learning formats (55% compared to 28%) [χ(2)(1) =5.951, p < .015]. Results from this study provide the Georgia Division of Aging with insight into specific policy areas that are not well understood by APS staff

  10. Childhood Maltreatment and Child Protective Services Involvement Among the Commercially Sexually Exploited: A Comparison of Women Who Enter as Juveniles or as Adults.

    PubMed

    Cimino, Andrea N; Madden, Elissa E; Hohn, Kris; Cronley, Courtney M; Davis, Jaya B; Magruder, Karen; Kennedy, M Alexis

    2017-04-01

    A risk for commercial sexual exploitation is childhood maltreatment. It's unknown whether juveniles in commercial sexual exploitation experience more childhood maltreatment than adults or how involved child protective services is in investigating maltreatment, a focus of this study. Women (N = 96) who sold sex commercially completed a cross-sectional questionnaire. Descriptive statistics, t tests, chi-squares, and odds ratios were used to examine differences in background, childhood maltreatment, and child protective services involvement by juvenile or adult entry. Although 93% of participants experienced child maltreatment, juveniles had increased odds of parent/caregiver sexual abuse, being left alone, being kicked out, and running away from a parent/caregiver. There were no differences in cumulative childhood maltreatment resulting in an investigation or removal, indicating that juveniles not investigated or removed by child protective services had as much childhood maltreatment as juveniles who were investigated or removed by child protective services. Results highlight the need for child welfare staff to recognize childhood maltreatment as risks for commercial sexual exploitation.

  11. The patient protection and affordable care act: what does it mean for mental health services for older adults?

    PubMed

    Sorrell, Jeanne M

    2012-11-01

    The U.S. Supreme Court recently upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA). It is important to think about how this act will affect mental health services for older adults. The act has the potential to improve health outcomes across all income and age groups. There are specific provisions that are expected to improve care for individuals with mental illness, but there is little information about how these provisions will affect older adults with mental illness. As we move toward implementation of the PPACA, psychiatric nurses need to be aware of myths surrounding the act and to think about changes in the health care system, such as collaborative models of care, that may help identify and overcome barriers to treatment of older adults with mental illness. Copyright 2012, SLACK Incorporated.

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

    PubMed

    Phelan, A; Fealy, G; Downes, C

    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. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Identification and characteristics of vulnerable adults attending an inner city sexual health service.

    PubMed

    Sullivan, Verity; Cheserem, Emily; Milne, Cliodhna; Hopkins, Marina; Lock, Eleanor; Hamlyn, Elizabeth

    2015-10-01

    Adult safeguarding is the function of protecting vulnerable adults from abuse or neglect. The 2012 Department of Health Draft Care and Support Bill highlighted adult safeguarding as a key government priority and stated that a clear framework is required for organisations dealing with 'adults at risk'. Adults at risk present to sexual health services but no formal guidance currently exists to aid their identification and management in this setting. We conducted a retrospective case note review which identified that vulnerable adults attend our service. They may display recognised risk factors, awareness of which is likely to facilitate identification and assessment of this group and aid appropriate onward referral. © The Author(s) 2015.

  14. Interagency collaboration between child protection and mental health services: practices, attitudes and barriers.

    PubMed

    Darlington, Yvonne; Feeney, Judith A; Rixon, Kylie

    2005-10-01

    The aim of this paper is to examine some of the factors that facilitate and hinder interagency collaboration between child protection services and mental health services in cases where there is a parent with a mental illness and there are protection concerns for the child(ren). The paper reports on agency practices, worker attitudes and experiences, and barriers to effective collaboration. A self-administered, cross-sectional survey was developed and distributed via direct mail or via line supervisors to workers in statutory child protection services, adult mental health services, child and youth mental health services, and Suspected Child Abuse and Neglect (SCAN) Teams. There were 232 completed questionnaires returned, with an overall response rate of 21%. Thirty-eight percent of respondents were statutory child protection workers, 39% were adult mental health workers, 16% were child and youth mental health workers, and 4% were SCAN Team medical officers (with 3% missing data). Analysis revealed that workers were engaging in a moderate amount of interagency contact, but that they were unhappy with the support provided by their agency. Principle components analysis and multivariate analysis of variance (MANOVA) on items assessing attitudes toward other workers identified four factors, which differed in rates of endorsement: inadequate training, positive regard for child protection workers, positive regard for mental health workers, and mutual mistrust (from highest to lowest level of endorsement). The same procedure identified the relative endorsement of five factors extracted from items about potential barriers: inadequate resources, confidentiality, gaps in interagency processes, unrealistic expectations, and professional knowledge domains and boundaries. Mental health and child protection professionals believe that collaborative practice is necessary; however, their efforts are hindered by a lack of supportive structures and practices at the organizational level.

  15. Applying the Recovery Approach to the Interface between Mental Health and Child Protection Services

    ERIC Educational Resources Information Center

    Duffy, Joe; Davidson, Gavin; Kavanagh, Damien

    2016-01-01

    There is a range of theoretical approaches which may inform the interface between child protection and adult mental health services. These theoretical perspectives tend to be focused on either child protection or mental health with no agreed integrating framework. The interface continues to be identified, in research, case management reviews and…

  16. Reactions of protective service workers towards people who stutter.

    PubMed

    Li, Jian; Arnold, Hayley S; Beste-Guldborg, Ann

    2016-12-01

    This study sought to assess whether protective service workers differ from people in non-protective services occupations in their intended reactions towards people who stutter (PWS). Analyses were based on questionnaire responses regarding intended reactions toward PWS from 171 protective services workers and 2595 non-protective services workers in the United States. A propensity score matching procedure was used to identify a comparison group of non-protective services workers for the protective services workers. The matching covariate variables included age, gender, years of education, familiarity with PWS, and beliefs about PWS. Findings indicated that protective services workers had less helpful intended behavioral reactions and more negative affective reactions towards PWS than the matched non-protective services workers. Examination of the matching covariate variables in the larger sample also indicated that protective services workers had less accurate beliefs about PWS compared to respondents not in protective services professions. Less favorable intended reactions of protective services workers toward PWS indicate a need for protective services workers to receive training in best practices when interacting with PWS. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. 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.

  18. Behavioral health services utilization among older adults identified within a state abuse hotline database.

    PubMed

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

    2006-04-01

    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. We compared Medicaid and Medicare claims data for two groups of older adults: those using health services and identified within a statewide abuse hotline information system and those claimants not identified within the hotline database. Behavioral health service use was greater among those identified in the abuse hotline database. The penetration rate (percentage of service users out of all enrollees) for Medicaid behavioral health service claims was more than twice that of other service users, with costs of services about 30% greater. Analyses of Medicare data revealed that the penetration rate for those in the hotline data was almost 6 times greater at approximately twice the cost compared to other service users. The results provide evidence for previous assumptions that mistreated individuals experience a higher rate of behavioral health disorders. As mental health screening by adult protective services is rarely conducted, the results suggest the need to train investigators and other service providers to screen older adults for behavioral health and substance-abuse issues as well as physical signs of abuse. Further research on the relationship of abuse to behavioral health might focus on collection of additional data involving more specific victim-related characteristics and comparisons of cases of mistreatment versus self-neglect.

  19. Adult Day Services

    MedlinePlus

    ... views of various members of the National Adult Day Services Association. 2. U.S. Health Care Costs: Background Brief , The Henry J. Kaiser Family Foundation (2008) (www.kaiseredu.org); excerpt ...

  20. To what extent can ecosystem services motivate protecting biodiversity?

    PubMed

    Dee, Laura E; De Lara, Michel; Costello, Christopher; Gaines, Steven D

    2017-08-01

    Society increasingly focuses on managing nature for the services it provides people rather than for the existence of particular species. How much biodiversity protection would result from this modified focus? Although biodiversity contributes to ecosystem services, the details of which species are critical, and whether they will go functionally extinct in the future, are fraught with uncertainty. Explicitly considering this uncertainty, we develop an analytical framework to determine how much biodiversity protection would arise solely from optimising net value from an ecosystem service. Using stochastic dynamic programming, we find that protecting a threshold number of species is optimal, and uncertainty surrounding how biodiversity produces services makes it optimal to protect more species than are presumed critical. We define conditions under which the economically optimal protection strategy is to protect all species, no species, and cases in between. We show how the optimal number of species to protect depends upon different relationships between species and services, including considering multiple services. Our analysis provides simple criteria to evaluate when managing for particular ecosystem services could warrant protecting all species, given uncertainty. Evaluating this criterion with empirical estimates from different ecosystems suggests that optimising some services will be more likely to protect most species than others. © 2017 John Wiley & Sons Ltd/CNRS.

  1. Identifying spatial priorities for protecting ecosystem services

    PubMed Central

    Luck, Gary W

    2012-01-01

    Priorities for protecting ecosystem services must be identified to ensure future human well-being. Approaches to broad-scale spatial prioritization of ecosystem services are becoming increasingly popular and are a vital precursor to identifying locations where further detailed analyses of the management of ecosystem services is required (e.g., examining trade-offs among management actions). Prioritization approaches often examine the spatial congruence between priorities for protecting ecosystem services and priorities for protecting biodiversity; therefore, the spatial prioritization method used is crucial because it will influence the alignment of service protection and conservation goals. While spatial prioritization of ecosystem services and prioritization for conservation share similarities, such as the need to document threats and costs, the former differs substantially from the latter owing to the requirement to measure the following components: supply of services; availability of human-derived alternatives to service provision; capacity to meet beneficiary demand; and site dependency in and scale of service delivery. We review studies that identify broad-scale spatial priorities for managing ecosystem services and demonstrate that researchers have used different approaches and included various measures for identifying priorities, and most studies do not consider all of the components listed above. We describe a conceptual framework for integrating each of these components into spatial prioritization of ecosystem services and illustrate our approach using a worked example for water provision. A fuller characterization of the biophysical and social context for ecosystem services that we call for should improve future prioritization and the identification of locations where ecosystem-service management is especially important or cost effective. PMID:24555017

  2. Jewishly-Informed Mature Adult Service-Learning

    ERIC Educational Resources Information Center

    Bretan, Gail Helene

    2013-01-01

    The purpose of this study is to describe, implement, and interpret the intersection of service-learning, Jewish values and ways of knowing, adult education, and lifelong learning for people over the age of 50. By expanding service-learning to include both older adults and Jewish ways of knowing, there is potential for transforming these frameworks…

  3. 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. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. 'Mind the gap'--mapping services for young people with ADHD transitioning from child to adult mental health services.

    PubMed

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

    2013-07-10

    Once considered to be a disorder restricted to childhood, Attention Deficit/Hyperactivity Disorder (ADHD) is now recognised to persist into adult life. However, service provision for adults with ADHD is limited. Additionally, there is little guidance or research on how best to transition young people with ADHD from child to adult services. We report the findings of a survey of 96 healthcare professionals working in children's (Child and Adolescent Mental Health Services and Community Paediatrics) and adult services across five NHS Trusts within the East Midlands region of England to gain a better understanding of the current provision of services for young people with ADHD transitioning into adult mental health services. Our findings indicate a lack of structured guidelines on transitioning and little communication between child and adult services. Child and adult services had differing opinions on what they felt adult services should provide for ADHD cases. Adult services reported feeling ill-prepared to deal with ADHD patients, with clinicians in these services citing a lack of specific knowledge of ADHD and a paucity of resources to deal with such cases. We discuss suggestions for further research, including the need to map the national provision of services for adults with ADHD, and provide recommendations for commissioned adult ADHD services. We specifically advocate an increase in ADHD-specific training for clinicians in adult services, the development of specialist adult ADHD clinics and greater involvement of Primary Care to support the work of generic adult mental health services in adult ADHD management.

  5. 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…

  6. 25 CFR 20.403 - What do protective services include?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... allegations of child abuse and neglect, abandonment, and conditions that may require referrals (such as mental... AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.403 What do protective services include? Protective services provided to a child, family or elderly person will be documented in...

  7. 25 CFR 20.403 - What do protective services include?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... allegations of child abuse and neglect, abandonment, and conditions that may require referrals (such as mental... AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.403 What do protective services include? Protective services provided to a child, family or elderly person will be documented in...

  8. 25 CFR 20.403 - What do protective services include?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... allegations of child abuse and neglect, abandonment, and conditions that may require referrals (such as mental... AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.403 What do protective services include? Protective services provided to a child, family or elderly person will be documented in...

  9. 25 CFR 20.403 - What do protective services include?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... of child abuse and neglect, abandonment, and conditions that may require referrals (such as mental or... SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.403 What do protective services include? Protective services provided to a child, family or elderly person will be documented in the case...

  10. ‘Mind the gap’ - mapping services for young people with ADHD transitioning from child to adult mental health services

    PubMed Central

    2013-01-01

    Background Once considered to be a disorder restricted to childhood, Attention Deficit/Hyperactivity Disorder (ADHD) is now recognised to persist into adult life. However, service provision for adults with ADHD is limited. Additionally, there is little guidance or research on how best to transition young people with ADHD from child to adult services. Method We report the findings of a survey of 96 healthcare professionals working in children’s (Child and Adolescent Mental Health Services and Community Paediatrics) and adult services across five NHS Trusts within the East Midlands region of England to gain a better understanding of the current provision of services for young people with ADHD transitioning into adult mental health services. Results Our findings indicate a lack of structured guidelines on transitioning and little communication between child and adult services. Child and adult services had differing opinions on what they felt adult services should provide for ADHD cases. Adult services reported feeling ill-prepared to deal with ADHD patients, with clinicians in these services citing a lack of specific knowledge of ADHD and a paucity of resources to deal with such cases. Conclusions We discuss suggestions for further research, including the need to map the national provision of services for adults with ADHD, and provide recommendations for commissioned adult ADHD services. We specifically advocate an increase in ADHD-specific training for clinicians in adult services, the development of specialist adult ADHD clinics and greater involvement of Primary Care to support the work of generic adult mental health services in adult ADHD management. PMID:23842080

  11. Advanced Protection & Service Restoration for FREEDM Systems

    NASA Astrophysics Data System (ADS)

    Singh, Urvir

    A smart electric power distribution system (FREEDM system) that incorporates DERs (Distributed Energy Resources), SSTs (Solid State Transformers - that can limit the fault current to two times of the rated current) & RSC (Reliable & Secure Communication) capabilities has been studied in this work in order to develop its appropriate protection & service restoration techniques. First, a solution is proposed that can make conventional protective devices be able to provide effective protection for FREEDM systems. Results show that although this scheme can provide required protection but it can be quite slow. Using the FREEDM system's communication capabilities, a communication assisted Overcurrent (O/C) protection scheme is proposed & results show that by using communication (blocking signals) very fast operating times are achieved thereby, mitigating the problem of conventional O/C scheme. Using the FREEDM System's DGI (Distributed Grid Intelligence) capability, an automated FLISR (Fault Location, Isolation & Service Restoration) scheme is proposed that is based on the concept of 'software agents' & uses lesser data (than conventional centralized approaches). Test results illustrated that this scheme is able to provide a global optimal system reconfiguration for service restoration.

  12. Uniformed Services Former Spouses’ Protection Act

    DTIC Science & Technology

    2005-11-01

    Uniformed Services Former Spouses’ Protection Act Legal Assistance Branch Administrative and Civil Law ...1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law , no person shall be subject to a penalty...ADMINISTRATIVE & CIVIL LAW DEP’T, THE JUDGE ADVOCATE GENERAL’S LEGAL CENTER AND SCHOOL, U.S. ARMY, JA 274, Uniformed Services Former Spouses’ Protection

  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. 49 CFR 179.20 - Service equipment; protection systems.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Service equipment; protection systems. 179.20 Section 179.20 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND... CARS General Design Requirements § 179.20 Service equipment; protection systems. If an applicable tank...

  15. Personalised electronic messages to improve sun protection in young adults.

    PubMed

    Mair, Sarah; Soyer, H Peter; Youl, Philippa; Hurst, Cameron; Marshall, Alison; Janda, Monika

    2012-07-01

    We studied the acceptability and feasibility of delivering sun protection messages via electronic media such as short message services (SMS) to people aged 18-40 years. An online survey was conducted using a pre-established panel of volunteers. We compared the characteristics of those who indicated that they would like to be alerted to the UV index, with those who would not, using bivariate logistic regression. Characteristics found to be associated with a desire to receive such advice were entered into a multivariate logistic regression analysis. The median age of the 141 participants was 34 years. Overall, 80% of participants agreed that they would like to receive some form of sun protection advice. Of these, 20% preferred to receive it via SMS and 42% via email. Willingness to receive electronic messages about the UV index was associated with being unsure about whether a suntanned person would look healthy and greater use of sun protection in the past. Careful attention to message framing and timing of message delivery, and focus on the short-term effects of sun exposure such as sunburn and skin ageing should increase the acceptability of such messages to young people. Sun protection messages delivered to young adults via electronic media appear to be feasible and acceptable.

  16. Predicting Perceived Isolation among Midlife and Older LGBT Adults: The Role of Welcoming Aging Service Providers.

    PubMed

    Yang, Jie; Chu, Yoosun; Salmon, Mary Anne

    2017-06-16

    Older lesbian, gay, bisexual, and transgender (LGBT) adults are more likely to live alone and less likely to have children compared with their heterosexual counterparts. The lack of immediate family system can render older LGBT adults particularly vulnerable to social isolation and its consequences. The current study utilizes social exclusion theory, which asserts that not only material resources but also engagement with and inclusion into the society are necessary for marginalized people to be integrated into the mainstream. The study examines whether aging service providers (e.g., senior centers, adult day care, transportation, employment services) who are perceived by older LGBT adults as welcoming to LGBT people may reduce this population's perceived isolation. Data were collected through a needs assessment survey designed for the aging LGBT community in North Carolina. Adults aged 45 and over who self-identified as LGBT were recruited at several formal and informal groups. The survey yielded 222 valid responses. The outcome variable was perceived isolation. Key independent variables included having experienced welcoming aging service providers and living alone. After controlling for potential confounders and demographics, logistic regression results showed that having experienced welcoming aging service providers was a protective factor against perceived isolation and it also buffered the negative impact of living alone. The findings provided preliminary evidence for a new direction of intervention research-targeting LGBT cultural competence training for medical and social service providers. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. 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…

  18. 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…

  19. Advanced Protected Services: A Concept Paper on Survivable Service-Oriented Systems

    DTIC Science & Technology

    2010-05-07

    resiliency and protection of such systems to a level where they can withstand sustained attacks from well-motivated adversaries. In this paper we...that are designed for the protection of systems that are based on service-oriented architectures. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF...resilient against malicious attacks , and to demonstrate the utility of the developed advanced protection techniques in settings that exhibit various

  20. Differentiated protection services with failure probability guarantee for workflow-based applications

    NASA Astrophysics Data System (ADS)

    Zhong, Yaoquan; Guo, Wei; Jin, Yaohui; Sun, Weiqiang; Hu, Weisheng

    2010-12-01

    A cost-effective and service-differentiated provisioning strategy is very desirable to service providers so that they can offer users satisfactory services, while optimizing network resource allocation. Providing differentiated protection services to connections for surviving link failure has been extensively studied in recent years. However, the differentiated protection services for workflow-based applications, which consist of many interdependent tasks, have scarcely been studied. This paper investigates the problem of providing differentiated services for workflow-based applications in optical grid. In this paper, we develop three differentiated protection services provisioning strategies which can provide security level guarantee and network-resource optimization for workflow-based applications. The simulation demonstrates that these heuristic algorithms provide protection cost-effectively while satisfying the applications' failure probability requirements.

  1. Protecting Sensitive Information in Directory Services Using Virtual Directories

    NASA Astrophysics Data System (ADS)

    Claycomb, William; Shin, Dongwan

    Directory services are commonly used to store information related to individuals, and often act as a source for security services, such as authentication and access control, in collaborative applications within/across organizations. Hence, there is an urgent need to protect the sensitive information they contain. Existing solutions offer minimal protection against insider attacks, a growing threat to both government and industry data services. In this paper we present a solution for data protection that leverages virtual directories and data encryption to provide a user-centric approach to data protection, delegation, and collaboration. A security architecture is presented, along with the discussion of the benefits and vulnerabilities of our approach. We also discuss a proof-of-concept implementation and performance testing results.

  2. 47 CFR 73.809 - Interference protection to full service FM stations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 4 2011-10-01 2011-10-01 false Interference protection to full service FM... RADIO SERVICES RADIO BROADCAST SERVICES Low Power FM Broadcast Stations (LPFM) § 73.809 Interference protection to full service FM stations. (a) If a full service commercial or NCE FM facility application is...

  3. 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

  4. 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

  5. Introduction of a university-based counselling service for older adults.

    PubMed

    Bhar, Sunil S; Silver, Mark

    2014-03-01

    Despite the growing number of older adults in Australia, many do not access counselling, partly because of the lack of trained mental health professionals for older people. This paper describes an innovative solution for providing counselling services to older adults, and geropsychology training to postgraduate psychology students. A university-based counselling clinic for older adults was described – an outreach service for older adults living in the community or in residential aged care facilities in metropolitan Melbourne, Australia. Over its first 13 months, the clinic provided a total of 266 sessions of counselling to 57 clients (41 living in residential aged care), and involved six postgraduate students. This paper describes the potential benefits of the clinic for clients and students and the resources needed to support this model of service delivery. Thus, it provides a blueprint for other universities for developing similar services for older adults.

  6. 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…

  7. 25 CFR 11.1208 - Service of the protection order.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Service of the protection order. 11.1208 Section 11.1208 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Child Protection and Domestic Violence Procedures § 11.1208 Service of the...

  8. 25 CFR 11.1208 - Service of the protection order.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Service of the protection order. 11.1208 Section 11.1208 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Child Protection and Domestic Violence Procedures § 11.1208 Service of the...

  9. 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…

  10. 38 CFR 75.118 - Other credit protection services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... harm. (c) The Secretary will take action to obtain data mining and data breach analyses services, as... (CONTINUED) INFORMATION SECURITY MATTERS Data Breaches § 75.118 Other credit protection services. (a) With... relevant credit bureau reports; (2) Data breach analysis; (3) Fraud resolution services, including writing...

  11. 38 CFR 75.118 - Other credit protection services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... harm. (c) The Secretary will take action to obtain data mining and data breach analyses services, as... (CONTINUED) INFORMATION SECURITY MATTERS Data Breaches § 75.118 Other credit protection services. (a) With... relevant credit bureau reports; (2) Data breach analysis; (3) Fraud resolution services, including writing...

  12. 38 CFR 75.118 - Other credit protection services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... harm. (c) The Secretary will take action to obtain data mining and data breach analyses services, as... (CONTINUED) INFORMATION SECURITY MATTERS Data Breaches § 75.118 Other credit protection services. (a) With... relevant credit bureau reports; (2) Data breach analysis; (3) Fraud resolution services, including writing...

  13. 38 CFR 75.118 - Other credit protection services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... harm. (c) The Secretary will take action to obtain data mining and data breach analyses services, as... (CONTINUED) INFORMATION SECURITY MATTERS Data Breaches § 75.118 Other credit protection services. (a) With... relevant credit bureau reports; (2) Data breach analysis; (3) Fraud resolution services, including writing...

  14. 38 CFR 75.118 - Other credit protection services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... harm. (c) The Secretary will take action to obtain data mining and data breach analyses services, as... (CONTINUED) INFORMATION SECURITY MATTERS Data Breaches § 75.118 Other credit protection services. (a) With... relevant credit bureau reports; (2) Data breach analysis; (3) Fraud resolution services, including writing...

  15. Dissatisfaction with the dental services and associated factors among adults.

    PubMed

    Roberto, Luana Leal; Martins, Andréa Maria Eleutério de Barros Lima; Paula, Alfredo Maurício Batista de; Ferreira, Efigênia Ferreira E; Haikal, Desirée Sant' Ana

    2017-05-01

    This study aimed to identify factors associated with dissatisfaction with dental services among adults. It analyzed 830 adult participants of an epidemiological survey of oral health. The dependent variable was dissatisfaction with the dental service, and the independent ones were selected according to the theoretical model set forth by Andersen and Davidson (1997). Estimates were corrected by the sample design effect, and Binary Logistic Regression was carried out. It was found that about 11% of adults were dissatisfied with the dental service. In the final model, dissatisfaction with dental services was lower among older adults (OR = 0.559) and among smokers (OR = 0.332). On the other hand, it was higher among adults who self-perceived their chewing as negative (OR = 2,804), who self-perceived some discomfort in the mouth and head and neck region (OR = 2.065), and among those who did not have access to information on how to avoid oral problems (OR = 3.020). Therefore, the services need to access the perceptions and expectations expressed by users, and provide information in appropriate quantity and quality, in the context of "health literacy" in order to achieve greater satisfaction among its users.

  16. 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…

  17. Transition from children's to adult services for young adults with life-limiting conditions: A realist review of the literature.

    PubMed

    Kerr, Helen; Price, Jayne; Nicholl, Honor; O'Halloran, Peter

    2017-11-01

    Improvements in care and treatment have led to more young adults with life-limiting conditions living beyond childhood, which means they must make the transition from children's to adult services. This has proved a challenging process for both young adults and service providers, with complex transition interventions interacting in unpredictable ways with local contexts. To explain how intervention processes interact with contextual factors to help transition from children's to adult services for young adults with life-limiting conditions. Systematic realist review of the literature. Literature was sourced from four electronic databases: Embase, MEDLINE, Science Direct and Cochrane Library from January 1995 to April 2016. This was supplemented with a search in Google Scholar and articles sourced from reference lists of included papers. Data were extracted using an adapted standardised data extraction tool which included identifying information related to interventions, mechanisms, contextual influences and outcomes. Two reviewers assessed the relevance of papers based on the inclusion criteria. Methodological rigor was assessed using the relevant Critical Appraisal Skills Programme tools. 78 articles were included in the review. Six interventions were identified related to an effective transition to adult services. Contextual factors include the need for children's service providers to collaborate with adult service providers to prepare an environment with knowledgeable staff and adequate resources. Mechanisms triggered by the interventions include a sense of empowerment and agency amongst all stakeholders. Early planning, collaboration between children's and adult service providers, and a focus on increasing the young adults' confidence in decision-making and engaging with adult services, are vital to a successful transition. Interventions should be tailored to their context and focused not only on organisational procedures but on equipping young adults, parents

  18. A Program Inspection on Transition of Developmentally Disabled Young Adults from School to Adult Services.

    ERIC Educational Resources Information Center

    Office of Inspector General (DHHS), Washington, DC.

    Discussions were held with 252 respondents (state and local officials, service providers, educators, parents) in 28 states concerning the problems in transition from school to adult services for developmentally disabled young adults. Transition issues were seen to include questions of where to live, what to do, and how to obtain support. The…

  19. The effect of fathers or father figures on child behavioral problems in families referred to child protective services.

    PubMed

    Marshall, D B; English, D J; Stewart, A J

    2001-11-01

    This study examines some possible effects of the presence and quality of parent-child interaction of fathers and father figures on the behavior of young children in a sample of families reported to child protective services. Whereas the presence or absence of a father or father figure seemed to make little difference in child behavioral problems at age 4, lower levels of aggression and depression were observed for children by age 6 if an adult male in some form of father-like relationship was present in the child's life. When controlling for mother's ethnicity, child's gender, the number of referrals to child protective services, and the presence of domestic violence, the direct effect of a father/father figure was no longer significant but remained in the multivariate models as a significant interaction term.

  20. Adult Service Clubs and Their Programs for Youth.

    ERIC Educational Resources Information Center

    Fitzgerald, Ann K.; Collins, Ann

    A study described youth programs sponsored by 17 major national adult service organizations, including the traditionally male groups, mainline women's groups, and minority service organizations. Specific focus was on developmentally appropriate, community-based services for at-risk adolescents, aged 10 to 15. Information was collected through…

  1. Resilience in young children involved with child protective services.

    PubMed

    Sattler, Kierra M P; Font, Sarah A

    2018-01-01

    Child maltreatment increases the risk of poor developmental outcomes. However, some children display resilience, meaning they are high-functioning despite their adverse experiences. To date, few research studies have examined protective factors among very young maltreated children. Yet, domains of resilience, and the protective factors that promote resilience among maltreated children, are likely to differ by developmental stage. Drawing on ecological systems theory and life course theory, we examined how protective factors at multiple ecological levels across early childhood were related to social and cognitive resilience among very young children involved with child protective services. The results demonstrated that the buffering effects of protective factors varied by social or cognitive resilience and the cumulative effects of protective factors were more consistently related to later resilience than protective factors at specific time points. In addition, the influence of specific protective factors on resilience slightly varied by initial in-home or out-of-home placement. These findings have important policy and research implications for promoting optimal development among children involved in child protective services. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. 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..., 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 services...

  3. 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 services...

  4. Child Protection, Public Services and the Chimera of Market Force Efficiency.

    ERIC Educational Resources Information Center

    Barker, Richard W.

    1996-01-01

    Describes child protection systems in England and ongoing changes in their services. Considers effects of a market force approach on the organization of child protection services in relation to coordination versus fragmentation and profit versus professionalism. Concludes that the idea that a market force approach to child protection will lead to…

  5. Receipt of Preventive Health Services in Young Adults

    PubMed Central

    Lau, Josephine S.; Adams, Sally H.; Irwin, Charles E.; Ozer, Elizabeth M.

    2013-01-01

    Objective To examine self-reported rates and disparities in delivery of preventive services to young adults. Design Population-based cross-sectional analysis. Multivariate logistic regression was used to examine how age, gender, race/ethnicity, income, insurance, and usual source of care influence the receipt of preventive services. Setting 2005 and 2007 California Health Interview Surveys (CHIS). Participants 3670 and 3621 young adults aged 18-26 years who responded to CHIS 2005 and 2007, respectively. Main Outcome Measures Self-reported receipt of flu vaccination, STD screening, cholesterol screening, diet counseling, exercise counseling and emotional health screening. Results Delivery rates ranged from 16.7% (flu vaccine) to 50.6% (cholesterol screening). Being female and having a usual source of care significantly increased receipt of services, with females more likely to receive STD screening (p<.001), cholesterol screening (p<.01), emotional health screening (p<.001), diet counseling (p<.01) and exercise counseling (p<.05) than males after controlling for age, race/ethnicity, income, insurance and usual source of care. Young adults with a usual source of care were more likely to receive a flu vaccine (p<.05), STD screening (p<.01), cholesterol screening (p<.001), diet counseling (p<.05) and exercise counseling (p<.05) than those without a usual source of care after adjusting for age, race/ethnicity, income, and insurance. Conclusions Rates of preventive service delivery are generally low. Greater efforts are needed to develop guidelines for young adults to increase the delivery of preventive care to this age group, and to address the gender and ethnic/racial disparities in preventive services delivery. PMID:23260833

  6. Past, present, and future roles of child protective services.

    PubMed

    Schene, P A

    1998-01-01

    Contemporary social issues typically spring from historical roots, and, as this article points out, that is particularly true of the effort to find a balanced, fair, and helpful way of responding to child abuse and neglect. This article examines how today's child protective services system evolved from a past of almshouses, orphan trains, anticruelty societies, and legislation establishing the protection of children as a government function. The author finds that the history of child protection in the United States is marked by a continuing, unresolved tension between the aim of rescuing children from abusive homes and that of strengthening the care their families can provide. Against that backdrop, this article explains the structure of the typical child protective services (CPS) agency (the unit within a broader public child welfare department that focuses on abuse and neglect) and outlines the roles in child protection that are played by the police, the courts, private and public social service agencies, and the community at large. According to the author's analysis, the fundamental challenges facing CPS can be captured in two questions regarding appropriate boundaries for the agency: Which situations require the agency's intervention? And how can the broader resources of the community be mobilized in the effort to protect children?

  7. The Effect of Free Adult Preventive Care Services on Subsequent Utilization of Inpatient Services in Taiwan.

    PubMed

    Tian, Wei-Hua

    2016-07-01

    The objective of this article is to investigate the relationship between the utilization of free adult preventive care services and subsequent utilization of inpatient services among elderly people under the National Health Insurance program in Taiwan. The study used secondary data from the 2005 Taiwan National Health Interview Survey and claim data from the 2006 Taiwan National Health Insurance Research Database for the elderly aged 65 or over. A bivariate probit model was used to avoid the possible endogeneity in individuals' utilization of free adult preventive care and inpatient services. This study finds that, when individuals had utilized the preventive care services in 2005, the probability that they utilized inpatient services in 2006 was significantly reduced by 13.89%. The findings of this study may provide a good reference for policy makers to guide the efficient allocation of medical resources through the continuous promotion of free adult preventive care services under the National Health Insurance program. © Australian Council for Educational Research 2016.

  8. More Rhode Island Adults Have Dental Coverage After the Medicaid Expansion: Did More Adults Receive Dental Services? Did More Dentists Provide Services?

    PubMed

    Zwetchkenbaum, Samuel; Oh, Junhie

    2017-10-02

    Under the Affordable Care Act (ACA) Medicaid expansion since 2014, 68,000 more adults under age 65 years were enrolled in Rhode Island Medicaid as of December 2015, a 78% increase from 2013 enrollment. This report assesses changes in dental utilization associated with this expansion. Medicaid enrollment and dental claims for calendar years 2012-2015 were extracted from the RI Medicaid Management Information System. Among adults aged 18-64 years, annual numbers and percentages of Medicaid enrollees who received any dental service were summarized. Additionally, dental service claims were assessed by provider type (private practice or health center). Although 15,000 more adults utilized dental services by the end of 2015, the annual percentage of Medicaid enrollees who received any dental services decreased over the reporting periods, compared to pre-ACA years (2012-13: 39%, 2014: 35%, 2015: 32%). From 2012 to 2015, dental patient increases in community health centers were larger than in private dental offices (78% vs. 34%). Contrary to the Medicaid population increase, the number of dentists that submitted Medicaid claims decreased, particularly among dentists in private dental offices; the percentage of RI private dentists who provided any dental service to adult Medicaid enrollees decreased from 29% in 2012 to 21% in 2015. Implementation of Medicaid expansion has played a critical role in increasing the number of Rhode Islanders with dental coverage, particularly among low-income adults under age 65. However, policymakers must address the persistent and worsening shortage of dental providers that accept Medicaid to provide a more accessible source of oral healthcare for all Rhode Islanders. [Full article available at http://rimed.org/rimedicaljournal-2017-10.asp].

  9. Older Adults' Perceptions of Nutrition as Protective Against Detrimental Effects of Environmental Pollution.

    PubMed

    Dunn, Kristina; Gaetke, Lisa; Stephenson, Tammy; Brewer, Dawn

    2017-08-01

    The aging process makes older adults vulnerable to the detrimental health effects of environmental contaminants. Our study assessed older adults' perceptions regarding diet being protective against environmental contaminants, their levels of concern about exposure, and their interest in learning about protective food-related strategies. A needs assessment to collect such information has not been conducted among older adults. Health fair survey results showed that they perceived diet as beneficial against contaminants, were concerned about health implications of exposure, and were interested in learning how to protect health through diet-related strategies. Results suggest that a nutrition-focused curriculum addressing how dietary strategies can help protect against environmental contaminants is needed for Extension professionals.

  10. Measuring Protective Behavioral Strategies for Marijuana Use Among Young Adults.

    PubMed

    Pedersen, Eric R; Hummer, Justin F; Rinker, Dipali Venkataraman; Traylor, Zach K; Neighbors, Clayton

    2016-05-01

    Marijuana use can result in a variety of negative consequences, yet it remains popular among young adults and the general public at large. Combined with the growing empirical support for the benefits of medicinal marijuana as well as the steady increase in popular opinion regarding its legalization, it is of growing importance to identify strategies that may mitigate the harms related to marijuana use, reduce consumption levels, and limit resulting negative consequences among young adults who use marijuana. The purpose of this study was to develop and conduct initial psychometric analyses on a new scale, which we named the Protective Behavioral Strategies for Marijuana (PBSM) scale. A sample of undergraduate college students who reported past-6-month marijuana use (n = 210) responded to the initial pool of PBSM items and completed measures of marijuana use, consequences from marijuana use, alcohol use, and protective behavioral strategies for alcohol. Results from an iterative principal component analyses process yielded a single-factor structure with 39 items. The PBSM mean composite score negatively associated with marijuana use and consequences, with the strongest correlations evident for pastmonth users. The PBSM also significantly positively correlated with alcohol protective strategies. Protective behavioral strategies for marijuana appear to be a measurable construct that are related to marijuana frequency and consequences, and thus may be a useful component of intervention and prevention programs with young adults. More work testing the PBSM items with larger and more diverse samples of young adults is encouraged.

  11. Older adults who receive home-based services, on the verge of passivity: the perspective of service providers.

    PubMed

    Vik, Kjersti; Eide, Arne

    2013-05-01

    The increasing number of older adults will put pressure on health care services in the community. It is thus critical to ensure that services promote healthy ageing and participation.The aim of the study was to explore service providers' perception and understanding of the conditions for participation among older adults who receive home-based care. The study design was a grounded theory, with six focus groups representing different parts of home-based care in two different municipalities. The data were analysed by a constant comparative method following the guidelines from grounded theory. The findings showed how four different conditions influenced the opportunity for participation or could give a push towards passivity. Firstly, the timing of applications for services. Secondly, the older adults and their family's expectations about participation. Thirdly, external factors such as adequate housing and assistive devices. Finally, the service delivery per se could constitute a barrier for participation, because the services often focused on passive help and 'standard packages'. The findings show how factors at the system level, the execution of services and characteristics among older adults and their family may contribute to the individual service recipient being on the verge of being passive. © 2012 Blackwell Publishing Ltd.

  12. Hazard Assessment of Personal Protective Clothing for Hydrogen Peroxide Service

    NASA Technical Reports Server (NTRS)

    Greene, Ben; McClure, Mark B.; Johnson, Harry T.

    2004-01-01

    Selection of personal protective equipment (PPE) for hydrogen peroxide service is an important part of the hazard assessment process. But because drip testing of chemical protective clothing for hydrogen peroxide service has not been reported for about 40 years, it is of great interest to test new protective clothing materials with new, high-concentration hydrogen peroxide following similar procedures. The suitability of PPE for hydrogen peroxide service is in part determined by observations made when hydrogen peroxide is dripped onto swatches of protective clothing material. Protective clothing material was tested as received, in soiled condition, and in grossly soiled condition. Materials were soiled by pretreating the material with potassium permanganate (KMnO4) solution then drying to promote a reaction. Materials were grossly soiled with solid KMnO4 to greatly promote reaction. Observations of results including visual changes to the hydrogen peroxide and materials, times to ignition, and self-extinguishing characteristics of the materials are reported.

  13. Duty of Care and Autonomy: How Support Workers Managed the Tension between Protecting Service Users from Risk and Promoting Their Independence in a Specialist Group Home

    ERIC Educational Resources Information Center

    Hawkins, R.; Redley, M.; Holland, A. J.

    2011-01-01

    Background: In the UK those paid to support adults with intellectual disabilities must manage two potentially conflicting duties that are set out in policy documents as being vital to their role: protecting service users (their duty of care) and recognising service users' autonomy. This study focuses specifically on the support of people with the…

  14. Nurse-led liaison mental health service for older adults: service development using lean thinking methodology.

    PubMed

    Atkinson, Paula; Mukaetova-Ladinska, Elizabeta B

    2012-04-01

    Liaison Psychiatric Services for Older Adults in the UK have been established over the last decade, with rather divergent team composition and involvement. The latest documents (National Dementia Strategy, Who Cares Wins) set the gold standard for liaison services for older adults in England, requiring a proactive approach to services and integrating assessment and treatment of mental disorder into routine general hospital practice. This requires a physical presence of liaison services in the hospital, with collaboration with medical colleagues. We have adopted the above strategy in a nurse-led liaison service working in a General District Hospital, and used the Toyota Production System. In the current study we reflect on the 5 day rapid progress improvement workshops event for the liaison branch of the project, and describe the process of identifying real situation problems for the care of the medically ill, the involvement of the liaison team in their clinical care, and a feedback on the change in practice. The novel approach of identifying areas for change in an ongoing nurse-led Liaison service for Older Adults resulted in improving access to mental health services for elderly medically ill inpatients and improved quality of their overall care. Copyright © 2011 Elsevier Inc. All rights reserved.

  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, 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 Through...

  16. Psychiatric service use and psychiatric disorders in adults with intellectual disability.

    PubMed

    Bhaumik, S; Tyrer, F C; McGrother, C; Ganghadaran, S K

    2008-11-01

    UK policies aim to facilitate access to general psychiatric services for adults with intellectual disability (ID). If this is to be achieved, it is important to have a clear idea of the characteristics and proportion of people with ID who currently access specialist psychiatric services and the nature and extent of psychiatric disorders in this population. A cross-sectional study was carried out on all adults with ID using specialist services in Leicestershire and Rutland, UK, between 2001 and 2006. Characteristics of individuals seen by psychiatric services and the nature and prevalence of psychiatric disorders were investigated. Of 2711 adults identified, 1244 (45.9%) accessed specialist psychiatric services at least once during the study period. Individuals attending psychiatric services were more likely to be older and to live in residential settings; they were less likely to be south Asian or to have mild/moderate ID. The prevalence of psychiatric disorders among the total study population was 33.8%; the most common disorders were behaviour disorder (19.8%) and autistic spectrum disorders (8.8%). Epilepsy was highly prevalent (60.8%) among those attending psychiatric services without a mental health diagnosis. Behaviour disorders and autistic spectrum disorders were more common in men and in adults with severe/profound ID, whereas schizophrenia and organic disorders were more common in women and in adults with mild/moderate ID. Depression was also more common in women with ID. Psychiatric disorders and specialist health problems are common among adults with ID and the profile of psychiatric disorders differs from that found in general psychiatry. Close collaboration between general and specialist service providers is needed if the current move towards use of general psychiatric services in this population is to be achieved. The measures should include a clear care pathway for people with ID and mental health problems to facilitate the smooth transfer of

  17. Services for Adult Undergraduate Students in a Four-Year College.

    ERIC Educational Resources Information Center

    Brown, Carol Dunn; Linnemann, Ruth Eggert

    1995-01-01

    According to responses from 158 of 301 adults in evening and weekend college classes, most were especially satisfied with enrollment information and advising, and they wanted extended hours for most services. Six services were not used by over half of the students, either because adults focused on class attendance, had multiple commitments, or…

  18. 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..., 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 workers...

  19. 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? Supportive...

  20. 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 workers...

  1. 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 workers...

  2. 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 workers...

  3. 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? Supportive...

  4. 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..., 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 workers...

  5. 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 workers...

  6. The Process of Adult Day Service Use*

    PubMed Central

    Gaugler, Joseph E.

    2013-01-01

    The objective of this study was to examine why and how families and older adults utilize adult day services. The current study included three months of participant observation in one rural and one suburban adult day service program in an upper-Midwestern region of the United States as well as semi-structured interviews with 14 family members of clients and 12 staff members from these programs. Several key constructs emerged that organized the multiple sources of qualitative data including programmatic philosophy, positioning, and environment of ADS; clients’ and family members’ reasons for use; the process of ADS use by families and clients; and pathways to family/client psychosocial and client functional outcomes. A number of inter-related themes emerged within each construct. The constructs identified and their potential associations among each other were used to expand upon and refine prior conceptualizations of ADS to frame future clinical and research efforts. PMID:24239404

  7. 20 CFR 663.200 - What are intensive 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 intensive services for adults and..., DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Intensive Services § 663.200 What are intensive services for adults and dislocated workers? (a...

  8. 20 CFR 663.200 - What are intensive 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 intensive services for adults and..., DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Intensive Services § 663.200 What are intensive services for adults and dislocated workers? (a...

  9. 20 CFR 663.200 - What are intensive 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 intensive services for adults and..., DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Intensive Services § 663.200 What are intensive services for adults and dislocated workers? (a...

  10. 20 CFR 663.200 - What are intensive 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 intensive services for adults and..., DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Intensive Services § 663.200 What are intensive services for adults and dislocated workers? (a) Intensive...

  11. Measuring Protective Behavioral Strategies for Marijuana Use Among Young Adults

    PubMed Central

    Pedersen, Eric R.; Hummer, Justin F.; Rinker, Dipali Venkataraman; Traylor, Zach K.; Neighbors, Clayton

    2016-01-01

    Objective: Marijuana use can result in a variety of negative consequences, yet it remains popular among young adults and the general public at large. Combined with the growing empirical support for the benefits of medicinal marijuana as well as the steady increase in popular opinion regarding its legalization, it is of growing importance to identify strategies that may mitigate the harms related to marijuana use, reduce consumption levels, and limit resulting negative consequences among young adults who use marijuana. The purpose of this study was to develop and conduct initial psychometric analyses on a new scale, which we named the Protective Behavioral Strategies for Marijuana (PBSM) scale. Method: A sample of undergraduate college students who reported past-6-month marijuana use (n = 210) responded to the initial pool of PBSM items and completed measures of marijuana use, consequences from marijuana use, alcohol use, and protective behavioral strategies for alcohol. Results: Results from an iterative principal component analyses process yielded a single-factor structure with 39 items. The PBSM mean composite score negatively associated with marijuana use and consequences, with the strongest correlations evident for past-month users. The PBSM also significantly positively correlated with alcohol protective strategies. Conclusions: Protective behavioral strategies for marijuana appear to be a measurable construct that are related to marijuana frequency and consequences, and thus may be a useful component of intervention and prevention programs with young adults. More work testing the PBSM items with larger and more diverse samples of young adults is encouraged. PMID:27172576

  12. Costing Child Protective Services Staff Turnover.

    ERIC Educational Resources Information Center

    Graef, Michelle I.; Hill, Erick L.

    2000-01-01

    Details process of determining a child welfare agency's actual dollar costs directly attributed to protective services staff turnover, using the agency's human resources database and interviews with administrative personnel. Provides formulas and process for calculating specific cost elements due to employee separation, replacement, and training.…

  13. Effects of pictures and textual arguments in sun protection public service announcements.

    PubMed

    Boer, Henk; Ter Huurne, Ellen; Taal, Erik

    2006-01-01

    The effect of public service announcements aimed at promoting primary prevention of skin cancer may be limited by superficial cognitive processing. The use of both pictures and textual arguments in sun protection public service announcements were evaluated for their potentially beneficial effects on judgment, cognitive processing and persuasiveness. In a 2 x 2 factorial experimental design individuals were shown public service announcements that advocated the advantages of sun protection measures in different versions in which a picture was present or not present and a textual argument was present or not present. The 159 participants were randomly assigned to one of four conditions. In each condition, participants were shown 12 different public service announcements designed according to the condition. Participants judged each public service announcement on attractiveness, credibility, clarity of communication and the required amount of reflection. After the judgment task, they completed a questionnaire to assess knowledge, perceived advantages and disadvantages of sun protection and intended use of sun protection measures. Pictures enhanced attractiveness, but diminished comprehension. Textual arguments enhanced attractiveness, credibility and comprehension. Pictures as well as textual arguments increased knowledge of sun protection measures. Pictures and textual arguments in public service announcements positively influence the individual's perception of the advantages of sun protection methods and the advantages of their adoption.

  14. The use of hearing protection devices by older adults during recreational noise exposure.

    PubMed

    Nondahl, D M; Cruickshanks, K J; Dalton, D S; Klein, B E K; Klein, R; Tweed, T S; Wiley, T L

    2006-01-01

    A population-based study to assess the use of hearing protection devices by older adults during noisy recreational activities was performed. The population-based Epidemiology of Hearing Loss Study was designed to measure the prevalence of hearing loss in adults residing in Beaver Dam, Wisconsin. The use of hearing protection devices during noisy recreational activities was assessed by performing three examinations over a period of 10 years (1993-1995, no. of participants (n)=3753, aged 48-92 years; 1998-2000, n=2800, aged 53-97 years; 2003-2005, n=2395, aged 58-100 years). The recreational activities included hunting, target shooting, woodworking/carpentry, metalworking, driving loud recreational vehicles, and performing yard work using either power tools or a chain saw. The prevalence of using hearing protection devices during any of these activities increased with time (9.5%, 15.0%, and 19.9% at baseline, 5 years, and 10 years, respectively). However, the use of hearing protection devices remained low for most activities. Those under the age of 65 were twice as likely to use hearing protection devices during noisy activities than were older adults. Men, those with a hearing handicap, and those with significant tinnitus were more likely to use hearing protection devices. Smokers and the less educated were less likely to use hearing protection devices. The results demonstrated that many adults expose themselves to potentially damaging recreational noise, leaving them at risk for hearing loss.

  15. 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…

  16. 20 CFR 1002.20 - Does USERRA protect an individual who does not actually perform service in the uniformed services?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Does USERRA protect an individual who does... protect an individual who does not actually perform service in the uniformed services? Yes. Employers are prohibited from taking actions against an individual for any of the activities protected by the Act, whether...

  17. Trends in sun-protection behaviour in Australian adults 2007-2012.

    PubMed

    Koch, Severine; Pettigrew, Simone; Minto, Carolyn; Slevin, Terry; Strickland, Mark; Lin, Chad; Jalleh, Geoffrey

    2017-05-01

    Almost all skin cancers are the result of overexposure to UV radiation and could be prevented by adhering to a number of simple behavioural guidelines to minimise exposure to the sun. The present study examined trends in sun-protection behaviour among adults living in Western Australia, a region with high levels of UV radiation. During five summers from 2008 to 2012, 2076 Western Australian adults participated in annual, cross-sectional telephone surveys that assessed how often they engaged in a range of sun-protection behaviour (seeking shade, staying inside and wearing a hat, protective clothing, sunscreen or sunglasses). Apart from an increase in sunscreen use and a consistently high use of sunglasses, most sun-protection behaviour remained stable at moderate levels during the 5-year period. Seeking shade, staying inside and wearing a hat were all practised at levels ranging between 'sometimes' and 'usually' on sunny days in summer during peak UV hours, with little to no variability across the survey years. Wearing protective clothing was the least frequent behaviour across all survey years and was significantly lower in the most recent survey year relative to baseline. Further efforts are required to encourage greater enactment of sun-protection behaviour, especially on the use of protective clothing and seeking shade during periods of high UV radiation. © 2016 The Australasian College of Dermatologists.

  18. Older Adults' Perceptions of Nutrition as Protective against Detrimental Effects of Environmental Pollution

    ERIC Educational Resources Information Center

    Dunn, Kristina; Gaetke, Lisa; Stephenson, Tammy; Brewer, Dawn

    2017-01-01

    The aging process makes older adults vulnerable to the detrimental health effects of environmental contaminants. Our study assessed older adults' perceptions regarding diet as protective against environmental contaminants, levels of concern about exposure to environmental contaminants, and interest in learning about protective food-related…

  19. Protective Services for Abused and Neglected Children and Their Families. A Guide for State and Local Department of Public Social Services on the Delivery of Protective Services.

    ERIC Educational Resources Information Center

    Community Research Applications, Inc., New York, NY.

    Provided is a guide to assist state and local agencies in improving the administration and management of services to abused and neglected children and their families. Protective services at the state level are covered in the first section, including such topics as organization; initiating and reacting to proposed state legislation; developing…

  20. Willingness to Pay for Home-Based Rehabilitation Service Among Older Adults.

    PubMed

    Li, Xuemei; Wan, Xia; Pang, Yajuan; Zhou, Lanshu

    2018-06-18

    This study aims to investigate the willingness to pay (WTP) for a home-based rehabilitation service and explore the influencing factors of WTP among older adults in Shanghai, China. A cross-sectional design was used. A questionnaire survey based on the contingent valuation method was conducted by face-to-face survey over 3 months. Only 242 (44%) participants were willing to pay for a home-based rehabilitation service. The median amount they were willing to pay was RMB 8 (US$1.15) per visit. Older adults who had higher monthly income, had at least one partner who worked, and had medical insurance were willing to pay more for the service. Older adults showed low WTP for a home-based rehabilitation service. Economic status and health condition are the significant influencing factors of WTP. Studies on recipients' precise needs and ability to pay are required before home-based services are implemented.

  1. Mental Health Service Use Among Lesbian, Gay, and Bisexual Older Adults.

    PubMed

    Stanley, Ian H; Duong, Jeffrey

    2015-07-01

    Empirical efforts to measure use of mental health services among lesbian, gay, and bisexual (LGB) older adults have been notably lacking. Thus this study assessed associations between sexual orientation and mental health service use among older adults and determined the mediating role of nonspecific psychological distress, excessive alcohol use, and self-perceived poor general medical health. Data from the 2011 New York City Community Health Survey were analyzed. The analytic sample comprised 5,138 adults ages 50 and over. Logistic regression modeling was used to examine associations between sexual orientation (LGB versus heterosexual) and past-year mental health service use (counseling or medication), adjusting for sociodemographic and clinical characteristics. Mediation analyses using bootstrapping were conducted. Among LGB older adults, 23.9% reported receiving counseling, and 23.4% reported taking psychiatric medication in the past year. LGB respondents were significantly more likely than heterosexuals to have received counseling (adjusted odds ratio [AOR]=2.16, 95% confidence interval [CI]=1.49-3.13) and psychiatric medication (AOR=1.97, CI=1.36-2.86). Psychological distress, excessive alcohol use, and self-perceived poor general medical health did not mediate the association between sexual orientation and mental health service use. LGB older adults were more likely than heterosexuals to utilize mental health services, and this association was not explained by indicators of general medical, mental, or behavioral health.

  2. 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 ...

  3. Youth-Adult Connectedness:: A Key Protective Factor for Adolescent Health.

    PubMed

    Sieving, Renee E; McRee, Annie-Laurie; McMorris, Barbara J; Shlafer, Rebecca J; Gower, Amy L; Kapa, Hillary M; Beckman, Kara J; Doty, Jennifer L; Plowman, Shari L; Resnick, Michael D

    2017-03-01

    Over the past 30 years, prevention science in the adolescent health field has moved from interventions focused on preventing single problem behaviors to efforts employing a dual approach, addressing risk factors that predict problems while simultaneously nurturing protective factors and promoting positive development. Through an examination of previous research and empirical case examples with vulnerable youth, this article considers the hypothesis that adolescents' sense of connectedness to caring adults acts as a protective factor against a range of risk behaviors. Multivariate analyses with existing data examined indicators of youth-adult connectedness among two groups at high risk for poor health outcomes: (1) mentor-youth relationship quality in an urban, ethnically diverse sample of students in a school-based mentoring program (2014 survey, N=239); and (2) parent-youth connectedness in a statewide sample of high school students who reported homelessness in the past year (2013 survey, N=3,627). For youth in the mentoring program, a high-quality youth-mentor relationship was significantly associated with positive social, academic, and health-related behaviors. Among students who experienced homelessness, all measures of parent connectedness were significantly associated with lower sexual risk levels. Collectively, findings from these analyses and previously published studies by this research group provide evidence that strong, positive relationships with parents and other caring adults protect adolescents from a range of poor health-related outcomes and promote positive development. Youth-adult connectedness appears to be foundational for adolescent health and well-being. Program, practice, and policy decisions should consider what strengthens or hinders caring, connected youth-adult relationships. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  4. 25 CFR 20.403 - What do protective services include?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.403 What do protective... or physical handicaps); (ii) Providing social information related to the disposition of a case... to: (i) Evaluating social conditions that affect community well-being; (ii) Treating conditions...

  5. Adult Services in the Third Millennium.

    ERIC Educational Resources Information Center

    Monroe, Margaret E.

    1979-01-01

    Presents a four-step model for "planning" or "forecasting" future of adult services in public libraries: (1) identification of forces at work; (2) analysis of probable impacts of one force upon another; (3) identification of preferred (and rejected) elements of future with forces that control elements; and (4) strategies to be…

  6. Design and Recruitment for a Randomized Controlled Trial of Problem-Solving Therapy to Prevent Depression among Older Adults with Need for Supportive Services.

    PubMed

    Albert, Steven M; King, Jennifer; Dew, Mary Amanda; Begley, Amy; Anderson, Stewart; Karp, Jordan; Gildengers, Ari; Butters, Meryl; Reynolds, Charles F

    2016-01-01

    Addressing subthreshold depression (indicated prevention) and 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 (Dep-ABC) 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. Therefore, the authors examine the effectiveness of partnerships with aging services sites for recruiting at-risk older adults, the quality of recruitment and acceptability of the Dep-ABC assessment and intervention, and the baseline status of participants. 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 six to eight sessions of problem-solving therapy, in which older adults aged 60+ learn to break down problems that affect well-being 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. 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. 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. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  7. 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

  8. Visible Minority, Aboriginal, and Caucasian Children Investigated by Canadian Protective Services

    ERIC Educational Resources Information Center

    Lavergne, Chantal; Dufour, Sarah; Trocme, Nico; Larrivee, Marie-Claude

    2008-01-01

    The aim of this descriptive study was to compare the report profiles of Caucasian, Aboriginal, and other visible minority children whose cases were assessed by child protective services in Canada. The results show that children of Aboriginal ancestry and from visible minority groups are selected for investigation by child protective services 1.77…

  9. Knowledge and Behavioral Impact of Adult Participation in Child Sexual Abuse Prevention: Evaluation of the Protecting God's Children Program.

    PubMed

    Nurse, Anne M

    2017-07-01

    This article presents findings from an evaluation of a popular adult training program (Protecting God's Children) used in Catholic institutions, including schools, churches, and social service agencies. The study explores knowledge and behavior change based on pretest/posttest questionnaires administered to over 500 adults and follow-up questionnaires sent six months after the training. The participants in the training were compared to a control group of adults who did not participate in the program. The results indicate that participants arrive at the training with fairly high rates of preexisting knowledge but that the program increases knowledge across demographic groups. Follow-up surveys suggest that the new knowledge is retained over six months. The study indicates that the program is associated with an increase in participants talking to their own children about child sexual abuse. Participants also report sharing information with other adults and monitoring behavior around children more closely.

  10. 76 FR 14969 - Public Availability of Environmental Protection Agency FY 2010 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-18

    ... Environmental Protection Agency FY 2010 Service Contract Inventory AGENCY: Environmental Protection Agency. ACTION: Notice of public availability of FY 2010 Service Contract inventories. SUMMARY: In accordance... 2010 Service Contract inventory. This inventory provides information on service contract actions over...

  11. 77 FR 5513 - Public Availability of Environmental Protection Agency FY 2011 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-03

    ... Environmental Protection Agency FY 2011 Service Contract Inventory AGENCY: Environmental Protection Agency. ACTION: Notice of Public Availability of FY 2011 Service Contract Inventories. SUMMARY: In accordance... 2011 Service Contract Inventory. This inventory provides information on service contract actions over...

  12. Examining public knowledge and preferences for adult preventive services coverage.

    PubMed

    Williams, Jessica A R; Ortiz, Selena E

    2017-01-01

    To examine (1) what individuals know about the existing adult preventive service coverage provisions of the Affordable Care Act (ACA), and (2) which preventive services individuals think should be covered without cost sharing. An online panel from Survey Monkey was used to obtain a sample of 2,990 adults age 18 and older in March 2015, analyzed 2015-2017. A 17-item survey instrument was designed and used to evaluate respondents' knowledge of the adult preventive services provision of the ACA. Additionally, we asked whether various preventive services should be covered. The data include age, sex, race/ethnicity, and educational attainment as well as measures of political ideology, previous insurance status, the number of chronic conditions, and usual source of care. Respondents correctly answered 38.6% of the questions about existing coverage under the ACA, while on average respondents thought 12.1 of 15 preventive services should be covered (SD 3.5). Respondents were more knowledgeable about coverage for routine screenings, such as blood pressure (63.4% correct) than potentially stigmatizing screenings, such as for alcohol misuse (28.8% correct). Blood pressure screening received the highest support of coverage (89.8%) while coverage of gym memberships received the lowest support (59.4%). Individuals with conservative ideologies thought fewer services on average should be covered, but the difference was small-around one service less than those with liberal ideologies. Overwhelmingly, individuals think that most preventive services should be covered without cost sharing. Despite several years of coverage for preventive services, there is still confusion and lack of knowledge about which services are covered.

  13. 78 FR 14298 - Public Availability of Environmental Protection Agency FY 2012 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ... Environmental Protection Agency FY 2012 Service Contract Inventory AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of public availability of FY 2012 Service Contract Inventories. SUMMARY: In accordance... 2012 Service Contract Inventory. This inventory provides information on service contract actions over...

  14. Multigenerational Perceptions of Mental Health Services of Deaf Adults in Florida

    ERIC Educational Resources Information Center

    Feldman, David M.; Gum, Amber

    2007-01-01

    The objective of the study was to better understand the perceptions and needs of multigenerational Deaf adults related to mental health services. A survey sampled participants who were between 20 and 85 years old and Deaf. Questions were developed to identify the perspectives of Deaf adults related to the availability of mental health services,…

  15. Emergency Readiness for Older Adults and People with Disabilities

    MedlinePlus

    ... Justice Coordinating Council Help America Vote Act Programs Legal Assistance Long-Term Care Ombudsman Protection and Advocacy Systems Senior Medicare Patrol Supporting Adult Protective Services Research ...

  16. 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 in...

  17. Regular use of dental services among adults and older adults in a vulnerable region in Southern Brazil.

    PubMed

    Machado, Luciene Petcov; Camargo, Maria Beatriz Junqueira; Jeronymo, José Carlos Milanez; Bastos, Gisele Alsina Nader

    2012-06-01

    To estimate the prevalence of regular use of dental care services by adults and older adults residing in vulnerable community and to identify associated factors. A population-based cross-sectional study was carried out with 3,391 adults and older adults residing in areas of social vulnerability in Porto Alegre, Southern Brazil, from July to December of 2009. A systematic sampling method was used the selection probability proportional to the population of each of the the 121 census sectors. The outcome for regular use of dental care services was defined as regular use of dental services, regardless of the presence of dental problems. A standardized questionnaire was administered, which included demographic, socioeconomic, type of dental care services, self-perception of dental health and self-perceived needs variables. A chi-square test for heterogeneity was used for bivariate analyses, and a Poisson regression with a robust variance and Wald tests were performed for the adjusted analysis. The prevalence of regular use of dental services was 25.7%. The prevalence was higher among people with >12 years schooling (PR 2.48 [95%CI:1.96;3.15]), higher income (PR 1.95[95%CI: 1.03;1.53]), use of private health services (PR 1.43 [95%CI: 1.20;1.71]),excellent self-perceived oral health (PR 4.44 [95%CI: 3.07;6.42]) and a self-perceived need for consultation related to routine checkup (RP 2.13 [95%CI: 1.54;2.96]). Inequalities were found in the regular use of dental services. Integrated approaches that raise awareness of oral health, improve self-care and expand access to dental services, may contribute to increase the use of dental services on a regular basis.

  18. The protective service of mangrove ecosystems: A review of valuation methods.

    PubMed

    Barbier, Edward B

    2016-08-30

    Concern over the loss of mangrove ecosystems often focuses on their role in protecting coastal communities from storms that damage property and cause deaths and injury. With climate change, mangrove loss may also result in less protection against coastal storms as well as sea-level rise, saline intrusion and erosion. Past valuations of the storm protection benefit of mangroves have relied on the second-best replacement cost method, such as estimating this protective value with the cost of building human-made storm barriers. More reliable methods instead model the production of the protection service of mangroves and estimate its value in terms of reducing the expected damages or deaths avoided by coastal communities. This paper reviews recent methods of valuing the storm protection service of mangroves and their role in protecting coastal areas and communities of tropical developing countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. 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…

  20. Examining public knowledge and preferences for adult preventive services coverage

    PubMed Central

    Ortiz, Selena E.

    2017-01-01

    Introduction To examine (1) what individuals know about the existing adult preventive service coverage provisions of the Affordable Care Act (ACA), and (2) which preventive services individuals think should be covered without cost sharing. Methods An online panel from Survey Monkey was used to obtain a sample of 2,990 adults age 18 and older in March 2015, analyzed 2015–2017. A 17-item survey instrument was designed and used to evaluate respondents’ knowledge of the adult preventive services provision of the ACA. Additionally, we asked whether various preventive services should be covered. The data include age, sex, race/ethnicity, and educational attainment as well as measures of political ideology, previous insurance status, the number of chronic conditions, and usual source of care. Results Respondents correctly answered 38.6% of the questions about existing coverage under the ACA, while on average respondents thought 12.1 of 15 preventive services should be covered (SD 3.5). Respondents were more knowledgeable about coverage for routine screenings, such as blood pressure (63.4% correct) than potentially stigmatizing screenings, such as for alcohol misuse (28.8% correct). Blood pressure screening received the highest support of coverage (89.8%) while coverage of gym memberships received the lowest support (59.4%). Individuals with conservative ideologies thought fewer services on average should be covered, but the difference was small—around one service less than those with liberal ideologies. Conclusions Overwhelmingly, individuals think that most preventive services should be covered without cost sharing. Despite several years of coverage for preventive services, there is still confusion and lack of knowledge about which services are covered. PMID:29261757

  1. Casino gambling among older adults in North Dakota: a policy analysis.

    PubMed

    Bjelde, Kristine; Chromy, Barbara; Pankow, Debra

    2008-12-01

    This article examined social issues surrounding casino gambling among older adults both nationally and in the state of North Dakota. An exploratory review of gambling trends among older adults and an examination of policies to protect older gamblers revealed that older adults are targeted by the gaming industry as a lucrative market (Singh et al. J Retail Leisure Property 2007, 6(1):61-68). The authors used the national literature to frame their qualitative study, which explored gambling issues among older adults in North Dakota from the perspective of six counselors trained in gambling addiction who provide treatment services in the state. Findings indicated that relatively few policies existed at the state and national levels to protect older, more vulnerable adults who gamble. Further, the six casinos in North Dakota were viewed as very effective in marketing their casino gaming opportunities to older citizens by the gambling treatment providers interviewed. Additionally, barriers to gambling addiction treatment involved lack of available services and distance to receive services in this rural state. Based on the findings of this study, social policy changes which could lead to increased protection for older adult gamblers in the state were included.

  2. Prior Military Service, Identity Stigma, and Mental Health Among Transgender Older Adults

    PubMed Central

    Hoy-Ellis, Charles P.; Shiu, Chengshi; Sullivan, Kathleen M.; Kim, Hyun-Jun; Sturges, Allison M.; Fredriksen-Goldsen, Karen I.

    2017-01-01

    Purpose of the Study: Converging evidence from large community-based samples, Internet studies, and Veterans Health Administration data suggest that transgender adults have high rates of U.S. military service. However, little is known about the role of prior military service in their mental health later in life, particularly in relation to identity stigma. In this article, we examine relationships between prior military service, identity stigma, and mental health among transgender older adults. Design and Methods: We used a subsample of transgender older adults (n = 183) from the 2014 survey of Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS). We employed weighted multivariate linear models to evaluate the relationships between psychological health-related quality of life (HRQOL), depressive symptomatology (Center for Epidemiological Studies Depression Scale [CES-D] scores), identity stigma, and prior military service, controlling for background characteristics. Results: Identity stigma was significantly related with higher depressive symptomatology and lower psychological HRQOL. Having a history of prior military service significantly predicted lower depressive symptomatology and higher psychological HRQOL. The relationships between psychological HRQOL, identity stigma, and prior military service were largely explained by depressive symptomatology. Prior military service significantly attenuated the relationship between identity stigma and depressive symptomatology. Implications: By identifying the role of military service in the mental health of transgender older adults, this study provides insights into how prior military service may contribute to resilience and positive mental health outcomes. Directions for future research are discussed. PMID:28087796

  3. Patterns of Risk in Adult Protection Referrals for Sexual Abuse and People with Intellectual Disability

    ERIC Educational Resources Information Center

    Cambridge, Paul; Beadle-Brown, Julie; Milne, Alisoun; Mansell, Jim; Whelton, Beckie

    2011-01-01

    Background: Adult protection monitoring data held by local authorities in England provide opportunities to examine referrals for alleged sexual abuse for people with intellectual disability to identify patterns of risk. Methods: Adult protection monitoring data collected by two local authorities was analysed, with referrals for alleged sexual…

  4. Prior Military Service, Identity Stigma, and Mental Health Among Transgender Older Adults.

    PubMed

    Hoy-Ellis, Charles P; Shiu, Chengshi; Sullivan, Kathleen M; Kim, Hyun-Jun; Sturges, Allison M; Fredriksen-Goldsen, Karen I

    2017-02-01

    Converging evidence from large community-based samples, Internet studies, and Veterans Health Administration data suggest that transgender adults have high rates of U.S. military service. However, little is known about the role of prior military service in their mental health later in life, particularly in relation to identity stigma. In this article, we examine relationships between prior military service, identity stigma, and mental health among transgender older adults. We used a subsample of transgender older adults (n = 183) from the 2014 survey of Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS). We employed weighted multivariate linear models to evaluate the relationships between psychological health-related quality of life (HRQOL), depressive symptomatology (Center for Epidemiological Studies Depression Scale [CES-D] scores), identity stigma, and prior military service, controlling for background characteristics. Identity stigma was significantly related with higher depressive symptomatology and lower psychological HRQOL. Having a history of prior military service significantly predicted lower depressive symptomatology and higher psychological HRQOL. The relationships between psychological HRQOL, identity stigma, and prior military service were largely explained by depressive symptomatology. Prior military service significantly attenuated the relationship between identity stigma and depressive symptomatology. By identifying the role of military service in the mental health of transgender older adults, this study provides insights into how prior military service may contribute to resilience and positive mental health outcomes. Directions for future research are discussed. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Is an ecosystem services-based approach developed for setting specific protection goals for plant protection products applicable to other chemicals?

    PubMed

    Maltby, Lorraine; Jackson, Mathew; Whale, Graham; Brown, A Ross; Hamer, Mick; Solga, Andreas; Kabouw, Patrick; Woods, Richard; Marshall, Stuart

    2017-02-15

    Clearly defined protection goals specifying what to protect, where and when, are required for designing scientifically sound risk assessments and effective risk management of chemicals. Environmental protection goals specified in EU legislation are defined in general terms, resulting in uncertainty in how to achieve them. In 2010, the European Food Safety Authority (EFSA) published a framework to identify more specific protection goals based on ecosystem services potentially affected by plant protection products. But how applicable is this framework to chemicals with different emission scenarios and receptor ecosystems? Four case studies used to address this question were: (i) oil refinery waste water exposure in estuarine environments; (ii) oil dispersant exposure in aquatic environments; (iii) down the drain chemicals exposure in a wide range of ecosystems (terrestrial and aquatic); (iv) persistent organic pollutant exposure in remote (pristine) Arctic environments. A four-step process was followed to identify ecosystems and services potentially impacted by chemical emissions and to define specific protection goals. Case studies demonstrated that, in principle, the ecosystem services concept and the EFSA framework can be applied to derive specific protection goals for a broad range of chemical exposure scenarios. By identifying key habitats and ecosystem services of concern, the approach offers the potential for greater spatial and temporal resolution, together with increased environmental relevance, in chemical risk assessments. With modifications including improved clarity on terminology/definitions and further development/refinement of the key concepts, we believe the principles of the EFSA framework could provide a methodical approach to the identification and prioritization of ecosystems, ecosystem services and the service providing units that are most at risk from chemical exposure. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights

  6. Older adults' home- and community-based care service use and residential transitions: a longitudinal study.

    PubMed

    Chen, Ya-Mei; Berkowitz, Bobbie

    2012-08-10

    As Home-and Community-Based Services (HCBS), such as skilled nursing services or personal care services, have become increasingly available, it has become clear that older adults transit through different residential statuses over time. Older adults may transit through different residential statuses as the various services meet their needs. The purpose of this exploratory study was to better understand the interplay between community-dwelling older adults' use of home- and community-based services and their residential transitions. The study compared HCBS service-use patterns and residential transitions of 3,085 older adults from the Second Longitudinal Study of Aging. Based on older adults' residential status at the three follow-up interviews, four residential transitions were tracked: (1) Community-Community-Community (CCC: Resided in community during the entire study period); (2) Community-Institution-Community (CIC: Resided in community at T1, had lived in an institution at some time between T1 and T2, then had returned to community by T3); (3) Community-Community-Institution (CCI: Resided in community between at T1, and betweenT1 and T2, including at T2, but had used institutional services between T2 and T3); (4) Community-Institution-Institution (CII: Resided in community at T1 but in an institution at some time between T1 and T2, and at some time between T2 and T3.). Older adults' use of nondiscretionary and discretionary services differed significantly among the four groups, and the patterns of HCBS use among these groups were also different. Older adults' use of nondiscretionary services, such as skilled nursing care, may help them to return to communities from institutions. Personal care services (PCS) and senior center services may be the key to either support elders to stay in communities longer or help elders to return to their communities from institutions. Different combinations of PCS with other services, such as senior center services or meal

  7. Dental service trends for older US adults, 1998-2006.

    PubMed

    Skaar, Daniel D; O'Connor, Heidi

    2012-03-01

    This study of the Medicare Current Beneficiary Survey (MCBS) updates trends in utilization of dental services between 1998 and 2006 for community-dwelling U.S. adults of age 65 years and older. Bivariate comparisons were made between dependent variables (annual dental visits and types of dental procedures) and independent variables (age, gender, race, income, education, population density, marital status, U.S. Census Bureau regions, and self-reported health). The estimated percentage of community-dwelling Medicare beneficiaries with a dental visit for the years studied increased from 45.0% in 1998 to 46.3% in 2006. The age group of respondents who were 85 years and older had the greatest percentage increase in dental visits. Those reporting visits with preventive procedures increased from 87.8% to 91.2% whereas those reporting visits with nonpreventive procedures declined from 63.9% to 58.4%. The prevalence of dental visits continues to trend upward for this population of older adults. Increasing delivery of preventive services will likely impact the future mix of dental services as U.S. adults live longer. © 2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

  8. Racial and Ethnic Disparities in Services and the Patient Protection and Affordable Care Act

    PubMed Central

    Abdus, Salam; Mistry, Kamila B.

    2015-01-01

    Objectives. We examined prereform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA). Methods. We used pre-ACA household data from the Medical Expenditure Panel Survey to identify groups targeted by the coverage provisions of the Act (Medicaid expansions and subsidized Marketplace coverage). We examined racial/ethnic differences in coverage, access to care, and preventive service use, across and within ACA relevant subgroups from 2005 to 2010. The study took place at the Agency for Healthcare Research and Quality in Rockville, Maryland. Results. Minorities were disproportionately represented among those targeted by the coverage provisions of the ACA. Targeted groups had lower rates of coverage, access to care, and preventive services use, and racial/ethnic disparities were, in some cases, widest within these targeted groups. Conclusions. Our findings highlighted the opportunity of the ACA to not only to improve coverage, access, and use for all racial/ethnic groups, but also to narrow racial/ethnic disparities in these outcomes. Our results might have particular importance for states that are deciding whether to implement the ACA Medicaid expansions. PMID:26447920

  9. Racial and Ethnic Disparities in Services and the Patient Protection and Affordable Care Act.

    PubMed

    Abdus, Salam; Mistry, Kamila B; Selden, Thomas M

    2015-11-01

    We examined prereform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA). We used pre-ACA household data from the Medical Expenditure Panel Survey to identify groups targeted by the coverage provisions of the Act (Medicaid expansions and subsidized Marketplace coverage). We examined racial/ethnic differences in coverage, access to care, and preventive service use, across and within ACA relevant subgroups from 2005 to 2010. The study took place at the Agency for Healthcare Research and Quality in Rockville, Maryland. Minorities were disproportionately represented among those targeted by the coverage provisions of the ACA. Targeted groups had lower rates of coverage, access to care, and preventive services use, and racial/ethnic disparities were, in some cases, widest within these targeted groups. Our findings highlighted the opportunity of the ACA to not only to improve coverage, access, and use for all racial/ethnic groups, but also to narrow racial/ethnic disparities in these outcomes. Our results might have particular importance for states that are deciding whether to implement the ACA Medicaid expansions.

  10. The Outlook in the Protective Service Fields

    ERIC Educational Resources Information Center

    Talley, Gregory; Korsgren, Susan

    2009-01-01

    Opportunities abound for prospective employees in the protective services. On the surface, it appears that few employers require a college education as a condition of employment at the state or local level. But the reality is that many employers use at least some college as a screening tool for prospective employees. Although the federal…

  11. Beliefs and Intentions for Skin Protection and UV Exposure in Young Adults

    ERIC Educational Resources Information Center

    Heckman, Carolyn J.; Manne, Sharon L.; Kloss, Jacqueline D.; Bass, Sarah Bauerle; Collins, Bradley; Lessin, Stuart R.

    2011-01-01

    Objective: To evaluate Fishbein's integrative model in predicting young adults' skin protection, sun exposure, and indoor tanning intentions. Methods: Two hundred twelve participants completed an online survey. Results: Damage distress, self-efficacy, and perceived control accounted for 34% of the variance in skin protection intentions. Outcome…

  12. Prevalence and determinants of Australian adolescents' and adults' weekend sun protection and sunburn, summer 2003-2004.

    PubMed

    Dobbinson, Suzanne; Wakefield, Melanie; Hill, David; Girgis, Afaf; Aitken, Joanne F; Beckmann, Kerri; Reeder, Anthony I; Herd, Natalie; Fairthorne, Andrew; Bowles, Kelly-Ann

    2008-10-01

    Reducing people's exposure to ultraviolet radiation is the primary strategy for skin cancer prevention. We sought to provide comprehensive national data on preventive behaviors and risk assessment for Australia. A national survey was conducted in summer 2003-2004. In 8 weekly cross-sectional surveys, adults and adolescents were interviewed about their sun protection and sunburn on the previous summer weekend. Adjustments were made for specific weather and ultraviolet radiation conditions relevant to time and location. Adolescents were relatively homogeneous in their low compliance with sun protection (significantly less use of hats, covering clothing, shade, and sunglasses than adults) on weekends, and consequently were more likely to be sunburned than adults (25% compared with 18%; odds ratio=1.80, P<.001). Temperature was a significant predictor of sun-protective behaviors and a strong determinant of sunburn, as was ultraviolet radiation for adults' sunburn. Using shade, spending less time outdoors, and, for adults, wearing clothing covering were associated with reduced odds of sunburn. The study relied on self-reported behaviors and sunburn. Further improvement in Australians' sun-protective behaviors is needed.

  13. Seven-year trends in sun protection and sunburn among Australian adolescents and adults.

    PubMed

    Volkov, Angela; Dobbinson, Suzanne; Wakefield, Melanie; Slevin, Terry

    2013-02-01

    To examine the change in sun protective behaviours and sunburn of Australians over a seven-year period, in the context of sustained skin cancer prevention campaigns and programs. Weekly cross-sectional telephone interviews of Australians were conducted throughout summer in 2010/11 for comparison with 2003/04 and 2006/07. In 2010/11, n=1,367 adolescents (12-17 years) and n=5,412 adults (18-69 years) were interviewed about their sun-related attitudes, weekend sun protection and sunburn. Multivariate analyses adjusted for key demographics, temperature, cloud, wind and ultraviolet radiation (UVR) to assess change in outcomes over time. There were consistent improvements in adolescents' and adults' attitudes, intentional tanning and incidence of sunburn over time. Behavioural changes were variable. Adults spent less time outdoors during peak UVR compared to past surveys, while adolescents were less likely to be outdoors compared with 2006/07. Sunscreen use and wearing of long sleeves increased among adults, but hat wearing decreased for both age groups, as did leg cover by adolescents since 2003/04. There has been a sustained decrease in weekend sunburn among adolescents and adults. The findings suggest improvements in skin cancer prevention attitudes of Australians over time. Australians' compliance with sun protection during summer has improved in some areas, but is still far from ideal. The sustained decrease in weekend sunburn among adolescents and adults is encouraging, but further improvements are required. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

  14. 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

  15. The Experience of Adult Learners in Academic Service Learning Courses

    ERIC Educational Resources Information Center

    Finley, Amy E.

    2017-01-01

    Adult learners represent a significant, and growing, portion of enrollment at higher education institutions. Despite their growing enrollment, adult learners are not retained at nearly the rate of their "traditional" peers, leaving colleges and universities with the need to identify programs and services that specifically address the…

  16. Ecosystem services-based SWOT analysis of protected areas for conservation strategies.

    PubMed

    Scolozzi, Rocco; Schirpke, Uta; Morri, Elisa; D'Amato, Dalia; Santolini, Riccardo

    2014-12-15

    An ecosystem services-based SWOT analysis is proposed in order to identify and quantify internal and external factors supporting or threatening the conservation effectiveness of protected areas. The proposed approach concerns both the ecological and the social perspective. Strengths and weaknesses, opportunities and threats were evaluated based on 12 selected environmental and socio-economic indicators for all terrestrial Italian protected areas, belonging to the Natura 2000 network, and for their 5-km buffer area. The indicators, used as criteria within a multi-criteria assessment, include: core area, cost-distance between protected areas, changes in ecosystem services values, intensification of land use, and urbanization. The results were aggregated for three biogeographical regions, Alpine, Continental, and Mediterranean, indicating that Alpine sites have more opportunities and strengths than Continental and Mediterranean sites. The results call attention to where connectivity and land-use changes may have stronger influence on protected areas, in particular, whereas urbanization or intensification of agriculture may hamper conservation goals of protected areas. The proposed SWOT analysis provides helpful information for a multiple scale perspective and for identifying conservation priorities and for defining management strategies to assure biodiversity conservation and ecosystem services provision. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Social determinants of dental health services utilisation of Greek adults.

    PubMed

    Pavi, E; Karampli, E; Zavras, D; Dardavesis, T; Kyriopoulos, J

    2010-09-01

    To identify the determinants of dental care utilisation among Greek adults, with a particular emphasis on socio-economic determinants. Data were collected through a national survey on health and health care services utilisation of a sample of 4,003 Greek adults stratified by geographic region, age and gender. A purpose made questionnaire was used during face-to-face interviews. A 2-stage model was developed to assess the impact of independent variables on dental utilisation likelihood and frequency. 39.6% (1,562) of Greek adults reported having visited a dentist within the last year. Among dental attenders, 32.6% reported prevention as the reason for visit. Statistically significant differences in dental care utilisation were observed in relation to demographic, socioeconomic and lifestyle factors. Logistic regression analysis showed that gender, age, income, education, place of residence, private insurance coverage and self-rated oral health are important determinants of dental services utilisation. Mean number of dental visits within previous year was 1.6. Results from Poisson regression analysis indicated that lower income level correlates to lower number of dental visits, while having visited for treatment (rather than for prevention) correlated to higher number of dental visits. Greek adults do not exhibit satisfactory dental visiting behaviour. Extent of care sought is associated with need for treatment rather than preventive reasons. The findings confirm the existence of socioeconomic inequalities in dental services utilisation among Greek adults.

  18. 48 CFR 3009.171 - Prohibition on Federal Protective Service guard services contracts with business concerns owned...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Prohibition on Federal Protective Service guard services contracts with business concerns owned, controlled, or operated by an individual convicted of a felony. 3009.171 Section 3009.171 Federal Acquisition Regulations System DEPARTMENT...

  19. Workers safety in public psychiatric services: problems, laws and protections.

    PubMed

    Carabellese, F; Urbano, M; Coluccia, A; Gualtieri, G

    2017-01-01

    The dramatic case of murder of a psychiatrist during her service in her public office (Centro di Salute Mentale of Bari-Libertà) has led the authors to reflect on the safety of workplaces, in detail of public psychiatric services. It is in the light of current legislation, represented by the Legislative Decree of April 9th, 2008 no. 81, which states the implementing rules of Law 123/2007. In particular, the Authors analyzed the criticalities of the application of this Law, with the aim of safeguarding the health and safety of the workers in all psychiatric services (nursing departments, outpatient clinics, community centers, day care centers, etc.). The Authors suggest the need to set up an articulated specific organizational system of risk assessment of psychiatric services, that can prevent and protect the workers from identified risks, and finally to ensure their active participation in prevention and protection activities, in absence of which specific profiles of responsibility would be opened up to the employers.

  20. Use of protective eyewear in U.S. adults: results from the 2002 national health interview survey.

    PubMed

    Forrest, Kimberly Y Z; Cali, Joseph M; Cavill, Wilma J

    2008-01-01

    Many eye injuries occur because of not using protective eyewear. This study analyzed the 2002 National Health Interview Survey data to examine the rate of using protective eyewear during activities that could cause eye injuries outside the workplace and the correlates of not using protective eyewear among U.S. adults. The rate of participation in activities that could cause eye injuries and the rate of protective eyewear use during these activities were estimated using sample weights to yield national estimates. A total of 30,894 individuals in the survey provided valid data for the current analysis, which revealed that 29.3% of the U.S. adults reported engaging in activities that could cause an eye injury and 32.1% of those used eye protection while doing such activities. Males were more likely to use eye protection than females (34.7% vs. 25.2%). The age group of 18-24 years was least likely to use eye protection (15.3%). Other factors associated with not using protective eyewear included being black or other races, non-retired individuals, and those from low-income families (all p-values < 0.05). Use of protective eyewear during activities that could cause eye injuries was relatively low in the US adult population. Certain groups were at a higher risk for not using eye protection, including females, young adults aged 18-24 years, black or other races, and individuals with a low socioeconomic status. To promote eye safety, health education programs should target these high-risk groups.

  1. Hanford Radiological Protection Support Services Annual Report for 1998

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    DE Bihl; JA MacLellan; ML Johnson

    1999-05-14

    During calendar year (CY) 1998, the Pacific Northwest National Laboratory (PNNL) performed its customary radiological protection support services in support of the U.S. Department of Energy (DOE) Richland Operations OffIce (RL) and the Hanford contractors. These services included: 1) external dosimetry, 2) internal dosimetry, 3) in vivo measurements, 4) radiological records, 5) instrument calibra- tion and evaluation, and 6) calibration of radiation sources traceable to the National Institute of Standards and Technology (MST). The services were provided under a number of projects as summarized here.

  2. Predicted body weight relationships for protective ventilation - unisex proposals from pre-term through to adult.

    PubMed

    Martin, Dion C; Richards, Glenn N

    2017-05-23

    The lung-protective ventilation bundle has been shown to reduce mortality in adult acute respiratory distress syndrome (ARDS). This concept has expanded to other areas of acute adult ventilation and is recommended for pediatric ventilation. A component of lung-protective ventilation relies on a prediction of lean body weight from height. The predicted body weight (PBW) relationship employed in the ARDS Network trial is considered valid only for adults, with a dedicated formula required for each sex. No agreed PBW formula applies to smaller body sizes. This analysis investigated whether it might be practical to derive a unisex PBW formula spanning all body sizes, while retaining relevance to established adult protective ventilation practice. Historic population-based growth charts were adopted as a reference for lean body weight, from pre-term infant through to adult median weight. The traditional ARDSNet PBW formulae acted as the reference for prevailing protective ventilation practice. Error limits for derived PBW models were relative to these references. The ARDSNet PBW formulae typically predict weights heavier than the population median, therefore no single relationship could satisfy both references. Four alternate piecewise-linear lean body-weight predictive formulae were presented for consideration, each with different balance between the objectives. The 'PBWuf + MBW' model is proposed as an appropriate compromise between prevailing practice and simplification, while also better representing lean adult body-weight. This model applies the ARDSNet 'female' formula to both adult sexes, while providing a tight fit to median body weight at smaller statures down to pre-term. The 'PBWmf + MBW' model retains consistency with current practice over the adult range, while adding prediction for small statures.

  3. Characteristics and Service Use of Older Adults with Schizoaffective Disorder Versus Older Adults with Schizophrenia and Bipolar Disorder.

    PubMed

    Rolin, Stephanie A; Aschbrenner, Kelly A; Whiteman, Karen L; Scherer, Emily; Bartels, Stephen J

    2017-09-01

    The purpose of this study was to determine if schizoaffective disorder in older adults is differentiated from schizophrenia and bipolar disorder with respect to community functioning, cognitive functioning, psychiatric symptoms, and service use. Secondary analysis of baseline data collected from the Helping Older People Experience Success psychosocial skills training and health management study. Three community mental health centers in New Hampshire and Massachusetts. Adults over the age of 50 (N = 139, mean age: 59.7 years, SD: 7.4 years) with persistent functional impairment and a diagnosis of schizoaffective disorder (N = 52), schizophrenia (N = 51), or bipolar disorder (N = 36). Health status (36-Item Short Form Health Survey [SF-36]), performance-based community living skills (UCSD Performance-Based Skills Assessment), neuropsychological functioning (Delis-Kaplan Executive Functioning subtests), psychiatric symptoms (Brief Psychiatric Rating Scale, Center for Epidemiologic Studies Depression Scale, Scale for the Assessment of Negative Symptoms), medical severity (Charlson comorbidity index), and acute service use. Older adults with schizoaffective disorder had depressive symptoms of similar severity to bipolar disorder, and thought disorder symptoms of similar severity to schizophrenia. Schizoaffective disorder compared with schizophrenia was associated with better community functioning, but poorer subjective physical and mental health functioning as measured by the SF-36. Older adults with schizoaffective disorder had greater acute hospitalization compared with adults with schizophrenia, though their use of acute care services was comparable to individuals with bipolar disorder. Findings from this study suggest that schizoaffective disorder in older adults occupies a distinct profile from either schizophrenia or bipolar disorder with respect to community functional status, symptom profile, and acute services utilization. Copyright © 2017

  4. 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 Worker...

  5. 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 Worker...

  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, 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 Worker...

  7. Data Protection-Aware Design for Cloud Services

    NASA Astrophysics Data System (ADS)

    Creese, Sadie; Hopkins, Paul; Pearson, Siani; Shen, Yun

    The Cloud is a relatively new concept and so it is unsurprising that the information assurance, data protection, network security and privacy concerns have yet to be fully addressed. This paper seeks to begin the process of designing data protection controls into clouds from the outset so as to avoid the costs associated with bolting on security as an afterthought. Our approach is firstly to consider cloud maturity from an enterprise level perspective, describing a novel capability maturity model. We use this model to explore privacy controls within an enterprise cloud deployment, and explore where there may be opportunities to design in data protection controls as exploitation of the Cloud matures. We demonstrate how we might enable such controls via the use of design patterns. Finally, we consider how Service Level Agreements (SLAs) might be used to ensure that third party suppliers act in support of such controls.

  8. Citizen Review Panels for Child Protective Services: A National Profile

    ERIC Educational Resources Information Center

    Jones, Blake L.; Royse, David

    2008-01-01

    Citizen Review Panels (CRPs) for Child Protective Services are groups of citizen-volunteers throughout the United States who are federally mandated to evaluate local and state child protection systems. This study presents a profile of 332 CRP members in 20 states with regards to their demographic information, length of time on the panel, and …

  9. 47 CFR 73.6020 - Protection of stations in the land mobile radio service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... stations in the land mobile radio service. An application for digital operation of an existing Class A TV... 47 Telecommunication 4 2010-10-01 2010-10-01 false Protection of stations in the land mobile radio... accepted if it fails to protect stations in the land mobile radio service pursuant to the requirements...

  10. 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 Delivery...

  11. 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 Delivery...

  12. 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 Delivery...

  13. A Strategy toward Collaborative Filter Recommended Location Service for Privacy Protection

    PubMed Central

    Wang, Peng; Yang, Jing; Zhang, Jianpei

    2018-01-01

    A new collaborative filtered recommendation strategy was proposed for existing privacy and security issues in location services. In this strategy, every user establishes his/her own position profiles according to their daily position data, which is preprocessed using a density clustering method. Then, density prioritization was used to choose similar user groups as service request responders and the neighboring users in the chosen groups recommended appropriate location services using a collaborative filter recommendation algorithm. The two filter algorithms based on position profile similarity and position point similarity measures were designed in the recommendation, respectively. At the same time, the homomorphic encryption method was used to transfer location data for effective protection of privacy and security. A real location dataset was applied to test the proposed strategy and the results showed that the strategy provides better location service and protects users’ privacy. PMID:29751670

  14. A Strategy toward Collaborative Filter Recommended Location Service for Privacy Protection.

    PubMed

    Wang, Peng; Yang, Jing; Zhang, Jianpei

    2018-05-11

    A new collaborative filtered recommendation strategy was proposed for existing privacy and security issues in location services. In this strategy, every user establishes his/her own position profiles according to their daily position data, which is preprocessed using a density clustering method. Then, density prioritization was used to choose similar user groups as service request responders and the neighboring users in the chosen groups recommended appropriate location services using a collaborative filter recommendation algorithm. The two filter algorithms based on position profile similarity and position point similarity measures were designed in the recommendation, respectively. At the same time, the homomorphic encryption method was used to transfer location data for effective protection of privacy and security. A real location dataset was applied to test the proposed strategy and the results showed that the strategy provides better location service and protects users' privacy.

  15. 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 § 663...

  16. 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…

  17. Interagency Collaboration between Child Protection and Mental Health Services: Practices, Attitudes and Barriers

    ERIC Educational Resources Information Center

    Darlington, Yvonne; Feeney, Judith A.; Rixon, Kylie

    2005-01-01

    Objective: The aim of this paper is to examine some of the factors that facilitate and hinder interagency collaboration between child protection services and mental health services in cases where there is a parent with a mental illness and there are protection concerns for the child(ren). The paper reports on agency practices, worker attitudes and…

  18. Management Services; A Training Guide for Out-of-school Youth and Adults.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Bureau of Continuing Education Curriculum Development.

    This guide is intended to aid adult education directors, school principals, supervisors of home economics, and area center program planners in organizing occupational programs for adults, and to help instructors train adults for employment in management services in public and private institutions and housing projects. Section I outlines suggested…

  19. Alcohol use disorders and the use of treatment services among college-age young adults.

    PubMed

    Wu, Li-Tzy; Pilowsky, Daniel J; Schlenger, William E; Hasin, Deborah

    2007-02-01

    This study examined the utilization of and the perceived need for alcohol treatment services among college-age young adults (18-22 years) according to their educational status: full-time college students, part-time college students, noncollege students (currently in school with the highest grade level below college), and nonstudents (N=11,337). This breakdown of young adults had not been addressed previously. Secondary analyses were conducted on data from the 2002 National Survey on Drug Use and Health. Full-time college students (21%) were as likely to have an alcohol use disorder as nonstudents (19%), but were more likely than part-time college students (15%) and noncollege students (12%). Only 4% of full-time college students with an alcohol use disorder received any alcohol services in the past year. Of those with an alcohol use disorder who did not receive treatment services, only 2% of full-time college students, close to 1% of part-time college students, and approximately 3% of young adults who were not in college reported a perceived need for alcohol treatment. Full-time college students were less likely than noncollege students to receive treatment for alcohol use disorders. All young adults with an alcohol use disorder were very unlikely to perceive a need for alcohol treatment or counseling. College-age adults have a high prevalence of alcohol use disorders, yet they are very unlikely to receive alcohol treatment or early intervention services or to perceive a need for such services. Underutilization of alcohol-related services among college-age young adults deserves greater research attention.

  20. Alternatives to Conservatorship: The Role of Daily Money Management Services.

    ERIC Educational Resources Information Center

    Wilber, Kathleen H.

    1991-01-01

    Tested hypothesis that daily money management services divert vulnerable elders from conservatorship. Assigned community-residing elders (n=63) to money management service or screening by Office of the Public Guardian or Adult Protective Services. Found no difference in rates of conservatorship for those offered money management service.…

  1. Utilizing Volunteers in Expanding Services to Disadvantaged Adults. Revised Edition.

    ERIC Educational Resources Information Center

    Schmidt, Susan K.

    One of a series on library services to disadvantaged adults, this guide suggests ways the public library can use volunteers to expand library services. The library should plan to its volunteer program and develop job descriptions for the volunteers. Then volunteers can be recruited through advertising or community organizations. Volunteers can be…

  2. The Multicultural Café: Enhancing Authentic Interaction for Adult English Language Learners through Service Learning

    ERIC Educational Resources Information Center

    Riley, Tracy; Douglas, Scott Roy

    2016-01-01

    While service learning platforms hold great potential for adult learners of English as an additional language (EAL), there has been little research to date related to the impact of these programs on adult newcomers' linguistic and social development. The Multicultural Café was a food service learning platform for adult EAL learners operated over a…

  3. A data protection scheme for a remote vital signs monitoring healthcare service.

    PubMed

    Gritzalis, D; Lambrinoudakis, C

    2000-01-01

    Personal and medical data processed by Healthcare Information Systems must be protected against unauthorized access, modification and withholding. Security measures should be selected to provide the required level of protection in a cost-efficient manner. This is only feasible if specific characteristics of the information system are examined on a basis of a risk analysis methodology. This paper presents the results of a risk analysis, based on the CRAMM methodology, for a healthcare organization offering a patient home-monitoring service through the transmission of vital signs, focusing on the identified security needs and the proposed countermeasures. The architectural and functional models of this service were utilized for identifying and valuating the system assets, the associated threats and vulnerabilities, as well as for assessing the impact on the patients and on the service provider, should the security of any of these assets is affected. A set of adequate organizational, administrative and technical countermeasures is described for the remote vital signs monitoring service, thus providing the healthcare organization with a data protection framework that can be utilized for the development of its own security plan.

  4. Tracking health care service use and the experiences of adults with autism spectrum disorder without intellectual disability: A longitudinal study of service rates, barriers and satisfaction.

    PubMed

    Vogan, Vanessa; Lake, Johanna K; Tint, Ami; Weiss, Jonathan A; Lunsky, Yona

    2017-04-01

    Adults with Autism Spectrum Disorder (ASD) encounter many difficulties finding and accessing health care services. Despite this, few studies have considered the health service use patterns of adults with ASD without intellectual disability (ID). The current study examines a diverse range of medical and mental health services and supports, as well as adults' personal experiences accessing and using these services, barriers to service use, and reported unmet service needs. Forty adults (ages 18-61 years) with ASD without ID completed surveys every two months about their health service use for a total of 12-18 months. Bivariate analyses were conducted to understand the individual demographic and clinical factors associated with rate of service use, satisfaction with services, and barriers to health care. Results indicated that, beyond a family doctor, the most commonly used services were dentistry, individual counseling, and psychiatry. Individuals who had medical problems experienced significantly more barriers to service use than those who did not, and those who had medical and mental health problems were less satisfied with services. Findings highlight the challenges adults with ASD without ID face accessing appropriate, quality services to meet their needs, particularly those with complex medical and mental health issues. Service providers must strive to provide adequate health care to this population who may become distressed if their needs are left unmet. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Teaching caring and competence: Student transformation during an older adult focused service-learning course.

    PubMed

    Brown, Karen M; Bright, Leslie M

    2017-11-01

    Innovative teaching strategies develop nurses' knowledge, skills, and attitudes while simultaneously integrating the art of caring and transforming attitudes toward adults over age 65. The study's purpose was to explore students' experiences and attitudes toward older adults with cognitive and/or physical limitations as well as the effects on students' knowledge and skills during a baccalaureate nursing, course which included a service-learning experience. Service-learning synthesizes meaningful community service, academic instruction, and reflection. Participants included baccalaureate students enrolled in a service-learning nursing course focused on older adults. This retrospective, qualitative, phenomenological study used reflective journals and an online survey to explore baccalaureate nursing students' experiences toward older adults with cognitive and/or physical limitations. Themes included initial attitudes of anticipation, apprehension, anxiety, and ageist stereotypes. Final attitudes included a "completely changed perspective" of caring, compassion, and respect indicative of a rewarding, "life-changing" experience. Participants cited enhanced learning, especially in the areas of patient-centered care, collaboration, communication, advocacy, empathy, assessment skills, and evidence-based practice. This innovative teaching strategy led to transformed attitudes toward older adults, reduced fear of older adult populations, an increased desire to work with older adults, and the ability to form a transpersonal, caring relationship while enhancing nursing knowledge and skills. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Effectiveness of Child Protection Training for Pre-Service Early Childhood Educators

    ERIC Educational Resources Information Center

    McKee, Bronagh E.; Dillenburger, Karola

    2012-01-01

    International evidence confirms that early childhood educators can enter professional practice unprepared for child protection due to inadequate pre-service preparation. This paper makes an original contribution by using the Child Protection Questionnaire for Educators (CPQE) to examine the pre- and post-intervention child maltreatment and…

  7. High Utilizers of Emergency Health Services in a Population-Based Cohort of Homeless Adults

    PubMed Central

    Chambers, Catharine; Chiu, Shirley; Katic, Marko; Kiss, Alex; Redelmeier, Donald A.; Levinson, Wendy

    2013-01-01

    Objectives. We identified predictors of emergency department (ED) use among a population-based prospective cohort of homeless adults in Toronto, Ontario. Methods. We assessed ED visit rates using administrative data from the Institute for Clinical Evaluative Sciences (2005–2009). We then used logistic regression to identify predictors of ED use. Frequent users were defined as participants with rates in the top decile (≥ 4.7 visits per person-year). Results. Among 1165 homeless adults, 892 (77%) had at least 1 ED visit during the study. The average rate of ED visits was 2.0 visits per person-year, whereas frequent users averaged 12.1 visits per person-year. Frequent users accounted for 10% of the sample but contributed more than 60% of visits. Predictors of frequent use in adjusted analyses included birth in Canada, higher monthly income, lower health status, perceived unmet mental health needs, and perceived external health locus of control from powerful others; being accompanied by a partner or dependent children had a protective effect on frequent use. Conclusions. Among homeless adults with universal health insurance, a small subgroup accounted for the majority of visits to emergency services. Frequent use was driven by multiple predisposing, enabling, and need factors. PMID:24148033

  8. How do abused elderly persons and their adult protective services caseworkers view law enforcement involvement and criminal prosecution, and what impact do these views have on case processing?

    PubMed

    Jackson, Shelly L; Hafemeister, Thomas L

    2013-01-01

    This study examined law enforcement and prosecution involvement in 71 cases of elder abuse where pure financial exploitation (PFE), physical abuse (PA), neglect (Neglect), or hybrid financial exploitation (HFE) (financial exploitation co-occurring with physical abuse and/or neglect) occurred in a domestic setting. Victims of elder abuse and assigned Adult Protective Services (APS) caseworkers were systematically interviewed. Law enforcement officials were involved in 54% of the cases, and 18% of the cases were prosecuted. PA was significantly more likely to trigger a law enforcement response and to be prosecuted than Neglect or PFE. HFE involved prosecution for assault rather than financial exploitation. Generally, the victims of elder abuse were not receptive to criminal justice involvement, which appears to have a significant impact upon the level of this involvement. The reasons for this reluctance are discussed, as well as the challenges and limitations of criminal justice system involvement and related implications for policy and practice.

  9. Food security in older adults: community service provider perceptions of their roles.

    PubMed

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

    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 security, and (c) opinions about constraints that influenced these roles. A constant comparison analysis identified key themes. The formal caregivers reported six roles for improving food security: (a) monitoring, (b) coordination, and (c) promoting services, (d) education, (e) advocacy, and (f) providing a social environment. The final theme summarizes these roles as "the need for personalization of service". Social and community service providers are involved in roles that can promote the health of older adults by addressing their food insecurity. Social service providers need to be acknowledged and supported in this health promotion role.

  10. Strengthening protected areas for biodiversity and ecosystem services in China.

    PubMed

    Xu, Weihua; Xiao, Yi; Zhang, Jingjing; Yang, Wu; Zhang, Lu; Hull, Vanessa; Wang, Zhi; Zheng, Hua; Liu, Jianguo; Polasky, Stephen; Jiang, Ling; Xiao, Yang; Shi, Xuewei; Rao, Enming; Lu, Fei; Wang, Xiaoke; Daily, Gretchen C; Ouyang, Zhiyun

    2017-02-14

    Recent expansion of the scale of human activities poses severe threats to Earth's life-support systems. Increasingly, protected areas (PAs) are expected to serve dual goals: protect biodiversity and secure ecosystem services. We report a nationwide assessment for China, quantifying the provision of threatened species habitat and four key regulating services-water retention, soil retention, sandstorm prevention, and carbon sequestration-in nature reserves (the primary category of PAs in China). We find that China's nature reserves serve moderately well for mammals and birds, but not for other major taxa, nor for these key regulating ecosystem services. China's nature reserves encompass 15.1% of the country's land surface. They capture 17.9% and 16.4% of the entire habitat area for threatened mammals and birds, but only 13.1% for plants, 10.0% for amphibians, and 8.5% for reptiles. Nature reserves encompass only 10.2-12.5% of the source areas for the four key regulating services. They are concentrated in western China, whereas much threatened species' habitat and regulating service source areas occur in eastern provinces. Our analysis illuminates a strategy for greatly strengthening PAs, through creating the first comprehensive national park system of China. This would encompass both nature reserves, in which human activities are highly restricted, and a new category of PAs for ecosystem services, in which human activities not impacting key services are permitted. This could close the gap in a politically feasible way. We also propose a new category of PAs globally, for sustaining the provision of ecosystems services and achieving sustainable development goals.

  11. Children's experiences of domestic violence: developing an integrated response from police and child protection services.

    PubMed

    Stanley, Nicky; Miller, Pam; Foster, Helen Richardson; Thomson, Gill

    2011-08-01

    Police notifications of incidents of domestic violence to child protection services constitute an acknowledgement of the harm that domestic violence inflicts on children. However, these notifications represent a substantial demand on child welfare services and the outcomes for children and victims of domestic violence have been questioned. This paper presents findings from the first UK study to examine these notifications in depth and examines the interface between the police and child protection services in responding to domestic violence incidents. The research reports on police interventions in 251 incidents of domestic violence involving children; the communication of information to child protection services and the subsequent filtering and service response. Social workers found that notifications conveyed little information on children's experiences of domestic violence. Forty per cent of families notified had had no previous contact with child protection services in that area, but those cases most likely to receive social work assessment or intervention were those where the case was already open. Notifications triggered a new social work intervention in only 5% of cases. The study also identified a range of innovative approaches for improving the co-ordination of police and child protective services in relation to children's exposure to domestic violence. Arrangements that maximized opportunities for police and social workers to share agency information appeared to offer the best option for achieving informed decisions about the appropriate level of service response to children and families experiencing domestic violence.

  12. Alcohol Use Disorders and the Use of Treatment Services Among College-Age Young Adults

    PubMed Central

    Wu, Li-Tzy; Pilowsky, Daniel J.; Schlenger, William E.; Hasin, Deborah

    2007-01-01

    Objectives This study examined the utilization of and the perceived need for alcohol treatment services among college-age young adults (18–22 years) according to their educational status: full-time college students, part-time college students, noncollege students (currently in school with the highest grade level below college), and nonstudents (N=11,337). This breakdown of young adults had not been addressed previously. Methods Secondary analyses were conducted on data from the 2002 National Survey on Drug Use and Health. Results Full-time college students (21%) were as likely to have an alcohol use disorder as nonstudents (19%), but were more likely than part-time college students (15%) and noncollege students (12%). Only 4% of full-time college students with an alcohol use disorder received any alcohol services in the past year. Of those with an alcohol use disorder who did not receive treatment services, only 2% of full-time college students, close to 1% of part-time college students, and approximately 3% of young adults who were not in college reported a perceived need for alcohol treatment. Full-time college students were less likely than noncollege students to receive treatment for alcohol use disorders. All young adults with an alcohol use disorder were very unlikely to perceive a need for alcohol treatment or counseling. Conclusions College-age adults have a high prevalence of alcohol use disorders, yet they are very unlikely to receive alcohol treatment or early intervention services or to perceive a need for such services. Underutilization of alcohol-related services among college-age young adults deserves greater research attention. PMID:17287375

  13. 20 CFR 663.150 - What core services must be provided to 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 core services must be provided to adults....150 What core services must be provided to adults and dislocated workers? (a) At a minimum, all of the core services described in WIA section 134(d)(2) and 20 CFR 662.240 must be provided in each local area...

  14. Use of technological aids and interpretation services among children and adults with hearing loss.

    PubMed

    Dammeyer, Jesper; Lehane, Christine; Marschark, Marc

    2017-10-01

    The technological development of communication aids for people with hearing loss has progressed rapidly over the last decades. Quality has improved and the number of different types of aids has increased. However, few studies have examined the prevalence of technology use and interpreting services use among people with hearing loss as they relate to demographic characteristics of this population. This study reports from national surveys of children and adults with hearing loss. Use of hearing aids, cochlear implants, other aids and interpreting services were analysed with regard to gender, age, degree of hearing loss, mode of communication, having an additional disability, level of educational achievement among adults, and whether or not children lived together with both of their parents. 269 children (0-15 years of age) and 839 adults (16-65 years of age). Differences in technology and service use were associated with age, degree of hearing loss, and mode of communication among children and adults, and gender and level of educational achievement among adults. Individual and social factors have an impact on technological hearing aid and interpreter use. More research about individual differences and clinical implications of support services is needed.

  15. 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,…

  16. Exclusory and Transformative Dimensions of Adult Environmental Education in Two Brazilian Protected Areas

    ERIC Educational Resources Information Center

    Valenti, Mayla Willik; de Oliveira, Haydée Torres; Logarezzi, Amadeu José Montagnini

    2017-01-01

    This study addresses the limitations and potential for the development of an adult environmental education program in two protected areas in Brazil. The investigation was based on critical communicative methodology and involved 25 people variously related to puma conservation and environmental education. We found that the staff of protected areas…

  17. 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…

  18. What do adult squash players think about protective eyewear?

    PubMed Central

    Finch, C.; Vear, P.

    1998-01-01

    OBJECTIVE: To determine the attitudes of adult squash players towards protective eyewear. METHODS: A survey of 197 competition and social squash players from seven squash centres in the outer eastern suburbs of Melbourne, Australia was conducted in September to October 1995. Information about participation in squash, previous injuries, use of protective eyewear, barriers towards eyewear use, and attitudes towards protective eyewear was obtained by a self report questionnaire. RESULTS: Squash is a popular sport in Australia. Of the players surveyed, 6% played in junior competitions, 67% in senior competitions, and 27% were social players. Most had been playing for more than ten years. Some 15% of players had previously suffered an eye injury, most commonly caused by a racquet. Less than 10% of players reported that they wore protective eyewear when they played squash, and 35% of these wore prescriptive lenses which they considered to be protective. The major reason for not wearing protective eyewear was the perception that it was unnecessary. Poor vision and a lack of comfort were also stated as reasons by a significant number of players. More than half (57%) of the respondents agreed that more players should wear protective eyewear, yet only 16% thought it should be compulsory for all players. There was considerable support for protective eyewear use by junior players, however. CONCLUSIONS: The rate of protective eyewear use is low among competition and social squash players in Melbourne. The major areas that need to be addressed are the ignorance of the need for protective eyewear among social and experienced players and the mistaken belief that prescription lenses provide adequate protection on a squash court. 


 PMID:9631225

  19. 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…

  20. 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…

  1. Specialist Advocacy Services for Parents with Learning Disabilities Involved in Child Protection Proceedings

    ERIC Educational Resources Information Center

    Tarleton, Beth

    2008-01-01

    Parents with learning disabilities frequently become involved with child protection and judicial proceedings. Parents report not understanding and being disempowered by the child protection system. This paper presents fourteen parents' views regarding how two specialist advocacy services supported them during child protection. The parents believed…

  2. Examining Fall Recurrence Risk of Homebound Hispanic Older Adults Receiving Home Care Services.

    PubMed

    Solis, Guillermina R; Champion, Jane Dimmitt

    2017-03-01

    Unintentional falls and injuries is a major problem among older adults and the fourth cause of death in the United States. A previous fall event doubles the risk of recurrence and lessens the person's quality of life. Hispanic older adults have higher rates of disability and lower independent functioning due to poor medical health and risk for fall recurrence. Most fall studies focus on fall risk with few studies on fall recurrence in older adults receiving home health care services unrelated to fall incident. A descriptive pilot study of 30 homebound Hispanic older adults receiving home care services who reported a fall within 3 months was conducted by a multidisciplinary team to evaluate risk of fall recurrence. A heightened risk for fall recurrence was identified with high number of chronic illnesses, high intake of medications, vision problems, and prevalence of urinary incontinence. Findings highlight significant number of intrinsic factors for fall risk recurrence and injuries in a Hispanic older adults population that is homebound and receiving home care services. A multidisciplinary evaluation and culturally appropriate interventions to lessen the risk of fall recurrence are recommended.

  3. Use of Protective Behavioral Strategies among Young Adult Veteran Marijuana Users.

    PubMed

    Pedersen, Eric R; Villarosa-Hurlocker, Margo C; Prince, Mark A

    2018-01-01

    Young adult veterans are at risk for problematic marijuana use and associated consequences, which is partially due to their high rates of Posttraumatic Stress Disorder (PTSD), depression, and problematic substance use. Veterans tend to endorse more severe and chronic mental health symptoms compared to their civilian counterparts and they identify marijuana use as a method to cope with their symptoms. Given the prevalence of marijuana use among veterans in the community and in clinical settings, it is important to explore the factors that may help minimize harm associated with use for those that choose to use the drug. The present study sought to examine the impact of protective behavioral strategies on the relationship between mental health symptoms and marijuana use and consequences in a sample of 180 young adult veteran marijuana users. Participants were recruited via social media advertisements and completed measures of marijuana use and consequences, protective behavioral strategies, and PTSD and depression symptoms. Findings indicated that more frequent use of protective behavioral strategies was associated with less marijuana use and consequences. Participants who screened positive for PTSD or depression reported more marijuana consequences than did those not positive on these screeners. Regression analyses revealed protective strategies moderated the relationship between PTSD and marijuana consequences such that young veterans who endorsed more PTSD symptoms and infrequent use of protective strategies reported the most marijuana consequences. No moderating effects were found for the relationship between depression and marijuana consequences. Findings have clinical implications for working with young veterans.

  4. Duty of care and autonomy: how support workers managed the tension between protecting service users from risk and promoting their independence in a specialist group home.

    PubMed

    Hawkins, R; Redley, M; Holland, A J

    2011-09-01

    In the UK those paid to support adults with intellectual disabilities must manage two potentially conflicting duties that are set out in policy documents as being vital to their role: protecting service users (their duty of care) and recognising service users' autonomy. This study focuses specifically on the support of people with the genetically determined condition, Prader-Willi syndrome (PWS). Due to the behaviours associated with PWS, the support of this group of people vividly illustrates the tension between respect for autonomy and duty of care. This article explores how support workers working in a residential group home managed their competing duties of managing risk and promoting independence in practice. An ethnographic study, comprising of qualitative observations, semi-structured interviews and documentary analysis, was undertaken to investigate the work of support workers in a UK residential group home specialising in the support of adults diagnosed with PWS. The study focused on how support workers attempted to reconcile the tension between protecting service users from the risks associated with the syndrome and acknowledging service users' autonomy by enabling independence. Findings demonstrate that risk was central to the structure of care delivery at the group home and support workers often adhered to standardised risk management procedures. The organisation also required support workers to promote service users' independence and many thought acknowledging service users' autonomy through the promotion of their independence was important. To manage tensions between their differing duties, some support workers deviated from standardised risk management procedures to allow service users a degree of independence. There is a tension between the duty of care and the duty to recognise autonomy at the level of service delivery in residential homes. Support workers attempt to manage this tension; however, further work needs to be done by both residential

  5. 77 FR 5012 - Environmental Protection Agency, Department of Health and Human Services and Department of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-01

    ... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OPP-2011-0038; FRL-9328-7] Environmental Protection Agency, Department of Health and Human Services and Department of Agriculture; Memorandum of Understanding Regarding... Department of Human Services (HHS) and the U.S. Department of Agriculture (USDA). HHS's Centers for Disease...

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

    PubMed

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

    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.

  7. Immigrants to the United States and Adult Education Services

    ERIC Educational Resources Information Center

    Larrotta, Clarena

    2017-01-01

    This chapter describes documented and undocumented immigrant populations in the United States. It discusses salient factors influencing their status as immigrants as well as adult education services available to them through publicly funded programs, social units, and community centers, especially churches and libraries.

  8. Service-based health human resources planning for older adults.

    PubMed

    Tomblin Murphy, Gail; MacKenzie, Adrian; Rigby, Janet; Rockwood, Kenneth; Gough, Amy; Greeley, Gogi; Montpetit, Frederick; Dill, Donna; Alder, Robert; Lackie, Kelly

    2013-08-01

    To test a service-based health human resources (HHR) planning approach for older adults in the context of home and long term care (LTC); to create a practical template/tools for use in various jurisdictions and/or health care settings. The most serious health needs of seniors in 2 Canadian jurisdictions were identified and linked to the specific services and associated competencies required of health care providers (HCPs) to address those needs. The amounts of each service required were quantified and compared against the capacity of HCPs to perform the services, measured using a self-assessment survey, by using a previously developed analytical framework. Home and LTC sectors in Nova Scotia and Nunavut, Canada. Regulated and nonregulated HCPs were invited to complete either an online or paper-based competency self-assessment survey. Survey response rates in Nova Scotia and Nunavut were 11% (160 responses) and 20% (22 responses), respectively. Comparisons of the estimated number of seniors likely to need each service with the number who can be served by the workforces in each jurisdiction indicated that the workforces in both jurisdictions are sufficiently numerous, active, productive, and competent to provide most of the services likely to be required. However, significant gaps were identified in pharmacy services, ongoing client assessment, client/family education and involvement, and client/family functional and social supports. Service-based HHR planning is feasible for identifying gaps in services required by older adults, and can guide policy makers in planning hiring/recruitment, professional development, and provider education curricula. Implementation will require commitment of policy makers and other stakeholders, as well as ongoing evaluation of its effectiveness. More broadly, the ongoing effectiveness of the approach will depend on workforce planning being conducted in an iterative way, driven by regular reevaluation of population health needs and HHR

  9. 78 FR 5122 - NASA Security and Protective Services Enforcement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-24

    ... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION 14 CFR Parts 1203a, 1203b, and 1204 [Docket No NASA-2012-0007] RIN 2700-AD89 NASA Security and Protective Services Enforcement AGENCY: National Aeronautics... nonsubstantive changes to NASA regulations to clarify the procedures for establishing controlled/ secure areas...

  10. Psychosocial service use and unmet need among recently diagnosed adolescent and young adult cancer patients.

    PubMed

    Zebrack, Brad J; Block, Rebecca; Hayes-Lattin, Brandon; Embry, Leanne; Aguilar, Christine; Meeske, Kathleen A; Li, Yun; Butler, Melissa; Cole, Steven

    2013-01-01

    Adolescents and young adults (AYAs) with cancer demonstrate biomedical risks and psychosocial issues distinct from those of children or older adults. In this study, the authors examined and compared the extent to which AYAs treated in pediatric or adult oncology settings reported use of, and unmet need for, psychosocial support services. Within 4 months of initial cancer diagnosis, 215 AYAs ages 14 to 39 years (99 from pediatric care settings and 116 from adult care settings; 75% response rate) were assessed for reporting use of information resources, emotional support services, and practical support services. Statistical analyses derived odds ratios and 95% confidence intervals for service use and unmet needs after controlling for race, employment/school status, sex, relationship status, severity of cancer, treatment, and treatment-related side effects. AYAs ages 20 to 29 years were significantly less likely than teens and older patients ages 30 to 39 years to report using professional mental health services and were significantly more likely to report an unmet need with regard to cancer information, infertility information, and diet/nutrition information. Compared with teens who were treated in pediatric facilities, AYAs who were treated in adult facilities were more likely to report an unmet need for age-appropriate Internet sites, professional mental health services, camp/retreats programs, transportation assistance, and complementary and alternative health services. Substantial proportions of AYAs are not getting their psychosocial care needs met. Bolstering psychosocial support staff and patient referral to community-based social service agencies and reputable Internet resources may enhance care and improve quality of life for AYAs. Copyright © 2012 American Cancer Society.

  11. 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

  12. Comments on "How Child Protective Services Investigators Decide to Substantiate Mothers for Failure-to-Protect in Sexual Abuse Cases"

    ERIC Educational Resources Information Center

    Shadoin, Amy L.; Carnes, Connie N.

    2006-01-01

    This commentary discusses the decisions of child protective service (CPS) investigators to substantiate mothers for failure-to-protect (FTP) in child sexual abuse cases. Four areas are identified in which the scientific literature remains inadequate to fully inform child maltreatment researchers, CPS practitioners and child welfare policymakers on…

  13. Strengthening protected areas for biodiversity and ecosystem services in China

    PubMed Central

    Xu, Weihua; Xiao, Yi; Zhang, Jingjing; Zhang, Lu; Hull, Vanessa; Wang, Zhi; Zheng, Hua; Polasky, Stephen; Jiang, Ling; Xiao, Yang; Shi, Xuewei; Rao, Enming; Lu, Fei; Wang, Xiaoke; Daily, Gretchen C.; Ouyang, Zhiyun

    2017-01-01

    Recent expansion of the scale of human activities poses severe threats to Earth’s life-support systems. Increasingly, protected areas (PAs) are expected to serve dual goals: protect biodiversity and secure ecosystem services. We report a nationwide assessment for China, quantifying the provision of threatened species habitat and four key regulating services—water retention, soil retention, sandstorm prevention, and carbon sequestration—in nature reserves (the primary category of PAs in China). We find that China’s nature reserves serve moderately well for mammals and birds, but not for other major taxa, nor for these key regulating ecosystem services. China’s nature reserves encompass 15.1% of the country’s land surface. They capture 17.9% and 16.4% of the entire habitat area for threatened mammals and birds, but only 13.1% for plants, 10.0% for amphibians, and 8.5% for reptiles. Nature reserves encompass only 10.2–12.5% of the source areas for the four key regulating services. They are concentrated in western China, whereas much threatened species’ habitat and regulating service source areas occur in eastern provinces. Our analysis illuminates a strategy for greatly strengthening PAs, through creating the first comprehensive national park system of China. This would encompass both nature reserves, in which human activities are highly restricted, and a new category of PAs for ecosystem services, in which human activities not impacting key services are permitted. This could close the gap in a politically feasible way. We also propose a new category of PAs globally, for sustaining the provision of ecosystems services and achieving sustainable development goals. PMID:28137858

  14. Transition of adolescent and young adult patients with childhood-onset chronic kidney disease from pediatric to adult renal services: a nationwide survey in Japan.

    PubMed

    Hattori, Motoshi; Iwano, Masayuki; Sako, Mayumi; Honda, Masataka; Okada, Hirokazu; Akioka, Yuko; Ashida, Akira; Kawasaki, Yukihiko; Kiyomoto, Hideyasu; Terada, Yoshio; Hirano, Daishi; Fujieda, Mikiya; Fujimoto, Shouichi; Masaki, Takao; Maruyama, Shoichi; Mastuo, Seiich

    2016-12-01

    Transition of adolescent and young adult (AYA) patients with childhood-onset chronic kidney diseases (C-CKD) from pediatric to adult renal services has received increasing attention. However, information on transition of Japanese patients with C-CKD is limited. The Transition Medicine Working Group, in collaboration with the Japanese Society for Nephrology, the Japanese Society for Pediatric Nephrology and the Japanese Society of Pediatric Urology, conducted a retrospective cross-sectional study in 2014 on issues concerning the transition of Japanese patients with C-CKD. Few institutions in Japan had transition programs and/or transition coordinators for patients with C-CKD. Refusal to transfer by patients or their families, lack of concern about transition and inability to decide on transfer were common reasons for non-transfer of patients still followed by pediatric renal services. Around 25 % of patients who had ended or interrupted follow-up by pediatric renal services presented to adult renal services because of symptoms associated with C-CKD. Patients with various types of childhood-onset nephrourological diseases were transferred from pediatric to adult renal services. IgA nephropathy, minimal change nephrotic syndrome and congenital anomalies of the kidney and urinary tract were the most frequent primary kidney diseases in adult patients with C-CKD. These survey results indicate the need for introduction of transitional care for Japanese AYA patients with C-CKD. Consensus guidelines for the optimal clinical management of AYA patients with C-CKD are required to ensure the continuity of care from child to adult renal services.

  15. Psychiatric Service Use and Psychiatric Disorders in Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Bhaumik, S.; Tyrer, F. C.; McGrother, C.; Ganghadaran, S. K.

    2008-01-01

    Background: UK policies aim to facilitate access to general psychiatric services for adults with intellectual disability (ID). If this is to be achieved, it is important to have a clear idea of the characteristics and proportion of people with ID who currently access specialist psychiatric services and the nature and extent of psychiatric…

  16. RETRAINING OLDER ADULTS FOR EMPLOYMENT IN COMMUNITY SERVICE. FINAL PROGRESS REPORT.

    ERIC Educational Resources Information Center

    THUNE, JEANNE M.; TINE, SEBASTIAN

    THIS PROJECT SOUGHT TO DEMONSTRATE THE CAPABILITY OF OLDER ADULTS TO BEGIN NEW CAREERS AS LEADERS IN COMMUNITY SERVICES. PROJECT STAFF OFFERED FIVE 3-MONTH TRAINING INSTITUTES IN COMMUNITY SERVICE IN NASHVILLE, TENNESSEE, DURING 1963-65 WITH THE HELP OF CONSULTANTS AND REPRESENTATIVES OF PUBLIC AND PRIVATE AGENCIES AND SEVERAL AREA UNIVERSITIES.…

  17. Caries experience and use of dental services in rural and urban adults and older adults from central Chile.

    PubMed

    Quinteros, Maria E; Cáceres, Dante D; Soto, Alex; Mariño, Rodrigo J; Giacaman, Rodrigo A

    2014-10-01

    To determine whether there is a relationship between the use of dental services and caries experience in adults and older adults from central Chile. A sample of 453 adults, 35-44 years of age, and 438 older adults, 65-74 years of age, was interviewed and examined using World Health Organisation (WHO) methods. Sociodemographic variables were also registered. Caries experience was assessed using the Decayed, Missing and Filled teeth (DMFT) index. Multiple linear regression models were used to determine whether there was an association between the independent variables and caries experience. Caries prevalence was 99.6% for adults [DMFT score = 14.89 (±6.16)] and 99.8% for older adults [DMFT score = 25.68 (±6.49)]. Less than half of the population - 41.7% of adults and 31.5% of older adults - received dental care. Regardless of the age group, there were no differences in the DMFT score between those who received and those who did not receive attention (P > 0.05). When the DMFT findings were analysed in greater detail, people who received dental care and urban participants had more fillings (P < 0.05) than did those who were not provided with attention or lived in rural areas, who, in turn, had more missing teeth (P < 0.05). A higher educational level was associated with a decrease of 1.15 DMFT points (P = 0.003) in the group of older adults. Adults and older adults from the Maule Region showed severe dental damage from caries. Although rurality and use of services do not seem to affect caries experience, they are associated with differences in fillings and missing teeth. © 2014 FDI World Dental Federation.

  18. Personality assessment of homeless adults as a tool for service planning.

    PubMed

    Tolomiczenko, G S; Sota, T; Goering, P N

    2000-01-01

    The psychiatric status of homeless adults has been described primarily in terms of Axis I disorders. By adding a subset of the Personality Assessment Inventory, this study tests the feasibility and usefulness of a brief, self-administered questionnaire to obtain scores on several dimensions of personality. Cluster analysis sorted 112 tested subjects into four groups characterized by distinct profiles. Two of these were characterized by extreme scores on pathological dimensions of personality (borderline features, antisocial traits, and aggressivity) and differed primarily on the dimension of suicidality. The third reflected moderate levels of personality dysfunction and the fourth did not deviate from adult nonclinical norms. The validity of the clusters was supported by demographic, background, and diagnostic subgroup differences. Brief personality assessment can be a cost-effective approach to matching services with clinical needs of homeless adults by attending to interpersonal dimensions that will likely affect service provision.

  19. 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…

  20. The Role of the Appropriate Adult in Supporting Vulnerable Adults in Custody: Comparing the Perspectives of Service Users and Service Providers

    ERIC Educational Resources Information Center

    Jessiman, Tricia; Cameron, Ailsa

    2017-01-01

    Background: Police custody sergeants have a duty to secure an AA to safeguard the rights and welfare of vulnerable people detained or questioned by the police. This study focuses on the role of the AA in supporting vulnerable adults and seeks to examine what stakeholders would expect from an effective AA service. Methods: This was a qualitative…

  1. Family Planning Services for Adolescents and Young Adults

    PubMed Central

    Minkowski, William L.; Weiss, Robert C.; Lowther, Laura; Shonick, Helen; Heidbreder, G. A.

    1974-01-01

    If we are to influence the numerical trends of venereal disease and of unwanted pregnancies in the young, family planning services should be made easily available to them. To encourage the widest possible and most effective use of such services requires that health professionals openly endorse their ready availability. They must foster non-judgmental attitudes, however unorthodox patient life styles may be, and provide the young with opportunities to explore their own sexual behavior. The Youth Clinics of the Department of Community Health Services in Los Angeles are designed to meet both the immediate therapeutic and preventive health needs of our patients. Contraceptive services, abortion counseling and referrals as well as individual, group and community education are the primary pillars of our program. There is an enormous task for all of us who are concerned with adolescents to press for sex education programs, in or out of the school system, that will include adults as well as our children. PMID:4813794

  2. 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…

  3. The Costs of Treating American Indian Adults With Diabetes Within the Indian Health Service

    PubMed Central

    O'Connell, Joan M.; Wilson, Charlton; Manson, Spero M.; Acton, Kelly J.

    2012-01-01

    Objectives. We examined the costs of treating American Indian adults with diabetes within the Indian Health Service (IHS). Methods. We extracted demographic and health service utilization data from the IHS electronic medical reporting system for 32 052 American Indian adults in central Arizona in 2004 and 2005. We derived treatment cost estimates from an IHS facility–specific cost report. We examined chronic condition prevalence, medical service utilization, and treatment costs for American Indians with and without diabetes. Results. IHS treatment costs for the 10.9% of American Indian adults with diabetes accounted for 37.0% of all adult treatment costs. Persons with diabetes accounted for nearly half of all hospital days (excluding days for obstetrical care). Hospital inpatient service costs for those with diabetes accounted for 32.2% of all costs. Conclusions. In this first study of treatment costs within the IHS, costs for American Indians with diabetes were found to consume a significant proportion of IHS resources. The findings give federal agencies and tribes critical information for resource allocation and policy formulation to reduce and eventually eliminate diabetes-related disparities between American Indians and Alaska Natives and other racial/ethnic populations. PMID:22390444

  4. Inequality in access to cultural ecosystem services from protected areas in the Chilean biodiversity hotspot.

    PubMed

    Martinez-Harms, Maria Jose; Bryan, Brett A; Wood, Spencer A; Fisher, David M; Law, Elizabeth; Rhodes, Jonathan R; Dobbs, Cynnamon; Biggs, Duan; Wilson, Kerrie A

    2018-09-15

    Experiences with nature through visits to protected areas provide important cultural ecosystem services that have the potential to strengthen pro-environmental attitudes and behavior. Understanding accessibility to protected areas and likely preferences for enjoying the benefits of nature visits are key factors in identifying ways to reduce inequality in access and inform the planning and management for future protected areas. We develop, at a regional scale, a novel social media database of visits to public protected areas in part of the Chilean biodiversity hotspot using geotagged photographs and assess the inequality of access using the home locations of the visitors and socio-economic data. We find that 20% of the population of the region make 87% of the visits to protected areas. The larger, more biodiverse protected areas were the most visited and provided most cultural ecosystem services. Wealthier people tend to travel further to visit protected areas while people with lower incomes tend to visit protected areas that are closer to home. By providing information on the current spatial flows of people to protected areas, we demonstrate the need to expand the protected area network, especially in lower income areas, to reduce inequality in access to the benefits from cultural ecosystem services provided by nature to people. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. Disparities in Unmet Service Needs among Adults with Intellectual and Other Developmental Disabilities

    ERIC Educational Resources Information Center

    Burke, Meghan M.; Heller, Tamar

    2017-01-01

    Background: Due to long waiting lists for services, many adults with intellectual and developmental disabilities in the United States have unmet service needs. Little research, however, has identified the characteristics of caregivers and individuals with intellectual and developmental disabilities that relate to the unmet service needs among…

  6. Engaging fathers in child protection services: A review of factors and strategies across ecological systems

    PubMed Central

    Gordon, Derrick M.; Oliveros, Arazais; Hawes, Samuel W.; Iwamoto, Derek K.; Rayford, Brett S.

    2014-01-01

    Current policy regarding child protection services places increasing demands for providers to engage fathers whose children are involved in the child protection process. This requisite brings to the fore the ongoing challenges that fathers have historically faced in working within these systems. Despite this need, there is little empirical evidence regarding the factors and strategies that impact the engagement of fathers in interventions relevant to child protection services. This comprehensive and systemic review synthesizes the available literature regarding factors and strategies that may foster paternal involvement in the child protection system and their services. We organize the literature concerning paternal engagement in child and family services around an ecological model that examines paternal engagement from individual, family, service provider, program, community, and policy levels. We consider factors and strategies along a continuum of engagement through intent to enroll, enrollment, and retention. This review advances theory by elucidating key factors that foster father engagement. The review also highlights the gaps in the literature and provides strategies for how researchers can address these areas. Future directions in the arenas of practice and policy are discussed. PMID:25232202

  7. Heavy consumption of dental services among Finnish adults.

    PubMed

    Nihtilä, A; Widström, E; Elonheimo, O

    2010-12-01

    To compare treatment of heavy and low users of dental services among adults in the Public Dental Service (PDS) in one of the biggest cities in Finland and to identify reasons for heavy use and to suggest improvements to care provision. All adults who attended the PDS in Espoo (pop. 227,500) in 2004 were allocated to a group (n = 3,173) who had made six or more dental visits and a comparison group (n = 22,820) who had three or fewer dental visits. The data were obtained from the patient register of the PDS. A sample of 320 patients was randomly selected from each group. Information on age, gender, number and types of visits, oral health status, treatment provided and fees paid was collected from treatment records. 10.5% of the adults were found to be heavy users and their treatment made up 31.6% of all adult dental visits. The proportion of men was greater among heavy users and the heavy users were on average 6.6 years older than the low users. The mean total treatment time for heavy users was 5.5 hours and 2.0 hours for low users. Heavy users had more untreated and treated caries and more periodontal pockets than low users. Restorative, endodontic and prosthetic treatment needs characterised the heavy user group, while the low users most often received restorative and periodontal treatment only. Our study indicates that complicated treatment needs of heavy users and lack of experience among the caregivers in dealing with them resulted in high numbers of dental visits for individual patients. The PDS should offer appropriate continuing education for its oral health care teams and organize a referral system offering specialist care for difficult endodontic, periodontal and prosthetic treatments.

  8. Ecosystem services in European protected areas: Ambiguity in the views of scientists and managers?

    PubMed

    Hummel, Christiaan; Provenzale, Antonello; van der Meer, Jaap; Wijnhoven, Sander; Nolte, Arno; Poursanidis, Dimitris; Janss, Guyonne; Jurek, Matthias; Andresen, Magnus; Poulin, Brigitte; Kobler, Johannes; Beierkuhnlein, Carl; Honrado, João; Razinkovas, Arturas; Stritih, Ana; Bargmann, Tessa; Ziemba, Alex; Bonet-García, Francisco; Adamescu, Mihai Cristian; Janssen, Gerard; Hummel, Herman

    2017-01-01

    Protected Areas are a key component of nature conservation. They can play an important role in counterbalancing the impacts of ecosystem degradation. For an optimal protection of a Protected Area it is essential to account for the variables underlying the major Ecosystem Services an area delivers, and the threats upon them. Here we show that the perception of these important variables differs markedly between scientists and managers of Protected Areas in mountains and transitional waters. Scientists emphasise variables of abiotic and biotic nature, whereas managers highlight socio-economic, cultural and anthropogenic variables. This indicates fundamental differences in perception. To be able to better protect an area it would be advisable to bring the perception of scientists and managers closer together. Intensified and harmonised communication across disciplinary and professional boundaries will be needed to implement and improve Ecosystem Service oriented management strategies in current and future Protected Areas.

  9. Ecosystem services in European protected areas: Ambiguity in the views of scientists and managers?

    PubMed Central

    Provenzale, Antonello; van der Meer, Jaap; Wijnhoven, Sander; Nolte, Arno; Poursanidis, Dimitris; Janss, Guyonne; Jurek, Matthias; Andresen, Magnus; Poulin, Brigitte; Kobler, Johannes; Beierkuhnlein, Carl; Honrado, João; Razinkovas, Arturas; Stritih, Ana; Bargmann, Tessa; Ziemba, Alex; Bonet-García, Francisco; Adamescu, Mihai Cristian; Janssen, Gerard; Hummel, Herman

    2017-01-01

    Protected Areas are a key component of nature conservation. They can play an important role in counterbalancing the impacts of ecosystem degradation. For an optimal protection of a Protected Area it is essential to account for the variables underlying the major Ecosystem Services an area delivers, and the threats upon them. Here we show that the perception of these important variables differs markedly between scientists and managers of Protected Areas in mountains and transitional waters. Scientists emphasise variables of abiotic and biotic nature, whereas managers highlight socio-economic, cultural and anthropogenic variables. This indicates fundamental differences in perception. To be able to better protect an area it would be advisable to bring the perception of scientists and managers closer together. Intensified and harmonised communication across disciplinary and professional boundaries will be needed to implement and improve Ecosystem Service oriented management strategies in current and future Protected Areas. PMID:29140983

  10. The U.K. service level audit of insulin pump therapy in adults.

    PubMed

    White, H D; Goenka, N; Furlong, N J; Saunders, S; Morrison, G; Langridge, P; Paul, P; Ghatak, A; Weston, P J

    2014-04-01

    The National Institute for Health and Clinical Excellence (NICE) published guidelines for the use of continuous subcutaneous insulin infusion in 2008 (technology appraisal 151). The first U.K.-wide insulin pump audit took place in 2012 with the aim of determining adherence to the guidance issued in NICE technology appraisal 151. The results of the adult service level audit are reported here. All centres providing continuous subcutaneous insulin infusion services to adults with diabetes in the U.K. were invited to participate. Audit metrics were aligned to technology appraisal 151. Data entry took place online using a DiabetesE formatted data collection tool. One hundred and eighty-three centres were identified as delivering adult continuous subcutaneous insulin infusion services in the U.K., of which 178 (97.3%) participated in the audit. At the time of the audit, 13 428 adults were using insulin pump therapy, giving an estimated prevalence of use of 6%. Ninety-three per cent of centres did not report any barriers in obtaining funding for patients who fulfilled NICE criteria. The mean number of consultant programmed activities dedicated to continuous subcutaneous insulin infusion services was 0.96 (range 0-8), mean whole-time equivalent diabetes specialist nurses was 0.62 (range 0-3) and mean whole-time equivalent dietitian services was 0.3 (range 0-2), of which 39, 61 and 60%, respectively, were not formally funded. The prevalence of continuous subcutaneous insulin infusion use in the U.K. falls well below the expectation of NICE (15-20%) and that of other European countries (> 15%) and the U.S.A. (40%). This may be attributable, in part, to lack of healthcare professional time needed for identification and training of new pump therapy users. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

  11. Defining Child Neglect Based on Child Protective Services Data

    ERIC Educational Resources Information Center

    Dubowitz, H.; Pitts, S.C.; Litrownik, A.J.; Cox, C.E.; Runyan, D.; Black, M.M.

    2005-01-01

    Objectives:: To compare neglect defined by Child Protective Services official codes with neglect defined by a review of CPS narrative data, and to examine the validity of the different neglect measures using children's functioning at age 8 years. Methods:: Data are from 740 children participating in a consortium of longitudinal studies on child…

  12. 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…

  13. Illicit and prescription drug problems among urban Aboriginal adults in Canada: the role of traditional culture in protection and resilience.

    PubMed

    Currie, Cheryl L; Wild, T Cameron; Schopflocher, Donald P; Laing, Lory; Veugelers, Paul

    2013-07-01

    Illicit and prescription drug use disorders are two to four times more prevalent among Aboriginal peoples in North America than the general population. Research suggests Aboriginal cultural participation may be protective against substance use problems in rural and remote Aboriginal communities. As Aboriginal peoples continue to urbanize rapidly around the globe, the role traditional Aboriginal beliefs and practices may play in reducing or even preventing substance use problems in cities is becoming increasingly relevant, and is the focus of the present study. Mainstream acculturation was also examined. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Associations were analysed using two sets of bootstrapped linear regression models adjusted for confounders with continuous illicit and prescription drug problem scores as outcomes. Psychological mechanisms that may explain why traditional culture is protective for Aboriginal peoples were examined using the cross-products of coefficients mediation method. The extent to which culture served as a resilience factor was examined via interaction testing. Results indicate Aboriginal enculturation was a protective factor associated with reduced 12-month illicit drug problems and 12-month prescription drug problems among Aboriginal adults in an urban setting. Increased self-esteem partially explained why cultural participation was protective. Cultural participation also promoted resilience by reducing the effects of high school incompletion on drug problems. In contrast, mainstream acculturation was not associated with illicit drug problems and served as a risk factor for prescription drug problems in this urban sample. Findings encourage the growth of programs and services that support Aboriginal peoples who strive to maintain their cultural traditions within cities, and further studies that examine how Aboriginal

  14. Quality of Life in Older Adults: Benefits from Caring Services in Hong Kong

    ERIC Educational Resources Information Center

    Cheung, Jacky Chau Kiu; Kwan, Alex Yui Huen; Chan, Sophia Siu Chee; Ngan, Raymond Man Hung; Ng, Sik Hung; Leung, Edward Man Fuk; Lau, Anna

    2005-01-01

    Many older adults are in need of care. Therefore, older people would generally benefit from the use of caring services, notably including home care, residential care, nursing, and medical services. The contributory factors underlying caring services tend to be a caring perspective that aspires to sustain older people's social relationships and…

  15. Patient-oncologist alliance as protection against suicidal ideation in young adults with advanced cancer.

    PubMed

    Trevino, Kelly M; Abbott, Caroline H; Fisch, Michael J; Friedlander, Robert J; Duberstein, Paul R; Prigerson, Holly G

    2014-08-01

    Young adults with cancer are at an increased risk of suicidal ideation. To the authors' knowledge, the impact of the patient-oncologist alliance on suicidal ideation has not been examined to date. The current study examined the relationship between the patient-oncologist therapeutic alliance and suicidal ideation in young adults with advanced cancer. A total of 93 young adult patients (aged 20 years-40 years) with incurable, recurrent, or metastatic cancer were evaluated by trained interviewers. Suicidal ideation was assessed with the Yale Evaluation of Suicidality scale, dichotomized into a positive and negative score. Predictors included diagnoses of major depressive disorder and posttraumatic stress disorder, physical quality of life, social support, and use of mental health and supportive care services. The Human Connection Scale, dichotomized into a strong (upper third) and weak (lower two-thirds) therapeutic alliance, assessed the strength of the patients' perceived oncologist alliance. Approximately 22.6% of patients screened positive for suicidal ideation. Patients with a strong therapeutic alliance were found to be at reduced risk of suicidal ideation after controlling for confounding influences of cancer diagnosis, Karnofsky performance status, number of physical symptoms, physical quality of life, major depressive disorder, posttraumatic stress disorder, and social support. A strong therapeutic alliance was also associated with a reduced risk of suicidal ideation after controlling for mental health discussions with health care providers and use of mental health interventions. The patient-oncologist alliance was found to be a robust predictor of suicidal ideation and provided better protection against suicidal ideation than mental health interventions, including psychotropic medications. Oncologists may significantly influence patients' mental health and may benefit from training and guidance in building strong alliances with their young adult patients.

  16. Clinical services for adults with an intellectual disability and epilepsy: A comparison of management alternatives.

    PubMed

    Wagner, Adam P; Croudace, Tim J; Bateman, Naomi; Pennington, Mark W; Prince, Elizabeth; Redley, Marcus; White, Simon R; Ring, Howard

    2017-01-01

    Intellectual disability (ID) is relatively common in people with epilepsy, with prevalence estimated to be around 25%. Surprisingly, given this relatively high frequency, along with higher rates of refractory epilepsy than in those without ID, little is known about outcomes of different management approaches/clinical services treating epilepsy in adults with ID-we investigate this area. We undertook a naturalistic observational cohort study measuring outcomes in n = 91 adults with ID over a 7-month period (recruited within the period March 2008 to April 2010). Participants were receiving treatment for refractory epilepsy (primarily) in one of two clinical service settings: community ID teams (CIDTs) or hospital Neurology services. The pattern of comorbidities appeared important in predicting clinical service, with Neurologists managing the epilepsy of relatively more of those with neurological comorbidities whilst CIDTs managed the epilepsy of relatively more of those with psychiatric comorbidities. Epilepsy-related outcomes, as measured by the Glasgow Epilepsy Outcome Scale 35 (GEOS-35) and the Epilepsy and Learning Disabilities Quality of Life Scale (ELDQoL) did not differ significantly between Neurology services and CIDTs. In the context of this study, the absence of evidence for differences in epilepsy-related outcomes amongst adults with ID and refractory epilepsy between mainstream neurology and specialist ID clinical services is considered. Determining the selection of the service managing the epilepsy of adults with an ID on the basis of the skill sets also required to treat associated comorbidities may hence be a reasonable heuristic.

  17. Assessing Protective Factors for Violence Risk in U.K. General Mental Health Services Using the Structured Assessment of Protective Factors.

    PubMed

    Haines, Alina; Brown, Andrew; Javaid, Syed Fahad; Khan, Fayyaz; Noblett, Steve; Omodunbi, Oladipupo; Sadiq, Khurram; Zaman, Wahid; Whittington, Richard

    2017-12-01

    Violence risk assessment and management are key tasks in mental health services and should be guided by validated instruments covering both risk and protective factors. This article is part of an international effort to validate the Structured Assessment of Protective Factors (SAPROF) for violence. The SAPROF, Historical, Clinical, Risk Management-20 (HCR-20) and the Psychopathy Checklist-Screening Version (PCL-SV) were administered in a sample of 261 patients in U.K. forensic, general inpatient, and community mental health settings. There was significant variation between these groups on SAPROF scores with fewer protective factors in the forensic group. The prospective validity of the SAPROF for nonviolence in the general inpatient and community samples was moderate (area under the curve [AUC] = .60). Adoption of the SAPROF or similar instruments as a supplement to risk-focused assessments has the potential to improve awareness of protective factors and enhance therapeutic engagement in a range of mental health services.

  18. 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.

  19. Suicide among emergency and protective service workers: A retrospective mortality study in Australia, 2001 to 2012.

    PubMed

    Milner, A; Witt, K; Maheen, H; LaMontagne, A D

    2017-01-01

    Emergency and protective services personnel (e.g., police, ambulance, fire-fighters, defence, prison and security officers) report elevated levels of job stress and health problems. While population-level research is lacking, there has been some research suggesting suicide rates may be elevated in emergency and protective services. This paper compares suicide rates between emergency and protective services occupational groups over a 12-year period (2001-2012) in Australia. Labour force data was obtained from the 2006 Australian Census. Suicide data was obtained from the National Coroners Information System (NCIS). Negative binomial regression was used to estimate the association between suicide and employment as an emergency or protective service worker (including prison and security officers) over the period 2001-2012, as compared to all other occupations. Information on suicide method was extracted from the NCIS. The age-adjusted suicide rate across all emergency and protective service workers was 22.4 (95% CI 19.5 to 25.2) per 100,000 in males and 7.8 in females (95% CI 4.6 to 11.00), compared to 15.5 per 100,000 (95% CI 15.2 to 15.9) for males and 3.4 (95% CI 3.2 to 3.6) for females in other occupations. The highest risk by subgroup was observed among those employed in the defence force, prison officers, and ambulance personnel. The major method of death for all occupational groups was hanging. Our results clearly highlight the need for suicide prevention among emergency and protective service occupations.

  20. Assessment of the responsiveness of a public health service from the perspective of older adults

    PubMed Central

    Melo, Denise da Silva; Martins, René Duarte; de Jesus, Renata Patrícia Freitas Soares; Samico, Isabella Chagas; Santo, Antônio Carlos Gomes do Espírito

    2017-01-01

    ABSTRACT OBJECTIVE To assess the quality of health care of older adults using as a parameter the assessment of the responsiveness of the service. METHODS This is a descriptive cross-sectional study conducted in a reference unit of the Brazilian Unified Health System at the outpatient level. The sample was probabilistic and had 385 older adults; data collection occurred in 2014. The domains assessed were: choice, autonomy, confidentiality, dignity, communication, physical facilities, and fast service. To this end, we used Pearson correlation test and Fisher’s exact test. RESULTS The domains of dignity, confidentiality, and communication reached the highest level of adequate responsiveness. On the other hand, freedom of choice and fast service received the worst assessments. Participation in decision-making regarding treatment was significantly lower among the older adults who had no education. In addition, the older adults that self-reported as black receive a lower quality of care regarding clear explanation and respected privacy in the appointment, when compared to users of any other race. CONCLUSIONS Although most domains studied have receive a positive assessment, we have found a need for an equal care by the health professionals, regardless of race, education level, or any other adjective characteristic of older adults, users of public health services. PMID:28678911

  1. Providing Competent and Affirming Services for Transgender and Gender Nonconforming Older Adults.

    PubMed

    Porter, Kristen E; Brennan-Ing, Mark; Chang, Sand C; Dickey, Lore M; Singh, Anneliese A; Bower, Kyle L; Witten, Tarynn M

    2016-01-01

    Despite the growing visibility and acceptance of transgender and gender nonconforming (TGNC) individuals, TGNC older adults experience many barriers in accessing competent and affirming health and social services due to anti-TGNC prejudice, discrimination, and lack of competent healthcare training on the part of healthcare workers. Clinical gerontologists and geriatricians will likely encounter TGNC adults in their practice given population aging and greater numbers of TGNC people who are living in their affirmed gender identities. The American Psychological Association recently published its Guidelines for Psychological Practice with Transgender and Gender Nonconforming People, which document the unique needs of TGNC individuals and outlines approaches for competent and affirming service provision (APA, 2015). We interpret these Guidelines using a gerontological lens to elucidate specific issues faced by the TGNC older adult along with the practice and policy implications for this population.

  2. Assessment of the Ecosystem Services Capacity in Natural Protected Areas for Biodiversity Conservation

    NASA Astrophysics Data System (ADS)

    Ronchi, Silvia; Salata, Stefano

    2017-10-01

    Recently, in Italy, a legislative proposal has been set to reform the role and the functions of natural protected areas promoting their aggregation (or the abolition) pursuing a better efficiency for their administration and economic saving. The system of natural protected areas is composed of different conservation levels: there are the Natural parks, established in the ‘80 by national or regional institution for the safeguard of natural elements, the Natura 2000 -Habitat 92/43/CEE promoted by European Union, with conservation measures for maintaining or restoring habitats and species of Communitarian interest, and the local parks of supra-municipal interest (namely PLIS) created by single municipalities or their aggregation aimed at limiting the soil sealing process. The hierarchical level of protection has determined differences in the management of the areas which leads to various approaches and strategies for biodiversity conservation and integrity. In order to assess strengths and weaknesses of the legislative initiative, the new management framework should be designed, considering the ecosystem characteristics of each natural protected area to define the future opportunities and critics, rather than, in the extreme case, remove the level of protection due to the absence of valuable ecosystem conditions. The paper provides an operative support to better apply the legislative proposal investigating the dynamics that affect all protected areas using the land take process as a major threat to biodiversity conservation in natural zones. The land take process is explored using the Land Use Change analysis (LUCa) as a possible way to determine the impact and the environmental effects of land transitions. LUCa is also useful to determine the loss of protected zones capacity to support Ecosystem Services. Finally, the assessment of the Ecosystem Services Capacity (ESC) index expresses the ability of each LULC to provide ES and, in particular, the Ecological

  3. Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement.

    PubMed

    Siu, Albert L; Bibbins-Domingo, Kirsten; Grossman, David C; Baumann, Linda Ciofu; Davidson, Karina W; Ebell, Mark; García, Francisco A R; Gillman, Matthew; Herzstein, Jessica; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Owens, Douglas K; Phillips, William R; Phipps, Maureen G; Pignone, Michael P

    2016-01-26

    Update of the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for depression in adults. The USPSTF reviewed the evidence on the benefits and harms of screening for depression in adult populations, including older adults and pregnant and postpartum women; the accuracy of depression screening instruments; and the benefits and harms of depression treatment in these populations. This recommendation applies to adults 18 years and older. The USPSTF recommends screening for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. (B recommendation).

  4. Psychological Distress, Service Utilization, and Prescribed Medications among Youth with and without Histories of Involvement with Child Protective Services

    ERIC Educational Resources Information Center

    Hamilton, Hayley A.; Paglia-Boak, Angela; Wekerle, Christine; Danielson, Anna Marie; Mann, Robert E.

    2011-01-01

    The objective of this study was to examine differences in psychological distress, service utilization, and prescriptions for medications between adolescents with histories of family involvement with child protective services (CPS) and adolescents without such involvement. Data on 3,497 students were obtained from the 2009 cycle of the Ontario…

  5. Relationship Between General Illness and Mental Health Service Use and Expenditures Among Racially-Ethnically Diverse Adults ≥65 Years.

    PubMed

    Jimenez, Daniel E; Cook, Benjamin Lê; Kim, Giyeon; Reynolds, Charles F; Alegría, Margarita; Coe-Odess, Sarah; Bartels, Stephen J

    2015-07-01

    The association of general medical illness and mental health service use among older adults from racial-ethnic minority groups is an important area of study given the disparities in mental health and general medical services and the low use of mental health services in this population. The purpose of this report is to describe the impact of comorbid general medical illness on mental health service use and expenditures among older adults and to evaluate disparities in mental health service use and expenditures in a racially-ethnically diverse sample of older adults with and without comorbid general medical illness. Data were obtained from the Medical Expenditure Panel Survey (years 2004-2011). The sample included 1,563 whites, 519 African Americans, and 642 Latinos (N=2,724) age ≥65 with probable mental illness. Two-part generalized linear models were used to estimate and compare mental health service use among adults with and without a comorbid general medical illness. Mental health service use was more likely for older adults with comorbid general medical illness than for those without it. Once mental health services were accessed, no differences in mental health expenditures were found. Comorbid general medical illness increased the likelihood of mental health service use by older whites and Latinos. However, the presence of comorbidity did not affect racial-ethnic disparities in mental health service use. This study highlighted the important role of comorbid general medical illness as a potential contributor to using mental health services and suggests intervention strategies to enhance engagement in mental health services by older adults from racial-ethnic minority groups.

  6. 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

  7. Hubble Space Telescope servicing mission scientific instrument protective enclosure design requirements and contamination controls

    NASA Technical Reports Server (NTRS)

    Hansen, Patricia A.; Hughes, David W.; Hedgeland, Randy J.; Chivatero, Craig J.; Studer, Robert J.; Kostos, Peter J.

    1994-01-01

    The Scientific Instrument Protective Enclosures were designed for the Hubble Space Telescope Servicing Missions to provide a beginning environment to a Scientific Instrument during ground and on orbit activities. The Scientific Instruments required very stringent surface cleanliness and molecular outgassing levels to maintain ultraviolet performance. Data from the First Servicing Mission verified that both the Scientific Instruments and Scientific Instrument Protective Enclosures met surface cleanliness level requirements during ground and on-orbit activities.

  8. Advancing the Field of Elder Mistreatment: A New Model for Integration of Social and Medical Services

    ERIC Educational Resources Information Center

    Mosqueda, Laura; Burnight, Kerry; Liao, Solomon; Kemp, Bryan

    2004-01-01

    Purpose: The purpose of this work is to describe the development and operation of a new model for integration of medical and social services. The Vulnerable Adult Specialist Team (VAST) provides Adult Protective Services (APS) and criminal justice agencies with access to medical experts who examine medical and psychological injuries of victims of…

  9. 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

  10. 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.…

  11. Predicting the decisions of hospital based child protection teams to report to child protective services, police and community welfare services.

    PubMed

    Benbenishty, Rami; Jedwab, Merav; Chen, Wendy; Glasser, Saralee; Slutzky, Hanna; Siegal, Gil; Lavi-Sahar, Zohar; Lerner-Geva, Liat

    2014-01-01

    This study examines judgments made by hospital-based child protection teams (CPTs) when determining if there is reasonable suspicion that a child has been maltreated, and whether to report the case to a community welfare agency, to child protective services (CPS) and/or to the police. A prospective multi-center study of all 968 consecutive cases referred to CPTs during 2010-2011 in six medical centers in Israel. Centers were purposefully selected to represent the heterogeneity of medical centers in Israel in terms of size, geographical location and population characteristics. A structured questionnaire was designed to capture relevant information and judgments on each child referred to the team. Bivariate associations and multivariate multinomial logistic regressions were conducted to predict whether the decisions would be (a) to close the case, (b) to refer the case to community welfare services, or (c) to report it to CPS and/or the police. Bivariate and multivariate analyses identified a large number of case characteristics associated with higher probability of reporting to CPS/police or of referral to community welfare services. Case characteristics associated with the decisions include socio-demographic (e.g., ethnicity and financial status), parental functioning (e.g., mental health), previous contacts with authorities and hospital, current referral characteristics (e.g., parental referral vs. child referral), physical findings, and suspicious behaviors of child and parent. Most of the findings suggest that decisions of CPTs are based on indices that have strong support in the professional literature. Existing heterogeneity between cases, practitioners and medical centers had an impact on the overall predictability of the decision to report. Attending to collaboration between hospitals and community agencies is suggested to support learning and quality improvement. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. 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…

  13. Transition to adult services - a positive step.

    PubMed

    Kim, Samuel; Kim, Sung Hee; McDonald, Susan; Fidler, Sarah; Foster, Caroline

    2017-07-01

    Following the success of antiretroviral therapy, an expanding cohort of adolescents with perinatally acquired HIV (PaHIV) is transitioning into adult care. Dedicated multidisciplinary transitional care HIV services have been established in the UK. However, published data on patient satisfaction with such services are sparse. A single centre survey of patient satisfaction was conducted in January 2014, and results compared to a previous similar survey in 2009. Patients were asked to complete a questionnaire regarding views of their care using a 7-point Likert scale. 51/96 attended within the time period and all completed the survey, compared with 21 in 2009. Ninety-two percent were satisfied with the care provided by the clinic, compared to 100% in 2009. The proportion who felt moving to their current service had a positive effect on their health increased from 68% in 2009 to 81% in 2014. Ninety-two percent were satisfied with the overall care provided by the clinic, compared to 100% in 2009. Ninety-four percent agreed that staff knew how to talk and listen to young people, 96% agreed staff were able to explain their treatments and problems clearly in a way that they could understand. Ninety-six percent felt that a clinic specifically for young people was useful. Despite a marked increase in clinic attendees and unchanged levels of service provision, patient satisfaction remained high. Patients strongly value the provision of dedicated services for young people.

  14. Behavioral health needs and problem recognition by older adults receiving home-based aging services.

    PubMed

    Gum, Amber M; Petkus, Andrew; McDougal, Sarah J; Present, Melanie; King-Kallimanis, Bellinda; Schonfeld, Lawrence

    2009-04-01

    Older adults' recognition of a behavioral health need is one of the strongest predictors of their use of behavioral health services. Thus, study aims were to examine behavioral health problems in a sample of older adults receiving home-based aging services, their recognition of behavioral health problems, and covariates of problem recognition. The study design was cross-sectional. Older adults (n = 141) receiving home-based aging services completed interviews that included: Structured Clinical Interview for DSM-IV; Brief Symptom Inventory-18; attitudinal scales of stigma, expectations regarding aging, and thought suppression; behavioral health treatment experience; and questions about recognition of behavioral health problems. Thirty (21.9%) participants received an Axis I diagnosis (depressive, anxiety, or substance); another 17 (12.1%) were diagnosed with an adjustment disorder. Participants were more likely to recognize having a problem if they had an Axis I diagnosis, more distress on the BSI-18, family member or friend with a behavioral health problem, and greater thought suppression. In logistic regression, participants who identified a family member or friend with a behavioral health problem were more likely to identify having a behavioral health problem themselves. Findings suggest that older adults receiving home-based aging services who recognize behavioral health problems are more likely to have a psychiatric diagnosis or be experiencing significant distress, and they are more familiar with behavioral health problems in others. This familiarity may facilitate treatment planning; thus, older adults with behavioral health problems who do not report familiarity of problems in others likely require additional education. (c) 2008 John Wiley & Sons, Ltd.

  15. Attitudes of GPs towards Older Adults Psychology Services in the Scottish Highlands.

    PubMed

    Todman, Jonathan P F; Law, Jim; MacDougall, Andrew

    2011-01-01

    The mental health of older adults is of increasing concern in an aging population and GPs are frequently the gatekeepers to specialist mental health services. Psychotherapy, social interventions and bibliotherapy all have an evidence-base for treating depression and anxiety in the elderly, as does pharmacological treatment. However, the referral rate from GPs for an Older Adults Clinical Psychology service in the Scottish Highlands in the months prior to the study had been very low and the reasons for this were not clear. General practitioners may have felt that depression and anxiety are 'understandable' in older adults and are therefore unsuitable for treatment, or they may have felt that psycho-pharmacotherapy treatments are more effective than the psychotherapy treatment options. Alternatively, local issues associated with the remote location of many NHS Highland GP practices and patients may have prevented them referring. Therefore, the current study aimed to elicit the therapeutic preferences of Highland GPs, the perceived availability of these options and an estimate of the prevalence of older adults in the area suffering from mild or moderate mental health problems. Questionnaires including brief quantitative and qualitative questions were sent to all 284 GPs in the area with 119 (46%) were completed and returned. Responses from GPs suggested that many patients with depression or anxiety may not be referred. The GPs indicated that social therapeutic options are seen to be as effective as pharmacological options and more effective than other psychological and bibliotherapy options. However, GPs indicated that they were substantially more likely to prescribe pharmacological options than other forms of therapy. The GPs suggested that lower waiting times and a more localised service would increase the likelihood of a referral being made. The current study suggests that low awareness of psychological service provision among GPs may have resulted in fewer

  16. Mechanisms through which reciprocal filial values protect wellbeing of Chinese adult-child caregivers in the US.

    PubMed

    Hsueh, Kuei-Hsiang; Bachman, Jean A; Richardson, Lloyd I; Cheng, Wen-Yung; Zimmerman, Rick S

    2014-04-01

    In this study, we explored the role of reciprocal filial values in protecting the wellbeing of Chinese adult-child caregivers in the US. Using survey data obtained from 137 Chinese adult-child caregivers living in seven US cities, we tested a latent variable model using structural equation modeling. In this model, informed by role theory, social exchange theory and stress-coping theory, reciprocal filial values affect caregiver wellbeing in the face of caregiver role strain, both directly and indirectly through protective effects of role rewards and coping. In the final model, reciprocal filial values had both direct and indirect protective effects on caregivers' wellbeing, offering evidence to address culturally sensitive issues in family caregivers with similar filial values. © 2014 Wiley Periodicals, Inc.

  17. Functional Limitations and Religious Service Attendance among African American and White Older Adults

    ERIC Educational Resources Information Center

    Roff, Lucinda Lee; Klemmack, David L.; Simon, Cassandra; Cho, Gi Won; Parker, Michael W.; Koenig, Harold G.; Sawyer-Baker, Patricia; Allman, Richard M.

    2006-01-01

    Church attendance is associated with improved health and well-being among older adults, but older adults with functional limitations may have difficulty attending church services. This article examines differences in the association between functional limitations and church attendance in a sample of 987 elderly African American and white…

  18. A randomised controlled trial of an online theory-based intervention to improve adult Australians' sun-protective behaviours.

    PubMed

    White, Katherine M; Starfelt, Louise C; Young, Ross McD; Hawkes, Anna L; Cleary, Catherine; Leske, Stuart; Wihardjo, Kylie

    2015-03-01

    To evaluate the effectiveness of a single-session online theory of planned behaviour (TPB)-based intervention to improve sun-protective attitudes and behaviour among Australian adults. Australian adults (N=534; 38.7% males; Mage=39.3 years) from major cities (80.9%), regional (17.6%) and remote areas (1.5%) were recruited and randomly allocated to an intervention (N=265) and information only group (N=267). The online intervention focused on fostering positive attitudes, perceptions of normative support, and control perceptions for sun protection. Participants completed questionnaires assessing standard TPB measures (attitude, subjective norm, perceived behavioural control, intention, behaviour) and extended TPB constructs of group norm (friends, family), personal norm, and image norm, pre-intervention (Time 1) and one week (Time 2) and one month post-intervention (Time 3). Repeated Measures Multivariate Analysis of Variance tested intervention effects across time. Intervention participants reported more positive attitudes towards sun protection and used sun-protective measures more often in the subsequent month than participants receiving information only. The intervention effects on control perceptions and norms were non-significant. A theory-based online intervention fostering more favourable attitudes towards sun safety can increase sun protection attitudes and self-reported behaviour among Australian adults in the short term. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. 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 Services...

  20. Health insurance, patient protection and Affordable Care Act, and young adults.

    PubMed

    Dodich, Colleen; Patel, Dilip

    2013-12-01

    In summary, the ACA aims to correct some of the shortcomings of our current health insurance systems. It aims to make health insurance more affordable and more accessible and the health insurance systems easier to navigate. For the young adult population, it aims to protect more individuals by allowing them to stay on their parent's insurance longer and by making it easier to choose an insurance plan that is right for them. Those with preexisting medical conditions do not have to worry about being excluded from a health plan because of their medical history. The law is also making health insurance mandatory, which may help prevent young adults who fall ill from incurring large medical bills. Initial outcomes from the implementation of the ACA have shown both positive and negative responses. All in all, it is giving young adults more options when it comes to obtaining health insurance. As part of discussion with adolescents and young adults, physicians may take into consideration key points summarized in Table 4.

  1. A Comparison of Learning Outcomes for Adult Students in On-Site and Online Service-Learning

    ERIC Educational Resources Information Center

    Schwehm, Jeremy S.; Lasker-Scott, Tennille; Elufiede, Oluwakemi

    2017-01-01

    As noted by Kolb's (1984) experiential learning theory, adults learn best through experiences. Typically delivered in a traditional, face-to-face classroom setting, service-learning integrates the knowledge learned in the classroom with real-world experience and community service. E-service-learning, service-learning delivered in part or entirely…

  2. Validity of the Working Alliance Inventory within Child Protection Services

    ERIC Educational Resources Information Center

    Killian, Michael; Forrester, Donald; Westlake, David; Antonopoulou, Paraskevi

    2017-01-01

    The Working Alliance Inventory remains a widely studied measure of quality of therapeutic relationships between the practitioner and client. No prior study has examined the psychometrics and validity of the Working Alliance Inventory-Short (WAI-S) in a sample of families, social workers, and trained observers within child protection services.…

  3. Influencing and protective factors of suicidal ideation among older adults.

    PubMed

    Huang, Li-Bi; Tsai, Yun-Fang; Liu, Chia-Yih; Chen, Ying-Jen

    2017-04-01

    Suicide is a global issue, but few studies have explored the triggers and psychological feelings of suicidal ideation in older adults. A qualitative design with face-to-face semistructured interviews examined the experience of suicidal ideation in adults aged 65 years and older. A purposive sampling of 32 outpatients with suicidal ideation from a medical centre in northern Taiwan participated. Interview data identified three themes: triggers for suicidal ideation, contributing psychological changes, and factors of adaptive response. The triggers for suicidal ideation included physical discomfort, loss of respect and/or support from family, impulsive emotions due to conflicts with others, and painful memories. Psychological changes contributed to suicidal ideation: feelings of loneliness, a sense of helplessness, or lack of self-worth. Participants described adaptive responses that acted as protective factors of suicidal ideation: support from family and friends, control of emotions, establishing a support network, comfort from religion, medication, and focussing on the family. Mental health nurses and clinicians should incorporate evaluations of stressful life events and psychological changes into a screening scale for older adults to improve detection of those at risk for suicide. Teaching coping strategies could provide timely interventions to secure the safety of this older population of adults. © 2016 Australian College of Mental Health Nurses Inc.

  4. 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 One...

  5. 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 One...

  6. 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 One...

  7. 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 Delivery...

  8. 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

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 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 Delivery...

  9. Risk and protective factors for recreational and hard drug use among Malaysian adolescents and young adults.

    PubMed

    Razali, Muzafar Mohd; Kliewer, Wendy

    2015-11-01

    This study investigated risk and protective factors for recreational and hard drug use in Malaysian adolescents and young adults. Participants (n = 859; M age = 17.24 years, SD = 2.75 years, range = 13-25 years; 59% male) were recruited from secondary schools, technical colleges, a juvenile detention center and a national training center in Malaysia. A version of the Communities That Care survey validated for use in Malaysia (Razali & Kliewer, 2015) was used to assess study constructs. One in 6 adolescents and 1 in 3 young adults reported lifetime recreational and hard drug use, with greater use reported by males across all drug categories. Structural equation modeling was used to determine the strongest risk and protective factors for recreational and hard drug use. The overall pattern of findings was similar for recreational and hard drug use. Shared risk factors for lifetime recreational and hard drug use included early initiation of antisocial behavior, peer antisocial behavior, and peer reinforcement for engaging in antisocial behavior; shared protective factors included religious practices and opportunities for prosocial school involvement. Multiple group analyses comparing adolescents and young adults indicated that patterns of risk and protective factors predicting drug use differed across these age groups. There were fewer significant predictors of either recreational or hard drug use for young adults relative to adolescents. Results suggest that interventions should target multiple microsystems (e.g., peer groups, family systems, school environments) and be tailored to the developmental stage of the individual. Copyright © 2015. Published by Elsevier Ltd.

  10. Clinical Preventive Services for Older Adults: The Interface Between Personal Health Care and Public Health Services

    PubMed Central

    Richards, Chesley L.; Shenson, Douglas

    2012-01-01

    Healthy aging must become a priority objective for both population and personal health services, and will require innovative prevention programming to span those systems. Uptake of essential clinical preventive services is currently suboptimal among adults, owing to a number of system- and office-based care barriers. To achieve maximum health results, prevention must be integrated across community and clinical settings. Many preventive services are portable, deliverable in either clinical or community settings. Capitalizing on that flexibility can improve uptake and health outcomes. Significant reductions in health disparities, mortality, and morbidity, along with decreases in health spending, are achievable through improved collaboration and synergy between population health and personal health systems. PMID:22390505

  11. A Privacy-Protecting Authentication Scheme for Roaming Services with Smart Cards

    NASA Astrophysics Data System (ADS)

    Son, Kyungho; Han, Dong-Guk; Won, Dongho

    In this work we propose a novel smart card based privacy-protecting authentication scheme for roaming services. Our proposal achieves so-called Class 2 privacy protection, i.e., no information identifying a roaming user and also linking the user's behaviors is not revealed in a visited network. It can be used to overcome the inherent structural flaws of smart card based anonymous authentication schemes issued recently. As shown in our analysis, our scheme is computationally efficient for a mobile user.

  12. Where is the Child in Family Therapy Service After Family Violence? A Study from the Norwegian Family Protection Service.

    PubMed

    Flåm, Anna Margrete; Handegård, Bjørn Helge

    Extensive documentation on consequences of family violence laid the ground for a politically decided mandate for the Norwegian Family Protection Service (FPS) to prioritize families with children and violence. This study explores the practice of one of the country's larger FPS offices following this mandate and its kick-off start. Data from all cases in 1 year with families with children and violence were gathered (106) as to what were cases referred, services provided, main cross-points, dilemmas, and challenges. Descriptive statistical analyses were utilized and qualitative analysis conducted. The study shows success in supplying a direct, much used route both for private persons and main collaborative agencies, although all abusers need others as promoters for change. The service succeeds to pioneer brief treatment combined with taking a stand against violence. However, while services are provided fairly quickly when violence is reported, several changes are called for: A more violence-sensitive intake procedure, stronger cooperation with specialty mental health service and primary health service, extended use of assessment tools and outcome measures. Given the nature of violence, particularly follow up measures are required. However, first and foremost, the study calls for a better inclusion of the child. Despite mandated priority, a major neglect of children takes place. In line with the UN Convention on the Rights of the Child, the Norwegian Family Protection Services in a country complying with this Convention is obliged to take the child more successfully into account in its own right. Future efforts are required to safeguard child-focused services.

  13. A Question of Diversity: An Analysis of the Young Adult Library Service Association's Best Books for Young Adults, 1994-1998.

    ERIC Educational Resources Information Center

    Benedikt, Anna R.

    This study examined the Young Adult Library Service Association's (YALSA's) Best Books for Young Adults (BBYA) recommended list for the years 1994-98 in order to determine if the list provides diversity in terms of the content of books and the gender and ethnicity of the authors and editors whose works appear on it. The results of the study…

  14. Child responsible personnel in adult mental health services.

    PubMed

    Lauritzen, Camilla; Reedtz, Charlotte

    2016-01-01

    Children who have parents with mental health problems are a vulnerable group. Intervening early to support parents with a mental illness can contribute to improve outcomes for children. Rigging the adult mental health system in such a manner that child responsible personnel are designated in wards is a strategy to systematically address the needs of families. It has since 2010 been mandatory for Norwegian hospitals to appoint such personnel in all hospital wards. The current study aimed to investigate the appointment of child responsible personnel in the adult mental health services in a regional hospital with local clinics. Additionally, to describe the characteristics of child responsible staff in terms of gender and educational background, their competence, clinical practice and knowledge about parental mental illness. A final aim was to study whether or not the clinics had established collaboration with other services concerning follow-up for the children of parents with mental illness. Participants in this study are the staff at psychiatric clinics in a large university hospital in Norway. Practitioners were asked to answer a questionnaire prior to the initial process of implementing the new legislation in 2010 (N = 219). After a three-year period of implementing routines to adopt the new law in the clinic, the same survey was sent out to the staff in 2013 (N = 185) to monitor if changes were taking place. To study if the changes were sustained within the clinics, we conducted a two-year follow up in 2015 (N = 108). The results indicated that the systematic work to change clinical practice in the participating hospital had made a difference. Routines to follow up children's patients after the new legislation had to some extent been implemented. The child responsible personnel had more knowledge and awareness about the consequences of parental mental illness for children. The results of this study suggested that the systems change of establishing child

  15. PROTECT: A Pilot Program to Integrate Mental Health Treatment Into Elder Abuse Services for Older Women.

    PubMed

    Sirey, Jo Anne; Halkett, Ashley; Chambers, Stephanie; Salamone, Aurora; Bruce, Martha L; Raue, Patrick J; Berman, Jacquelin

    2015-01-01

    The goal of this pilot program was to test the usefulness of adapted Problem-Solving Therapy (PST) and anxiety management, called PROTECT, integrated into elder abuse services to reduce depression and improve self-efficacy. Depressed women victims were randomized to receive elder abuse resolution services combined with either PROTECT or a mental health referral. At follow-up, the PROTECT group showed greater reduction in depressive symptoms and endorsed greater improved self-efficacy in problem-solving when compared to those in the Referral condition. These preliminary findings support the potential usefulness of PROTECT to alleviate depressive symptoms and enhance personal resources among abused older women.

  16. Ecosystem services and the protection, restoration, and management of ecosystems exposed to chemical stressors.

    PubMed

    Maltby, Lorraine

    2013-04-01

    Ecosystem services-the benefits people obtain from ecosystem structures and processes-are essential for human survival and well-being. Chemicals are also an essential component of modern life; however, they may cause adverse ecological effects and reduce ecosystem service provision. Environmental policy makers are increasingly adopting the ecosystem services concept, but applying this approach to the protection, restoration, and management of ecosystems requires the development of new understanding, tools, and frameworks. There is an urgent need to understand and predict the effect of single and multiple stressors on ecosystem service delivery across different spatial scales (local to global), to develop indicators that can be used to quantify and map services and identify synergies and trade-offs between them, to establish protection goals and restoration targets defined in terms of the types and levels of service delivery required, and to develop approaches for the assessment and management of chemical risk to ecosystem services that consider the whole life cycle of products and processes. These are major research challenges for the environmental science community in general and for ecotoxicologists and risk assessors in particular. Copyright © 2013 SETAC.

  17. Assessing Capacity for Providing Culturally Competent Services to LGBT Older Adults

    PubMed Central

    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” while 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. PMID:24798180

  18. 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…

  19. 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. © 2014 John Wiley & Sons Ltd.

  20. A Developmental Perspective in Mental Health Services Use Among Adults with Mental Disorders.

    PubMed

    Huỳnh, Christophe; Caron, Jean; Pelletier, Marilou; Liu, Aihua; Fleury, Marie-Josée

    2018-07-01

    This study examined factors associated with mental health services (MHS) use by individuals with mental disorders within a developmental perspective of adulthood. Bivariate and multivariate analyses were conducted separately for each developmental stage on independent variables using the Andersen's behavioral health service model. For 18-29-year-old emerging adults (n = 141), autonomy, daily life/relations, Internet searching, alcohol dependence, cognitive impulsiveness, number of stressful events, and self-harm were associated with MHS use. For 30-49-year olds (n = 292), being female, country of origin, being on welfare, social integration, Internet searching, and number of stressful events were associated with MHS use. For 50-64-year-old middle-aged adults (n = 126), current occupation was associated with MHS use. Developing online resources for emerging adults may increase MHS use. For 30-49-year olds, outreach should target male, immigrants, and individuals less socially integrated and on welfare. For middle-aged adults, workplace programs that reduce stigma and offer psychological help could increase MHS use.

  1. 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. © 2013 Eur J Oral Sci.

  2. 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…

  3. Reducing restrictive practice in adult services: not only an issue for mental health professionals.

    PubMed

    Hext, Greg; Clark, Louise L; Xyrichis, Andreas

    2018-05-10

    Reducing 'restrictive practices' is an issue of national importance, pertinent to all NHS sectors, yet there is poor awareness of the issue in mainstream adult services. Such practices potentially restrict a person's rights to choice, self-determination, privacy and freedom. Challenging behaviour is often the result of unmet needs, communication difficulties or diagnostic overshadowing, but there is a common misconception that patients exhibit such behaviours because of their impaired intellectual abilities or mental health problems. This article seeks to raise awareness of restrictive practices and suggest the way forward. It highlights the importance of good de-escalation skills, which, if adopted early in therapeutic relationships, may help reduce the occurrence of challenging behaviours and situations. Behavioural support plans that adopt a biopsychopharmacosocial approach (BPPS) detail a range of interventions for managing challenging behaviours. Tailored support that follows a BPPS approach could reduce incidents of challenging behaviour, reduce costly observation, improve the patient experience and protect the patient's liberty.

  4. Safeguarding and Protecting Children in Maternity Services: Implications for Practice

    ERIC Educational Resources Information Center

    Lazenbatt, Anne; Greer, Jean

    2009-01-01

    This article debates the issues involved in safeguarding and protecting children in maternity services and offers implications for professional practice. Midwives and other staff who work as members of the maternity team have a safeguarding role to play in the identification of babies and children who have been abused, or are at risk of abuse, and…

  5. DOPA, a Digital Observatory for Protected Areas including Monitoring and Forecasting Services

    NASA Astrophysics Data System (ADS)

    Dubois, Gregoire; Hartley, Andrew; Peedell, Stephen; de Jesus, Jorge; Ó Tuama, Éamonn; Cottam, Andrew; May, Ian; Fisher, Ian; Nativi, Stefano; Bertrand, Francis

    2010-05-01

    The Digital Observatory for Protected Areas (DOPA) is a biodiversity information system currently developed as an interoperable web service at the Joint Research Centre of the European Commission in collaboration with other international organizations, including GBIF, UNEP-WCMC, Birdlife International and RSPB. DOPA is designed to assess the state and pressure of Protected Areas (PAs) and to prioritize them accordingly, in order to support decision making and fund allocation processes. To become an operational web service allowing the automatic monitoring of protected areas, DOPA needs to be able to capture the dynamics of spatio-temporal changes in habitats and anthropogenic pressure on PAs as well as the changes in the species distributions. Because some of the most valuable natural ecosystems and species on the planet cover large areas making field monitoring methods very difficult for a large scale assessment, the automatic collection and processing of remote sensing data are processes at the heart of the problem. To further be able to forecast changes due to climate change, DOPA has to rely on an architecture that enables it to communicate with the appropriate modeling web services. The purpose of this presentation is to present the architecture of the DOPA with special attention to e-Habitat, its web processing service designed for assessing the irreplaceability of habitats as well as for the modeling of habitats under different climate change scenarios. The use of open standards for spatial data and of open source programming languages for the development of the core functionalities of the system are expected to encourage the participation of the scientific community beyond the current partnerships and to favour the sharing of such an observatory which could be installed at any other location. Acknowledgement: Part of this work is funded under the 7th Framework Programme by the EuroGEOSS (www.eurogeoss.eu) project of the European Commission. The views

  6. Testing if Social Services Prevent Fatal Child Maltreatment Among a Sample of Children Previously Known to Child Protective Services.

    PubMed

    Douglas, Emily M

    2016-08-01

    The purpose of this article was to examine the potential impact of child welfare services on the risk for fatal child maltreatment. This was conducted using a subsample of children who were identified as "prior victims" in the National Child Abuse and Neglect Data System from 2008 to 2012. At the multivariate level, the analyses show that case management services act to protect children from death as do family support services, family preservation services, and foster care, but that the results vary by type of maltreatment experienced. The author recommends that before strong conclusions are drawn, additional research in this area is warranted. © The Author(s) 2016.

  7. 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…

  8. Related factors and use of free preventive health services among adults with intellectual disabilities in Taiwan.

    PubMed

    Yen, Suh-May; Kung, Pei-Tseng; Chiu, Li-Ting; Tsai, Wen-Chen

    2014-06-12

    This study aimed to investigate the utilization of preventive health services in the adults with intellectual disabilities from the nationwide database. The research method of this study is secondary data analysis. The data was obtained from three nationwide databases from 2006 to 2008. This study employed descriptive statistics to analyze the use and rate of preventive health services by intellectual disabled adults. Chi-square test was used to determine the relationship between the utilization of preventive health services and these variables. Multivariate logistic regression analysis was used to explore the factors that affect intellectual disabled adults' use of preventive health services. Our findings indicated 16.65% of people with intellectual disabilities aged over 40 years used the preventive health services. Females were more frequent users than males (18.27% vs. 15.21%, p <0.001). The utilization rate decreased with increasing severity of intellectual disabilities. The utilization was lowest (13.83%) for those with very severe disability, whereas that was the highest (19.38%) for those with mild severity. The factors significantly influencing utilization of the services included gender, age, and marital status, urbanization of resident areas, monthly payroll, low-income household status, catastrophic illnesses status and relevant chronic diseases and severity of disability. Although Taiwan's Health Promotion Administration (HPA) has provided free preventive health services for more than 15 years, people with intellectual disabilities using preventive health care tend to be low. Demographics, economic conditions, health status, relevant chronic diseases, environmental factor, and severity of disability are the main factors influencing the use of preventive healthcare. According to the present findings, it is recommended that the government should increase the reimbursement of the medical staff performing health examinations for the persons with

  9. Experiences of adolescents and young adults with ADHD in Hong Kong: treatment services and clinical management.

    PubMed

    Cheung, Kerry K W; Wong, Ian C K; Ip, Patrick; Chan, Phyllis K L; Lin, Candy H Y; Wong, Lisa Y L; Chan, Esther W

    2015-05-01

    Specialist services for the treatment of attention deficit hyperactivity disorder (ADHD) in adulthood in Hong Kong are yet to be developed. This study aims to explore the experiences of adolescents and young adults with ADHD in accessing treatment and services, coping with ADHD-related impairment, and their expectations of future treatment in Hong Kong. Qualitative interviews were conducted with a semi-structured guide. Forty young adult patients aged between 16 and 23 were included in the study. The interview recordings were transcribed verbatim and anonymised. Data were analysed with a thematic approach based on key principles of Grounded Theory. Four meta-themes were developed: Accessing ADHD diagnosis and treatment services; ADHD-related impairment; Experience of ADHD treatments; and Attitudes and expectations of future ADHD treatment. The role of parents and schools were highly significant in accessing services for patients diagnosed with ADHD in childhood. In general, ADHD affected every aspect of patients' lives including academic outcome, employment, family and social relationships. Medications were the principal treatment for ADHD amongst the interviewees and were reported to be generally effective. Half of the patients received non-pharmacological treatments in childhood but these effects were reported to be temporary. There was general consensus that the needs of patients with ADHD could not be met by the current service. In particular, there is a lack of specialist service for adults with ADHD, follow-up by different clinicians, and insufficient provision of non-pharmacological treatments. The findings suggest that further development of specialist ADHD services and non-pharmacological options for young adults are essential to meet their diverse needs with a holistic approach.

  10. Weight management in Canada: an environmental scan of health services for adults with obesity

    PubMed Central

    2014-01-01

    Background Obesity in Canada is a growing concern, but little is known about the available services for managing obesity in adults. Our objectives were to (a) survey and describe programs dedicated to weight management and (b) evaluate program adherence to established recommendations for care. Methods We conducted an online environmental scan in 2011 to identify adult weight management services throughout Canada. We examined the degree to which programs adhered to the 2006 Canadian Clinical Practice Guidelines on the Management and Prevention of Obesity in Adults and Children (CCPGO) and the analysis criteria developed by the Association pour la Santé Publique du Québec (ASPQ). Results A total of 83 non-surgical (34 community-based, 42 primary care-based, 7 hospital-based) and 33 surgical programs were identified. All programs encouraged patient self-management. However, few non-surgical programs adhered to the CCPGO recommendations for assessment and intervention, and there was a general lack of screening for eating disorders, depression and other psychiatric diseases across all programs. Concordance with the ASPQ criteria was best among primary care-based programs, but less common in other settings with deficits most frequently revealed in multidisciplinary health assessment/management and physical activity counselling. Conclusions With more than 60% of Canadians overweight or obese, our findings highlight that availability of weight management services is far outstripped by need. Our observation that evidence-based recommendations are applied inconsistently across the country validates the need for knowledge translation of effective health services for managing obesity in adults. PMID:24521300

  11. Combinations of Types of Mental Health Services Received in the Past Year Among Young Adults

    MedlinePlus

    ... Spotlight December 08, 2015* Combinations of types of mental health services received in the past year among young adults Combinations of types of mental health services received in the past year among young ...

  12. Planning for the Future of the Adult Education Service: A Challenge for VECs

    ERIC Educational Resources Information Center

    Muircheartaigh, Lucas O.

    2004-01-01

    In this paper, the author points out that there has been a significant development of the adult education service in Ireland in recent years. However, if the service is to become part of the mainstream of Irish education, the issue of structures at all levels within the system has to be addressed. Quite frankly the present system is very…

  13. Mental health literacy as a mediator in use of mental health services among older korean adults.

    PubMed

    Kim, Young Sun; Rhee, T Greg; Lee, Hee Yun; Park, Byung Hyun; Sharratt, Monica L

    2017-02-01

    Existing literature suggests that mental health literacy is positively associated with mental health services utilization. Despite an aging population that faces significant mental health concerns in Korea, the role of mental health literacy on mental health services utilization is not known among older adults in Korea. This study aimed to (1) identify whether mental health literacy mediates the association between population characteristics and mental health services utilization and (2) identify an optimal path model for mental health services utilization among Korean older adults. Using a cross-sectional survey with a quota sampling strategy, we collected and analyzed responses from 596 community-dwelling individuals ages 65 years and older. We used structural equation modeling (SEM) to estimate the effect of mental health literacy as a mediator. When controlling for other relevant covariates in the optimal path model, mental health literacy mediated the relationships between three socio-demographic factors (education, general literacy, and health status) and mental health services utilization. The model fit index shows that the SEM fits very well (CFI = 0.92, NFI = 0.90, RMSEA = 0.07). Efforts to improve mental health literacy through community-based education programs may need to particularly target Korean older adults with the relevant socio-demographic characteristics to enhance their utilization of appropriate mental health services.

  14. Protecting an adult identity: A grounded theory of supportive care for young adults recently diagnosed with cancer.

    PubMed

    Soanes, Louise; Gibson, Faith

    2018-05-01

    For adolescents and young adults living in high-income countries cancer remains the most common disease-related death. Increasing survival rates and projected longevity are positive outcomes, although long-term consequences of cancer and/or its treatment will likely increase the global burden of cancer. In low and middle-income countries the impact and needs of young adults with cancer are largely unknown and require further attention. However, universal studies have revealed that cancer-related needs for this group are multifactorial, complex and largely unmet. In response to these findings, the body of work on supportive care for young adults with cancer is growing. Yet, there is no published research in the context of the United Kingdom, regarding the role young adults play in managing their supportive cancer care needs. To explore the experience, purpose and meaning of supportive cancer care to young adults recently diagnosed with cancer. Using constructivist grounded theory, data were collected in one to one interviews with eleven young adults (seven women and four men aged 19-24 years) being treated for cancer in two English hospitals. Data were analyzed using open and focused coding, constant comparison, theoretical coding and memoing, and this enabled construction of a subjective theory. Young adults in this study interpreted cancer as an interruption to the events, experiences and tasks forming the biographical work of their adult identity. Data analysis led to the construction of the theory, 'protecting an adult identity: self in relation to a diagnosis of cancer in young adulthood'. This theory arose from three categories: fragility of self, maintaining self in an altered reality and mobilizing external resources. Young adults faced the loss of their early adult identity. Interpreting cancer as a temporary interruption, they sought to re-establish their identity by directly and indirectly managing their supportive care needs. These findings contribute to

  15. Describing Maltreatment: Do Child Protective Service Reports and Research Definitions Agree?

    ERIC Educational Resources Information Center

    Runyan, Desmond K.; Cox, Christine E.; Dubowitz, Howard; Newton, Rae R.; Upadhyaya, Mukund; Kotch, Jonathan B.; Leeb, Rebecca T.; Everson, Mark D.; Knight, Elizabeth D.

    2005-01-01

    Objective: The National Research Council identified inadequate research definitions for abuse and neglect as barriers to research in child maltreatment. We examine the concordance between child protective services (CPS) classifications of maltreatment type with the determinations of type from two research coding systems. We contrast the two coding…

  16. [Factors Associated with the Use of Protective Gear among Adults during Recreational Sledging].

    PubMed

    Ruedl, G; Pocecco, E; Kopp, M; Raas, C; Blauth, M; Brucker, P U; Burtscher, M

    2015-09-01

    Recreational sledging (tobogganing) is a very popular winter sport in the Alps. Therefore, injury prevention through the usage of protective gear seems important. Therefore, the aim of this study was to evaluate factors associated with the use of protective gear among adults during recreational sledging. Adult recreational sledgers were interviewed during the winter seasons 2012/13 and 2013/14 at six sledging tracks in Austria on demographics, skill level, sledging frequency, risk taking behaviour, sitting alone or with another person on the sledge, previous sledging-related injuries, and use of protective gear, respectively. Interviews were conducted on all days of the week. A total of 1968 adult sledgers (49.4 % females) with a mean age of 37.1 ± 14.4 years participated in this study. A (ski) helmet, sun or snow goggles, a back protector, and wrist guards were used by 42.3 %, 71.0 %, 5.9 %, 2.6 % of sledgers, respectively. Helmet use was significantly higher with increasing age and increasing skill level as well as when sitting alone compared to sitting together with another person. Females, Austrians, persons sitting alone on the sledge, a higher frequency of sledging and a higher skill level were significantly associated with an increasing use of goggles. A back protector was significantly more often worn by younger people, more risky sledgers, and persons with a previous sledging-related injury. Wrist guards were significantly more often used by persons with a previous sledging-related injury. During recreational sledging, the factors age, sex, nationality, skill level, sitting alone compared to sitting together with another person on the sledge, sledging frequency, and injury experience were associated with the frequencies of usage of different types of protective gear. These factors should be considered when implementing preventive measures for recreational sledging. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Youth and young adults with cerebral palsy: their use of physician and hospital services.

    PubMed

    Young, Nancy L; Gilbert, Thomas K; McCormick, Anna; Ayling-Campos, Anne; Boydell, Katherine; Law, Mary; Fehlings, Darcy L; Mukherjee, Shubhra; Wedge, John H; Williams, Jack I

    2007-06-01

    To examine patterns of health care utilization among youth and young adults who have cerebral palsy (CP) and to provide information to guide the development of health services for adults who have CP. This study analyzed health insurance data for outpatient physician visits and hospital admissions for a 4-year period. Six children's treatment centers in Ontario, Canada. The sample included 587 youth and 477 adults with CP identified from health records. Youths were 13 to 17 years of age, and adults were 23 to 32 years of age at the end of the data range. Not applicable. We computed the annual rates of outpatient physician visits and hospitalizations per 1000 persons and compared these with rates for the general population. Annual rates of outpatient physician visits were 6052 for youth and 6404 for adults with CP, 2.2 times and 1.9 times higher, respectively, than rates for age-matched peers (P<.01). Specialists provided 28.4% of youth visits but only 18.8% of adult visits. Annual hospital admission rates were 180 for youth and 98 for adults with CP, 4.3 times and 10.6 times higher, respectively, than rates for age-matched peers (P<.01). It appears that youth and adults with CP continue to have complex care needs and rely heavily on the health care system. Comprehensive services are essential to support their health as they move into youth and adulthood. However, there appear to be gaps in the adult health care system, such as limited access to specialist physicians.

  18. Confidentiality Protection of User Data and Adaptive Resource Allocation for Managing Multiple Workflow Performance in Service-Based Systems

    ERIC Educational Resources Information Center

    An, Ho

    2012-01-01

    In this dissertation, two interrelated problems of service-based systems (SBS) are addressed: protecting users' data confidentiality from service providers, and managing performance of multiple workflows in SBS. Current SBSs pose serious limitations to protecting users' data confidentiality. Since users' sensitive data is sent in…

  19. Understanding of how older adults with low vision obtain, process, and understand health information and services.

    PubMed

    Kim, Hyung Nam

    2017-10-16

    Twenty-five years after the Americans with Disabilities Act, there has still been a lack of advancement of accessibility in healthcare for people with visual impairments, particularly older adults with low vision. This study aims to advance understanding of how older adults with low vision obtain, process, and use health information and services, and to seek opportunities of information technology to support them. A convenience sample of 10 older adults with low vision participated in semi-structured phone interviews, which were audio-recorded and transcribed verbatim for analysis. Participants shared various concerns in accessing, understanding, and using health information, care services, and multimedia technologies. Two main themes and nine subthemes emerged from the analysis. Due to the concerns, older adults with low vision tended to fail to obtain the full range of all health information and services to meet their specific needs. Those with low vision still rely on residual vision such that multimedia-based information which can be useful, but it should still be designed to ensure its accessibility, usability, and understandability.

  20. The effect of organisational resources and eligibility issues on transition from child and adolescent to adult mental health services.

    PubMed

    Belling, Ruth; McLaren, Susan; Paul, Moli; Ford, Tamsin; Kramer, Tami; Weaver, Tim; Hovish, Kimberly; Islam, Zoebia; White, Sarah; Singh, Swaran P

    2014-07-01

    To investigate the organisational factors that impede or facilitate transition of young people from child and adolescent (CAMHS) to adult mental health services (AMHS). Thirty-four semi-structured interviews were conducted with health and social care professionals working in child and adult services in four English NHS Mental Health Trusts and voluntary organisations. Data were analysed thematically using a structured framework. Findings revealed a lack of clarity on service availability and the operation of different eligibility criteria between child and adult mental health services, with variable service provision for young people with attention deficit hyperactivity disorder, autism spectrum disorders and learning disabilities. High workloads and staff shortages were perceived to influence service thresholds and eligibility criteria. A mutual lack of understanding of services and structures together with restrictive eligibility criteria exacerbated by perceived lack of resources can impact negatively on the transition between CAMHS and AMHS, disrupting continuity of care for young people. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  1. [Service use patterns among adults with mental health problems in Chile].

    PubMed

    Vicente, Benjamín; Kohn, Robert; Saldivia, Sandra; Rioseco, Pedro; Torres, Silverio

    2005-01-01

    To describe the patterns in the use of general health services and specialized health services among adults with mental health problems in Chile, as well as those persons' level of satisfaction with the services. The overall objective was to optimize the use of the limited resources available for mental health care in the countries of the Americas, especially Chile. The diagnoses and the patterns of use of mental health services were obtained from the Chilean Study of Psychiatric Prevalence (Estudio Chileno de Prevalencia Psiquiátrica). That representative research on the adult population of Chile was based on a stratified random sample of 2,987 people 15 years old and older, done over the period of 1992 to 1999. The psychiatric diagnoses were obtained using the Composite International Diagnostic Interview (CIDI). The interviewees were also asked about their use of general health care services and of mental health services in the preceding six months, as well as any barriers to accessing the services. More than 44% of the interviewees had had contact with some type of health service during the six months prior to the study, but only 5.6% received specialized care. Those who presented with a diagnosis of obsessive-compulsive disorder or of panic disorder consulted more frequently, but not in specialized centers. Consumption of substances such as alcohol and drugs as well as antisocial personality disorder were associated with a low level of consultation. When asked about sources of assistance for mental health problems, the majority of the interviewees mentioned only the formal health care system. More than 75% of the interviewees said that they were satisfied or very satisfied with the care that they had received. Our results confirm the existence of a wide gap between the need for care and the treatment that is actually received. The informal and folkloric alternative resources (priests, family members, healers, herbalists, etc.) were used less frequently than is

  2. Developing a Set of Uniform Outcome Measures for Adult Day Services.

    PubMed

    Anderson, Keith A; Geboy, Lyn; Jarrott, Shannon E; Missaelides, Lydia; Ogletree, Aaron M; Peters-Beumer, Lisa; Zarit, Steven H

    2018-06-01

    Adult day services (ADS) provide care to adults with physical, functional, and/or cognitive limitations in nonresidential, congregate, community-based settings. ADS programs have emerged as a growing and affordable approach within the home and community-based services sector. Although promising, the growth of ADS has been hampered by a lack of uniform outcome measures and data collection protocols. In this article, the authors detail a recent effort by leading researchers and practitioners in ADS to develop a set of uniform outcome measures. Based upon three recent efforts to develop outcome measures, selection criteria were established and an iterative process was conducted to debate the merits of outcome measures across three domains-participant well-being, caregiver well-being, and health care utilization. The authors conclude by proposing a uniform set of outcome measures to (a) standardize data collection, (b) aid in the development of programming, and (c) facilitate the leveraging of additional funding for ADS.

  3. Evaluation of a primary care adult mental health service: Year 2

    PubMed Central

    2013-01-01

    Aims This study aimed to examine the effectiveness of a primary care adult mental health service operating within a stepped care model of service delivery. Methods Supervised by a principal psychologist manager, psychology graduate practitioners provided one-to-one brief cognitive behavioural therapy (CBT) to service users. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) was used to assess service user treatment outcomes. Satisfaction questionnaires were administered to service users and referring general practitioners (GPs). Results A total of 43 individuals attended for an initial appointment, of whom 19 (44.2%) completed brief CBT treatment. Of the 13 service users who were in the clinical range pre-treatment, 11 (84.6%) achieved clinical and reliably significant improvement. Of the six service users who were in the non-clinical range pre-treatment, three (50%) achieved reliably significant improvement. Both service users and GPs indicated high levels of satisfaction with the service, although service accessibility was highlighted as needing improvement. Conclusion The service was effective in treating mild to moderate mental health problems in primary care. Stricter adherence to a stepped care model through the provision of low-intensity, high-throughput interventions would be desirable for future service provision. PMID:24381655

  4. Transfers and transitions between child and adult mental health services.

    PubMed

    Paul, Moli; Ford, Tamsin; Kramer, Tami; Islam, Zoebia; Harley, Kath; Singh, Swaran P

    2013-01-01

    Transfer of care from one healthcare provider to another is often understood as a suboptimal version of the process of transition. To separate and evaluate concepts of transfer and transition between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS). In a retrospective case-note survey of young people reaching the upper age boundary at six English CAMHS, optimal transition was evaluated using four criteria: continuity of care, parallel care, a transition planning meeting and information transfer. Of 154 cases, 76 transferred to AMHS. Failure to transfer resulted mainly from non-referral by CAMHS (n = 12) and refusal by service users (n = 12) rather than refusal by AMHS (n = 7). Four cases met all criteria for optimal transition, 13 met none; continuity of care (n = 63) was met most often. Transfer was common but good transition rare. Reasons for failure to transfer differ from barriers to transition. Transfer should be investigated alongside transition in research and service development.

  5. Contextual and individual factors associated with dental services utilisation by Brazilian adults: A multilevel analysis

    PubMed Central

    2018-01-01

    Background Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen’s behavioural model. Methods Individual-level data from 27,017 adults residents in the State capitals who were interviewed in the 2013 Brazilian National Health Survey were pooled with contextual city-level data. The outcomes were non-utilisation of dental services and last dental visit over 12 months ago. Individual predisposing variables were age, sex, race/skin colour, schooling and social network. Individual enabling variables included income, health insurance and registration in primary health care. Individual need variables were self-perceived dental health and self-reported missing teeth. Multilevel logistic regression models were performed to estimate odds ratio (OR) and 95% confidence intervals (95% CIs) of the association of contextual and individual predisposing, enabling and need-related variables with dental services outcomes. Results Predisposing (OR = 0.89; 95% CI 0.81–0.97) and enabling (OR = 0.90; 95% CI 0.85–0.96) contextual factors were associated with non-utilisation of dental services. Individual predisposing (sex, race/skin colour, schooling), enabling (income, health insurance) and need (self-perceived oral health, missing teeth) were associated with non-utilisation of dental services and last dental visit over 12 months ago. The latter was also associated with other individual predisposing (age, social network) and need (eating difficulties due to oral problems) characteristics. Conclusions Individual and contextual determinants influenced dental services utilisation in Brazilian adults. These factors should be on the policy agenda and considered in the organisation of health services aiming to reduce oral health inequalities related to access and utilisation of dental services

  6. Contextual and individual factors associated with dental services utilisation by Brazilian adults: A multilevel analysis.

    PubMed

    Herkrath, Fernando José; Vettore, Mario Vianna; Werneck, Guilherme Loureiro

    2018-01-01

    Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen's behavioural model. Individual-level data from 27,017 adults residents in the State capitals who were interviewed in the 2013 Brazilian National Health Survey were pooled with contextual city-level data. The outcomes were non-utilisation of dental services and last dental visit over 12 months ago. Individual predisposing variables were age, sex, race/skin colour, schooling and social network. Individual enabling variables included income, health insurance and registration in primary health care. Individual need variables were self-perceived dental health and self-reported missing teeth. Multilevel logistic regression models were performed to estimate odds ratio (OR) and 95% confidence intervals (95% CIs) of the association of contextual and individual predisposing, enabling and need-related variables with dental services outcomes. Predisposing (OR = 0.89; 95% CI 0.81-0.97) and enabling (OR = 0.90; 95% CI 0.85-0.96) contextual factors were associated with non-utilisation of dental services. Individual predisposing (sex, race/skin colour, schooling), enabling (income, health insurance) and need (self-perceived oral health, missing teeth) were associated with non-utilisation of dental services and last dental visit over 12 months ago. The latter was also associated with other individual predisposing (age, social network) and need (eating difficulties due to oral problems) characteristics. Individual and contextual determinants influenced dental services utilisation in Brazilian adults. These factors should be on the policy agenda and considered in the organisation of health services aiming to reduce oral health inequalities related to access and utilisation of dental services.

  7. Hearing loss and use of health services: a population-based cross-sectional study among Finnish older adults.

    PubMed

    Mikkola, Tuija M; Polku, Hannele; Sainio, Päivi; Koponen, Päivikki; Koskinen, Seppo; Viljanen, Anne

    2016-11-08

    Older adults with hearing difficulties face problems of communication which may lead to underuse of health services. This study investigated the association of hearing loss and self-reported hearing difficulty with the use of health services and unmet health care needs in older adults. Data on persons aged 65 and older (n = 2144) drawn from a population-based study, Health 2000, were analyzed. Hearing loss was determined with screening audiometry (n = 1680). Structured face-to-face interviews were used to assess self-reported hearing difficulty (n = 1962), use of health services (physician and nurse visits, health examinations, mental health services, physical therapy, health promotion groups, vision test, hearing test, mammography, PSA test) and perceived unmet health care needs. Multivariable logistic regression analyses were used. After adjusting for socio-economic and health-related confounders, persons with hearing loss (hearing level of better ear 0.5-2 kHz > 40 dB) were more likely to have used mental health services than those with non-impaired hearing (OR = 3.2, 95 % CI 1.3-7.9). Self-reported hearing difficulty was also associated with higher odds for mental health service use (OR = 2.1 95 % CI 1.2-3.5). Hearing was not associated with use of the other health services studied, except presenting for a hearing test. Persons with self-reported hearing difficulty were more likely to perceive unmet health care needs than those without hearing difficulty (OR = 1.7, 95 % CI 1.4-2.1). Older adults with hearing loss or self-reported hearing difficulty are as likely to use most health services as those without hearing loss. However, self-reported hearing difficulty is associated with experiencing unmet health care needs. Adequate health services should be ensured for older adults with hearing difficulties.

  8. Access to healthcare and financial risk protection for older adults in Mexico: secondary data analysis of a national survey

    PubMed Central

    Doubova, Svetlana V; Pérez-Cuevas, Ricardo; Canning, David; Reich, Michael R

    2015-01-01

    Objectives While the benefits of Seguro Popular health insurance in Mexico relative to no insurance have been widely documented, little has been reported on its effects relative to the pre-existing Social Security health insurance. We analyse the effects of Social Security and Seguro Popular health insurances in Mexico on access to healthcare of older adults, and on financial risk protection to their households, compared with older adults without health insurance. Setting Secondary data analysis was performed using the 2012 Mexican Survey of Health and Nutrition (ENSANUT). Participants The study population comprised 18 847 older adults and 13 180 households that have an elderly member. Outcome measures The dependent variables were access to healthcare given the reported need, the financial burden imposed by health expenditures measured through catastrophic health-related expenditures, and using savings for health-related expenditures. Separate propensity score matching analyses were conducted for each comparison. The analysis for access was performed at the individual level, and the analysis for financial burden at the household level. In each case, matching on a wide set of relevant characteristics was achieved. Results Seguro Popular showed a protective effect against lack of access to healthcare for older adults compared with those with no insurance. The average treatment effect on the treated (ATET) was ascertained through using the nearest-neighbour matching (−8.1%, t-stat −2.305) analysis. However, Seguro Popular did not show a protective effect against catastrophic expenditures in a household where an older adult lived. Social Security showed increased access to healthcare (ATET −11.3%, t-stat −3.138), and protective effect against catastrophic expenditures for households with an elderly member (ATET −1.9%, t-stat −2.178). Conclusions Seguro Popular increased access to healthcare for Mexican older adults. Social Security showed a significant

  9. Access to healthcare and financial risk protection for older adults in Mexico: secondary data analysis of a national survey.

    PubMed

    Doubova, Svetlana V; Pérez-Cuevas, Ricardo; Canning, David; Reich, Michael R

    2015-07-21

    While the benefits of Seguro Popular health insurance in Mexico relative to no insurance have been widely documented, little has been reported on its effects relative to the pre-existing Social Security health insurance. We analyse the effects of Social Security and Seguro Popular health insurances in Mexico on access to healthcare of older adults, and on financial risk protection to their households, compared with older adults without health insurance. Secondary data analysis was performed using the 2012 Mexican Survey of Health and Nutrition (ENSANUT). The study population comprised 18,847 older adults and 13,180 households that have an elderly member. The dependent variables were access to healthcare given the reported need, the financial burden imposed by health expenditures measured through catastrophic health-related expenditures, and using savings for health-related expenditures. Separate propensity score matching analyses were conducted for each comparison. The analysis for access was performed at the individual level, and the analysis for financial burden at the household level. In each case, matching on a wide set of relevant characteristics was achieved. Seguro Popular showed a protective effect against lack of access to healthcare for older adults compared with those with no insurance. The average treatment effect on the treated (ATET) was ascertained through using the nearest-neighbour matching (-8.1%, t-stat -2.305) analysis. However, Seguro Popular did not show a protective effect against catastrophic expenditures in a household where an older adult lived. Social Security showed increased access to healthcare (ATET -11.3%, t-stat -3.138), and protective effect against catastrophic expenditures for households with an elderly member (ATET -1.9%, t-stat -2.178). Seguro Popular increased access to healthcare for Mexican older adults. Social Security showed a significant protective effect against lack of access and catastrophic expenditures compared with

  10. Achieving sustainable ese of environment: a framework for payment for protected forest ecosystem service

    NASA Astrophysics Data System (ADS)

    Widicahyono, A.; Awang, S. A.; Maryudi, A.; Setiawan, M. A.; Rusdimi, A. U.; Handoko, D.; Muhammad, R. A.

    2018-04-01

    Over the last decade, deforestation in Indonesia has reduced the forest area down to more than 6 million hectares. There is conflict that the protected forest ecosystem service is still often perceived as public goods. Many of them went unrecognized in planning process and continue to be undervalued. The challenge lies in maintaining socioeconomic development and ecosystem services sustainability without overlooking the people’s opportunities and improving their livelihoods over the long term. An integrated approach is required to understand the comprehensive concept of protected forest ecosystem service. This research aims to formulate a scheme of payment for ecosystem service (PES) in a protected forest. It is a first step towards the attempt for the value of ecosystem services to be reflected in decision-making. Literatures, previous researches and secondary data are reviewed thoroughly to analyze the interrelated components by looking at the environment as a whole and recognize their linkages that have consequences to one another both positive and negative. The framework of implementation of PES schemes outlines the complexity of human-environment interconnecting relationships. It evaluates the contributing actors of different interest i.e. long term use and short term use. The concept of PES accommodates the fulfillment of both conservation and exploitation with an incentive scheme to the contributing parties who are willing to implement conservation and issuance of compensation expense for any exploitation means. The most crucial part in this concept is to have a good and effective communication between every policy makers concerning the forest ecosystem and local communities.

  11. The White Mountain Apache Child Protection Service Training Curriculum. Nohwii Chaghashe Baa da gontzaa (Protect Our Apache Children).

    ERIC Educational Resources Information Center

    Gonzalez-Santin, Edwin, Comp.

    This curriculum manual provides 8 days of training for child protective services (CPS) personnel (social workers and administrators) working in the White Mountain Apache tribal community. Each of the first seven units in the manual contains a brief description of contents, course objectives, time required, key concepts, possible discussion topics,…

  12. [Determining Factors in the Access to Mental Health Services by the Adult Colombian Population].

    PubMed

    González, Lina María; Peñaloza, Rolando Enrique; Matallana, María Alexandra; Gil, Fabián; Gómez-Restrepo, Carlos; Landaeta, Angela Patricia Vega

    2016-12-01

    Access to mental health services by people with mental disorders has traditionally been limited, and is associated with attitudinal, social, and structural variables. To analyse the factors that determine access to mental health services by the adult population (18-44 years old) in Colombia, from the results obtained in the 2015 National Mental Health Survey. Analysis of variables of access to attention in mental health care for adults. The reasons for not consulting were classified as barriers of behavioural supply and demand. To analyse the factors associated with access to mental health services in the Colombian adult population, the use of health services in the last 12 months for emotional, nervous or mental health problems was taken into account, as well as associated variables such as demographic characteristics, occupational activity, affiliation to social security, and health status variables. The relationships between these variables were estimated using bivariate multinomial logistic regression models. Rural residence, being married, and having a chronic disease were associated with the decision to consult or not to consult the doctor. Further studies should be conducted to evaluate the situation as regards mental health care access, as well as to determine the potential factors associated with these limitations. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  13. Client Violence and Its Negative Impacts on Work Attitudes of Child Protection Workers Compared to Community Service Workers

    ERIC Educational Resources Information Center

    Shin, Junseob

    2011-01-01

    This study investigated the prevalence of client violence toward child protection workers and its negative impacts on the work attitudes of those workers compared with community service workers in South Korea. This study is based on the assumption that child protection workers are more vulnerable to violence than are community service workers…

  14. Experiences and Outcomes of Transition from Pediatric to Adult Health Care Services for Young People with Congenital Heart Disease: A Systematic Review.

    PubMed

    Heery, Emily; Sheehan, Aisling M; While, Alison E; Coyne, Imelda

    2015-01-01

    This review synthesizes the empirical literature on outcomes and experiences of transfer and transition from pediatric to adult care for young people with congenital heart disease. A systematic review of papers published between January 2001 and May 2013 that examined outcomes or experiences of transfer and transition among young people with congenital heart disease was conducted. Data were extracted by two independent reviewers with the outcomes data combined using narrative synthesis and the experiences data integrated using thematic synthesis. Thirteen papers were included in the review: six reported outcomes following transfer, six reported experiences of transfer and transition, and one reported both outcomes and experiences. The review data indicate that high proportions of young people were lost to follow-up or experienced long gaps in care after leaving pediatric cardiology. Factors that protected against loss to follow-up or lapse in care included: beliefs that specialized adult care was necessary; poorer health status; attendance at pediatric appointments without parents; and pediatric referral to an adult congenital heart disease center. Data on experiences highlighted that many young people were unconcerned about transition, but lacked knowledge about their condition and were insufficiently prepared for transfer. In terms of adult services, many young people desired continuity in the quality of care, youth-oriented facilities, a personalized approach, and for their parents to remain involved in their care, but in a secondary, supportive capacity. In conclusion, the high proportions of young people lost to follow-up highlight the need for formal transition programs, which ensure a planned and coordinated transfer. Patients with congenital heart disease need education throughout adolescence about the implications of their condition, the differences between pediatric and adult services, and self-care management. © 2015 Wiley Periodicals, Inc.

  15. The exhausting dilemmas faced by home-care service providers when enhancing participation among older adults receiving home care.

    PubMed

    Vik, Kjersti; Eide, Arne H

    2012-09-01

    Older adults wish to stay at home, participate in society and manage on their own as long as possible. Many older adults will, however, eventually become dependent on care and help to maintain their daily living. Thus, to enhance activity and participation also among older adults that receive home-based services, there is a strong need for development of knowledge-based practice regarding participation. The specific aim of this study is to explore how service providers perceive that their working conditions influence on their possibilities to promote participation among older adults, and more specifically, how they perceive the influence of their working conditions. A purposeful sampling strategy was applied, and six focus groups with professionals in two municipalities were conducted. The focus groups comprised four and six participants of varying ages, length of working experience and professions. A total of 30 service providers participated. The data were analysed by a constant comparative method following the guidelines from Grounded Theory. The analysis identified the categories 'encountering needs that cannot be met', 'expectations about participation', 'organisation of services' and 'professional standards' influencing the service delivery. During this analytical process, 'being on the verge' emerged as a core category that describes the service providers' experience of a stressful workday, i.e. when they had the feeling of working against their own professional standards and being pushed to their limits. The findings indicate how the professional standards of service providers on the whole are in line with health policy for in-home services. Policy objectives are, however, not always followed owing to different constraints at the level of service delivery. Along the path from political ideals to the practical execution of services, external circumstances related to the organisation of services are perceived as crucial. © 2012 The Authors. Scandinavian

  16. Low-canopy seagrass beds still provide important coastal protection services.

    PubMed

    Christianen, Marjolijn J A; van Belzen, Jim; Herman, Peter M J; van Katwijk, Marieke M; Lamers, Leon P M; van Leent, Peter J M; Bouma, Tjeerd J

    2013-01-01

    One of the most frequently quoted ecosystem services of seagrass meadows is their value for coastal protection. Many studies emphasize the role of above-ground shoots in attenuating waves, enhancing sedimentation and preventing erosion. This raises the question if short-leaved, low density (grazed) seagrass meadows with most of their biomass in belowground tissues can also stabilize sediments. We examined this by combining manipulative field experiments and wave measurements along a typical tropical reef flat where green turtles intensively graze upon the seagrass canopy. We experimentally manipulated wave energy and grazing intensity along a transect perpendicular to the beach, and compared sediment bed level change between vegetated and experimentally created bare plots at three distances from the beach. Our experiments showed that i) even the short-leaved, low-biomass and heavily-grazed seagrass vegetation reduced wave-induced sediment erosion up to threefold, and ii) that erosion was a function of location along the vegetated reef flat. Where other studies stress the importance of the seagrass canopy for shoreline protection, our study on open, low-biomass and heavily grazed seagrass beds strongly suggests that belowground biomass also has a major effect on the immobilization of sediment. These results imply that, compared to shallow unvegetated nearshore reef flats, the presence of a short, low-biomass seagrass meadow maintains a higher bed level, attenuating waves before reaching the beach and hence lowering beach erosion rates. We propose that the sole use of aboveground biomass as a proxy for valuing coastal protection services should be reconsidered.

  17. MSFC Respiratory Protection Services

    NASA Technical Reports Server (NTRS)

    CoVan, James P.

    1999-01-01

    An overview of the Marshall Space Flight Center Respiratory Protection program is provided in this poster display. Respiratory protection personnel, building, facilities, equipment, customers, maintenance and operational activities, and Dynatech fit testing details are described and illustrated.

  18. Perspectives of intellectual disability in the People's Republic of China: epidemiology, policy, services for children and adults.

    PubMed

    Kwok, Henry W M; Cui, Yong; Li, Jing

    2011-09-01

    This review aims to provide an overview of the current status and recent developments in epidemiology, public policy and services for children and adults with intellectual disability in China. The most recent national survey on disability conducted in 2006 estimated that the prevalence of intellectual disability was 0.75% in China. People with intellectual disability accounted for 11.9% of all the people with disabilities and they have an uneven geographical distribution. The prevalence in urban areas was 0.4%, whereas that in rural areas was 1.02%. The Constitution of the People's Republic of China stated that people with disabilities have the right to receive assistance from the state and society. Based on this, laws have been formulated and revised to protect people with disabilities in areas of education, employment and rehabilitation. The variety, capacity and quality of services for people with intellectual disability are steadily increasing or improving, but there are still gaps and deficiencies such as mental health care and professional services. Supported by the Central Government of the People's Republic of China, there has been remarkable progress in the formulation of policies and provision of services for people with intellectual disability in recent years. However, there continue to be a lot of unmet needs among this population, particularly those living in rural areas. Therefore, further commitment, coordination and resource allocation are required to improve the lives of people with intellectual disability in China.

  19. Sirt1 Protects Stressed Adult Hematopoietic Stem Cells | Center for Cancer Research

    Cancer.gov

    The immune system relies on a stable pool of hematopoietic stem and progenitor cells (HSPCs) to respond properly to injury or stress. Maintaining genomic integrity and appropriate gene expression is essential for HSPC homeostasis, and dysregulation can result in myeloproliferative disorders or loss of immune function. Sirt1 is a histone deacetylase that can protect embryonic stem (ES) cells from accumulating DNA damage and has been linked to hematopoietic differentiation of ES cells. Satyendra Singh, Ph.D., a postdoctoral fellow working with Philipp Oberdoerffer, Ph.D., in CCR’s Laboratory of Receptor Biology and Gene Expression, and their colleagues set out to determine whether Sirt1 could play a similar protective role in adult HSPCs.

  20. Utilization of Clinical Preventive Services for Cancer and Heart Disease Among Insured Adults: United States, 2015.

    PubMed

    Vahratian, Anjel; Blumberg, Stephen J

    2017-03-01

    Data from the National Health Interview Survey •Two-thirds of insured adults aged 50-75 were screened for colorectal cancer within the recommended intervals. •Insured women aged 30-39 (90.5%) were more likely than their older peers to be screened for cervical cancer within the recommended intervals. •Seventy-three percent of insured women aged 50-74 had a mammogram in the past 2 years. •The percentage of insured adults who had a cardiovascular risk screening (blood pressure, blood sugar) within the recommended intervals significantly increased with advancing age for both men and women. Recent improvements in health insurance coverage (1) have been associated with improved access to health care (2-4) and increased utilization of preventive services (5). Most insurance plans are now required to cover specific clinical preventive services without copayment from the insured adult (6). This report presents the proportion of insured adults who received selected services that are recommended for the prevention or early detection of cancer and heart disease. Sex- and age-specific differences are examined. The age groups included in each chart vary because the selected preventive services are recommended for different age groups. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  1. 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…

  2. Timely and Needed Perspectives on Differential Response in Child Protective Services

    ERIC Educational Resources Information Center

    Ellett, Alberta J.

    2013-01-01

    This article is an invited commentary and analysis of the authors' completed systematic evaluation of Child Protective Services (CPS) differential response (DR) models. I write this commentary based on 25 years of public child welfare experience followed by 13 years as a social work professor and researcher. In their review of DR, the…

  3. Preventing Childhood Malaria in Africa by Protecting Adults from Mosquitoes with Insecticide-Treated Nets

    PubMed Central

    Killeen, Gerry F; Smith, Tom A; Ferguson, Heather M; Mshinda, Hassan; Abdulla, Salim; Lengeler, Christian; Kachur, Steven P

    2007-01-01

    Background Malaria prevention in Africa merits particular attention as the world strives toward a better life for the poorest. Insecticide-treated nets (ITNs) represent a practical means to prevent malaria in Africa, so scaling up coverage to at least 80% of young children and pregnant women by 2010 is integral to the Millennium Development Goals (MDG). Targeting individual protection to vulnerable groups is an accepted priority, but community-level impacts of broader population coverage are largely ignored even though they may be just as important. We therefore estimated coverage thresholds for entire populations at which individual- and community-level protection are equivalent, representing rational targets for ITN coverage beyond vulnerable groups. Methods and Findings Using field-parameterized malaria transmission models, we show that high (80% use) but exclusively targeted coverage of young children and pregnant women (representing <20% of the population) will deliver limited protection and equity for these vulnerable groups. In contrast, relatively modest coverage (35%–65% use, with this threshold depending on ecological scenario and net quality) of all adults and children, rather than just vulnerable groups, can achieve equitable community-wide benefits equivalent to or greater than personal protection. Conclusions Coverage of entire populations will be required to accomplish large reductions of the malaria burden in Africa. While coverage of vulnerable groups should still be prioritized, the equitable and communal benefits of wide-scale ITN use by older children and adults should be explicitly promoted and evaluated by national malaria control programmes. ITN use by the majority of entire populations could protect all children in such communities, even those not actually covered by achieving existing personal protection targets of the MDG, Roll Back Malaria Partnership, or the US President's Malaria Initiative. PMID:17608562

  4. Assessing the Relationship between Physical Illness and Mental Health Service Use and Expenditures among Older Adults from Racial/Ethnic Minority Groups

    PubMed Central

    Jimenez, Daniel E; Cook, Benjamin; Kim, Giyeon; Reynolds, Charles F.; Alegria, Margarita; Coe-Odess, Sarah; Bartels, Stephen J.

    2015-01-01

    Objective The association of physical illness and mental health service use in older adults from racial/ethnic minority groups is an important area of study given the mental and physical health disparities and the low use of mental health services in this population. The purpose of this study is to describe the impact of comorbid physical illness on mental health service use and expenditures in older adults; and to evaluate disparities in mental health service use and expenditures among a racially/ethnically diverse sample of older adults with and without comorbid physical illness. Methods Data were obtained from the Medical Expenditure Panel Survey (years 2004–2011). The sample included 1563 whites, 519 African-Americans, and 642 Latinos and (N=2,724) aged 65+ with probable mental illness. Using two-part generalized linear models, we estimated and compared mental health service use among those with and without a comorbid physical illness. Results Mental health service use was greater for older adults with comorbid physical illness compared to those without a comorbid physical illness. Once mental health services were accessed, no differences in mental health expenditures were found. Comorbid physical illness increased the likelihood of mental health service use in older whites and Latinos. However, the presence of a comorbidity did not impact racial/ethnic disparities in mental health service use. Conclusions This study highlighted the important role of comorbid physical illness as a potential contributor to using mental health services and suggests intervention strategies to enhance engagement in mental health services by older adults from racial/ethnic minority groups. PMID:25772763

  5. A Program for Counseling and Campus Support Services for African American and Latino Adult Learners

    ERIC Educational Resources Information Center

    Gary, Juneau Mahan; Kling, Beverly; Dodd, Betty N.

    2004-01-01

    This study describes counseling and support services for African American and Latino adult learners that reduce barriers to graduation. Procedures adapted traditional counseling by (a) using faculty counselors and (b) including gender-, culture-, and adult-based perspectives in individual and group counseling and peer support. Support relevant to…

  6. [Effects of Home Care Services Use by Older Adults on Family Caregiver Distress].

    PubMed

    Kim, Jiyeon; Kim, Hongsoo

    2016-12-01

    The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, χ² test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Presence of family caregiver distress was significantly associated with days of nurse visits (β=-.89, p=<.001) and home helper visits (β=-.53, p=.014). Level of caregiver distress was also significantly associated with days of nurse visits (β=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.

  7. Evaluation in the field of social services for minors: Measuring the efficacy of interventions in the Italian service for health protection and promotion.

    PubMed

    Iudici, Antonio; Gagliardo Corsi, Agnese

    2017-04-01

    This article presents the availment of a new Methodology for the efficacy evaluation of interventions in the field of social science: the Method of Computerized Textual Data Analysis (M.A.D.I.T.). In the beginning, we present some elements of the international and Italian legislation referred to the efficacy evaluation and about the child protection. Subsequently this work describes the process of efficacy evaluation of an intervention of minor protection delivered by a public Italian Service, the Minor and Family Service, MiFa. The MADIT Methodology is applied to the efficacy evaluation and it is interested in discursive repertoires, defined as "a linguistically intended mode of construction of finite reality". The aim of the research is to show, through the description of every step of the implementation of the Methodology based on text analysis, how is possible to notice if there are progress in the direction of the objective of intervention of child protection. The results describes how from a starting situation of "first appearance of psychiatric career" referred to the minor, the work of the psychologist of the Service MiFa has enabled to produce a shifting in the direction of objective of the intervention, that was "developing the competence of the minor to identify objectives". Through this work, we show how a rigorous methodology for assessing effectiveness may contribute to improve the quality of service of Minor Protection and may also be suitable for new fields of social science. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Access to Employee Wellness Programs and Use of Preventive Care Services Among U.S. Adults.

    PubMed

    Isehunwa, Oluwaseyi O; Carlton, Erik L; Wang, Yang; Jiang, Yu; Kedia, Satish; Chang, Cyril F; Fijabi, Daniel; Bhuyan, Soumitra S

    2017-12-01

    There is little research at the national level on access to employee wellness programs and the use of preventive care services. This study examined the use of seven preventive care services among U.S working adults with access to employee wellness programs. The study population comprised 17,699 working adults aged ≥18 years, obtained from the 2015 National Health Interview Survey. Multivariate logistic regression models examined the relationship between access to employee wellness programs and use of seven preventive care services: influenza vaccination, blood pressure check, diabetes check, cholesterol check, Pap smear test, mammogram, and colon cancer screening. Data analysis began in Fall 2016. Overall, 46.6% of working adults reported having access to employee wellness programs in 2015. Working adults with access to employee wellness programs had higher odds of receiving influenza vaccination (OR=1.57, 95% CI=1.43, 1.72, p<0.001), blood pressure check (OR=2.46, 95% CI=2.17, 2.78, p<0.001), diabetes check (OR=1.30, 95% CI=1.12, 1.50, p<0.001), cholesterol check (OR=1.48, 95% CI=1.33, 1.67, p<0.001), and mammogram (OR=1.57, 95% CI=1.24, 1.98, p<0.001). However, there was no significant difference between access to employee wellness programs and the use of Pap smear test and colon cancer screening services. Using a nationally representative sample of individuals, this study found a positive association between access to employee wellness programs and the use of preventive care services. The results support favorable policies to encourage implementing wellness programs in all worksites, especially those with <50 employees. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  9. 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.

  10. Use of health services by adult Latin American immigrants residing in Seville.

    PubMed

    González-López, José Rafael; Rodríguez-Gázquez, María de Los Ángeles; Lomas-Campos, María de Las Mercedes

    2014-01-01

    This work sought to describe the use of health services by adult Latin American immigrants from Seville. This was a descriptive cohort study with the participation of 190 adult Latin American immigrants from 25 to 44 years of age, residing in the city of Seville (Spain) in 2011. A self-report survey was applied. Within the past year, 67% of the individuals have visited a physician and 23% have attended nursing consultation. A total of 14% of the immigrants who called on a healthcare center reported that their experience was worse than that of others. La annual prevalence by accidents was: 10% domestic, 4% traffic-related and 9% occupational; nearly half these accidents justified emergency care or hospitalization due to their severity. The logistic regression model revealed that health services were used mostly by: women, those in poor self-perceived health status, those with secondary level of education, the elderly, and those who were single. The population studied presents adequate use of health services, although it would be recommendable to implement prevention activities by nurses in the immigrant's work and family environment to reduce the accident incidence described by this group.

  11. 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…

  12. Use of physical therapy services among middle-aged and older adults with multiple sclerosis.

    PubMed

    Finlayson, Marcia; Plow, Matthew; Cho, Chi

    2010-11-01

    There is limited understanding of the utilization of and perceived need for physical therapy services among middle-aged and older adults with multiple sclerosis (MS). The resulting knowledge gap compromises efforts for physical therapy service planning for this population. The purpose of this study was to examine the use of and need for physical therapy services in a sample of adults with MS living in the Midwestern United States. This was a cross-sectional, descriptive study. Data from telephone interviews with 1,065 people with MS, aged 45 to 90 years, were used for the study. A multinomial regression model was used to determine factors associated with use of physical therapy services (never, within the past year, more than a year ago). Logistic regression analysis examined factors associated with unmet needs for these services. Thirty-six percent of the sample reported never using physical therapy services, 33% reported using physical therapy services within the past year, and 31% reported using physical therapy services more than a year prior to the interview. Factors associated with recent use of physical therapy services included living in an urban or suburban community, deteriorating MS status, experiencing problems with spasticity (ie, hypertonicity), having difficulty moving inside the house, being hospitalized in the past 6 months, and seeing a family physician. These same factors were associated with unmet needs. Limitations Physical therapy service use was self-reported. Data were collected in 5 Midwestern states from people 45 years of age or older, which may limit generalizability. Factors associated with use of and need for physical therapy services reflect issues of access (geographical, referrals), MS status, and mobility difficulties.

  13. Text and Mobile Media Smoking Cessation Service for Young Adults in South Texas: Operation and Cost-Effectiveness Estimation.

    PubMed

    Ramirez, Amelie G; Chalela, Patricia; Akopian, David; Munoz, Edgar; Gallion, Kipling J; Despres, Cliff; Morales, Jafet; Escobar, Rodrigo; McAlister, Alfred L

    2017-07-01

    To realize the promising potential of services delivered via smart phones to help young adults quit smoking at a high level of cost-efficiency, we constructed a texting and mobile media system that was promoted in South Texas via social media advertising and other recruitment channels. During the 6-month service period described here, enrollments were achieved for 798 participants with a mean age of 29.3 years. Seven-month texted follow-up found that 21% (171) of the enrollees reported abstinence at that point. This is consistent with high rates of success found in studies of telephone counseling for young adults and confirms that text and mobile media service specifically designed for young adults provide a feasible and potentially cost-effective approach to promoting cessation.

  14. Transitioning adolescent and young adults with chronic disease and/or disabilities from paediatric to adult care services - an integrative review.

    PubMed

    Zhou, Huaqiong; Roberts, Pamela; Dhaliwal, Satvinder; Della, Phillip

    2016-11-01

    This paper aims to provide an updated comprehensive review of the research-based evidence related to the transitions of care process for adolescents and young adults with chronic illness/disabilities since 2010. Transitioning adolescent and young adults with chronic disease and/or disabilities to adult care services is a complex process, which requires coordination and continuity of health care. The quality of the transition process not only impacts on special health care needs of the patients, but also their psychosocial development. Inconsistent evidence was found regarding the process of transitioning adolescent and young adults. An integrative review was conducted using a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. A search was carried out using the EBSCOhost, Embase, MEDLINE, PsycINFO, and AustHealth, from 2010 to 31 October 2014. The key search terms were (adolescent or young adult) AND (chronic disease or long-term illness/conditions or disability) AND (transition to adult care or continuity of patient care or transfer or transition). A total of 5719 records were initially identified. After applying the inclusion criteria a final 61 studies were included. Six main categories derived from the data synthesis process are Timing of transition; Perceptions of the transition; Preparation for the transition; Patients' outcomes post-transition; Barriers to the transition; and Facilitating factors to the transition. A further 15 subcategories also surfaced. In the last five years, there has been improvement in health outcomes of adolescent and young adults post-transition by applying a structured multidisciplinary transition programme, especially for patients with cystic fibrosis and diabetes. However, overall patients' outcomes after being transited to adult health care services, if recorded, have remained poor both physically and psychosocially. An accurate tracking mechanism needs to be

  15. 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…

  16. Linking a research register to clinical records in older adults' mental health services: a mixed-methods study.

    PubMed

    Robotham, Dan; Evans, Joanne; Watson, Andrew; Perdue, Iain; Craig, Thomas; Rose, Diana; Wykes, Til

    2015-01-01

    Patients can provide consent to have their clinical records linked to a research register, a process known as consent for contact (C4C). There is evidence about how to engage people with mental illness in C4C, but nothing specific to older adults. This is a priority area for research (for example, dementia trials), although sign-up rates to C4C are lower than for younger populations. Through this study we seek to understand these disparities. This was a two-stage cross-sectional observational study. In phase one, focus groups with service users, carers and clinicians informed a framework for clinicians to explain C4C to those on their caseload. In phase two, clinicians explained C4C to 26 service users (and carers where applicable). These conversations were recorded, and their content was analysed. Service users and carers were then interviewed to provide further feedback on their conversations with clinicians. A total of 31 service users, 24 carers and 13 clinical staff took part across the two phases. In phase one, service users and carers sought assurance of the right to refuse participation in further studies (after joining C4C). Clinicians expressed concerns over legal and practical implications of ascertaining mental capacity and best interest. In phase two, clinicians' explanations were less thorough than similar explanations given to younger adults with psychosis. Clinicians omitted details of service users' right to stipulate contact arrangements, which was significantly associated with whether service users/carers agreed to join. Common reasons for joining C4C included altruism and the chance to speak to new people. Few participants refused to join, but reasons included avoidance of stress (potentially alleviated through the presence of a carer). Implementing C4C in older adults' services requires clinicians to deliver concise, simple explanations to individuals and their carers where applicable. Older adults can be suspicious of unsolicited contact; thus

  17. Children's Experiences of Domestic Violence: Developing an Integrated Response from Police and Child Protection Services

    ERIC Educational Resources Information Center

    Stanley, Nicky; Miller, Pam; Richardson Foster, Helen; Thomson, Gill

    2011-01-01

    Police notifications of incidents of domestic violence to child protection services constitute an acknowledgement of the harm that domestic violence inflicts on children. However, these notifications represent a substantial demand on child welfare services and the outcomes for children and victims of domestic violence have been questioned. This…

  18. The Relationship between Sun Protection Policy and Associated Practices in a National Sample of Early Childhood Services in Australia

    ERIC Educational Resources Information Center

    Ettridge, Kerry A.; Bowden, Jacqueline A.; Rayner, Joanne M.; Wilson, Carlene J.

    2011-01-01

    Limiting exposure to sunlight during childhood can significantly reduce the risk of skin cancer. This was the first national study to assess the sun protection policies and practices of early childhood services across Australia. It also examined the key predictors of services' sun protection practices. In 2007, 1017 respondents completed a…

  19. 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…

  20. Older Adults with Intellectual Disabilities: Targets for Increasing Victimization, a Call for a Preemptive Screening Policy

    ERIC Educational Resources Information Center

    Strasser, Sheryl; O'Quin, Karen; Price, Thomas; Leyda, Elizabeth

    2012-01-01

    The aging population is a rapidly growing demographic in the United States. Isolation, limited autonomy, and declining physical and mental health render many older adults vulnerable to abuse, neglect, and exploitation. As the population grows, so does the need for Adult Protective Services (APS). This article highlights an ultrasensitive subgroup…

  1. Protective Factors Against the Impact of School Bullying Perpetration and Victimization on Young Adult Externalizing and Internalizing Problems

    PubMed Central

    Hemphill, Sheryl A.; Tollit, Michelle; Herrenkohl, Todd I.

    2014-01-01

    School-based bullying perpetration and victimization is common worldwide and has profound impacts on student behavior and mental health. However, few studies have examined young adult outcomes of bullying perpetration or victimization. Research on factors that protect students who have bullied or been bullied is also lacking. This study examined young adult externalizing and internalizing problems (aged 18-19 years) and adolescent protective factors related to self-reported bullying perpetration and victimization among over 650 Victorians aged 16-17 years. Opportunities for prosocial involvement in the family lessened subsequent involvement in nonviolent antisocial behavior, as an outcome of prior bullying. High academic performance and having strategies to cope with stress reduced young adult depressive symptoms for participants who had been victims of bullying. The implications for bullying prevention and early intervention programs are discussed. PMID:25419190

  2. Corrosion protection service life of epoxy-coated reinforcing steel in Virginia bridge decks.

    DOT National Transportation Integrated Search

    2003-01-01

    The corrosion protection service life extension provided by epoxy-coated reinforcement (ECR) was determined by comparing ECR and bare steel bars from 10 Virginia bridge decks built between 1981 and 1995. The objective was to determine the corrosion p...

  3. 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…

  4. 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

    ... depending on whether the dependent's sponsor is active duty, retired or eligible under another plan such as... catastrophic caps upon purchasing TRICARE Young Adult coverage. Young adult dependents of members on active... services sponsor's status (active duty, retired, Selected Reserve, or Retired Reserve) and the availability...

  5. 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…

  6. 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

  7. Community service provider perceptions of implementing older adult fall prevention in Ontario, Canada: a qualitative study.

    PubMed

    Dykeman, Catherine S; Markle-Reid, Maureen F; Boratto, Lorna J; Bowes, Chris; Gagné, Hélène; McGugan, Jennifer L; Orr-Shaw, Sarah

    2018-02-01

    Despite evidence for effective fall prevention interventions, measurable reductions in older adult (≥ 65 years) fall rates remain unrealized. This study aimed to describe the perceived barriers to and effective strategies for the implementation of evidence-based fall prevention practices within and across diverse community organizations. This study is unique in that it included community service providers who are not generally thought to provide fall prevention services to older adults, such as retail business, community support, volunteer services, community foundations, recreation centres, and various emergency services. Interviews and focus groups were conducted with a purposive sampling of providers (n = 84) in varied roles within diverse community-based organizations across disparate geographical settings. Community service providers experience significant multi-level barriers to fall prevention within and across organizations and settings. The overall challenge of serving dispersed populations in adverse environmental conditions was heightened in northern rural areas. Barriers across the system, within organizations and among providers themselves emerged along themes of Limited Coordination of Communication, Restrictive Organizational Mandates and Policies, Insufficient Resources, and Beliefs about Aging and Falls. Participants perceived that Educating Providers, Working Together, and Changing Policies and Legislation were strategies that have worked or would work well in implementing fall prevention. An unintentional observation was made that several participants in this extremely varied sample identified expanded roles in fall prevention for themselves during the interview process. Community service providers experience disabling contexts for implementing fall prevention on many levels: their specific geography, their service systems, their organizations and themselves. A systemic lack of fit between the older adult and fall prevention services

  8. Measuring the Effectiveness of Routine Child Protection Services: The Results from an Evidence Based Strategy

    ERIC Educational Resources Information Center

    O'Brien, Michael

    2011-01-01

    Most of what is known about the effectiveness of child welfare is found in studies of specific programs. Little is known about the effectiveness of the routine services provided in child protection systems. Family and Children's Services of Renfrew County is a Canadian child welfare agency that decided to expand its mission beyond protecting…

  9. Cross-scale feedbacks and scale mismatches as influences on cultural services and the resilience of protected areas.

    PubMed

    Maciejewski, Kristine; De Vos, Alta; Cumming, Graeme S; Moore, Christine; Biggs, Duan

    2015-01-01

    Protected areas are a central strategy for achieving global conservation goals, but their continued existence depends heavily on maintaining sufficient social and political support to outweigh economic interests or other motives for land conversion. Thus, the resilience of protected areas can be considered a function of their perceived benefits to society. Nature-based tourism (NBT), a cultural ecosystem service, provides a key source of income to protected areas, facilitating a sustainable solution to conservation. The ability of tourism to generate income depends, however, on both the scales at which this cultural service is provided and the scales at which tourists respond to services on offer. This observation raises a set of location-, context-, and scale-related questions that need to be confronted before we can understand and value cultural service provision appropriately. We combine elements of resilience analysis with a systems ecology framework and apply this to NBT in protected areas to investigate cross-scale interactions and scale mismatches. We postulate that cross-scale effects can either have a positive effect on protected area resilience or lead to scale mismatches, depending on their interactions with cross-scale feedbacks. To demonstrate this, we compare spatial scales and nested levels of institutions to develop a typology of scale mismatches for common scenarios in NBT. In our new typology, the severity of a scale mismatch is expressed as the ratio of spatial scale to institutional level, producing 25 possible outcomes with differing consequences for system resilience. We predict that greater differences between interacting scales and levels, and greater magnitudes of cross-scale interactions, will lead to greater magnitudes of scale mismatch. Achieving a better understanding of feedbacks and mismatches, and finding ways of aligning spatial and institutional scales, will be critical for strengthening the resilience of protected areas that

  10. Protective connections and educational attainment among young adults with childhood-onset chronic illness.

    PubMed

    Maslow, Gary; Haydon, Abigail A; McRee, Annie-Laurie; Halpern, Carolyn T

    2012-08-01

    Youth with childhood-onset chronic illness (COCI) are at risk of poor educational attainment. Specific protective factors that promote college graduation in this population have not been studied previously. In this study, we examine the role protective factors during adolescence play in promoting college graduation among young adults with COCI. Data were collected from 10,925 participants in the National Longitudinal Study of Adolescent Health (Add Health). Protective factors present before 18 years of age included mentoring, parent relationship quality, school connectedness, and religious attendance. College graduation was the outcome of interest assessed when participants had a mean age of 28 years. Analysis was stratified by presence of COCI. About 2% of participants (N = 230) had 1 of 4 COCIs (cancer, diabetes, epilepsy, or heart disease). All 4 protective factors were associated with college graduation for youth without COCI. In the final multivariate model, only school connectedness was associated with college graduation for youth with COCI. School connectedness is of particular importance in promoting educational attainment for youth with COCI. © 2012, American School Health Association.

  11. 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…

  12. Relationship between health service use and health information technology use among older adults: analysis of the US National Health Interview Survey.

    PubMed

    Choi, Namkee

    2011-04-20

    Older adults are the most frequent and heaviest users of health services in the United States; however, previous research on older adults' use of health information technology (HIT) has not examined the possible association of HIT use among older adults with their use of health services. This study examined the relationship between US older adults' use of health services and their use of the Internet for health-related activities, controlling for socioeconomic characteristics and aging-related limitations in sensory and cognitive function. It also examined gender differences in the pattern of association between the types of health services used and HIT use. The data for this study were drawn from the 2009 US National Health Interview Survey (NHIS), which was the first nationally representative household survey to collect data on HIT (Internet) use. First, the rates of lifetime and 12-month HIT use among sample adults (n = 27,731) by age group (18-29 to 85 and over) were analyzed. Second, bivariate analysis of sociodemographic characteristics, health status, and health service use by HIT use status among those aged 65 or older (n = 5294) was conducted. Finally, multivariate binary logistic regression analysis was used to test the study hypotheses with 12-month HIT use as the dependent variable and 12-month health service uses among the age group 65 or older as possible correlates. The rates of HIT use were significantly lower among the age groups 65 or older compared with the younger age groups, although the age group 55 to 64 was not different from those younger. The rates of HIT use decreased from 32.2% in the age group 65 to 74 to 14.5% in the age group 75 to 84 and 4.9% in the 85 and older age group. For both genders, having seen or talked to a general practitioner increased the odds of HIT use. However, having seen or talked to a medical specialist, eye doctor, or physical therapist/occupational therapist (PT/OT) were significantly associated with HIT use only

  13. 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…

  14. Using Mobile Phone Technology to Support Young Liver Transplant Recipients Moving to Adult Services.

    PubMed

    Coad, Jane; Toft, Alex; Claridge, Lee; Ferguson, James; Hind, Jonathon; Jones, Rebecca; McClean, Patricia; McKiernan, Patrick; Samyn, Marianne; Taylor, Rachel

    2017-06-01

    The process and preparation of moving from child to adult services (transition) is a challenging period of time for young people and represents significant changes in care and support systems. The proliferation of mobile phone applications for health purposes suggests that it is an area for further investigation. The review explores the potential to use mobile phone technology to help support young liver transplant recipients moving to adult services. It represents the first review conducted in this specialism and considers a new model of support for young liver patients. A systematic rapid review of the published peer-reviewed literature. Two searches were conducted: Search 1: the use of technology to support transition to adult services (6 studies) and Search 2: how best to support liver transplant recipients during transition (6 studies). Research shows that to achieve positive transition young people need information about their condition and transition. The process needs to be guided by transition readiness, rather than the young persons' age. Although parents and support networks should be in place and are valued, transition should build upon self-management and independence. Results suggest that there appears to be scope to use mobile phone technology to support transition. This is the first time a review has explored the types of issues or concerns facing liver transplant patients and how these can be addressed through mobile phone technology.

  15. Perspectives of intellectual disability in Asia: epidemiology, policy, and services for children and adults.

    PubMed

    Jeevanandam, Lohsnah

    2009-09-01

    Given the scarcity of Asian literature on intellectual disability, the aim of this review article is to shed light on the epidemiology, policy, and services for children and adults with intellectual disability in Asia. The prevalence of intellectual disability across Asia appears to be consistent with western estimates at 0.06-1.3%, with the exception being China at 6.68%. In the only two studies of mental health conducted in Asia, the prevalence ranged from 4.4 to 48.3%. Some of the common physical health problems among Singaporean adults with intellectual disability are obesity, high blood pressure, and high blood cholesterol. All Asian countries/territories have at least one law or policy that promotes the well being of persons with disabilities, with Japan being the only country that has a law specifically enacted for persons with intellectual disability. Although there is an array of services being offered for children and adults with intellectual disability across south-east Asia, there is also a variation in the proportion of countries that offer these services. Overall, the challenge for Asia will be to develop a localized base of knowledge by conducting epidemiological studies, modeling after evidence-based practices, and evaluating its effectiveness. By adopting a scientific approach and formal publication of data, intellectual disability standards can be evaluated, managed, and improved in a systematic manner.

  16. Hanford radiological protection support services. Annual report for 1995

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lyon, M.; Bihl, D.E.; Carbaugh, E.H.

    1996-05-01

    Various Hanford Site radiation protection services provided by the Pacific Northwest National Laboratory for the U.S. Department of Energy Richland Operations Office and Hanford contractors are described in this annual report for calendar year 1995. These activities include external dosimetry measurements and evaluations, internal dosimetry measurements and evaluations, in vivo measurements, radiological record keeping, radiation source calibration, and instrument calibration and evaluation. For each of these activities, the routine program and any program changes or enhancements are described, as well as associated tasks, investigations, and studies. Program-related publications, presentations, and other staff professional activities are also described.

  17. Hanford radiological protection support services annual report for 1994

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lyon, M.; Bihl, D.E.; Fix, J.J.

    1995-06-01

    Various Hanford Site radiation protection services provided by the Pacific Northwest Laboratory for the US Department of Energy Richland Operations Office and Hanford contractors are described in this annual report for the calendar year 1994. These activities include external dosimetry measurements and evaluations, internal dosimetry measurements and evaluations, in vivo measurements, radiological record keeping, radiation source calibration, and instrument calibration and evaluation. For each of these activities, the routine program and any program changes or enhancements are described, as well as associated tasks, investigations, and studies. Program- related publications, presentations, and other staff professional activities are also described.

  18. Participation of Primary School Pupils Who Stay at Institution of Social Services and Child Protection Dormitories in Social Science Lessons

    ERIC Educational Resources Information Center

    Guven, Sibel; Sahin Taskin, Cigdem

    2008-01-01

    This research aims to understand to what extent primary school pupils who stay at the Institution of Social Services and Child Protection dormitories participate in social science lessons. Data were obtained from pupils staying at the Institution of Social Services and Child Protection dormitories and attending primary schools in Istanbul and…

  19. Depression and Its Correlates Among Older Adults Accessing Aging Services

    PubMed Central

    Richardson, Thomas M.; Friedman, Bruce; Podgorski, Carol; Knox, Kerry; Fisher, Susan; He, Hua; Conwell, Yeates

    2011-01-01

    Objectives To define the prevalence and correlates of depression among older adults receiving assessments by nonmedical community-based care managers at the point of entry to care and thus prior to provision of aging services. Our long-term goal is to inform development of collaborative care models for late life depression that incorporate Aging Services Providers. Methods Aging Services Provider Network (ASPN) clients receiving in-home assessments were administered the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition module for affective disorders and measures of depression symptom severity, alcohol use, physical health, functional status, social support, stressful life events, and religiosity. Engagement in mental healthcare was documented. Results Subjects (N = 378) were primarily white (84%) and women (69%) with household incomes under $1,750/month (62%). Half lived alone (48%). Their mean age was 77 years. Thirty-one percent had clinically significant depressive symptoms and 27% met criteria for a current major depressive episode, of which 61% were being treated with medication and 25% by a mental health provider. Nearly half (47%) had experienced one or more episodes of major depression during their lives. Disability, number of medical conditions, number and severity of recent stressful life events, low social support, and low religiosity were independently associated with current major depression. Conclusion Depressive illness was common among this sample of ASPN clients. Because ASPN care managers have expertise in managing many of the problems correlated with depression, they may play a significant role in identifying, preventing, and collaborating in the treatment of depressive illnesses among community-dwelling older adults. PMID:22434017

  20. 22 CFR 102.13 - Protective services with respect to deceased victims of accidents.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... victims of accidents. 102.13 Section 102.13 Foreign Relations DEPARTMENT OF STATE ECONOMIC AND OTHER FUNCTIONS CIVIL AVIATION United States Aircraft Accidents Abroad § 102.13 Protective services with respect to deceased victims of accidents. (a) Interim disposition of remains. Generally, local authorities...

  1. 22 CFR 102.13 - Protective services with respect to deceased victims of accidents.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... victims of accidents. 102.13 Section 102.13 Foreign Relations DEPARTMENT OF STATE ECONOMIC AND OTHER FUNCTIONS CIVIL AVIATION United States Aircraft Accidents Abroad § 102.13 Protective services with respect to deceased victims of accidents. (a) Interim disposition of remains. Generally, local authorities...

  2. Adult College Career Employment Support Services: ACCESS. Emeritus Career and Vocational Exploration.

    ERIC Educational Resources Information Center

    McGrew, Lee

    A part of the Adult College Career Employment Support Services (ACCESS), the minicourse entitled Emeritus Career and Vocational Exploration has been designed to facilitate the entry or reentry of older persons into the work force as paid or volunteer workers. Organized into two four-week modules, the course offers participants assistance in…

  3. 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.

  4. Youth and young adults with spina bifida: their utilization of physician and hospital services.

    PubMed

    Young, Nancy L; Anselmo, Lianne A; Burke, Tricia A; McCormick, Anna; Mukherjee, Shubhra

    2014-03-01

    To describe current patterns of health care utilization of youth and young adults who have spina bifida (SB) and provide evidence to guide the development of health care for this growing population. We conducted a secondary analysis of health services utilization data from the Canadian Institute for Health Information to determine the rates and patterns of health care utilization, because comprehensive health care has been recognized as critical to positive health outcomes. Participants were identified from 6 publicly funded children's treatment centers. Health records from youth (n=164; age range, 13.0-17.9y) and adults (n=120; age range, 23.0-32.9y) with SB contributed to this study. Not applicable. The rates of outpatient physician visits and hospital admissions for the youth and adult groups were calculated. The proportion with a "medical home" was also calculated. The annual rates of outpatient physician visits per 1000 persons were 8031 for youth and 8524 for adults with SB. These rates were approximately 2.9 and 2.2 times higher, respectively, than for their age-matched peers. On average, 12% of youth and 24% of adults with SB had a medical home. The annual rates of hospital admissions per 1000 persons were 329 for youth and 285 for adults with SB. Rates of admissions were 19.4 and 12.4 times higher, respectively, for these groups than for the general population. It appears that persons with SB are accessing health services more often than their age-matched peers, and few have a medical home. We recommend that seamless medical care be provided to all adults with SB, coordinated by a primary care provider, to facilitate comprehensive care. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  5. Sunburn and sun protective behaviors among adults aged 18-29 years--United States, 2000-2010.

    PubMed

    2012-05-11

    Skin cancer is an important public health concern. Nonmelanoma skin cancers, comprised mainly of basal cell carcinoma and squamous cell carcinoma, are the most common malignancies in the United States. Melanoma, although less common, is the deadliest form of skin cancer. Both melanoma and nonmelanoma skin cancers can be disfiguring, negatively affect quality of life, and create economic burden. Furthermore, age-adjusted incidence rates of both have increased in recent years. Different patterns of sun exposure are associated with different types of skin cancer. Continuous, chronic sun exposure, such as that observed among outdoor workers is associated with squamous cell carcinoma. Intermittent exposure, such as recreational exposure, is associated with melanoma and basal cell carcinoma. Sunburn typically occurs after intermittent exposure, and the risk for melanoma increases with an increasing number of sunburns during all periods of life. Sunburn is more common among persons aged 18-29 years compared with older adults. To evaluate trends in sunburn and sun protective behaviors among persons aged 18-29 years, CDC and the National Cancer Institute analyzed data from the 2000, 2003, 2005, 2008, and 2010 National Health Interview Survey (NHIS). The results indicated that although protective behaviors such as sunscreen use, shade use, and wearing long clothing to the ankles have increased in recent years, sunburn prevalence remains high, with 50.1% of all adults and 65.6% of whites aged 18-29 years reporting at least one sunburn in the past 12 months. These results suggest that additional efforts are needed to identify and implement effective strategies targeting younger adults to improve their sun protective behaviors and prevent sunburn and ultimately skin cancer.

  6. Leg preference associated with protective stepping responses in older adults.

    PubMed

    Young, Patricia M; Whitall, Jill; Bair, Woei-Nan; Rogers, Mark W

    2013-10-01

    Asymmetries in dynamic balance stability have been previously observed. The goal of this study was to determine whether leg preference influenced the stepping response to a waist-pull perturbation in older adult fallers and non-fallers. 39 healthy, community-dwelling, older adult (>65 years) volunteers participated. Participants were grouped into non-faller and faller cohorts based on fall history in the 12 months prior to the study. Participants received 60 lateral waist-pull perturbations of varying magnitude towards their preferred and non-preferred sides during quiet standing. Outcome measures included balance tolerance limit, number of recovery steps taken and type of recovery step taken for perturbations to each side. No significant differences in balance tolerance limit (P ≥ 0.102) or number of recovery steps taken (η(2)partial ≤ 0.027; P ≥ 0.442) were observed between perturbations towards the preferred and non-preferred legs. However, non-faller participants more frequently responded with a medial step when pulled towards their non-preferred side and cross-over steps when pulled towards their preferred side (P=0.015). Leg preference may influence the protective stepping response to standing balance perturbations in older adults at risk for falls, particularly with the type of recovery responses used. Such asymmetries in balance stability recovery may represent a contributing factor for falls among older individuals and should be considered for rehabilitation interventions aimed at improving balance stability and reducing fall risk. © 2013.

  7. Leg preference associated with protective stepping responses in older adults

    PubMed Central

    Young, Patricia M.; Whitall, Jill; Bair, Woei-Nan; Rogers, Mark W.

    2014-01-01

    Background Asymmetries in dynamic balance stability have been previously observed. The goal of this study was to determine whether leg preference influenced the stepping response to a waist-pull perturbation in older adult fallers and non-fallers. Methods 39 healthy, community-dwelling, older adult (>65 years) volunteers participated. Participants were grouped into non-faller and faller cohorts based on fall history in the 12 months prior to the study. Participants received 60 lateral waist-pull perturbations of varying magnitude towards their preferred and non-preferred sides during quiet standing. Outcome measures included balance tolerance limit, number of recovery steps taken and type of recovery step taken for perturbations to each side. Findings No significant differences in balance tolerance limit (P ≥ 0.102) or number of recovery steps taken (η2partial ≤ 0.027; P ≥ 0.442) were observed between perturbations towards the preferred and non-preferred legs. However, non-faller participants more frequently responded with a medial step when pulled towards their non-preferred side and cross-over steps when pulled towards their preferred side (P = 0.015). Interpretation Leg preference may influence the protective stepping response to standing balance perturbations in older adults at risk for falls, particularly with the type of recovery responses used. Such asymmetries in balance stability recovery may represent a contributing factor for falls among older individuals and should be considered for rehabilitation interventions aimed at improving balance stability and reducing fall risk. PMID:23962655

  8. 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…

  9. 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 Dislocated...

  10. 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 Dislocated...

  11. 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 Dislocated...

  12. 3 CFR - Ensuring the Uniformed Services Employment and Reemployment Rights Act (USERRA) Protections

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... representatives from: (i) the Department of Defense; (ii) the Department of Justice; (iii) the Department of Labor...) The Department of Defense and the Office of Personnel Management shall work together to improve data...) Protections Memorandum for the Heads of Executive Departments and Agencies The Uniformed Services Employment...

  13. Antibiotic use among older adults on an acute care general surgery service

    PubMed Central

    Pollmann, André S.; Bailey, Jon G.; Davis, Philip J.B.; Johnson, Paul M.

    2017-01-01

    Background Antibiotics play an important role in the treatment of many surgical diseases that affect older adults, and the potential for inappropriate use of these drugs is high. Our objective was to describe antibiotic use among older adults admitted to an acute care surgery service at a tertiary care teaching hospital. Methods Detailed data regarding diagnosis, comorbidities, surgery and antibiotic use were retrospectively collected for patients 70 years and older admitted to an acute care surgery service. We evaluated antibiotic use (perioperative prophylaxis and treatment) for appropriateness based on published guidelines. Results During the study period 453 patients were admitted to the acute care surgery service, and 229 underwent surgery. The most common diagnoses were small bowel obstruction (27.2%) and acute cholecystitis (11.0%). In total 251 nonelective abdominal operations were performed, and perioperative antibiotic prophylaxis was appropriate in 49.5% of cases. The most common prophylaxis errors were incorrect timing (15.5%) and incorrect dose (12.4%). Overall 206 patients received treatment with antibiotics for their underlying disease process, and 44.2% received appropriate first-line drug therapy. The most common therapeutic errors were administration of second- or third-line antibiotics without indication (37.9%) and use of antibiotics when not indicated (12.1%). There was considerable variation in the duration of treatment for patients with the same diagnoses. Conclusion Inappropriate antibiotic use was common among older patients admitted to an acute care surgery service. Quality improvement initiatives are needed to ensure patients receive optimal care in this complex hospital environment. PMID:28930045

  14. Utilization of oral health care services among adults attending community outreach programs.

    PubMed

    Kadaluru, Umashankar Gangadhariah; Kempraj, Vanishree Mysore; Muddaiah, Pramila

    2012-01-01

    Good oral health is a mirror of overall health and well-being. Oral health is determined by diet, oral hygiene practices, and the pattern of dental visits. Poor oral health has significant social and economic consequences. Outreach programs conducted by dental schools offer an opportunity for early diagnosis and treatment, dental health education, and institution of preventive measures. To assess the utilization of oral healthcare services among adults attending outreach programs. This study included 246 adults aged 18-55 years attending community outreach programs in and around Bangalore. Using a questionnaire we collected data on dental visits, perceived oral health status, reasons for seeking care, and barriers in seeking care. Statistical significance was assessed using the Chi-square test. In this sample, 28% had visited the dentist in the last 12 months. Males visited dentist more frequently than females. The main reason for a dental visit was for tooth extraction (11%), followed by restorative and endodontic treatment 6%. The main barriers to utilization of dental services were high cost (22%), inability to take time off from child care duties (19.5%), and fear of the dentist or dental tools (8.5%). The utilization of dental services in this population was poor. The majority of the dental visits were for treatment of acute symptoms rather than for preventive care. High cost was the main barrier to the utilization of dental services. Policies and programs should focus on these factors to decrease the burden of oral diseases and to improve quality of life among the socioeconomically disadvantaged.

  15. A Feminist Analysis of the Voices for Advocacy in Young Adult Services.

    ERIC Educational Resources Information Center

    Hannigan, Jane Anne

    1996-01-01

    This article is a study of six women and their contributions to young adult services in public libraries: Mabel Williams, Margaret Scoggin, Jean Carolyn Roos, Margaret A. Edwards, Dorothy M. Broderick, and Mary K. Chelton. The feminist perspective employed focuses on the voices of these women as advocates for young people. Contains 63 references.…

  16. 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…

  17. 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

  18. 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.

  19. Disparities in Unmet Service Needs Among Adults with Intellectual and Other Developmental Disabilities.

    PubMed

    Burke, Meghan M; Heller, Tamar

    2017-09-01

    Due to long waiting lists for services, many adults with intellectual and developmental disabilities in the United States have unmet service needs. Little research, however, has identified the characteristics of caregivers and individuals with intellectual and developmental disabilities that relate to the unmet service needs among individuals who are waiting for services. The present authors conducted a statewide mail survey of 234 caregivers of individuals with intellectual and developmental disabilities who were waiting for services. The present authors identified which parent and individual with intellectual and developmental disability characteristics were significantly associated with the number of unmet service needs. Individuals with intellectual and developmental disabilities who were in poor health, from minority backgrounds and non-verbal were significantly more likely to have a greater number of unmet service needs. Additionally, individuals with younger caregivers and individuals with caregivers from low-income backgrounds were significantly more likely to report a greater number of unmet service needs. Implications for research and policy are discussed. © 2016 John Wiley & Sons Ltd.

  20. Guidelines for the development of social marketing programmes for sun protection among adolescents and young adults.

    PubMed

    Johnson, K M; Jones, S C; Iverson, D

    2009-09-01

    To formulate 'best practice' guidelines for social marketing programmes for adolescents' and young adults' sun protection. A Delphi consensus process. Eleven experts in sun protection and social marketing participated in a Delphi consensus process, where they were asked to provide up to 10 key points, based on their knowledge and practical experience, which they felt were most important in developing social marketing interventions for the primary prevention of skin cancer among adolescents and young adults. After reaching consensus, the evidence base for each guideline was determined and graded via the Scottish Intercollegiate Guideline Network grading system. Participants were then asked to indicate how strongly they rated the finalized 15 recommendations based on all aspects relating to their knowledge and practical opinion, as well as the research evidence, on a visual analogue scale. The resultant 15 guidelines offer general principles for sun protection interventions utilizing a social marketing approach. This method of guideline development brought the expertise of practitioners to the forefront of guideline development, whilst still utilizing established methods of evidence confirmation. It thus offers a useful method for guideline development in a public health context.

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

    PubMed Central

    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.

    2017-01-01

    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. PMID:28011064

  2. Self-rated oral health status, oral health service utilization, and oral hygiene practices among adult Nigerians.

    PubMed

    Olusile, Adeyemi Oluniyi; Adeniyi, Abiola Adetokunbo; Orebanjo, Olufemi

    2014-11-27

    There is scarce information available on oral health service utilization patterns and common oral hygiene practices among adult Nigerians. We conducted the 2010-2011 national oral health survey before the introduction of the national oral health policy to determine the prevalence of oral health service utilization, patterns of oral hygiene practices, and self reported oral health status, among adults in various social classes, educational strata, ethnic groups and geopolitical zones in Nigeria. We conducted a cross-sectional survey in North-Central, North-West, South-East, South-South and South-West geopolitical zones of Nigeria. Multi-stage cluster sampling method was used for the sample selection. We administered a structured questionnaire to a total of 7,630 participants. Information on the socio-demographic characteristics, oral hygiene practices and oral health services utilization pattern of participants was obtained. We interviewed 7, 630 participants (55.6% female). The participants ages ranged between 18 and 81 years, mean age was 37.96 (SD = 13.2). Overall 21.2% of the participants rated their oral health status as very good, 37.1% as good and 27.4% as fair. Only 26.4% reported having visited the dentist at least once prior to the conduct of the survey. More than half of these visits (54.9%) were for treatment purpose. Utilization of oral health services was significantly (p < 0.05) associated with being older, more educated and being engaged in a skilled profession. More educated persons, females and younger persons used toothbrushes for daily tooth cleaning. Age, sex, marital status, level of education and occupation were significantly related to daily frequency of tooth cleaning (p < 0.05). Our results show that while most Nigerian adults have a positive view of their oral health status, majority reported poor oral health utilization habits. Older persons resident in the northern zones of the country and less educated persons displayed

  3. Oral health status and dental service use of adults with learning disabilities living in residential institutions and in the community.

    PubMed

    Tiller, S; Wilson, K I; Gallagher, J E

    2001-09-01

    To investigate the oral health status of adults on Sheffield's Learning Disability Case Register, and their reported use of dental services. A short questionnaire interview of subjects with learning disabilities or their carers followed by a standardised epidemiological examination, by one trained and calibrated examiner. Residential homes, day centres or community homes of people with learning disabilities in Sheffield. A 20% random sample of adults (18-65 years) on the register. A response rate of 209 (67%) was achieved, 62% (n=130) of whom were living in the community. People living in residential care were significantly older (43.2 years) than those based in the community (36.3 years) (P<0.05). Both groups had similar mean DMFT scores; however, adults living in the community had significantly more untreated decay (DT = 1.6) and poorer oral hygiene than their counterparts in residential care (DT = 0.7). Adults in residential care had significantly more missing teeth (MT = 10.1) than those in community care (MT = 7.5). General and community dental services were the main providers of dental care. Subjects living in the community were significantly less likely to have a dentist and to use community dental services than their residential counterparts; they were more likely to attend only when having trouble. Adults with learning disabilities living in the community have greater unmet oral health needs than their residential counterparts and are less likely to have regular contact with dental services. Commissioners and providers of dental services have a responsibility to ensure that the health of adults with learning disabilities is not compromised by 'normalisation'.

  4. Effectiveness of a Parent Training Program "Incredible Years" in a Child Protection Service

    ERIC Educational Resources Information Center

    Letarte, Marie-Josee; Normandeau, Sylvie; Allard, Julie

    2010-01-01

    Objective: This study aims to evaluate the effectiveness of a parent training program in improving parenting practices, parents' feeling of self-efficacy and parents' perception of their child's behavior, implemented in a child protection service, with trained professionals from the agency acting as facilitators. Method: Thirty-five parents…

  5. National Characteristics of Emergency Medical Services Responses for Older Adults in the United States.

    PubMed

    Duong, Hieu V; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E

    2018-01-01

    Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses. We defined older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71-1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96-1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96-3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00-2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

  6. Study of Federal Funding Sources and Services for Adult Education. Final Report.

    ERIC Educational Resources Information Center

    Alamprese, Judith A.; Sivilli, June S.

    This report from phase 1 of a two-phase study conducted during 1989-1991 reviews 85 programs in 12 federal agencies that authorize the expenditure of funds for adult education services. The impetus for this study was the requirement in Section 6214 of the Hawkins-Stafford Elementary and Secondary School Improvement Amendments of 1988. Data were…

  7. The protective role of ethnic and racial identity and aspects of an Africentric orientation against drug use among African American young adults.

    PubMed

    Brook, Judith S; Pahl, Kerstin

    2005-09-01

    In this study, the authors examined (a) the protective potential of multiple components of ethnic and racial identity and (b) the aspects of an Africentric orientation for moderating psychobehavioral risk and protective factors for drug use among a sample of 333 urban low-income African American young adults. Ethnic and racial identity and Africentric variables moderated the relationship between psychobehavioral variables and drug stage in 32.5% of the cases. Ethnic and racial identity and Africentric values for African American young adults seemed to be important as moderators of the association between psychobehavioral factors and young adult drug use. The authors suggested implications for future research and interventions.

  8. Performance of the measures of processes of care for adults and service providers in rehabilitation settings.

    PubMed

    Bamm, Elena L; Rosenbaum, Peter; Wilkins, Seanne; Stratford, Paul

    2015-01-01

    In recent years, client-centered care has been embraced as a new philosophy of care by many organizations around the world. Clinicians and researchers have identified the need for valid and reliable outcome measures that are easy to use to evaluate success of implementation of new concepts. The current study was developed to complete adaptation and field testing of the companion patient-reported measures of processes of care for adults (MPOC-A) and the service provider self-reflection measure of processes of care for service providers working with adult clients (MPOC-SP(A)). A validation study. In-patient rehabilitation facilities. MPOC-A and measure of processes of care for service providers working with adult clients (MPOC-SP(A)). Three hundred and eighty-four health care providers, 61 patients, and 16 family members completed the questionnaires. Good to excellent internal consistency (0.71-0.88 for health care professionals, 0.82-0.90 for patients, and 0.87-0.94 for family members), as well as moderate to good correlations between domains (0.40-0.78 for health care professionals and 0.52-0.84 for clients) supported internal reliability of the tools. Exploratory factor analysis of the MPOC-SP(A) responses supported the multidimensionality of the questionnaire. MPOC-A and MPOC-SP(A) are valid and reliable tools to assess patient and service-provider accounts, respectively, of the extent to which they experience, or are able to provide, client-centered service. Research should now be undertaken to explore in more detail the relationships between client experience and provider reports of their own behavior.

  9. Unmet need for disability-related health care services and employment status among adults with disabilities in the Massachusetts Medicaid program.

    PubMed

    Henry, Alexis D; Long-Bellil, Linda; Zhang, Jianying; Himmelstein, Jay

    2011-10-01

    The employment rate among adults with disabilities is significantly lower than that among adults without disabilities. Ensuring access to rehabilitative and other health care services may help to address health-related barriers to employment for working-age people with disabilities. This study examined the relationship of unmet need for 6 disability-related health care services to current employment status among working-age adults with disabilities enrolled in the Massachusetts Medicaid (MassHealth Standard) program. Study participants included 436 MassHealth Standard members aged 19 to 64 who responded to the 2005/2006 MassHealth Employment and Disability Survey. Variables included members' demographic characteristics; Medicaid health plan and Medicare enrollment; members' self-report of potentially disabling conditions and current health status; access to health care as well as need and unmet need for 6 specific disability-related health care services (medications, mental health services, substance abuse services, medical supplies, durable medical equipment, personal assistance services); and current employment status. Fifteen percent of members reported currently working. Logistic regression analysis showed that (controlling for demographics, disability, health status, and other factors) members with greater unmet need were significantly less likely to be working (odds ratio = 0.58; 95% confidence interval = 0.33 to 0.99). Members' experience of unmet need was significantly greater for physical health services (supplies, durable medical equipment, personal assistance services) than for behavioral health services (mental health and substance abuse services) or medications. Working members generally rated services as important to work. Approximately 10% to 22% of nonworking members thought they would be able to work if needs were met. Meeting unmet needs for disability-related health care services may result in modest increases in employment among certain working

  10. Related factors and use of free preventive health services among adults with intellectual disabilities in Taiwan

    PubMed Central

    2014-01-01

    Background This study aimed to investigate the utilization of preventive health services in the adults with intellectual disabilities from the nationwide database. Methods The research method of this study is secondary data analysis. The data was obtained from three nationwide databases from 2006 to 2008. This study employed descriptive statistics to analyze the use and rate of preventive health services by intellectual disabled adults. Chi-square test was used to determine the relationship between the utilization of preventive health services and these variables. Multivariate logistic regression analysis was used to explore the factors that affect intellectual disabled adults’ use of preventive health services. Results Our findings indicated 16.65% of people with intellectual disabilities aged over 40 years used the preventive health services. Females were more frequent users than males (18.27% vs. 15.21%, p <0.001). The utilization rate decreased with increasing severity of intellectual disabilities. The utilization was lowest (13.83%) for those with very severe disability, whereas that was the highest (19.38%) for those with mild severity. The factors significantly influencing utilization of the services included gender, age, and marital status, urbanization of resident areas, monthly payroll, low-income household status, catastrophic illnesses status and relevant chronic diseases and severity of disability. Conclusions Although Taiwan’s Health Promotion Administration (HPA) has provided free preventive health services for more than 15 years, people with intellectual disabilities using preventive health care tend to be low. Demographics, economic conditions, health status, relevant chronic diseases, environmental factor, and severity of disability are the main factors influencing the use of preventive healthcare. According to the present findings, it is recommended that the government should increase the reimbursement of the medical staff performing health

  11. 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

    2017-09-01

    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.

  12. 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:…

  13. Unmet need for healthcare services in adolescents and young adults with cancer and their parent carers.

    PubMed

    Sawyer, Susan M; McNeil, Robyn; McCarthy, Maria; Orme, Lisa; Thompson, Kate; Drew, Sarah; Dunt, David

    2017-07-01

    Cancer in adolescents in and young adults (AYA) has the potential to disrupt health, well-being and developmental trajectories. This study aimed to describe the healthcare support service needs of AYAs with cancer and parent carers and to explore the association of unmet need and emotional distress. As part of a national Australian survey of 15-25 year olds with cancer and a nominated parent carer, 196 AYAs reported total and unmet need for 10 clinical services and 204 parents reported on their child's and their own healthcare service needs. Proportions of total and unmet need for specific clinical services are reported. The association of unmet service needs and distress (measured using the Posttraumatic Stress Disorder Checklist) was also examined. AYAs and parent carers expressed high total need for clinical services during treatment. Leading AYA unmet needs were for an exercise therapist (37%), genetic counsellor (30%), dietitian (26%), peer support group (26%) and educational and vocational advisor (24%). After treatment, AYAs and parents had fewer total needs. However, 60% of AYA and 38% of parents had two or more unmet needs, similar to during treatment. Female gender and receiving treatment in an adult setting were significantly associated with unmet need for clinical services. After treatment, higher distress levels in AYAs and parents were associated with two or more unmet service needs. AYAs and parents had high levels of total and unmet service need, which were associated with greater emotional distress. These results highlight opportunities to re-orientate services to better meet AYA and parent needs.

  14. Quantifying causal mechanisms to determine how protected areas affect poverty through changes in ecosystem services and infrastructure.

    PubMed

    Ferraro, Paul J; Hanauer, Merlin M

    2014-03-18

    To develop effective environmental policies, we must understand the mechanisms through which the policies affect social and environmental outcomes. Unfortunately, empirical evidence about these mechanisms is limited, and little guidance for quantifying them exists. We develop an approach to quantifying the mechanisms through which protected areas affect poverty. We focus on three mechanisms: changes in tourism and recreational services; changes in infrastructure in the form of road networks, health clinics, and schools; and changes in regulating and provisioning ecosystem services and foregone production activities that arise from land-use restrictions. The contributions of ecotourism and other ecosystem services to poverty alleviation in the context of a real environmental program have not yet been empirically estimated. Nearly two-thirds of the poverty reduction associated with the establishment of Costa Rican protected areas is causally attributable to opportunities afforded by tourism. Although protected areas reduced deforestation and increased regrowth, these land cover changes neither reduced nor exacerbated poverty, on average. Protected areas did not, on average, affect our measures of infrastructure and thus did not contribute to poverty reduction through this mechanism. We attribute the remaining poverty reduction to unobserved dimensions of our mechanisms or to other mechanisms. Our study empirically estimates previously unidentified contributions of ecotourism and other ecosystem services to poverty alleviation in the context of a real environmental program. We demonstrate that, with existing data and appropriate empirical methods, conservation scientists and policymakers can begin to elucidate the mechanisms through which ecosystem conservation programs affect human welfare.

  15. Quantifying causal mechanisms to determine how protected areas affect poverty through changes in ecosystem services and infrastructure

    PubMed Central

    Ferraro, Paul J.; Hanauer, Merlin M.

    2014-01-01

    To develop effective environmental policies, we must understand the mechanisms through which the policies affect social and environmental outcomes. Unfortunately, empirical evidence about these mechanisms is limited, and little guidance for quantifying them exists. We develop an approach to quantifying the mechanisms through which protected areas affect poverty. We focus on three mechanisms: changes in tourism and recreational services; changes in infrastructure in the form of road networks, health clinics, and schools; and changes in regulating and provisioning ecosystem services and foregone production activities that arise from land-use restrictions. The contributions of ecotourism and other ecosystem services to poverty alleviation in the context of a real environmental program have not yet been empirically estimated. Nearly two-thirds of the poverty reduction associated with the establishment of Costa Rican protected areas is causally attributable to opportunities afforded by tourism. Although protected areas reduced deforestation and increased regrowth, these land cover changes neither reduced nor exacerbated poverty, on average. Protected areas did not, on average, affect our measures of infrastructure and thus did not contribute to poverty reduction through this mechanism. We attribute the remaining poverty reduction to unobserved dimensions of our mechanisms or to other mechanisms. Our study empirically estimates previously unidentified contributions of ecotourism and other ecosystem services to poverty alleviation in the context of a real environmental program. We demonstrate that, with existing data and appropriate empirical methods, conservation scientists and policymakers can begin to elucidate the mechanisms through which ecosystem conservation programs affect human welfare. PMID:24567397

  16. Drug treatment services for adult offenders: The state of the state

    PubMed Central

    Taxman, Faye S.; Perdoni, Matthew L.; Harrison, Lana D.

    2007-01-01

    We conducted a national survey of prisons, jails, and community correctional agencies to estimate the prevalence of entry into and accessibility of correctional programs and drug treatment services for adult offenders. Substance abuse education and awareness is the most prevalent form of service provided, being offered in 74% of prisons, 61% of jails, and 53% of community correctional agencies; at the same time, remedial education is the most frequently available correctional program in prisons (89%) and jails (59.5%), whereas sex offender therapy (57.2%) and intensive supervision (41.9%) dominate in community correctional programs. Most substance abuse services provided to offenders are offered through correctional programs such as intensive supervision, day reporting, vocational education, and work release, among others. Although agencies report a high frequency of providing substance abuse services, the prevalence rates are misleading because less than a quarter of the offenders in prisons and jails and less than 10% of those in community correctional agencies have access to these services through correctional agencies; in addition, these are predominantly drug treatment services that offer few clinical services. Given that drug-involved offenders are likely to have dependence rates that are four times greater than those among the general public, the drug treatment services and correctional programs available to offenders do not appear to be appropriate for the needs of this population. The National Criminal Justice Treatment Practices survey provides a better understanding of the distribution of services and programs across prisons, jails, and community correctional agencies and allows researchers and policymakers to understand some of the gaps in services and programs that may negatively affect recidivism reduction efforts. PMID:17383549

  17. Legislative Proposals To Protect Children from Inappropriate Materials on the Internet. Hearing on H.R. 3783, H.R. 774, H.R. 1180, H.R. 1964, H.R. 3177, and H.R. 3442 before the Subcommittee on Telecommunications, Trade, and Consumer Protection of the Committee on Commerce, House of Representatives, One Hundred Fifth Congress, Second Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Commerce.

    This hearing addresses legislative proposals to protect children from inappropriate materials on the Internet. Among the issues discussed are federal investments and information access, defining standards for protection, child pornography and marketing to children, filtering technology and adult verification services, and freedom of speech.…

  18. The Impact of Child, Family, and Child Protective Services Factors on Reports of Child Sexual Abuse Recurrence

    ERIC Educational Resources Information Center

    Sinanan, Allison N.

    2011-01-01

    This study identified selected child factors (e.g., age, gender, race/ethnicity, disabilities, prior victimization, and relationship to perpetrator of abuse), family risk factors (e.g., substance abuse, domestic violence, inadequate housing, and financial problems), and services provided by child protective services that likely increased reports…

  19. Contamination design of a Scientific Instrument Protective Enclosure for the Hubble Space Telescope Servicing Mission

    NASA Technical Reports Server (NTRS)

    Hedgeland, Randy J.; Hansen, Patricia A.

    1993-01-01

    A Scientific Instrument Protective Enclosure (SIPE) was designed to accommodate second generation science instruments (SIs) for the Hubble Space Telescope (HST) First Servicing Mission (FSM). One of the main design drivers for the SIPE is to provide a protective environment for the SIs against particulate and molecular contaminants that pose a viable threat to the SI performance. The focus of this paper will detail the methodology incorporated in the design of the SIPE to provide a controlled environment for SI protection at the launch site, during pre-launch/launch activities, and during on-orbit operations in the Shuttle bay.

  20. Maternal care and paternal protection influence response to psychotherapy treatment for adult depression.

    PubMed

    Johnstone, Jeanette M; Carter, Janet D; Luty, Suzanne E; Mulder, Roger T; Frampton, Christopher M; Joyce, Peter R

    2013-07-01

    Adverse childhood experiences of neglect, overprotection and abuse, well-recognized risk factors for the development of adult psychopathology, were examined as predictors of response to psychotherapy treatment for adults with depression. Outpatients in a randomized clinical trial of interpersonal psychotherapy (IPT) or cognitive-behavioral therapy (CBT) completed the parental bonding instrument (PBI) at baseline to establish levels of care and protection. Childhood abuse was asked about using clinical interviews. The PBI variables were examined in tertiles while the abuse variables were categorized as "none," "some," and "severe." Associations between these childhood adversities and treatment response were examined in those who completed the trial. Of 177 outpatients with depression who were randomized, 159 completed an adequate trial of therapy. Within these 159 patients, 57% were categorized as responders to treatment. The mean percentage improvement on the MADRS was 57.7% (±31.4). Across both treatments, patients reporting intermediate levels of maternal care had the best response to treatment. Also across both treatments, the interaction effects of maternal care and paternal protection by treatment were statistically significant. Examining the two therapies independently, maternal care and paternal protection were associated with a differential response to IPT but not CBT. Reports of abuse, whether physical, emotional or sexual, did not impact treatment response. This study examined patients who completed treatment, which may have attenuated the findings. Two categories of childhood adversity were measured although a range of other adverse childhood experiences exist. The results were from exploratory analyses and require replication. Maternal care, demonstrating a robust main effect across treatments, appears to be the childhood variable most strongly associated with response to psychotherapy in this sample. In addition, maternal care and paternal protection

  1. 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. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  2. Correlates of physician visits among older adults in China: the effects of family support.

    PubMed

    Li, Yawen; Chi, Iris

    2011-09-01

    We examined how family support influenced the use of health services among older Chinese adults. Data came from a national representative survey including 20,255 respondents aged 60 and older. The dependent variable was the number of physician visits in the past 12 months. Family support variables include living arrangement, family size, financial support, instrumental support, and filial piety. Providing or receiving financial support increased the likelihood as well as number of physician visits. By contrast, living with children and regarding children as filial decreased physician visits. Financial sufficiency as indicated by the exchange of financial resources within families indicates the importance of money in predicting older adults' physician visits. Living with children may indicate a higher level of support, which substitutes some of physician services. Perceiving children as being filial may render psychological protective effects to older adults which results in less health service use.

  3. Relationship Between Health Service Use and Health Information Technology Use Among Older Adults: Analysis of the US National Health Interview Survey

    PubMed Central

    2011-01-01

    Background Older adults are the most frequent and heaviest users of health services in the United States; however, previous research on older adults’ use of health information technology (HIT) has not examined the possible association of HIT use among older adults with their use of health services. Objective This study examined the relationship between US older adults’ use of health services and their use of the Internet for health-related activities, controlling for socioeconomic characteristics and aging-related limitations in sensory and cognitive function. It also examined gender differences in the pattern of association between the types of health services used and HIT use. Methods The data for this study were drawn from the 2009 US National Health Interview Survey (NHIS), which was the first nationally representative household survey to collect data on HIT (Internet) use. First, the rates of lifetime and 12-month HIT use among sample adults (n = 27,731) by age group (18-29 to 85 and over) were analyzed. Second, bivariate analysis of sociodemographic characteristics, health status, and health service use by HIT use status among those aged 65 or older (n = 5294) was conducted. Finally, multivariate binary logistic regression analysis was used to test the study hypotheses with 12-month HIT use as the dependent variable and 12-month health service uses among the age group 65 or older as possible correlates. Results The rates of HIT use were significantly lower among the age groups 65 or older compared with the younger age groups, although the age group 55 to 64 was not different from those younger. The rates of HIT use decreased from 32.2% in the age group 65 to 74 to 14.5% in the age group 75 to 84 and 4.9% in the 85 and older age group. For both genders, having seen or talked to a general practitioner increased the odds of HIT use. However, having seen or talked to a medical specialist, eye doctor, or physical therapist/occupational therapist (PT/OT) were

  4. Effect of socio-economic factors in utilization of different healthcare services among older adult men and women in Ghana.

    PubMed

    Saeed, B I I; Yawson, A E; Nguah, S; Agyei-Baffour, Peter; Emmanuel, Nakua; Ayesu, Edmund

    2016-08-16

    The older adult population is increasing all over the world. In sub-Saharan Africa, due to poverty and low policy coverage, older adults are not well catered for. The effect of socio-economic inequality in the use of healthcare services among older adult men and women in Ghana was investigated in this paper. The data employed in the study were drawn from Global Ageing and Adult Health survey SAGE Wave 1 Ghana and was based on the design for the World Health Survey 2003, SAGE Wave 0, Ghana. The survey was conducted in 2007-2008 and collected data on socio-economic characteristics and other variables of the 5573 individuals interviewed. Using generalized logit model, the study found that health status is a very strong determinant of the type of healthcare services preferred by older adults Ghanaians. Men with higher income preferred the private health facilities, while those who completed tertiary education, those with health insurance and those who self-rated their health as very bad, bad or moderate preferred public facility. Self-employed men and those in informal employment, preferred other health facilities outside the formal public health service. Women with primary and secondary education, preferred the private health facilities. Women with health insurance, those in middle and upper class income quintiles or those with self-rated bad and moderate health status or being relatively younger preferred the public facility to other health services. Self-employed women and those in informal employment preferred traditional treatment. In Ghana, there are important socio-economic gradients in the use of some healthcare services. In both sexes, those without insurance and rural residents preferred the pharmacy and traditional treatment. These differences may be due to socio-economic inequities but could also indicate that the existing health facilities are not always used in an optimal way. Patient factors may be equally important as supply factors in explaining the

  5. Psychotropic medication use among adolescents and young adults with an autism spectrum disorder: parent views about medication use and healthcare services.

    PubMed

    Lake, Johanna K; Vogan, Vanessa; Sawyer, Amanda; Weiss, Jonathan A; Lunsky, Yona

    2015-04-01

    Psychotropic medications are frequently used to treat mental health and behavioral issues in adolescents and adults with an autism spectrum disorder (ASD). Although parents of individuals with ASD frequently take on medication management for their child, there is limited literature on parent perspectives of their child's medication use or their views about the healthcare services they receive, particularly in adulthood. The current study examined and compared parents of adolescents and of young adults with ASD regarding their child's psychotropic medication use and their views about healthcare services. One hundred parents of adolescents and young adults with ASD (ages 12-30 years) completed an online survey about their experience with their child's healthcare services and medication use. Parents of young adults were less likely to use nonpharmacological services before using a psychotropic medication than were parents of adolescents. Parents of young adults were also less likely to believe that their prescribing healthcare provider had adequate expertise in ASD, and were less satisfied with how their prescriber monitored their child's medication use. Findings highlight the need to build capacity among healthcare providers supporting individuals with ASD as they transition into adulthood. There is also a need for improved medication monitoring and increased awareness of the different mental health challenges that individuals with ASD encounter as they age.

  6. The Potential of Information: Guidance and Counselling Services for Improving the Access of Adults to Learning Opportunities.

    ERIC Educational Resources Information Center

    Bertelsen, P. H.

    Well-developed information and counseling services not only afford immediate assistance to adult learners, but also generate a significant feedback effect on many other components of the overall system and thus make a considerable contribution to the overall development of adult education. Access to learning and progress in learning should be like…

  7. Investigating the perception of Romanian adults on ophthalmology services from an experiential marketing perspective

    PubMed Central

    Gheorghe, Consuela-Mădălina; Gheorghe, Iuliana-Raluca; Purcărea, Victor Lorin

    2017-01-01

    Nowadays, we live in a world in which we are daily bombed by hundreds of advertisements. Specialists have to discover other channels or embed attractive elements in the advertisements’ messages to cut through the clutter and catch the consumers’ attention. The evolution of the concept of service has changed from the commercial status to determining a lifestyle. Buying a service has led to a change in the consumer behavior. Consumers want to buy services that dazzle their senses, touch their hearts, and stimulate their minds, not as before, excellent or satisfying. Ophthalmology is the medical specialty that is the most oriented toward outpatient care, as hospitalization is required only in a small percentage of cases. The objective of this case study was to investigate the perception of Romanian adult consumers on ophthalmology services from an experiential marketing perspective, by using the Focus Group method. Ophthalmology requires a wide range of skills due to the diversity of consumers who demand specialized consultations. Experiential marketing is a valuable strategy that ophthalmologic organizations may use to target specific consumers. The purpose of this case study was to identify the perceptions of Romanian adults on experiential marketing campaigns and determine the degree to which these campaigns influenced their decisions of buying an ophthalmologic service. Using a snowball sampling technique we have sent a filter questionnaire to 40 people on the internet. The filter questionnaire consisted of questions about wearing eyeglasses, the period of wearing them, the last ophthalmologic consultation, the type of ophthalmologic clinic they were going to, age and education. The respondents revealed there is almost no visibility on promoting services even if there is an upsurge of organizations offering this type of health service in the Romanian ophthalmology sector. PMID:29450395

  8. Investigating the perception of Romanian adults on ophthalmology services from an experiential marketing perspective.

    PubMed

    Gheorghe, Consuela-Mădălina; Gheorghe, Iuliana-Raluca; Purcărea, Victor Lorin

    2017-01-01

    Nowadays, we live in a world in which we are daily bombed by hundreds of advertisements. Specialists have to discover other channels or embed attractive elements in the advertisements' messages to cut through the clutter and catch the consumers' attention. The evolution of the concept of service has changed from the commercial status to determining a lifestyle. Buying a service has led to a change in the consumer behavior. Consumers want to buy services that dazzle their senses, touch their hearts, and stimulate their minds, not as before, excellent or satisfying. Ophthalmology is the medical specialty that is the most oriented toward outpatient care, as hospitalization is required only in a small percentage of cases. The objective of this case study was to investigate the perception of Romanian adult consumers on ophthalmology services from an experiential marketing perspective, by using the Focus Group method. Ophthalmology requires a wide range of skills due to the diversity of consumers who demand specialized consultations. Experiential marketing is a valuable strategy that ophthalmologic organizations may use to target specific consumers. The purpose of this case study was to identify the perceptions of Romanian adults on experiential marketing campaigns and determine the degree to which these campaigns influenced their decisions of buying an ophthalmologic service. Using a snowball sampling technique we have sent a filter questionnaire to 40 people on the internet. The filter questionnaire consisted of questions about wearing eyeglasses, the period of wearing them, the last ophthalmologic consultation, the type of ophthalmologic clinic they were going to, age and education. The respondents revealed there is almost no visibility on promoting services even if there is an upsurge of organizations offering this type of health service in the Romanian ophthalmology sector.

  9. Spontaneous strategy use protects against visual working memory deficits in older adults infected with HIV.

    PubMed

    Woods, Steven Paul; Weber, Erica; Cameron, Marizela V; Dawson, Matthew S; Delano-Wood, Lisa; Bondi, Mark W; Grant, Igor

    2010-12-01

    Recent studies suggest that older human immunodeficiency virus (HIV)-infected adults are at particular risk for HIV-associated neurocognitive disorders (HAND), including dementia. Deficits in attention/working memory are posited to play a central role in the development of HAND among older adults. The aim of the present study was to examine the possible protective benefits of spontaneous strategy use during a visual working memory task in 46 older and 42 younger adults infected with HIV. Results revealed a significant interaction between age and strategy use, with older adults who used a meta-cognitive strategy demonstrating superior working memory performance versus non-strategy users. This effect was not observed in the younger HIV-infected sample and was not better explained by possible confounding factors, such as education, comorbid medical conditions, or HIV disease severity. Within the older group, strategy use was associated with better executive functions and higher estimated verbal intelligence. Findings from this study suggest that working memory declines in older HIV-infected adults are moderated by the use of higher-level mnemonic strategies and may inform cognitive neurorehabilitation efforts to improve cognitive and everyday functioning outcomes in older persons living with HIV infection.

  10. [Determinants of dental services utilization by adults: a population-based study in Florianópolis, Santa Catarina State, Brazil].

    PubMed

    Miranda, Camila Dal-Bó Coradini; Peres, Marco Aurélio

    2013-11-01

    This study aimed to estimate the prevalence of dental services utilization by adults and to identify associated socioeconomic, demographic, behavioral, and self-awareness factors. A cross-sectional population-based study was conducted with adults living in the urban area of Florianópolis, Santa Catarina State, Brazil, in 2009. Associations were tested between use of dental services and predisposing, enabling, and needs-based variables. Multivariate analysis was conducted using Poisson regression with estimates of prevalence ratios and was stratified by place of last dental appointment. Prevalence of dental services utilization was 66% (95%CI: 62.9-70.7). Dental visits were 20% more frequent among women and 72% more frequent among individuals with more schooling (the latter in both public and private dental services). Individuals with private dental plans used dental services 13% more than those without. Schooling was the most important variable in predicting utilization. The study's results show the importance of monitoring associated factors in order to promote more equitable use of dental services.

  11. Preventive Services Use among African American and Latino Adult Caregivers in South Los Angeles

    PubMed Central

    Mendez-Luck, Carolyn A.; Walker, Kara Odom; Luck, Jeff

    2016-01-01

    Background The burden of informal caregiving is significant and well-documented, yet the evidence is mixed as to whether being a caregiver presents an additional barrier to receiving recommended preventive care. Objectives To determine whether (1) caregivers compared to non-caregivers were less likely to receive preventive health services; and (2) higher intensity caregivers were less likely to receive preventive health services than lower intensity caregivers. Research Design, Subjects, and Measures Data were from a telephone survey of Latino and African American adults 50 years or older in South Los Angeles (n=702). Outcomes were flu vaccination, pneumococcal vaccination, and colorectal cancer screening. Logistic regression models adjusted for predisposing, enabling, and need factors according to the Andersen Model of Access to Health Care for Low-Income Populations. Results Caregiver type (e.g., adult child, non-related) was associated with varying odds of receiving a preventive service. Caregivers had lower odds than non-caregivers of receiving preventive services although odds of receiving a flu vaccination improved slightly for caregivers of persons with memory loss compared to other caregivers. More weekly caregiving hours was associated with higher odds of receiving flu vaccination (AOR 1.1, 95% CI=1.0, 1.1) or colorectal cancer screening (AOR 1.1, 95% CI=1.0, 1.1). Caregivers and non-caregivers age 65 and older or with chronic conditions were more likely to receive vaccinations. Conclusions Preventive service use was influenced by characteristics of the caregiving situation. An opportunity may exist to leverage care recipients’ ongoing contact with health care providers to increase caregivers’ own access to preventive services. PMID:27414461

  12. 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…

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

    PubMed

    Levy, Sharon; Wynd, Andrew H D; Carachi, Robert

    2014-11-01

    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. 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. 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. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  14. Sex education and family planning services for young adults: alternative urban strategies in Mexico.

    PubMed

    Townsend, J W; Diaz de May, E; Sepúlveda, Y; Santos de Garza, Y; Rosenhouse, S

    1987-01-01

    In Mexico, youth face difficulties in obtaining reliable information on sex education and family planning through existing community programs. Two alternative strategies to provide these services are being tested in poor urban areas of Monterrey. In one experimental area, Integrated Youth Centers were established, which provide sex education and family planning services as well as counseling, academic tutoring, and recreational activities. In another area, trained young adults and community counselors work through informal networks to provide sex education and family planning information. Both utilization and the cost of these services are examined in the context of plans for expanding coverage in Mexico-U.S. border areas.

  15. Antisense reduction of tau in adult mice protects against seizures.

    PubMed

    DeVos, Sarah L; Goncharoff, Dustin K; Chen, Guo; Kebodeaux, Carey S; Yamada, Kaoru; Stewart, Floy R; Schuler, Dorothy R; Maloney, Susan E; Wozniak, David F; Rigo, Frank; Bennett, C Frank; Cirrito, John R; Holtzman, David M; Miller, Timothy M

    2013-07-31

    Tau, a microtubule-associated protein, is implicated in the pathogenesis of Alzheimer's Disease (AD) in regard to both neurofibrillary tangle formation and neuronal network hyperexcitability. The genetic ablation of tau substantially reduces hyperexcitability in AD mouse lines, induced seizure models, and genetic in vivo models of epilepsy. These data demonstrate that tau is an important regulator of network excitability. However, developmental compensation in the genetic tau knock-out line may account for the protective effect against seizures. To test the efficacy of a tau reducing therapy for disorders with a detrimental hyperexcitability profile in adult animals, we identified antisense oligonucleotides that selectively decrease endogenous tau expression throughout the entire mouse CNS--brain and spinal cord tissue, interstitial fluid, and CSF--while having no effect on baseline motor or cognitive behavior. In two chemically induced seizure models, mice with reduced tau protein had less severe seizures than control mice. Total tau protein levels and seizure severity were highly correlated, such that those mice with the most severe seizures also had the highest levels of tau. Our results demonstrate that endogenous tau is integral for regulating neuronal hyperexcitability in adult animals and suggest that an antisense oligonucleotide reduction of tau could benefit those with epilepsy and perhaps other disorders associated with tau-mediated neuronal hyperexcitability.

  16. Transition to adult services for young people with mental health needs: A systematic review.

    PubMed

    Paul, Moli; Street, Cathy; Wheeler, Nicola; Singh, Swaran P

    2015-07-01

    Young people's transition from child and adolescent (CAMHS) to adult mental health services (AMHS). To systematically review evidence on the effectiveness of different models of CAMHS-AMHS transitional care, service user and staff perspectives, and facilitators of/barriers to effective CAMHS-AMHS transition. A systematic search in May 2012 of Medline, PsycINFO, CINAHL, EMBASE, AMED, Health Business Elite, HMIC, Cochrane Database, Web of Science and ASSIA; ancestral searches; and consultation with experts in the field. Qualitative, quantitative and mixed-methods primary research on the CAMHS-AMHS health-care transition of young people (aged 16-21 years) with mental health problems. Two reviewers independently completed a standardised data extraction form and critically evaluated identified documents using a validated appraisal tool for empirical studies with varied methodologies. A total of 19 studies of variable quality were identified. None were randomised or case-controlled trials. Studies incorporating service user/carer perspectives highlighted the need to tackle stigma and provide accessible, age-appropriate services. Parents/carers wanted more involvement with AMHS. Transitional care provision was considered patchy and often not prioritised within mental health services. There was no clear evidence of superior effectiveness of any particular model. High-quality evidence of transitional care models is lacking. Data broadly support the development of programmes that address the broader transitional care needs of 'emerging adults' and their mental health needs but further evaluation is necessary. Developing robust transitional mental health care will require the policy-practice gap to be addressed and development of accessible, acceptable, responsive, age-appropriate provision. © The Author(s) 2014.

  17. [Innovative Services: The Use of Parent Aides in Child Protective Services]. Module 2. Program Models--Which One is Right for You?

    ERIC Educational Resources Information Center

    Anderson, Stephen C.; And Others

    Module 2 of a seven module package for child protective service workers explores various types of parent aide programs for abused and neglected children and their families. Four training activities address models of parent aide programs, organization analysis, and selection of the appropriate program model. Included are directions for using the…

  18. Suicide Ideation in Older Adults: Relationship to Mental Health Problems and Service Use

    ERIC Educational Resources Information Center

    Corna, Laurie M.; Cairney, John; Streiner, David L.

    2010-01-01

    Purpose: To assess the prevalence of suicide ideation among community-dwelling older adults and the relationship between suicide ideation, major psychiatric disorder, and mental health service use. Design and Methods: We use data from the Canadian Community Health Survey 1.2: Mental Health and Well-being (CCHS 1.2). We estimate the prevalence of…

  19. 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.

  20. Health Concerns and Health Service Utilization in a Population Cohort of Young Adults with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Weiss, Jonathan A.; Isaacs, Barry; Diepstra, Heidi; Wilton, Andrew S.; Brown, Hilary K.; McGarry, Caitlin; Lunsky, Yona

    2018-01-01

    Individuals with autism spectrum disorder (ASD) have many health needs that place demands on the health service sector. This study used administrative data to compare health profiles in young adults 18-24 years of age with ASD to peers with and without other developmental disability. Young adults with ASD were more likely to have almost all the…

  1. Predicting Help-Seeking Attitudes Toward Mental Health Services Among American Indian Older Adults: Is Andersen's Behavioral Model a Good Fit?

    PubMed

    Roh, Soonhee; Burnette, Catherine E; Lee, Kyoung Hag; Lee, Yeon-Shim; Martin, James I; Lawler, Michael J

    2017-01-01

    American Indian (AI) older adults are vulnerable to mental health disparities, yet very little is known about the factors associated with help-seeking for mental health services among them. The purpose of this study was to investigate the utility of Andersen's Behavioral Model in explaining AI older adults' help-seeking attitudes toward professional mental health services. Hierarchical regression analysis was used to examine predisposing, enabling, and need variables as predictors of help-seeking attitudes toward mental health services in a sample of 233 AI older adults from the Midwest. The model was found to have limited utility in the context of older AI help-seeking attitudes, as the proportion of explained variance was low. Gender, perceived stigma, social support, and physical health were significant predictors, whereas age, perceived mental health, and health insurance were not. © The Author(s) 2014.

  2. The relationship between child protection contact and mental health outcomes among Canadian adults with a child abuse history.

    PubMed

    Afifi, Tracie O; McTavish, Jill; Turner, Sarah; MacMillan, Harriet L; Wathen, C Nadine

    2018-05-01

    Despite being a primary response to child abuse, it is currently unknown whether contact with child protection services (CPS) does more good than harm. The aim of the current study was to examine whether contact with CPS is associated with improved mental health outcomes among adult respondents who reported experiencing child abuse, after adjusting for sociodemographic factors and abuse severity. The data were drawn from the 2012 Canadian Community Health Survey-Mental Health (CCHS-2012), which used a multistage stratified cluster design (household-level response rate = 79.8%). Included in this study were individuals aged 18 years and older living in the 10 Canadian provinces (N = 23,395). Child abuse included physical abuse, sexual abuse, and exposure to intimate partner violence (IPV). Mental health outcomes included lifetime mental disorders, lifetime and past year suicidal ideation, plans, and attempts, and current psychological well-being and functioning and distress. All models were adjusted for sociodemographic factors and severity of child abuse. For the majority of outcomes, there were no statistically significant differences between adults with a child abuse history who had CPS contact compared to those without CPS contact. However, those with CPS contact were more likely to report lifetime suicide attempts. These findings suggest that CPS contact is not associated with improved mental health outcomes. Implications are discussed. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  3. Muscle Strength Is Protective Against Osteoporosis in an Ethnically Diverse Sample of Adults.

    PubMed

    McGrath, Ryan P; Kraemer, William J; Vincent, Brenda M; Hall, Orman T; Peterson, Mark D

    2017-09-01

    McGrath, RP, Kraemer, WJ, Vincent, BM, Hall, OT, and Peterson, MD. Muscle strength is protective against osteoporosis in an ethnically diverse sample of adults. J Strength Cond Res 31(9): 2586-2589, 2017-The odds of developing osteoporosis may be affected by modifiable and nonmodifiable factors such as muscle strength and ethnicity. This study sought to (a) determine whether increased muscle strength was associated with decreased odds of osteoporosis and (b) identify whether the odds of osteoporosis differed by ethnicity. Data from the 2013 to 2014 National Health and Nutrition Examination Survey were analyzed. Muscle strength was measured with a hand-held dynamometer, and dual-energy x-ray absorptiometry was used to assess femoral neck bone mineral density. A T-score of ≤2.5 was used to define osteoporosis. Separate covariate-adjusted logistic regression models were performed on each sex to determine the association between muscle strength and osteoporosis. Odds ratios (ORs) were also generated to identify if the association between muscle strength and osteoporosis differed by ethnicity using non-Hispanic blacks as the reference group. There were 2,861 participants included. Muscle strength was shown to be protective against osteoporosis for men (OR: 0.94; 95% confidence interval [CI]: 0.94-0.94) and women (OR: 0.90; CI: 0.90-0.90). Although ORs varied across ethnicities, non-Hispanic Asian men (OR: 6.62; CI: 6.51-6.72) and women (OR: 6.42; CI: 6.37-6.48) were at highest odds of osteoporosis. Increased muscle strength reduced the odds of osteoporosis among both men and women in a nationally representative, ethnically diverse sample of adults. Non-Hispanic Asians had the highest odds of developing osteoporosis. Irrespective of sex or ethnicity, increased muscle strength may help protect against the odds of developing osteoporosis.

  4. Workplace satisfaction in a mental health service for older adults: an analysis of the effects of setting and professional status.

    PubMed

    McCrae, Niall; Prior, Sue; Silverman, Marisa; Banerjee, Sube

    2007-02-01

    Research in mental health services for working-age adults has repeatedly shown that work is found more satisfying, if more stressful, by community practitioners than by hospital-based staff. This study examined whether similar differences exist in services for older adults and how this might be influenced by the high proportion of nonprofessionally qualified workers in inpatient settings for mentally infirm older people. The Work Environment Scale was given to all practitioners in a mental health service for older adults in a single London borough. Adjusting for the effect of professional status, community practitioners rated involvement, task orientation, and supervision more positively than institutional staff, but gave less favorable ratings for work pressure and physical comfort. Nurses rated peer cohesion, supervision, autonomy, and innovation more positively than nursing assistants, after controlling for type of setting. Multivariate modeling confirmed that type of setting and professional group were both associated with workplace satisfaction, accounting for 24% and 13% of the variance, respectively. The study highlights aspects of the work environment of mental health staff working with older adults that might benefit from attention.

  5. Screening for Impaired Visual Acuity in Older Adults: US Preventive Services Task Force Recommendation Statement.

    PubMed

    Siu, Albert L; Bibbins-Domingo, Kirsten; Grossman, David C; Baumann, Linda Ciofu; Davidson, Karina W; Ebell, Mark; García, Francisco A R; Gillman, Matthew; Herzstein, Jessica; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Owens, Douglas K; Phillips, William R; Phipps, Maureen G; Pignone, Michael P

    2016-03-01

    Update of the US Preventive Services Task Force (USPSTF) recommendation on screening for impaired visual acuity in older adults. The USPSTF reviewed the evidence on screening for visual acuity impairment associated with uncorrected refractive error, cataracts, and age-related macular degeneration among adults 65 years or older in the primary care setting; the benefits and harms of screening; the accuracy of screening; and the benefits and harms of treatment of early vision impairment due to uncorrected refractive error, cataracts, and age-related macular degeneration. This recommendation applies to asymptomatic adults 65 years or older who do not present to their primary care clinician with vision problems. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for impaired visual acuity in older adults. (I statement).

  6. 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

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012...

  7. 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

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2013 Through June 30, 2014...

  8. 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

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012...

  9. How do migratory species add ecosystem service value to wilderness? Calculating the spatial subsidies provided by protected areas

    USGS Publications Warehouse

    Lopez-Hoffman, Laura; Semmens, Darius J.; Diffendorfer, Jay

    2013-01-01

    Species that migrate through protected and wilderness areas and utilize their resources, deliver ecosystem services to people in faraway locations. The mismatch between the areas that most support a species and those areas where the species provides most benefits to society can lead to underestimation of the true value of protected areas such as wilderness. We present a method to communicate the “off-site” value of wilderness and protected areas in providing habitat to migratory species that, in turn, provide benefits to people in distant locations. Using northern pintail ducks (Anas acuta) as an example, the article provides a method to estimate the amount of subsidy – the value of the ecosystem services provided by a migratory species in one area versus the cost to support the species and its habitat elsewhere.

  10. The physical and mental health of lesbian, gay male, and bisexual (LGB) older adults: the role of key health indicators and risk and protective factors.

    PubMed

    Fredriksen-Goldsen, Karen I; Emlet, Charles A; Kim, Hyun-Jun; Muraco, Anna; Erosheva, Elena A; Goldsen, Jayn; Hoy-Ellis, Charles P

    2013-08-01

    Based on resilience theory, this paper investigates the influence of key health indicators and risk and protective factors on health outcomes (including general health, disability, and depression) among lesbian, gay male, and bisexual (LGB) older adults. A cross-sectional survey was conducted with LGB older adults, aged 50 and older (N = 2,439). Logistic regressions were conducted to examine the contributions of key health indicators (access to health care and health behaviors), risk factors (lifetime victimization, internalized stigma, and sexual identity concealment), and protective factors (social support and social network size) to health outcomes, when controlling for background characteristics. The findings revealed that lifetime victimization, financial barriers to health care, obesity, and limited physical activity independently and significantly accounted for poor general health, disability, and depression among LGB older adults. Internalized stigma was also a significant predictor of disability and depression. Social support and social network size served as protective factors, decreasing the odds of poor general health, disability, and depression. Some distinct differences by gender and sexual orientation were also observed. High levels of poor general health, disability, and depression among LGB older adults are of major concern. These findings highlight the important role of key risk and protective factors, which significantly influences health outcomes among LGB older adults. Tailored interventions must be developed to address the distinct health issues facing this historically disadvantaged population.

  11. Transition from child and adolescent to adult mental health services in the Republic of Ireland: an investigation of process and operational practice.

    PubMed

    McNamara, Niamh; McNicholas, Fiona; Ford, Tamsin; Paul, Moli; Gavin, Blanaid; Coyne, Imelda; Cullen, Walter; O'Connor, Karen; Ramperti, Nicolas; Dooley, Barbara; Barry, Siobhan; Singh, Swaran P

    2014-08-01

    Ensuring a seamless transition from child to adult mental health services poses challenges for services worldwide. This is an important process in the ongoing care of young people with mental illness; therefore, it is incumbent on all countries to probe their individual structures to assess the quality of mental health service delivery to this vulnerable cohort. To date, there have been no published studies on the transition from Child to Adult Mental Health Services in the Republic of Ireland. To this end, a nationwide survey of transition policies of community mental health teams in both services was conducted in order to compare best practice guidelines for transition with current process and experience in clinical practice. Structured interviews were conducted with 57 consultant psychiatrists (representing 32 CAMHS teams and 25 AMHS teams) to obtain information on annual transition numbers, existing transition policies and operational practice from the professional perspective. Numbers of young people considered suitable for transfer to adult services (M = 7.73, SD = 9.86, n = 25) were slightly higher than numbers who actually transferred (M = 4.50, SD = 3.33, n = 20). There is a lack of standardized practice nationwide regarding the service transition boundary, an absence of written transition policies and protocols, and minimal formal interaction between child and adult services. The findings suggest that there are critical gaps between current operational practice and best practice guidelines. Future studies will investigate the impact this has on the transition experiences of young people, their carers and health-care professionals. © 2013 Wiley Publishing Asia Pty Ltd.

  12. Delivery of preventive services to adults aged 50-64: monitoring performance using a composite measure, 1997-2004.

    PubMed

    Shenson, Douglas; Adams, Mary; Bolen, Julie

    2008-06-01

    Population-based rates for the delivery of adult vaccinations or screenings are typically tracked as individual services. The current approach is useful in monitoring progress toward national health goals but does not yield information regarding how many U.S. adults receive a combination of preventive services routinely recommended based on a person's age and gender. A composite measure is important for policymaking, for developing public health interventions, and for monitoring the quality of clinical care. During the period under study, influenza vaccination was newly recommended (2000) to be routinely delivered to adults in this age range. The objective of the study was to compare the delivery of routine clinical preventive services to U.S. adults aged 50-64 years between 1997 and 2004 using a composite measure that includes cancer screenings and vaccinations. Data were collected via telephone surveys in 1997, 2002, and 2004 as part of the Behavioral Risk Factor Surveillance System. The participants were randomly selected adults aged 50-64 years in the 50 states and the District of Columbia in the selected years. Sample sizes ranged from 24,917 to 77,244. The composite measure includes screening for colorectal cancer, cervical cancer, breast cancer, and vaccination against influenza (2002 and 2004 only). The composite measure quantifies the percentage of adults who are up-to-date with the complete set according to recommended schedules. With the inclusion of newly recommended influenza vaccination, the percentage of men and women aged 50-64 who were up-to-date on all selected measures in 2004 was 23.4% and 23.0%, respectively, compared with 37.6% and 30.5% in 1997. Without including influenza vaccination, the percentage of up-to-date adults aged 50-64 would have risen in 2004 to 50.5% (men) and to 44.7% (women). For both sexes, results varied by education, race/ethnicity, marriage status, insurance status, health status, and state. In 2004, the percentage of

  13. Leucine partially protects muscle mass and function during bed rest in middle-aged adults1,2

    PubMed Central

    English, Kirk L; Mettler, Joni A; Ellison, Jennifer B; Mamerow, Madonna M; Arentson-Lantz, Emily; Pattarini, James M; Ploutz-Snyder, Robert; Sheffield-Moore, Melinda; Paddon-Jones, Douglas

    2016-01-01

    Background: Physical inactivity triggers a rapid loss of muscle mass and function in older adults. Middle-aged adults show few phenotypic signs of aging yet may be more susceptible to inactivity than younger adults. Objective: The aim was to determine whether leucine, a stimulator of translation initiation and skeletal muscle protein synthesis (MPS), can protect skeletal muscle health during bed rest. Design: We used a randomized, double-blind, placebo-controlled trial to assess changes in skeletal MPS, cellular signaling, body composition, and skeletal muscle function in middle-aged adults (n = 19; age ± SEM: 52 ± 1 y) in response to leucine supplementation (LEU group: 0.06 g ∙ kg−1 ∙ meal−1) or an alanine control (CON group) during 14 d of bed rest. Results: Bed rest decreased postabsorptive MPS by 30% ± 9% (CON group) and by 10% ± 10% (LEU group) (main effect for time, P < 0.05), but no differences between groups with respect to pre-post changes (group × time interactions) were detected for MPS or cell signaling. Leucine protected knee extensor peak torque (CON compared with LEU group: −15% ± 2% and −7% ± 3%; group × time interaction, P < 0.05) and endurance (CON compared with LEU: −14% ± 3% and −2% ± 4%; group × time interaction, P < 0.05), prevented an increase in body fat percentage (group × time interaction, P < 0.05), and reduced whole-body lean mass loss after 7 d (CON compared with LEU: −1.5 ± 0.3 and −0.8 ± 0.3 kg; group × time interaction, P < 0.05) but not 14 d (CON compared with LEU: −1.5 ± 0.3 and −1.0 ± 0.3 kg) of bed rest. Leucine also maintained muscle quality (peak torque/kg leg lean mass) after 14 d of bed-rest inactivity (CON compared with LEU: −9% ± 2% and +1% ± 3%; group × time interaction, P < 0.05). Conclusions: Bed rest has a profoundly negative effect on muscle metabolism, mass, and function in middle-aged adults. Leucine supplementation may partially protect muscle health during relatively

  14. A longitudinal, observational study examining the relationships of patient satisfaction with services and mental well-being to their clinical course in young people with Type 1 diabetes mellitus during transition from child to adult health services.

    PubMed

    Gray, S; Cheetham, T; McConachie, H; Mann, K D; Parr, J R; Pearce, M S; Colver, A

    2018-05-31

    We hypothesized that participant well-being and satisfaction with services would be positively associated with a satisfactory clinical course during transition from child to adult health care. Some 150 young people with Type 1 diabetes mellitus from five diabetes units in England were recruited to a longitudinal study of transition. Each young person was visited at home four times by a research assistant; each visit was 1 year apart. Satisfaction with services (Mind the Gap; MTG) and mental well-being (Warwick-Edinburgh Mental Well-being Scale; WEMWBS) were captured. Change in HbA 1c , episodes of ketoacidosis, clinic and retinal screening attendance were used to assess clinical course. In total, 108 of 150 (72%) young people had sufficient data for analysis at visit 4. Mean age at entry was 16 years. By visit 4, 81.5% had left paediatric healthcare services. Median HbA 1c increased significantly (P = 0.01) from 69 mmol/mol (8.5%) at baseline to 75 mmol/mol (9.0%) at visit 4. WEMWBS scores were comparable with those in the general population at baseline and were stable over the study period. MTG scores were also stable. By visit 4, some 32 individuals had a 'satisfactory' and 76 a 'suboptimal' clinical course. There were no significant differences in average WEMWBS and MTG scores between the clinical course groups (P = 0.96, 0.52 respectively); nor was there a significant difference in transfer status between the clinical course groups. The well-being of young people with diabetes and their satisfaction with transition services are not closely related to their clinical course. Investigating whether innovative psycho-educational interventions can improve the clinical course is a research priority. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  15. A feasibility study comparing UK older adult mental health inpatient wards which use protected engagement time with other wards which do not: study protocol.

    PubMed

    Nolan, Fiona M; Fox, Chris; Cheston, Richard; Turner, David; Clark, Allan; Dodd, Emily; Khoo, Mary-Ellen; Gray, Richard

    2016-01-01

    Protected engagement time (PET) is a concept of managing staff time on mental health inpatient wards with the aim of increasing staff and patient interaction. Despite apparent widespread use of PET, there remains a dearth of evidence as to how it is implemented and whether it carries benefits for staff or patients. This protocol describes a study which is being carried out on mental health wards caring for older adults (aged over 65) in England. The study shares a large proportion of the procedures, measures and study team membership of a recently completed investigation of the impact of PET in adult acute mental health wards. The study aims to identify prevalence and components of PET to construct a model for the intervention, in addition to testing the feasibility of the measures and procedures in preparation for a randomised trial. The study comprises four modules and uses a mixed methods approach. Module 1 involves mapping all inpatient wards in England which provide care for older adults, including those with dementia, ascertaining how many of these provide PET and in what way. Module 2 uses a prospective cohort method to compare five older adult mental health wards that use PET with five that do not across three National Health Service (NHS) Foundation Trust sites. The comparison comprises questionnaires, observation tools and routinely collected clinical service data and combines validated measures with questions developed specifically for the study. Module 3 entails an in-depth case study evaluation of three of the participating PET wards (one from each NHS Trust site) using semi-structured interviews with patients, carers and staff. Module 4 describes the development of a model and fidelity scale for PET using the information derived from the other modules with a working group of patients, carers and staff. This is a feasibility study to test the application of the measures and methods in inpatient wards for older adults and develop a draft model for the

  16. Risk factors for overweight and obesity in young healthy adults during compulsory military service.

    PubMed

    Grotto, Itamar; Zarka, Salman; Balicer, Ran D; Sherf, Michael; Meyerovitch, Joseph

    2008-01-01

    In view of the rising prevalence of obesity, the identification of young adult populations at risk is important for the formulation of intervention and prevention programs. To assess demographic and behavioral factors associated with an increase in body mass index in young healthy adults and to identify the incidence of overweight/obesity in this population. Data on anthropometric measures, demographic characteristics, and health behaviors were collected retrospectively for a representative sample of young Israeli adults (11,391 men, 11,280 women) on their release from military service (age 20-22 years) between 1989 and 2003. The incidence of overweight (BMI < 25 < or =30 kg/m2), incidence of obesity (BMI > or =30 kg/m2), and increase in BMI during military service were calculated. The average increase in BMI during military service was 1.11 kg/m2 in males and 1.08 kg/m2 in females. Agreater increase was positively associated with low paternal education and smoking cessation, and negatively associated with high physical activity. Twelve percent of subjects with a normal BMI on recruitment became overweight, and 21.7% of overweight subjects became obese. On multivariate logistic regression analysis, a higher incidence of overweight was associated with low education level (in both the subject and his or her father) in both genders, and non-use of oral contraceptives and low level of physical activity in females. BMI appears to increase significantly during early adulthood. Intervention programs should be targeted specifically at subjects with low education or who started smoking before age 18, and physical activity (especially among females) should be encouraged.

  17. 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

  18. 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

    Islam, Zoebia; Ford, Tamsin; Kramer, Tami; Paul, Moli; Parsons, Helen; Harley, Katherine; Weaver, Tim; McLaren, Susan; Singh, Swaran P

    2016-06-01

    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.

  19. Sun Protection Belief Clusters: Analysis of Amazon Mechanical Turk Data.

    PubMed

    Santiago-Rivas, Marimer; Schnur, Julie B; Jandorf, Lina

    2016-12-01

    This study aimed (i) to determine whether people could be differentiated on the basis of their sun protection belief profiles and individual characteristics and (ii) explore the use of a crowdsourcing web service for the assessment of sun protection beliefs. A sample of 500 adults completed an online survey of sun protection belief items using Amazon Mechanical Turk. A two-phased cluster analysis (i.e., hierarchical and non-hierarchical K-means) was utilized to determine clusters of sun protection barriers and facilitators. Results yielded three distinct clusters of sun protection barriers and three distinct clusters of sun protection facilitators. Significant associations between gender, age, sun sensitivity, and cluster membership were identified. Results also showed an association between barrier and facilitator cluster membership. The results of this study provided a potential alternative approach to developing future sun protection promotion initiatives in the population. Findings add to our knowledge regarding individuals who support, oppose, or are ambivalent toward sun protection and inform intervention research by identifying distinct subtypes that may best benefit from (or have a higher need for) skin cancer prevention efforts.

  20. Perceptions of adults with hearing impairment regarding the promotion of trust in hearing healthcare service delivery.

    PubMed

    Preminger, Jill E; Oxenbøll, Maria; Barnett, Margaret B; Jensen, Lisbeth D; Laplante-Lévesque, Ariane

    2015-01-01

    This paper describes how trust is promoted in adults with hearing impairment within the context of hearing healthcare (HHC) service delivery. Data were analysed from a previously published descriptive qualitative study that explored perspectives of adults with hearing impairment on hearing help-seeking and rehabilitation. Interview transcripts from 29 adults from four countries with different levels of hearing impairment and different experience with the HHC system were analysed thematically. Patients enter into the HHC system with service expectations resulting in a preconceived level of trust that can vary from low to high. Relational competence, technical competence, commercialized approach, and clinical environment (relevant to both the clinician and the clinic) influence a patient's resulting level of trust. Trust is evolving rather than static in HHC: Both clinicians and clinics can promote trust. The characteristics of HHC that engender trust are: practicing good communication, supporting shared decision making, displaying technical competence, offering comprehensive hearing rehabilitation, promoting self-management, avoiding a focus on hearing-aid sales, and offering a professional clinic setting.

  1. Urban adolescents with intellectual disability and challenging behaviour: costs and characteristics during transition to adult services.

    PubMed

    Barron, Diana A; Molosankwe, Iris; Romeo, Renee; Hassiotis, Angela

    2013-05-01

    Young persons with intellectual disabilities and challenging behaviour in transition usually have complex needs, which may not be served well within existing resources. In this article, we present a survey of all the young people, between 16 and 18 years of age with intellectual disabilities and challenging behaviour identified in one inner London borough. They were in transition to adult services at the time of the study (between 2006 and 2008). The objective was to examine their socio-demographic and clinical characteristics, pattern of service use and associated costs of care. An assessment toolkit was devised to measure the mental and physical health, challenging behaviour and service use of the sample. Instruments within the toolkit included the Strengths and Difficulties Questionnaire, challenging behaviour scale, Client Service Receipt Inventory (CSRI) and socio-demographic data form. Twenty-seven individuals in transition to adult services had challenging behaviour, 23 of whom had mental health diagnoses and 18 of whom had physical diagnoses. Severity of challenging behaviour did not correlate with cost of care. Informal care accounted for the highest proportion of the total cost of care (66%) with education being the second largest contributor at 22%. Evidence on transition outcomes for young people with complex needs and intellectual disabilities and associated costs is lacking. This article illustrates some of the relevant issues in this area. Further research is required to investigate these aspects and guide commissioning of appropriate services. © 2013 Blackwell Publishing Ltd.

  2. The effect of victimization, mental health, and protective factors on crime and illicit drug use among homeless young adults.

    PubMed

    Tyler, Kimberly A; Kort-Butler, Lisa A; Swendener, Alexis

    2014-01-01

    Although research has found high rates of child maltreatment, widespread victimization, and other negative outcomes among homeless youth and young adults, resiliency among this population has largely been understudied. Specifically, a gap remains in terms of how protective factors such as self-efficacy, low deviant beliefs, and religiosity operate among homeless youth and young adults. The purpose of this study is to examine the relationship between various forms of victimization, mental health, and protective factors with property and violent crime and illicit drug use among homeless young adults. Results from regression analyses indicate that running away from home more frequently, experiencing more physical victimization on the street, higher levels of self-efficacy, and more deviant beliefs were associated with greater property crime. Significant correlates of violent crime included being male, running away from home more frequently, greater sexual and physical victimization on the street, higher levels of self-efficacy, and more deviant beliefs. Finally, being male, running away more frequently from home, greater child physical abuse and partner victimization, and more deviant beliefs were all associated with greater illicit drug use. Self-efficacy was positively related to both property and violent crime, suggesting that it may not operate for homeless young adults in the same manner as it does for normative populations.

  3. What Criteria Do Child Protective Services Investigators Use to Substantiate Exposure to Domestic Violence?

    ERIC Educational Resources Information Center

    Coohey, Carol

    2007-01-01

    The primary purpose of this study is to determine whether child protective services investigators apply a recognizable set of criteria to substantiate batterers and victims of battering for exposing their children to domestic violence. Although domestic violence occurred in 35% of the 1,248 substantiated incidents of child maltreatment, only 31…

  4. A Structural Equation Model of Burnout and Job Exit among Child Protective Services Workers.

    ERIC Educational Resources Information Center

    Drake, Brett; Yadama, Gautam N.

    1996-01-01

    Uses a structural equation model to examine the three elements of the Maslach Burnout Inventory (MBI)--emotional exhaustion, depersonalization, and personal accomplishment--in relation to job exit among child protective services workers over a 15-month period. The model was supported, showing the relevance of all three MBI elements of job exit.…

  5. Transition Services for DHH Adolescents and Young Adults with Disabilities: Challenges and Theoretical Frameworks

    ERIC Educational Resources Information Center

    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…

  6. Social Support and Health Service Use in Depressed Adults: Findings From the National Health and Nutrition Examination Survey.

    PubMed

    Andrea, Sarah B; Siegel, Sarah A R; Teo, Alan R

    2016-01-01

    We investigated the relationship between social support and health service use among men and women with depression. Participants were 1379 adults with symptoms of depression (Patient Health Questionnaire-9 score ≥ 5) in the National Health and Nutrition Examination Survey. Using the framework of the Andersen Behavioral Model of Health Services Use, multivariable regression models used social support, stratified by depression severity, to estimate association with utilization of mental health and nonmental health services. Partial F-tests examined a priori interactions between social support and gender. Among those with adequate social support, odds of seeing a nonmental health provider were much higher when depression was moderate [Odds Ratio (OR): 2.6 (1.3-5.3)] or severe [OR: 3.2 (1.2-8.7)], compared to those lacking social support. Conversely, odds of mental health service use were 60% lower among those with moderate depression [OR: 0.4 (0.2-1.0)] when social support was adequate as opposed to inadequate. Social support was unrelated to service use when depression was mild. Gender moderated the relationship between social support and health service use among individuals with severe depression. Social support has opposite associations with mental and nonmental health service use among adults with clinically significant depression. This association is largely attributable to the effect of male gender on the relationship between social support and health service use. Published by Elsevier Inc.

  7. Risk and protective factors for heavy binge alcohol use among American Indian adolescents utilizing emergency health services.

    PubMed

    Tingey, Lauren; Cwik, Mary F; Rosenstock, Summer; Goklish, Novalene; Larzelere-Hinton, Francene; Lee, Angelita; Suttle, Rosemarie; Alchesay, Melanie; Massey, Kirk; Barlow, Allison

    2016-11-01

    American Indian (AI) adolescents are disproportionately burdened by alcohol abuse and heavy binge use, often leading to problematic drinking in adulthood. However, many AI communities also have large proportions of adults who abstain from alcohol. To understand these concurrent and divergent patterns, we explored the relationship between risk and protective factors for heavy binge alcohol use among a reservation-based sample of AI adolescents. Factors at individual, peer, family, and cultural/community levels were examined using a cross-sectional case-control study design. Cases were adolescents with recent heavy binge alcohol use that resulted in necessary medical care. Controls had no lifetime history of heavy binge alcohol use. 68 cases and 55 controls were recruited from emergency health services visits. Participants were 50% male; average age 15.4 years old, range 10 to 19. Independent variables were explored using logistic regression; those statistically significant were combined into a larger multivariate model. Exploratory analyses showed adolescents who were aggressive, impulsive, had deviant peers, poor family functioning or more people living at home were at greater risk for heavy binge alcohol use. Protective factors included attending school, family closeness, residential stability, social problem-solving skills, having traditional AI values and practices, and strong ethnic identity. Confirmatory analysis concluded that school attendance and residential stability reduce the probability of heavy binge alcohol use, even among those already at low risk. Findings deepen the understanding of AI adolescent heavy binge alcohol use and inform adolescent intervention development fostering trajectories to low-risk drinking and abstinence.

  8. 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…

  9. How gender and task difficulty affect a sport-protective response in young adults

    PubMed Central

    Lipps, David B.; Eckner, James T.; Richardson, James K.; Ashton-Miller, James A.

    2013-01-01

    We tested the hypotheses that gender and task difficulty affect the reaction, movement, and total response times associated with performing a head protective response. Twenty-four healthy young adults (13 females) performed a protective response of raising their hands from waist level to block a foam ball fired at their head from an air cannon. Participants initially stood 8.25 m away from the cannon (‘low difficulty’), and were moved successively closer in 60 cm increments until they failed to block at least 5 of 8 balls (‘high difficulty’). Limb motion was quantified using optoelectronic markers on the participants’ left wrist. Males had significantly faster total response times (p = 0.042), a trend towards faster movement times (p = 0.054), and faster peak wrist velocity (p < .001) and acceleration (p = 0.032) than females. Reaction time, movement time, and total response time were significantly faster under high difficulty conditions for both genders (p < .001). This study suggests that baseball and softball pitchers and fielders should have sufficient time to protect their head from a batted ball under optimal conditions if they are adequately prepared for the task. PMID:23234296

  10. The Role of Adult Day Services in Supporting the Occupational Participation of People with Dementia and Their Carers: An Integrative Review.

    PubMed

    Du Preez, Janice; Millsteed, Jeannine; Marquis, Ruth; Richmond, Janet

    2018-05-08

    The increasing numbers of people with dementia places considerable stress on health and aged care services and has resulted in the development of community adult day services. Aim : The aim of this integrative review is to determine the extent to which these services support the occupational participation of people with dementia, and how they impact their primary carers. Method : The mixed-methods appraisal tool (MMAT) was used to identify relevant studies in the period 2011⁻2016. Results : Nine databases were searched and yielded 16 articles with a variety of research designs for inclusion in the review. Conclusions : Findings indicate that adult day services use a range of approaches to support attendees and their carers. In spite of these efforts, there appears to be a lack of interest in utilizing these services while a person is in the early stages of dementia. This suggests that policies in aged care, such as aging-in-place, need to consider the pressure and stress they exert on carer’s quality of life. Another consideration is to better promote the benefits of participating in adult day services in the early stages of dementia for both the attendees and their carers, thereby delaying the tendency towards early institutionalization.

  11. [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. © Georg Thieme Verlag KG Stuttgart · New York.

  12. A collaborative approach to improve the assessment of physical health in adult consumers with schizophrenia in Queensland mental health services.

    PubMed

    Plever, Sally; McCarthy, Irene; Anzolin, Melissa; Emmerson, Brett; Khatun, Mohsina

    2016-02-01

    The objective of this study was to apply a quality improvement collaborative to increase the number of physical health assessments conducted with consumers diagnosed with schizophrenia in adult community mental health services across Queensland. Sixteen adult mental health service organisations voluntarily took part in the statewide collaborative initiative to increase the number of physical health assessments completed on persons with a diagnosis of schizophrenia spectrum disorders managed through the community mental health service. Improvement in the physical health assessment clinical indicator was demonstrated across the state over a 3-year period with an increase in the number of physical health assessments recorded from 12% to 58%. Significant improvements were made over a 3-year period by all mental health services involved in the collaborative, supporting the application of a quality improvement methodology to drive change across mental health services. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  13. The transition of young adults with lifelong urological needs from pediatric to adult services: An international children's continence society position statement.

    PubMed

    Bower, Wendy F; Christie, Deborah; DeGennaro, Mario; Latthe, Pallavi; Raes, Ann; Romao, Rodrigo L P; Taghizadeh, Arash; Wood, Dan; Woodhouse, Christopher R J; Bauer, Stuart B

    2017-03-01

    Children with urinary tract disorders managed by teams, or individual pediatricians, urologists, nephrologists, gastroenterologists, neurologists, psychologists, and nurses at some point move from child-centered to adult-centered health systems. The actual physical change is referred to as the transfer whilst the process preceding this move constitutes transition of care. Our aims are twofold: to identify management and health-service problems related to children with congenital or acquired urological conditions who advance into adulthood and the clinical implications this has for long-term health and specialist care; and, to understand the issues facing both pediatric and adult-care clinicians and to develop a systems-approach model that meets the needs of young adults, their families and the clinicians working within adult services. Information was gleaned from presentations at an International Children's Continence Society meeting with collaboration from the International Continence Society, that discussed problems of transfer and transitioning such children. Several specialists attending this conference finalized this document identifying issues and highlighting ways to ease this transition and transfer of care for both patients and practitioners. The consensus was, urological patients with congenital or other lifelong care needs, are now entering adulthood in larger numbers than previously, necessitating new planning processes for tailored transfer of management. Adult teams must become familiar with new clinical problems in multiple organ systems and anticipate issues provoked by adolescence and physical growth. During this period of transitional care the clinician or team assists young patients to build attitudes, skills and understanding of processes needed to maximize function of their urinary tract-thus taking responsibility for their own healthcare needs. Preparation must also address, negotiating adult health care systems, psychosocial, educational or

  14. [Analysis on occupational exposure to dust and harmful gas and corresponding protection in adults aged 40 years and older in China, 2014].

    PubMed

    Wang, B H; Cong, S; Bao, H L; Feng, Y J; Fan, J; Wang, N; Fang, L W; Wang, L H

    2018-05-10

    Objective: To understand the current status of dust and/or harmful gas exposure in adults aged ≥40 years and corresponding protection in China, and provide evidence for strengthening the occupational protection against dust and harmful gas exposure. Methods: The data were obtained from 2014-2015 COPD surveillance in China. A total of 75 107 adults aged ≥40 years selected through multi-stage stratified cluster sampling from 125 surveillance points in 31 provinces (autonomous regions and municipalities) were surveyed in face to face interviews. Occupational exposure was defined as occupational exposure to dust and/or harmful gas for more than 1 year. The weighted percentages of exposure were estimated by using complex sampling design. Results: Among eligible 71 061 participants, the exposure rate of dust and/or harmful gas was 46.3 % . The exposure rate in rural area (51.7 % ) was significantly higher than that in urban area (40.3 % ), and the exposure rate in the western area was higher than those in the eastern and central areas ( P <0.001). Among the groups with different education level, the exposure rate in those with education level of primary school and below was highest (49.7 % , P <0.001). The exposure protection rate was 26.7 % , and the exposure protection rate was highest in the eastern area (29.9 % ), followed by that in the central area (27.0 % ) and that in the western area (22.9 % ) The exposure protection rate in urban area was significantly higher than that in rural area, and the exposure protection rate was lowest in those with education level of primary school and below. The regular exposure protection was taken by only 50.7 % of the adults surveyed. Conclusion: The exposure rate of dust and/or harmful gas is high in China, while the exposure protection rate is very low. Health education, occupational protection and supervision should be strengthened among those with low education level, and those living in rural area and in the western area.

  15. Factors influencing utilization of hospital services by adult sickle cell disease patients: a systematic review.

    PubMed

    Benenson, Irina; Jadotte, Yuri; Echevarria, Mercedes

    2017-03-01

    Painful vaso-occlusive crisis is a hallmark of sickle cell disease (SCD) that commonly results in utilization of hospital services. Recurrent use of hospital services by SCD patients is associated with high healthcare costs and adverse clinical outcomes. Understanding the factors influencing the pattern of utilization is a first step in improving medical care of this patient population while reducing healthcare expenditures. The primary objective of this systematic review was to determine what modifiable and non-modifiable factors influence utilization of hospital services by adult SCD patients. Adult SCD patients of both sexes who utilized hospital services for acute or emergency care. Non-modifiable and modifiable factors influencing utilization of hospital services. Prospective and retrospective cohort studies, case-control and analytical cross-sectional studies. The primary outcome of interest was high utilization of hospital services by adult SCD patients based on non-modifiable and modifiable factors measured as an odds ratio (analytical outcome). The secondary outcome was the prevalence of non-modifiable and modifiable factors among SCD patients who utilized hospital services measured as an event rate (descriptive outcome). A comprehensive multi-step search was undertaken to find both published and unpublished studies. Only studies published in the English language were included. The search was not limited by year of publication. Retrieved papers were assessed for methodological quality using standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument. Data were extracted using a researcher-developed tool. Included studies were combined in a statistical meta-analysis. The meta-analysis was based on a random effect model. For studies that did not allow statistical pooling, the findings have been presented in a narrative form. Fourteen studies were included in this review. The

  16. Service use and financial performance in a replication program on adult day centers.

    PubMed

    Reifler, B V; Cox, N J; Jones, B N; Rushing, J; Yates, K

    1999-01-01

    The authors describe results from Partners in Caregiving: The Dementia Services Program, and present information on service utilization and financial performance among a group of 48 adult day centers across the United States from 1992 to 1996. Centers, with nonrandom assignment, received either grant support (average value: $93,000) or intensive technical assistance (average value: $39,000). Sites reported baseline data and submitted utilization information (enrollment and census) and financial data (revenue and expenses) quarterly. Overall, there were significant increases in enrollment, census, and financial performance (percent of cash expenses met through operating revenue) over the 4-year period. The grant-supported and technical-assistance sites had similar rates of improvement. Results provide data on service utilization and financial performance and demonstrate gains that can be achieved in these areas through improved marketing and financial management.

  17. Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement.

    PubMed

    Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Caughey, Aaron B; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kubik, Martha; Landefeld, Seth; Mangione, Carol M; Pignone, Michael; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

    2018-04-24

    Falls are the leading cause of injury-related morbidity and mortality among older adults in the United States. In 2014, 28.7% of community-dwelling adults 65 years or older reported falling, resulting in 29 million falls (37.5% of which needed medical treatment or restricted activity for a day or longer) and an estimated 33 000 deaths in 2015. To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on the prevention of falls in community-dwelling older adults. The USPSTF reviewed the evidence on the effectiveness and harms of primary care-relevant interventions to prevent falls and fall-related morbidity and mortality in community-dwelling older adults 65 years or older who are not known to have osteoporosis or vitamin D deficiency. The USPSTF found adequate evidence that exercise interventions have a moderate benefit in preventing falls in older adults at increased risk for falls and that multifactorial interventions have a small benefit. The USPSTF found adequate evidence that vitamin D supplementation has no benefit in preventing falls in older adults. The USPSTF found adequate evidence to bound the harms of exercise and multifactorial interventions as no greater than small. The USPSTF found adequate evidence that the overall harms of vitamin D supplementation are small to moderate. The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. (B recommendation) The USPSTF recommends that clinicians selectively offer multifactorial interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. Existing evidence indicates that the overall net benefit of routinely offering multifactorial interventions to prevent falls is small. When determining whether this service is appropriate for an individual, patients and clinicians should consider the balance of benefits and harms based on the circumstances of prior

  18. Service user engagement: A co-created interview schedule exploring mental health recovery in young adults.

    PubMed

    McCauley, Claire-Odile; McKenna, Hugh; Keeney, Sinead; McLaughlin, Derek

    2017-10-01

    The aim of this study was to co-create of an interview schedule exploring mental health recovery in collaboration with young adult service users. Service user involvement in research has been increasingly recognized as providing a vital authentic insight into mental health recovery. Engagement and collaboration with service users have facilitated the exploration of inaccessible or under-investigated aspects of the lived experience of mental health recovery, not only directing the trajectory of research, but making it relevant to their own contextual experience. A qualitative content analysis framework was employed in the co-creation of a semi-structured interview schedule through an engagement process with service users. Two separate engagement groups took place at the premises of the service user organizations, between January - February 2014. Miles and Huberman's analysis framework was chosen for this phase as it enabled the visual presentation of factors, concepts or variables and the established relationship between them. The lived experience of mental ill health in young adulthood and how this was understood by others was a particularly relevant theme for participants. Further themes were identified between the impact of painful experiences at this developmental life stage leading to a deeper understanding of others through finding meaning in their own mental health recovery journey. Our findings identified that suffering painful experiences is an integral aspect in the process of mental health recovery. This understanding has particular relevance to mental health nursing practice, ensuring the care delivered is cognizant of the suffering or painful experiences that young adults are encountering. © 2017 John Wiley & Sons Ltd.

  19. Deconstructing the surrogate species concept: a life history approach to the protection of ecosystem services

    USDA-ARS?s Scientific Manuscript database

    The use of the surrogate species concept is widespread in environmental risk assessment and in particular the protection of species that provide ecosystem services, yet there are no standard protocols in place for the choice of surrogates. Surrogates are often chosen on the basis of convenience or ...

  20. An Examination of New York State's Integrated Primary and Mental Health Care Services for Adults with Serious Mental Illness.

    PubMed

    Scharf, Deborah M; Breslau, Joshua; Hackbarth, Nicole Schmidt; Kusuke, Daniela; Staplefoote, B Lynette; Pincus, Harold Alan

    2014-12-30

    The poor physical health of adults with serious mental illnesses is a public health crisis. Greater integration of mental health and primary medical care services at the clinic and system levels could address this need. In New York state, there are several ongoing initiatives that promote integrated care for adults with serious mental illness, provided or coordinated by community mental health center staff. This study examines three initiatives. Data were collected by RAND through site visits and surveys of mental health clinic administrators and associated professionals. Results showed that Primary and Behavioral Health Care Integration grantees developed infrastructure that supported a broad scope of primary and preventive health care services; these broad changes appeared to contribute to clinic-wide culture shifts toward integration and shared accountability for consumers' "whole person" health. Clinics participating in the Medicaid Incentive tended to implement only those services for which they could bill, which resulted in newly identified consumer physical health care needs but did not help consumers to connect to physical health care services. Finally, while administrators and providers were optimistic that Medicaid Health Homes have potential to improve access to care for adults with serious mental illness, the newness of the initiative made it difficult to assess the degree to which Health Home networks would meet these goals. We conclude with recommendations to state policymakers, clinical providers, and technical assistance providers and recommendations for future research, all designed to strengthen New York state's integrated care initiatives for adults with serious mental illness.

  1. What criteria do child protective services investigators use to substantiate exposure to domestic violence?

    PubMed

    Coohey, Carol

    2007-01-01

    The primary purpose of this study is to determine whether child protective services investigators apply a recognizable set of criteria to substantiate batterers and victims of battering for exposing their children to domestic violence. Although domestic violence occurred in 35% of the 1,248 substantiated incidents of child maltreatment, only 31 (7.1%) couples were investigated for exposing a child to domestic violence or failing to protect a child from domestic violence. All of the batterers investigated and in the caregiver role when their children were exposed to domestic violence were substantiated. The unsubstantiated victims of battering tended to use more protective behaviors (M=3.82) than the substantiated victims (M=2.00); yet, at the case level, using more than one protective behavior did not seem to be a criterion used to substantiate the victims. Instead, it appears that investigators were discriminating between those protective behaviors by the victims that ended contact between the batterers and the children--for a substantial amount of time--and those that did not in both the substantiation and removal decision. Key issues related to applying criteria in incidents involving domestic violence are discussed along with recommendations to further refine and document them.

  2. Transition to adult mental health services for young people with attention deficit hyperactivity disorder in Italy: Parents' and clinicians' experiences.

    PubMed

    Reale, Laura; Frassica, Simona; Gollner, Astrid; Bonati, Maurizio

    2015-01-01

    The aim of this study was to describe the experiences of parents and clinicians in relation to the transition from child and adolescent neuropsychiatric services (CANPS) to adult services for people with attention deficit hyperactivity disorder (ADHD) in Italy. Parents of people with ADHD who reached the transition boundary for CANPS were sampled from the A.I.F.A. association (Italian Association of ADHD Families). We thematically analyzed informative and qualitative questionnaires completed by parents and clinicians. Parents' (n = 24) and clinicians' (n = 27) experiences differed slightly on challenges and unmet needs, whereas clinicians agreed on the variables required for an optimal transition process. Poor transition and multiple barriers to such care were identified. Specifically, far fewer people received services, especially public health services, after reaching the age of 18, and perceived barriers included problems with user access, limited transition protocols, poor service coordination, and possible lack of ADHD-related knowledge on the part of adult practitioners. Care continuity in mental healthcare remains a need to be prioritized and better defined also for ADHD patients (and their parents). Parents' and clinicians' experiences are more likely to be positive if transition management is characterized by a gradual preparation, a period of parallel care, and commonly acknowledged, clear information on available services and how to access them. Identifying the needs and barriers of the people representing the different roles (clinicians, parents, and users) involved in the transition to adult mental health services is of particular importance in designing effective, shared transfer planning procedures.

  3. 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…

  4. Evaluation of health care services provided for older adults in primary health care centers and its internal environment

    PubMed Central

    Alhamdan, Adel A.; Alshammari, Sulaiman A.; Al-Amoud, Maysoon M.; Hameed, Tariq A.; Al-Muammar, May N.; Bindawas, Saad M.; Al-Orf, Saada M.; Mohamed, Ashry G.; Al-Ghamdi, Essam A.; Calder, Philip C.

    2015-01-01

    Objectives: To evaluate the health care services provided for older adults by primary health care centers (PHCCs) in Riyadh, Kingdom of Saudi Arabia (KSA), and the ease of use of these centers by older adults. Methods: Between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by older adults. Evaluations were based upon the age-friendly PHCCs toolkit of the World Health Organization. Results: Coverage of basic health assessments (such as blood pressure, diabetes, and blood cholesterol) was generally good. However, fewer than half of the PHCCs offered annual comprehensive screening for the common age-related conditions. There was no screening for cancer. Counseling on improving lifestyle was provided by most centers. However, there was no standard protocol for counseling. Coverage of common vaccinations was poor. The layout of most PHCCs and their signage were good, except for lack of Braille signage. There may be issues of access of older adults to PHCCs through lack of public transport, limited parking opportunities, the presence of steps, ramps, and internal stairs, and the lack of handrails. Conclusions: Clinical services and the internal environment of PHCCs can be improved. The data will be useful for health-policy makers to improve PHCCs to be more age-friendly. PMID:26318467

  5. 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.…

  6. Deconstructing the surrogate species concept:a life history approach to the protection of ecosystem services.

    USDA-ARS?s Scientific Manuscript database

    The use of the surrogate species concept is widespread in environmental risk assessment and in particular the protection of species that provide ecosystem services, yet there are no standard protocols in place for the choice of surrogates. Surrogates are often chosen on the basis of convenience or v...

  7. Risk and Protective Factors Associated with Gambling Products and Services: Indigenous Gamblers in North Queensland

    ERIC Educational Resources Information Center

    Breen, Helen

    2012-01-01

    As part of a larger study, this paper reports on findings into risk and protective factors associated with gambling products and services by Indigenous Australians. Both Indigenous card gambling (traditional or unregulated) and commercial gambling (regulated) were investigated. Permission was granted by Indigenous Elders and by a university ethics…

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

    USDA-ARS?s Scientific Manuscript database

    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...

  9. PROTECTED-UK - Clinical pharmacist interventions in the UK critical care unit: exploration of relationship between intervention, service characteristics and experience level.

    PubMed

    Rudall, Nicola; McKenzie, Catherine; Landa, June; Bourne, Richard S; Bates, Ian; Shulman, Rob

    2017-08-01

    Clinical pharmacist (CP) interventions from the PROTECTED-UK cohort, a multi-site critical care interventions study, were further analysed to assess effects of: time on critical care, number of interventions, CP expertise and days of week, on impact of intervention and ultimately contribution to patient care. Intervention data were collected from 21 adult critical care units over 14 days. Interventions could be error, optimisation or consults, and were blind-coded to ensure consistency, prior to bivariate analysis. Pharmacy service demographics were further collated by investigator survey. Of the 20 758 prescriptions reviewed, 3375 interventions were made (intervention rate 16.1%). CPs spent 3.5 h per day (mean, ±SD 1.7) on direct patient care, reviewed 10.3 patients per day (±SD 4.2) and required 22.5 min (±SD 9.5) per review. Intervention rate had a moderate inverse correlation with the time the pharmacist spent on critical care (P = 0.05; r = 0.4). Optimisation rate had a strong inverse association with total number of prescriptions reviewed per day (P = 0.001; r = 0.7). A consultant CP had a moderate inverse correlation with number of errors identified (P = 0.008; r = 0.6). No correlation existed between the presence of electronic prescribing in critical care and any intervention rate. Few centres provided weekend services, although the intervention rate was significantly higher on weekends than weekdays. A CP is essential for safe and optimised patient medication therapy; an extended and developed pharmacy service is expected to reduce errors. CP services should be adequately staffed to enable adequate time for prescription review and maximal therapy optimisation. © 2016 Royal Pharmaceutical Society.

  10. Work Engagement, Burnout and Personal Accomplishments Among Social Workers: A Comparison Between Those Working in Children and Adults' Services in England.

    PubMed

    Hussein, Shereen

    2018-04-26

    Social workers (SWs) provide emotional and practical support to vulnerable service users who are likely to suffer from emotional trauma and mental health conditions. Stress and burnout levels are reported to be high among SWs, however, little is known about their relationships with different characteristics. The current article utilises unique and large dataset (n = 3786) on SWs working in adults and children's services to examine factors associated with burnout. Employing job-demand/resources model and structural equations modelling, we highlight the varying significant impact of work-engagement, administrative support and work experience as moderating factors to burnout across adult and children service specialism in this sample.

  11. 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…

  12. Sun Protection Preferences and Behaviors among Young Adult Males during Maximum Ultraviolet Radiation Exposure Activities

    PubMed Central

    Wickenheiser, Marilyn; Baker, Mary Kate; Gaber, Rikki; Blatt, Hanz; Robinson, June K.

    2013-01-01

    This study explores sun protection attitudes, preferences, and behaviors among young adult males participating in an open-field activity with extreme ultraviolet radiation exposure. Male drum corps members (n = 137) responded to survey questions regarding their behavior and willingness to engage in sun protection and barriers to sunscreen usage. A subset of members (n = 31) participated in cognitive interviews exploring various sunscreen products and intervention techniques. Participants were knowledgeable about health risks and protection benefits regarding sun exposure. Generally, males had positive attitudes and normative beliefs about using sunscreen. A barrier to sunscreen re-application was lack of adequate time to reapply sunscreen during the open field activity. Males preferred a towelette application method, but were unfamiliar with its efficacy and proper use. Thus, they were more likely to use the more familiar sunscreen spray. To increase sun protection behaviors and lower skin cancer risk for males participating in open-field activities, breaks must be allotted every 2 h and have sufficient time to allow sunscreen application. Future development and research into delivery systems that rapidly and evenly apply sunscreen may help lower exposure in this population. PMID:23912201

  13. [Thermal injuries in the OEAMTC air rescue service. Epidemiological characteristics of burns/scalds in children and adults].

    PubMed

    Selig, H F; Nagele, P; Lumenta, D B; Voelckel, W G; Trimmel, H; Hüpfl, M; Kamolz, L P

    2014-04-01

    Few data exist on the epidemiological characteristics of thermal injuries in prehospital emergency care, especially in the context of air rescue. Therefore, this study aimed to analyze the epidemiology of pediatric and adult thermal injuries in the helicopter emergency medical service (HEMS) run by the Austrian Automobile Motorcycle Touring Club (OEAMTC) air rescue service from an almost nationwide sample. All OEAMTC-HEMS rescue missions flown for thermal injuries in 2009 were retrospectively reviewed. Primary (n=88) and secondary missions (n=17) were collated and all primary missions were analyzed in detail. In total 71 out of 16,100 (0.4 %) primary HEMS rescue missions were for patients suffering from burns or scalds (children n=27, adults n=44). The proportion of major burns (burns covering >20 % of the total body surface area) was 40.7 % in children and 54.5 % in adults, 44 (62 %) burn/scald injuries were related to the head/neck, 37 (52.1 %) to the upper limbs and 10 (14.1 %) to the anogenital region. More than half of the victims (63.4%) suffered potentially life-threatening injury. In HEMS thermal injuries are infrequent but mostly life-threatening. Differences in epidemiological characteristics of pediatric and adult burns/scalds may have important operational, training and public health implications.

  14. Meteorological operational services for civil protection in Veneto region (North-eastern Italy).

    NASA Astrophysics Data System (ADS)

    Barbi, A.; Monai, M.; Zardini, F.

    2009-09-01

    The Meteorological Centre of Teolo (CMT), part of the Regional Agency for Environmental Prevention and Protection of the North-eastern Italian region Veneto (ARPAV), is the operational regional meteorological service. Since April 2009 the Centre is linked to and supplies meteorological monitoring and forecasting to the recently constituted Functional Centre of the regional civil protection (CFD Veneto), which operates in the framework of National Civil Protection. The CFD Veneto supplies a multi-disciplinary, technical-scientific support to civil protection activities, to early warnings of natural hazards, in particular related to hydrogeological, hydraulic, and avalanches risks. The north-eastern part of Italy is known to be one of the rainiest regions in Europe. The region Veneto, due to its topographic configuration which includes Alpine reliefs, plans and a coast exposed to the Adriatic Sea, is conducive to heavy and long-lasting precipitation events. Also, strong thunderstorm activity with high precipitation rates, hail, wind gusts, and even tornadoes are relatively frequent occurrences. In this contribution two recent examples of different types of extreme events are briefly analysed by means of the ARPAV multi-sensor observing system which includes weather radar and a dense surface network. We show some of the impacts of such weather events on the territory, the services provided by CFD Veneto, in terms of meteorological forecasting and nowcasting products, and hydrogeologic/hydraulic hazard bullettins. The analysis highlights the difficulty of an efficient wheather forecast for civil defence purposes in a complex situation as ours, where many types of different events are possible. Especially cases of rapid convective events with their intense and very localized phenomena are a significant challenge. It is well-known that such events can bring remarkable material damages and serious danger for the people. For this reason an effective warning system which

  15. 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. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  16. Behavioral Counseling to Prevent Skin Cancer: US Preventive Services Task Force Recommendation Statement.

    PubMed

    Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Caughey, Aaron B; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kubik, Martha; Landefeld, Seth; Mangione, Carol M; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

    2018-03-20

    Skin cancer is the most common type of cancer in the United States. Although invasive melanoma accounts for only 2% of all skin cancer cases, it is responsible for 80% of skin cancer deaths. Basal and squamous cell carcinoma, the 2 predominant types of nonmelanoma skin cancer, represent the vast majority of skin cancer cases. To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on behavioral counseling for the primary prevention of skin cancer and the 2009 recommendation on screening for skin cancer with skin self-examination. The USPSTF reviewed the evidence on whether counseling patients about sun protection reduces intermediate outcomes (eg, sunburn or precursor skin lesions) or skin cancer; the link between counseling and behavior change, the link between behavior change and skin cancer incidence, and the harms of counseling or changes in sun protection behavior; and the link between counseling patients to perform skin self-examination and skin cancer outcomes, as well as the harms of skin self-examination. The USPSTF determined that behavioral counseling interventions are of moderate benefit in increasing sun protection behaviors in children, adolescents, and young adults with fair skin types. The USPSTF found adequate evidence that behavioral counseling interventions result in a small increase in sun protection behaviors in adults older than 24 years with fair skin types. The USPSTF found inadequate evidence on the benefits and harms of counseling adults about skin self-examination to prevent skin cancer. The USPSTF recommends counseling young adults, adolescents, children, and parents of young children about minimizing exposure to UV radiation for persons aged 6 months to 24 years with fair skin types to reduce their risk of skin cancer. (B recommendation) The USPSTF recommends that clinicians selectively offer counseling to adults older than 24 years with fair skin types about minimizing their exposure to UV radiation to reduce risk

  17. Decision making in child protective services: a risky business?

    PubMed

    Camasso, Michael J; Jagannathan, Radha

    2013-09-01

    Child Protective Services (CPS) in the United States has received a torrent of criticism from politicians, the media, child advocate groups, and the general public for a perceived propensity to make decisions that are detrimental to children and families. This perception has resulted in numerous lawsuits and court takeovers of CPS in 35 states, and calls for profound restructuring in other states. A widely prescribed remedy for decision errors and faulty judgments is an improvement of risk assessment strategies that enhance hazard evaluation through an improved understanding of threat potentials and exposure likelihoods. We examine the reliability and validity problems that continue to plague current CPS risk assessment and discuss actions that can be taken in the field, including the use of receiver operating characteristic (ROC) curve technology to improve the predictive validity of risk assessment strategies. © 2012 Society for Risk Analysis.

  18. Incorporation of Socio-Economic Features' Ranking in Multicriteria Analysis Based on Ecosystem Services for Marine Protected Area Planning

    PubMed Central

    Portman, Michelle E.; Shabtay-Yanai, Ateret; Zanzuri, Asaf

    2016-01-01

    Developed decades ago for spatial choice problems related to zoning in the urban planning field, multicriteria analysis (MCA) has more recently been applied to environmental conflicts and presented in several documented cases for the creation of protected area management plans. Its application is considered here for the development of zoning as part of a proposed marine protected area management plan. The case study incorporates specially-explicit conservation features while considering stakeholder preferences, expert opinion and characteristics of data quality. It involves the weighting of criteria using a modified analytical hierarchy process. Experts ranked physical attributes which include socio-economically valued physical features. The parameters used for the ranking of (physical) attributes important for socio-economic reasons are derived from the field of ecosystem services assessment. Inclusion of these feature values results in protection that emphasizes those areas closest to shore, most likely because of accessibility and familiarity parameters and because of data biases. Therefore, other spatial conservation prioritization methods should be considered to supplement the MCA and efforts should be made to improve data about ecosystem service values farther from shore. Otherwise, the MCA method allows incorporation of expert and stakeholder preferences and ecosystem services values while maintaining the advantages of simplicity and clarity. PMID:27183224

  19. Incorporation of Socio-Economic Features' Ranking in Multicriteria Analysis Based on Ecosystem Services for Marine Protected Area Planning.

    PubMed

    Portman, Michelle E; Shabtay-Yanai, Ateret; Zanzuri, Asaf

    2016-01-01

    Developed decades ago for spatial choice problems related to zoning in the urban planning field, multicriteria analysis (MCA) has more recently been applied to environmental conflicts and presented in several documented cases for the creation of protected area management plans. Its application is considered here for the development of zoning as part of a proposed marine protected area management plan. The case study incorporates specially-explicit conservation features while considering stakeholder preferences, expert opinion and characteristics of data quality. It involves the weighting of criteria using a modified analytical hierarchy process. Experts ranked physical attributes which include socio-economically valued physical features. The parameters used for the ranking of (physical) attributes important for socio-economic reasons are derived from the field of ecosystem services assessment. Inclusion of these feature values results in protection that emphasizes those areas closest to shore, most likely because of accessibility and familiarity parameters and because of data biases. Therefore, other spatial conservation prioritization methods should be considered to supplement the MCA and efforts should be made to improve data about ecosystem service values farther from shore. Otherwise, the MCA method allows incorporation of expert and stakeholder preferences and ecosystem services values while maintaining the advantages of simplicity and clarity.

  20. Mental healthcare need and service utilization in older adults living in public housing.

    PubMed

    Simning, Adam; van Wijngaarden, Edwin; Fisher, Susan G; Richardson, Thomas M; Conwell, Yeates

    2012-05-01

    Anxiety and depression in socioeconomically disadvantaged older adults frequently go unrecognized and untreated. This study aims to characterize mental illness and its treatment in older adult public housing residents who have many risk factors for anxiety and depression. Cross-sectional study. Public housing high-rises in Rochester, New York. One hundred ninety residents aged 60 years and older. Anxiety and depression were assessed using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, GAD-7, and Patient Health Questionnaire. We obtained information on mental healthcare from medication review and self-report. Participants had a median age of 66 years, 58% were women, 80% were black, and 92% lived alone. Many participants (31%) were in need of mental healthcare: 21% had syndromal and 11% had subsyndromal anxiety or depression. Mental healthcare need was associated with younger age; intact cognitive functioning; impairments in instrumental activities of daily living (IADL); more medical illness; decreased mobility; smaller social network size; more severe life events; and increased utilization of medical, human, and informal services. Of those with mental healthcare need, most were not receiving it. Compared with residents receiving mental healthcare, residents with untreated need were more likely to be men and have less IADL impairment, medical illness, severe life events, onsite social worker use, and human services utilization. Mental illness was common and largely untreated in public housing residents. Increasing collaboration between medical, mental, and human services is needed to improve identification, treatment, and ultimately prevention of late-life mental illness in this community setting.

  1. Screening for asymptomatic bacteriuria in adults: U.S. Preventive Services Task Force reaffirmation recommendation statement.

    PubMed

    2008-07-01

    Reaffirmation of the 2004 U.S. Preventive Services Task Force recommendation statement about screening for asymptomatic bacteriuria in adults. The U.S. Preventive Services Task Force did a targeted literature search for evidence on the benefits and harms of screening for asymptomatic bacteriuria in pregnant women, nonpregnant women, and men. Screen for asymptomatic bacteriuria with urine culture in pregnant women at 12 to 16 weeks' gestation or at the first prenatal visit, if later. (Grade A recommendation.) Do not screen for asymptomatic bacteriuria in men and nonpregnant women. (Grade D recommendation.).

  2. Racial and Ethnic Service Use Disparities Among Homeless Adults With Severe Mental Illnesses Receiving ACT

    PubMed Central

    Horvitz-Lennon, Marcela; Zhou, Dongli; Normand, Sharon-Lise T.; Alegría, Margarita; Thompson, Wes K.

    2013-01-01

    Objective Case management–based interventions aimed at improving quality of care have the potential to narrow racial and ethnic disparities among people with chronic illnesses. The aim of this study was to assess the equity effects of assertive community treatment (ACT), an evidence-based case management intervention, among homeless adults with severe mental illness. Methods This study used baseline, three-, and 12-month data for 6,829 black, Latino, and white adults who received ACT services through the ACCESS study (Access to Community Care and Effective Services and Support). Zero-inflated Poisson random regression models were used to estimate the adjusted probability of use of outpatient psychiatric services and, among service users, the intensity of use. Odds ratios and rate ratios (RRs) were computed to assess disparities at baseline and over time. Results No disparities were found in probability of use at baseline or over time. Compared with white users, baseline intensity of use was lower for black users (RR=.89; 95% confidence interval [CI]=.83–.96) and Latino users (RR=.65; CI=.52–.81]). Intensity did not change over time for whites, but it did for black and Latino users. Intensity increased for blacks between baseline and three months (RR=1.11, CI=1.06–1.17]) and baseline and 12 months (RR=1.17, CI=1.11–1.22]). Intensity of use dropped for Latinos between baseline and three months (RR=.83, CI=.70–.98). Conclusions Receipt of ACT was associated with a reduction in service use disparities for blacks but not for Latinos. Findings suggest that ACT’s equity effects differ depending on race-ethnicity. PMID:21632726

  3. Liaison psychiatry for older adults in the general hospital: service activity, development and outcomes.

    PubMed

    Mujic, Fedza; Cairns, Ruth; Mak, Vivienne; Squire, Clare; Wells, Andrew; Al-Harrasi, Ahmed; Prince, Martin

    2018-02-01

    Aims and method This study used data collected to describe the activity, case-load characteristics and outcome measures for all patients seen during a 6-year period. The service reviewed 2153 patients over 6 years with referral rates and case-load characteristics comparable to those described in a previous study period. The team saw 82% of patients on the day they were referred. Data and outcome measures collected showed significant complexity in the cases seen and statistically significant improvement in Health of the Nation Outcome Scales (HoNOS) scores following service input. Clinical implications The outcome measures used were limited, but the study supports the need for specialist liaison psychiatry for older adults (LPOA) services in the general hospital. The Framework of Outcome Measures - Liaison Psychiatry has now been introduced, but it remains unclear how valid this is in LPOA. It is of note that cost-effectiveness secondary to service input and training activities are not adequately monitored. Declaration of interest None.

  4. Youth experiences of transition from child mental health services to adult mental health services: a qualitative thematic synthesis.

    PubMed

    Broad, Kathleen L; Sandhu, Vijay K; Sunderji, Nadiya; Charach, Alice

    2017-11-28

    Adolescence and young adulthood is a vulnerable time during which young people experience many development milestones, as well as an increased incidence of mental illness. During this time, youth also transition between Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). This transition puts many youth at risk of disengagement from service use; however, our understanding of this transition from the perspective of youth is limited. This systematic review aims to provide a more comprehensive understanding of youth experiences of transition from CAMHS to AMHS, through a qualitative thematic synthesis of the extant literature in this area. Published and unpublished literature was searched using keywords targeting three subject areas: Transition, Age and Mental Health. Studies were included if they qualitatively explored the perceptions and experiences of youth who received mental health services in both CAMHS and AMHS. There were no limitations on diagnosis or age of youth. Studies examining youth with chronic physical health conditions were excluded. Eighteen studies, representing 14 datasets and the experiences of 253 unique service-users were included. Youth experiences of moving from CAMHS and AMHS are influenced by concurrent life transitions and their individual preferences regarding autonomy and independence. Youth identified preparation, flexible transition timing, individualized transition plans, and informational continuity as positive factors during transition. Youth also valued joint working and relational continuity between CAMHS and AMHS. Youth experience a dramatic culture shift between CAMHS and AMHS, which can be mitigated by individualized and flexible approaches to transition. Youth have valuable perspectives to guide the intelligent design of mental health services and their perspectives should be used to inform tools to evaluate and incorporate youth perspectives into transitional service improvement

  5. Associations of health insurance coverage, mental health problems, and drug use with mental health service use in US adults: an analysis of 2013 National Survey on Drug Use and Health.

    PubMed

    Wang, Nianyang; Xie, Xin

    2018-02-22

    To estimate the prevalence of mental health service use among US adults, examine the associations of mental health service use with health insurance coverage, mental health problems and drug use, and detect health disparities. This was a cross-sectional study with 5,434 adults receiving mental health service out of 37,424 adult respondents from the 2013 National Survey on Drug Use and Health. Weighted univariate and multiple logistic regression analyses were used to estimate the associations of potential factors with mental health service use. The overall prevalence of mental health services use was 14.7%. Our results showed that being female, aging, having a major depressive episode, serious psychological distress, and illicit drug or alcohol abuse/dependence were positively associated with mental health service use; whereas being African American, Asian or Hispanic ethnicity, married, and having any form of insurance were negatively associated with mental health service use . Stratified analysis by insurance types showed that Medicaid/CHIP, CHAMPUS, and other insurance were positively associated with mental health service use. Health insurance coverage, mental health problems, and drug abuse or dependence were associated with mental health service use in US adults. Furthermore, adults with different insurances had disparities in access of mental health service.

  6. 47 CFR 27.1136 - Protection of mobile satellite services in the 2000-2020 MHz and 2180-2200 MHz bands.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 2000-2020 MHz and 2180-2200 MHz bands. 27.1136 Section 27.1136 Telecommunication FEDERAL COMMUNICATIONS..., 2110-2155 MHz, 2000-2020 MHz, and 2180-2200 MHz bands Protection of Incumbent Operations § 27.1136 Protection of mobile satellite services in the 2000-2020 MHz and 2180-2200 MHz bands. An AWS licensee of the...

  7. Screening for Obstructive Sleep Apnea in Adults: US Preventive Services Task Force Recommendation Statement.

    PubMed

    Bibbins-Domingo, Kirsten; Grossman, David C; Curry, Susan J; Davidson, Karina W; Epling, John W; García, Francisco A R; Herzstein, Jessica; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phillips, William R; Phipps, Maureen G; Pignone, Michael P; Silverstein, Michael; Tseng, Chien-Wen

    2017-01-24

    Based on data from the 1990s, estimated prevalence of obstructive sleep apnea (OSA) in the United States is 10% for mild OSA and 3.8% to 6.5% for moderate to severe OSA; current prevalence may be higher, given the increasing prevalence of obesity. Severe OSA is associated with increased all-cause mortality, cardiovascular disease and cerebrovascular events, diabetes, cognitive impairment, decreased quality of life, and motor vehicle crashes. To issue a new US Preventive Services Task Force (USPSTF) recommendation on screening for OSA in asymptomatic adults. The USPSTF reviewed the evidence on the accuracy, benefits, and potential harms of screening for OSA in asymptomatic adults seen in primary care, including those with unrecognized symptoms. The USPSTF also evaluated the evidence on the benefits and harms of treatment of OSA on intermediate and final health outcomes. The USPSTF found insufficient evidence on screening for or treatment of OSA in asymptomatic adults or adults with unrecognized symptoms. Therefore, the USPSTF was unable to determine the magnitude of the benefits or harms of screening for OSA or whether there is a net benefit or harm to screening. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for OSA in asymptomatic adults. (I statement).

  8. Book Beat: A Young Adult Services Manual for Louisiana's Libraries. Face It: Read a Book: Be Somebody. [Updated Edition.

    ERIC Educational Resources Information Center

    Fairbanks, Gretchen, Ed.; Jaques, Thomas F., Ed.

    Libraries need to reach out to teens and enhance their skills in serving the teenage population. Through the Louisiana Young Adult Services program, it is hoped that all staff working with young adults will be reached to accomplish the following: (1) promote a better understanding of the psychology of this age group; (2) increase skills in…

  9. When Losing Means Winning: The Impact of Conflict in a Digital Game on Young Adults' Intentions to Get Protected from Cancer.

    PubMed

    Khalil, Georges E

    2012-08-01

    Despite the improved survival rate for patients with cancer in the United States, there is a need for successful intervention programs that can raise awareness about cancer risks among healthy young adults. This research experimentally examines how conflict in a digital game called "Re-Mission™" (HopeLab, Redwood City, CA) may influence young adults' perception of cancer risk, their motivation to get protected from cancer, and their intention to seek cancer-related information from their doctors. "Re-Mission" is a game in which players control a nanorobot that goes inside patients' virtual bodies to fight cancer cells. Two days after completing a baseline survey, participants (n=48) played "Re-Mission" at either low or high conflict (i.e., low or high level of obstacles and challenges in the game). Then, participants completed a post-experience survey. Participants in the high conflict condition experienced an increase in perceived susceptibility to and severity of cancer. They also increased their intentions to seek information by talking with a physician. Conflict also blocked any decrease in protective motivation. This study suggests that by virtually experiencing the consequences of cancer cell behavior, young adult players of "Re-Mission" increased in perception of cancer risks, protective motivation, and intentions to seek cancer-related information. In practice, health interventions should not only disseminate visual information about cancer, but also give the public the opportunity to virtually experience the consequences of cancer in order to understand the risks and become motivated to get protected. Implications for future research are also discussed.

  10. Why Older Adults May Decline Offers of Post-Acute Care Services: A Qualitative Descriptive Study

    PubMed Central

    Sefcik, Justine S.; Ritter, Ashley Z.; Flores, Emilia J.; Nock, Rebecca H.; Chase, Jo-Ana D.; Bradway, Christine; Potashnik, Sheryl; Bowles, Kathryn H.

    2016-01-01

    The most common post-acute care (PAC) services available to patients after hospital discharge include home care, skilled nursing facilities, nursing homes, inpatient rehabilitation, and hospice. Patients who need PAC and receive services have better outcomes, however almost one-third of those offered services decline. Little research exists on PAC decision-making and why patients may decline services. This qualitative descriptive study explored the responses of thirty older adults to the question: “Can you, from the patient point of view, tell me why someone would not want post hospital care?” Three themes emerged. Participants may decline due to 1) previous negative experiences with PAC, or 2) a preference to be home. Some participants stated, “I'd be there” and would not decline services. Participants also discussed 3) why other patients might decline PAC which included patients’ past experiences, fear of the unknown, and preferences. Clinical implications include assessing patients’ knowledge and experience before providing recommendations. PMID:27964972

  11. Why older adults may decline offers of post-acute care services: A qualitative descriptive study.

    PubMed

    Sefcik, Justine S; Ritter, Ashley Z; Flores, Emilia J; Nock, Rebecca H; Chase, Jo-Ana D; Bradway, Christine; Potashnik, Sheryl; Bowles, Kathryn H

    The most common post-acute care (PAC) services available to patients after hospital discharge include home care, skilled nursing facilities, nursing homes, inpatient rehabilitation, and hospice. Patients who need PAC and receive services have better outcomes, however almost one-third of those offered services decline. Little research exists on PAC decision-making and why patients may decline services. This qualitative descriptive study explored the responses of thirty older adults to the question: "Can you, from the patient point of view, tell me why someone would not want post hospital care?" Three themes emerged. Participants may decline due to 1) previous negative experiences with PAC, or 2) a preference to be home. Some participants stated, "I'd be there" and would not decline services. Participants also discussed 3) why other patients might decline PAC which included patients' past experiences, lack of understanding/preconceived ideas, and preferences. Clinical implications include assessing patients' knowledge and experience before providing recommendations. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Consecutive Isoproterenol and Adenosine Treatment Confers Marked Protection against Reperfusion Injury in Adult but Not in Immature Heart: A Role for Glycogen.

    PubMed

    Lewis, Martin; Szobi, Adrian; Balaska, Dirki; Khaliulin, Igor; Adameova, Adriana; Griffiths, Elinor; Orchard, Clive H; Suleiman, M-Saadeh

    2018-02-07

    Consecutive treatment of adult rat heart with isoproterenol and adenosine (Iso/Aden), known to consecutively activate PKA/PKC signaling, is cardioprotective against ischemia and reperfusion (I/R). Whether this is cardioprotective in an immature heart is unknown. Langendorff-perfused hearts from adult and immature (60 and 14 days old) male Wistar rats were exposed to 30 min ischemia and 120 min reperfusion, with or without prior perfusion with 5 nM Iso for 3 min followed by 30 μM Aden for 5 min. Changes in hemodynamics (developed pressure and coronary flow) and cardiac injury (Lactate Dehydrogenase (LDH) release and infarct size) were measured. Additional hearts were used to measure glycogen content. Iso induced a similar inotropic response in both age groups. Treatment with Iso/Aden resulted in a significant reduction in time to the onset of ischemic contracture in both age groups whilst time to peak contracture was significantly shorter only in immature hearts. Upon reperfusion, the intervention reduced cardiac injury and functional impairment in adults with no protection of immature heart. Immature hearts have significantly less glycogen content compared to adult. This work shows that Iso/Aden perfusion confers protection in an adult heart but not in an immature heart. It is likely that metabolic differences including glycogen content contribute to this difference.

  13. Building national public health capacity for managing chemical events: A case study of the development of health protection services in the United Kingdom

    PubMed Central

    Palmer, Stephen; Coleman, Gary

    2013-01-01

    The revised International Health Regulations (2005) require that countries develop plans for chemical threats. In 2012, the World Health Assembly reported that most countries had not yet achieved ‘adequate capacity'. We review the evolution of chemical hazards services in the United Kingdom, the result of 15 years of grass-roots pressure and an accumulating weight of chemical incidents that eventually convinced the UK Department of Health of the need for a new national public health function, culminating, in 2003, in the creation of the Chemical Hazards Division of the new Health Protection Agency. Ten years later, public health services are again being radically reorganized with the creation of Public Health England, potentially destabilizing health protection arrangements and creating confusion among roles in managing chemical emergencies. Incorporating health protection into a broader public health organization, however, offers a new opportunity to broaden the scope of health protection services to embrace prevention of non-infectious environmental diseases. PMID:23447032

  14. Building national public health capacity for managing chemical events: a case study of the development of health protection services in the United Kingdom.

    PubMed

    Palmer, Stephen; Coleman, Gary

    2013-05-01

    The revised International Health Regulations (2005) require that countries develop plans for chemical threats. In 2012, the World Health Assembly reported that most countries had not yet achieved 'adequate capacity'. We review the evolution of chemical hazards services in the United Kingdom, the result of 15 years of grass-roots pressure and an accumulating weight of chemical incidents that eventually convinced the UK Department of Health of the need for a new national public health function, culminating, in 2003, in the creation of the Chemical Hazards Division of the new Health Protection Agency. Ten years later, public health services are again being radically reorganized with the creation of Public Health England, potentially destabilizing health protection arrangements and creating confusion among roles in managing chemical emergencies. Incorporating health protection into a broader public health organization, however, offers a new opportunity to broaden the scope of health protection services to embrace prevention of non-infectious environmental diseases.

  15. Protective Factors Against the Impact of School Bullying Perpetration and Victimization on Young Adult Externalizing and Internalizing Problems

    ERIC Educational Resources Information Center

    Hemphill, Sheryl A.; Tollit, Michelle; Herrenkohl, Todd I.

    2014-01-01

    School-based bullying perpetration and victimization is common worldwide and has profound impacts on student behavior and mental health. However, few studies have examined young adult outcomes of bullying perpetration or victimization. Research on factors that protect students who have bullied or been bullied is also lacking. This study examined…

  16. Costs and Trends in Utilization of Low-value Services Among Older Adults With Commercial Insurance or Medicare Advantage.

    PubMed

    Carter, Elizabeth A; Morin, Pamela E; Lind, Keith D

    2017-11-01

    Overutilization of low-value services (unnecessary or minimally beneficial tests or procedures) has been cited as a large contributor to the high costs of health care in the United States. To analyze trends in utilization of low-value services from 2009 to 2014 among commercial and Medicare Advantage (MA) enrollees 50 and older. A retrospective analysis of deidentified claims obtained from the OptumLab Data Warehouse. Adults 50 and older enrolled in commercial plans and adults 65 and older enrolled in MA plans between 2009 and 2014. Costs and utilization of 16 low-value services in the following categories: cancer screening, imaging, and invasive procedures. The most commonly performed low-value service was imaging of the head for syncope, at rates of 33%-39% in commercial enrollees and 45% in MA enrollees. The least common service was peripheral artery stenting (<1%) in commercial enrollees, and laminectomy (0.15% in 2009) and renal artery stenting in MA enrollees (0.07% in 2014). Renal artery stenting decreased by roughly 75% over the study period, the largest decrease in utilization, with ∼$30 million and $10 million in reduced spending for commercial and MA plans and enrollees, respectively. Spending on these services in 2014 totaled $317.6 million for commercial and $100.8 million for MA health plans. Clinicians, researchers, and policymakers should strive to reach consensus on methods for more reliably and accurately identifying low-value service utilization. Greater consistency would facilitate monitoring use of low-value services and changing clinical practice patterns over time.

  17. Implementation of Medicaid Managed Long-Term Services and Supports for Adults with Intellectual And/Or Developmental Disabilities in Kansas

    ERIC Educational Resources Information Center

    Williamson, Heather J.; Perkins, Elizabeth A.; Levin, Bruce L.; Baldwin, Julie A.; Lulinski, Amie; Armstrong, Mary I.; Massey, Oliver T.

    2017-01-01

    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…

  18. 20 CFR 663.115 - What are the eligibility criteria for core services for dislocated workers in the adult and...

    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... Through the One-Stop Delivery System § 663.115 What are the eligibility criteria for core services for dislocated workers in the adult and dislocated worker programs? (a) To be eligible to receive core services...

  19. Trends and predictors of publicly subsidized chiropractic service use among adults age 50+.

    PubMed

    Votova, Kristine; Penning, Margaret J; Zheng, Chi; Brackley, Moyra E

    2010-09-01

    This article examines trends in and predictors of publicly subsidized chiropractic use from 1991 to 2000, a decade characterized by health care system reforms throughout North America. The sample included adults age 50+ who visited a publicly subsidized chiropractor in the Canadian province of British Columbia during the study period. Administrative claims data for chiropractic service use were drawn from the Medical Services Plan (MSP) Master file in the British Columbia Linked Health Data resource. The MSP Master file contains claims reported for every provincially insured medical service and supplementary health benefit including chiropractic visits. Joinpoint regression analyses demonstrate that while annual rates of chiropractic users did not change over the decade, visit rates decreased during this period. Predictors of a greater number of chiropractic visits include increasing age, female gender, urban residence, low to moderate income, and use of chiropractic services earlier in the decade. The trend toward decreasing visit rates over the 1990s both conflicts with and is consistent with findings from other North American chiropractic studies using similar time periods. Results indicating that low and moderate income and advancing age predict more frequent chiropractic service are novel. However, given that lower income and older individuals were exempted from chiropractic service limits during this period, these results suggest support for the responsive nature of chiropractic use to financial barriers.

  20. A Novel Protective Framework for Defeating HTTP-Based Denial of Service and Distributed Denial of Service Attacks.

    PubMed

    Saleh, Mohammed A; Abdul Manaf, Azizah

    2015-01-01

    The growth of web technology has brought convenience to our life, since it has become the most important communication channel. However, now this merit is threatened by complicated network-based attacks, such as denial of service (DoS) and distributed denial of service (DDoS) attacks. Despite many researchers' efforts, no optimal solution that addresses all sorts of HTTP DoS/DDoS attacks is on offer. Therefore, this research aims to fix this gap by designing an alternative solution called a flexible, collaborative, multilayer, DDoS prevention framework (FCMDPF). The innovative design of the FCMDPF framework handles all aspects of HTTP-based DoS/DDoS attacks through the following three subsequent framework's schemes (layers). Firstly, an outer blocking (OB) scheme blocks attacking IP source if it is listed on the black list table. Secondly, the service traceback oriented architecture (STBOA) scheme is to validate whether the incoming request is launched by a human or by an automated tool. Then, it traces back the true attacking IP source. Thirdly, the flexible advanced entropy based (FAEB) scheme is to eliminate high rate DDoS (HR-DDoS) and flash crowd (FC) attacks. Compared to the previous researches, our framework's design provides an efficient protection for web applications against all sorts of DoS/DDoS attacks.

  1. A Novel Protective Framework for Defeating HTTP-Based Denial of Service and Distributed Denial of Service Attacks

    PubMed Central

    Saleh, Mohammed A.; Abdul Manaf, Azizah

    2015-01-01

    The growth of web technology has brought convenience to our life, since it has become the most important communication channel. However, now this merit is threatened by complicated network-based attacks, such as denial of service (DoS) and distributed denial of service (DDoS) attacks. Despite many researchers' efforts, no optimal solution that addresses all sorts of HTTP DoS/DDoS attacks is on offer. Therefore, this research aims to fix this gap by designing an alternative solution called a flexible, collaborative, multilayer, DDoS prevention framework (FCMDPF). The innovative design of the FCMDPF framework handles all aspects of HTTP-based DoS/DDoS attacks through the following three subsequent framework's schemes (layers). Firstly, an outer blocking (OB) scheme blocks attacking IP source if it is listed on the black list table. Secondly, the service traceback oriented architecture (STBOA) scheme is to validate whether the incoming request is launched by a human or by an automated tool. Then, it traces back the true attacking IP source. Thirdly, the flexible advanced entropy based (FAEB) scheme is to eliminate high rate DDoS (HR-DDoS) and flash crowd (FC) attacks. Compared to the previous researches, our framework's design provides an efficient protection for web applications against all sorts of DoS/DDoS attacks. PMID:26065015

  2. How Are Service Dogs for Adults with Post Traumatic Stress Disorder Integrated with Rehabilitation in Denmark? A Case Study

    PubMed Central

    Glintborg, Chalotte; Hansen, Tia G. B.

    2017-01-01

    Simple Summary The use of service dogs for adults with mental illnesses has become generally accepted. With reference to a single case study of a client with Post Traumatic Stress (PTSD), this study illustrates some of the potential advantages, but also note an important concern that appears to have gone unnoticed. The provision of service animals/therapy animals for adults with mental illnesses must be sufficiently informed by relevant knowledge and integrated with concurrent rehabilitation efforts. When it is not, it may contradict existing evidence-based treatments or unintentionally worsen conditions such as anxiety. This study argues that integration is possible and greater coordination efforts should be made. Abstract A severe mental illness like Post Traumatic Stress Disorder (PTSD) is known to have psychosocial consequences that can lead to a decreased quality of life. Research in Animal-Assisted Therapy (AAT) has revealed that the presence of a dog can have a positive effect on health, e.g., increase quality of life and lessen depression and anxiety. However, canine companionship is not a catch-all solution. Previous research has revealed methodological limitations that prohibit any clear conclusions, as well as a sparsity of critical reflection in anecdotal reports and case studies, which means that more research is needed to contextualize the findings. There has been an increasing interest in animal-assisted intervention in Denmark in recent years. Previously, authorities could only grant service dogs to adults with physical disabilities, but now this has been extended to adults with mental illnesses. Therefore, it has become important to explore how these service dogs are incorporated into rehabilitation practices in mental health, and how rehabilitation professionals react to the use of service dogs. This paper is a case study of a person who suffers from PTSD. This study examines how the person describes the significance of having a dog during her

  3. Organic Techniques for Protecting Virtual Private Network (VPN) Services from Access Link Flooding Attacks

    DTIC Science & Technology

    2002-01-01

    Submitted to ICN 2002 Organic Techniques for Protecting Virtual Private Network (VPN) Services from Access Link Flooding Attacks1 Ranga S. Ramanujan ...using these techniques is also described. Contact author: Dr. Ranga S. Ramanujan Architecture Technology Corporation 9971 Valley View Road Eden Prairie...OF ABSTRACT 18. NUMBER OF PAGES 15 19a. NAME OF RESPONSIBLE PERSON a. REPORT unclassified b. ABSTRACT unclassified c . THIS PAGE unclassified

  4. Adolescents' and Young Adults' Beliefs about Mental Health Services and Care: A Systematic Review.

    PubMed

    Goodwin, John; Savage, Eileen; Horgan, Aine

    2016-10-01

    Adolescents and young people are known to hold negative views about mental illness. There is less known about their beliefs about mental health services and care. The aim of this study was to systematically examine literature on the beliefs of adolescents and young people from the general population about mental health services and care. Factors that positively and negatively influence these beliefs are also explored. Relevant electronic databases were searched for papers published in the English language between January 2004 and October 2015. Culture seemed to influence how adolescents and young adults perceived mental health interventions. This was particularly evident in countries such as Palestine and South Africa where prayer was highly valued. Adolescents and young people were uninformed about psychiatric medication. They believed that accessing mental health care was a sign of weakness. Furthermore, they viewed psychiatric hospitals and various mental health professionals negatively. Film was found to have a negative impact on how adolescents and young people perceived mental health services, whereas open communication with family members was found to have a positive impact. Adolescents and young adults hold uninformed and stigmatizing beliefs about mental health treatments, mental health professionals, and access to care. The sources of these beliefs remain unclear although some at least seem influenced by culture. Further research, (particularly qualitative research) in this area is recommended in order to address current gaps in knowledge. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Working with child protective services and law enforcement: what to expect.

    PubMed

    Kellogg, Nancy D

    2014-10-01

    The process whereby a clinician decides that child abuse is a diagnostic possibility is often marked with doubt and fear. Abusive parents can present convincing lies, and children with suspicious injuries can have unusual accidents. Personal thresholds for reporting suspected abuse vary considerably. Clinicians may mistrust or misunderstand the roles and responsibilities of the investigators and legal professionals involved. This article aims to improve understanding of the community responses to a report of child abuse, and enable the clinician to work effectively with child protective services, law enforcement agencies, and legal professionals to ensure child safety and family integrity when appropriate. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Training Parents of Youth with Autism Spectrum Disorder to Advocate for Adult Disability Services: Results from a Pilot Randomized Controlled Trial

    PubMed Central

    Taylor, Julie Lounds; Hodapp, Robert M.; Burke, Meghan M.; Waitz-Kudla, Sydney N.; Rabideau, Carol

    2017-01-01

    This study presents findings from a pilot randomized controlled trial, testing a 12-week intervention to train parents of youth with autism spectrum disorder (ASD) to advocate for adult disability services—the Volunteer Advocacy Project-Transition (VAP-T). Participants included 41 parents of youth with ASD within two years of high school exit, randomly assigned to a treatment (N = 20) or wait-list control (N = 21) group. Outcomes, collected before and after the intervention, included parental knowledge about adult services, advocacy skills-comfort, and empowerment. The VAP-T had acceptable feasibility, treatment fidelity, and acceptability. After participating in the VAP-T, intervention parents (compared to controls) knew more about the adult service system, were more skilled/comfortable advocating, and felt more empowered. PMID:28070786

  7. Domestic violence in women with serious mental illness involved with child protective services.

    PubMed

    Lewin, Linda C; Abdrbo, Amany; Burant, Christopher J

    2010-02-01

    The purpose of this study is to describe mothers with serious mental illness who have experienced domestic violence and are involved with child protective services. One hundred twenty-two files from the Department of Child and Family Services were reviewed. According to this retrospective review, the majority of the mothers and children had been exposed to domestic violence (62.6%). Mothers with the diagnoses of major depression-single episode and major depression-recurrent were most likely to have disclosed domestic violence exposure, compared to mothers with other serious mental illnesses. Our findings, and that of other cited studies, support the practice of routine assessment of domestic violence in women with serious mental illnesses, identification of safe havens for mothers and children, and access to continuing parenting support for these vulnerable family groups.

  8. Knowledge, behaviors, and attitudes about hearing loss and hearing protection among racial/ethnically diverse young adults.

    PubMed

    Crandell, Carl; Mills, Terry L; Gauthier, Ricardo

    2004-02-01

    Over 11 million individuals exhibit some degree of permanent noise induced hearing loss (NIHL). Despite such data, there remains a paucity of empirical evidence on the knowledge of noise exposure and hearing protection devices (HPDs) for young adults, particularly those of diverse racial/ethnic backgrounds. This lack of research is unfortunate, as prior research suggests that the incidence of NIHL can be reduced through educational programs, such as hearing conservation programs (HCPs). Moreover, research also indicates that such educational programs are more beneficial when developed for specific age and/or ethnic/racial groups. The primary aim of this investigation was to determine the knowledge base of 200 college-aged young adults aged 18-29, concerning the auditory mechanism, NIHL, and the use of HPDs. The second aim of this study was to identify race and ethnicity differences or similarities in knowledge of these areas among African-American and caucasian young adults. Overall, in many instances, a majority of the young adults in our study demonstrated a high degree of knowledge concerning factors associated with exposure to excessive noise and the risk of hearing loss. Yet, the results also revealed significant racial/ethnic differences in knowledge, behaviors, and attitudes about the use of HPDs. Recent estimates suggest that more than 11 million individuals in the United States exhibit some degree of NIHL. Moreover, 40 million individuals work in environments that contain potentially harmful noise levels, and over 50 million Americans routinely use firearms--a common cause of noise-induced hearing impairment. A specific hallmark manifestation of NIHL is a permanent decrease in hearing sensitivity from 3,000-6,000 Hz, with a characteristic notch at 4,000 Hz. Additional effects of exposure to high noise levels include physiological changes in heart rate and blood pressure, decrease in work productivity, and an interference with communication that results

  9. The Effects of Medicaid Policy Changes on Adults' Service Use Patterns in Kentucky and Idaho

    PubMed Central

    Marton, James; Kenney, Genevieve M.; Pelletier, Jennifer E.; Talbert, Jeffery; Klein, Ariel

    2013-01-01

    Background In 2006, Idaho and Kentucky became two of the first states to implement changes to their Medicaid programs under authority granted by the 2005 Deficit Reduction Act (DRA). The DRA granted new flexibility in the design of state Medicaid programs, including a state plan amendment (SPA) option for changes that previously would have required a waiver. This paper uses state Medicaid administrative data to analyze the impact of Medicaid policy changes implemented in these states through a series of SPAs in 2006 and 2007. Methods Changes in utilization are examined for multiple services, including physician, dental, and ER visits, inpatient stays, and prescriptions, among non-elderly adult Medicaid recipients following changes in cost sharing, reimbursement, service delivery, and covered services. Where possible, enrollees not affected by the changes served as a comparison group. Results While relatively few adults in Idaho received a wellness exam after such coverage was added, the adoption of managed care for dental services was associated with increased receipt of dental care, including preventive care. The new limits on brand name prescriptions in Kentucky were associated with a reduction in the proportion of enrollees with two or more monthly name brand prescriptions while the small copayments introduced did not appear to have a dramatic impact. Conclusions We find that changes in financial incentives on both the supply-side (such as reimbursement increases) and the demand-side (i.e., benefit changes) alone may not be enough to generate the desired levels of preventive care, especially among those with chronic health conditions. PMID:24800159

  10. The effects of Medicaid policy changes on adults' service use patterns in Kentucky and Idaho.

    PubMed

    Marton, James; Kenney, Genevieve M; Pelletier, Jennifer E; Talbert, Jeffery; Klein, Ariel

    2012-01-01

    In 2006, Idaho and Kentucky became two of the first states to implement changes to their Medicaid programs under authority granted by the 2005 Deficit Reduction Act (DRA). The DRA granted new flexibility in the design of state Medicaid programs, including a state plan amendment (SPA) option for changes that previously would have required a waiver. This paper uses state Medicaid administrative data to analyze the impact of Medicaid policy changes implemented in these states through a series of SPAs in 2006 and 2007. Changes in utilization are examined for multiple services, including physician, dental, and ER visits, inpatient stays, and prescriptions, among non-elderly adult Medicaid recipients following changes in cost sharing, reimbursement, service delivery, and covered services. Where possible, enrollees not affected by the changes served as a comparison group. While relatively few adults in Idaho received a wellness exam after such coverage was added, the adoption of managed care for dental services was associated with increased receipt of dental care, including preventive care. The new limits on brand name prescriptions in Kentucky were associated with a reduction in the proportion of enrollees with two or more monthly name brand prescriptions while the small copayments introduced did not appear to have a dramatic impact. We find that changes in financial incentives on both the supply-side (such as reimbursement increases) and the demand-side (i.e., benefit changes) alone may not be enough to generate the desired levels of preventive care, especially among those with chronic health conditions.

  11. A comparative empirical study on mobile ICT services, social responsibility and the protection of children.

    PubMed

    De-Miguel-Molina, María; Martínez-Gómez, Mónica

    2011-06-01

    The purpose of this paper is to analyse the Spanish mobile phone industry to determine how mobile phone companies and certain institutions can improve protection for children who use mobile phones. We carried out a multivariate statistical analysis using anonymous primary data from mobile phone companies, and institutions and associations that protect children, to compare these stakeholders' opinions and to put forward solutions. We proved that, even though some European countries have made an effort to provide safer ICT services, all stakeholders still need to cooperate and agree on solutions to the commercial problems associated with children using mobile phones. This can be done by signing codes of conduct. We found that even though some companies implement measures to protect children from accessing harmful content via their mobile phones, they do so for reasons of legal and not social responsibility.

  12. 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…

  13. Adult Learning Services: A Status Report on Programs of the [New York] State Education Department.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Adult Learning Services Committee.

    This paper describes the development of an array of adult services within New York State's educational structure. The first of seven sections reviews the roles of Melvin Dewey, the 1938 Regents Inquiry, and Proficiency Exams/Regents Degrees in the evolution of state education policy. In section 2, three studies (1972 Postsecondary Education Study,…

  14. Adult Learners.

    ERIC Educational Resources Information Center

    Brodzinski, Frederick R., Ed.; Shriberg, Arthur, Ed.

    1984-01-01

    Presents nine articles which provide a broad overview of issues and concerns related to the delivery of student services to adult learners. Specific topics include needs and interests of adult learners, marketing, special technology, adult resource centers, adult support groups, and the role of the chief student affairs officer. (JAC)

  15. [Knowledge about UV-radiation and sun protection: survey of adolescents and young adults in Bavaria].

    PubMed

    Eichhorn, C; Seibold, C; Loss, J; Steinmann, A; Nagel, E

    2008-10-01

    Identifying deficits in sun protection knowledge and behavior can serve as a starting point for primary prevention interventions. The aim of this study was to investigate knowledge and behavior related to ultraviolet radiation in the population between 14 and 45 years of age in Bavaria, as well as effects of the awareness campaign "Sensible in the Sun". In two Bavarian districts, 545 individuals of the target population completed a telephone survey about risks of UV-radiation, sun protection knowledge and behavior, and effects of the campaign. Sunburn and skin cancer as adverse effects of ultraviolet radiation were named by almost every participant. When asked about protective interventions, 91% mentioned sunscreen and 45-54% clothing, limited stay in the sun and seeking shade at noon. Women were better informed than men, adults better than adolescents. 10.6% were aware of the campaign. In this group, 37.9% had been motivated to consider their sun protective behavior; 13.8% (especially women >30 years) stated they had changed their behavior because of the campaign. There were deficits in knowledge, especially about eye damage and the importance of getting slowly used to UV radiation. Physician advice, but also broadcast and print media, has an effect on UV-related knowledge.

  16. 40 CFR 65.106 - Standards: Valves in gas/vapor service and in light liquid service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Standards: Valves in gas/vapor service and in light liquid service. (a) Compliance schedule. (1) The owner... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Standards: Valves in gas/vapor service and in light liquid service. 65.106 Section 65.106 Protection of Environment ENVIRONMENTAL PROTECTION...

  17. 40 CFR 65.106 - Standards: Valves in gas/vapor service and in light liquid service.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Standards: Valves in gas/vapor service and in light liquid service. (a) Compliance schedule. (1) The owner... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Standards: Valves in gas/vapor service and in light liquid service. 65.106 Section 65.106 Protection of Environment ENVIRONMENTAL PROTECTION...

  18. 40 CFR 65.106 - Standards: Valves in gas/vapor service and in light liquid service.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Standards: Valves in gas/vapor service and in light liquid service. (a) Compliance schedule. (1) The owner... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Standards: Valves in gas/vapor service and in light liquid service. 65.106 Section 65.106 Protection of Environment ENVIRONMENTAL PROTECTION...

  19. 40 CFR 65.106 - Standards: Valves in gas/vapor service and in light liquid service.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Standards: Valves in gas/vapor service and in light liquid service. (a) Compliance schedule. (1) The owner... 40 Protection of Environment 16 2013-07-01 2013-07-01 false Standards: Valves in gas/vapor service and in light liquid service. 65.106 Section 65.106 Protection of Environment ENVIRONMENTAL PROTECTION...

  20. 40 CFR 65.106 - Standards: Valves in gas/vapor service and in light liquid service.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Standards: Valves in gas/vapor service and in light liquid service. (a) Compliance schedule. (1) The owner... 40 Protection of Environment 16 2012-07-01 2012-07-01 false Standards: Valves in gas/vapor service and in light liquid service. 65.106 Section 65.106 Protection of Environment ENVIRONMENTAL PROTECTION...

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