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Sample records for carers pcq-c reliability

  1. [Alzheimer's disease, supporting carers].

    PubMed

    Lottin, Arlette; Botter, René

    2016-03-01

    The association France Alzheimer provides carers with resources. It runs training programmes and organises "Memory Cafes". These initiatives give carers the opportunity to talk about their daily struggles, close to home, and to obtain advice on how to better manage their situation.

  2. Development of the Motor Neuron Disease Carer Questionnaire.

    PubMed

    Mockford, Carole; Jenkinson, Crispin; Fitzpatrick, Raymond

    2009-01-01

    Our objective was to develop a validated questionnaire that can measure the extent to which dimensions of caring affect the health of carers of patients with motor neuron disease. An initial 190-item questionnaire was developed from in-depth interviews, focus groups and two pilot studies with carers. Factor analysis was applied to the data obtained from a large survey in the UK that identified the underlying dimensions of caring. The newly formed scales were tested for reliability using Cronbach's alpha, and for construct validity. The SF36-v2 was the benchmark instrument on which correlations were made to ascertain the relationship with carers' health. A 34-item instrument was developed which has demonstrated promising evidence of internal reliability and validity for six scales: emotional well-being, physical well-being, self care, disturbed sleep, carers' support needs and statutory services. High correlations were found with the Mental Component Score summary scale of the SF-36v2 (0.40-0.66). The development and testing of the MNDCQ indicates that as the carers' score on the MNDCQ increases, suggesting a higher level of burden, they are more likely to report poor health. Further longitudinal studies are needed to further test the instruments' ability to detect change over time. PMID:19922141

  3. Peer support for carers: a qualitative investigation of the experiences of carers and peer volunteers.

    PubMed

    Greenwood, Nan; Habibi, Ruth; Mackenzie, Ann; Drennan, Vari; Easton, Nicky

    2013-09-01

    Being a carer of someone with dementia can be rewarding and also challenging. Volunteer peer support schemes for carers are being introduced, little is known about either their impact on carers and volunteers or about volunteers' and carers' experiences. This study investigated peer volunteer and carer recipient experiences of a peer support service. Thematic analysis of 13 in-depth interviews with 9 carers and 4 peer volunteers revealed that peer support helped both carers and peer volunteers through the realization that they were "not alone" in their experiences and emotions. Additional carer benefits included opportunities to talk freely about difficult experiences and learning how others cope. Volunteers found their role rewarding, describing satisfaction from putting their own experiences to good use. These findings highlight the isolation and exclusion experienced by current and former carers of people with dementia and draw attention to the benefits of peer support for both the groups.

  4. Caring for carers: how community nurses can support carers of people with cancer.

    PubMed

    Argyle, Charlotte

    2016-04-01

    There are more than 1 million people in the UK looking after a family member or friend with cancer, but half the number of these carers do not receive support to care. Providing this care significantly affects cancer carers emotionally, physically, and financially. Community and district nurses have a vital role to play in reaching out to these hidden carers and signposting them to the correct support. This article provides tips on identifying carers, including who they are, the challenges they face, and how health professionals can approach and speak to them. It also provides guidance on signposting carers to national and local sources of support in the UK. PMID:27282503

  5. A questionnaire to measure satisfaction with community services for informal carers of stroke patients: construction and initial piloting.

    PubMed

    Simon, Chantal; Little, Paul; Birtwistle, Jon; Kendrick, Tony

    2003-03-01

    Stroke affects 120 000 people each year in the UK and is the most common cause of adult-onset disability. Most stroke patients are cared for at home by informal carers. Support for these carers is provided by the community services, but although single-item measures have shown that there is a relatively high level of dissatisfaction with those services, there is no specific satisfaction measurement instrument. The present study aimed to construct and initially validate a questionnaire to measure carers' satisfaction with community services for clinical and research purposes. Qualitative interviews with a purposive sample of informal carers of stroke patients identified via stroke unit discharge records gave information about content, context and language. Together with information from the carers' literature, this formed the basis of the questionnaire. A self-completion questionnaire proved unacceptable to carers with a very poor response rate (20%). Face-to-face interviews were more acceptable, with the questionnaire taking approximately 10 minutes to administer. All carers approached agreed to take part and only three carers dropped out from follow up, all because of reasons not related to the study. Initial validity and reliability testing with a sample of 44 carers identified through stroke groups and general practice showed good correlation with a single-item satisfaction measure (RHO = 0.797), test-retest reliability (RHO = 0.885) and inter-rater reliability (RHO = 0.868), and a high degree of internal consistency (Cronbach's alpha = 0.859). Further validation with larger and more diverse groups of informal carers is needed before the questionnaire can be considered to be a robust and reliable tool. Factor analysis revealed seven factors: information about community support and involving the carer; amount, appropriateness and coordination of services; information about stroke; speed of change and concern about the carer; listening to the carer and being heard

  6. CarerSupport - An Innovative Approach to Informal Carers' Training and Collaboration.

    PubMed

    Lunde, Lene; Moen, Anne

    2016-01-01

    EU and national policies for long-term care acknowledge the role of informal carers. However, there is still little adequate support to prepare or ease informal carers in terms of training to allow them improve their skills, alleviate psychosocial stress and maintain their own health and well-being. In the CarerSupport project, we seek to integrate services, deploy and test an integrated ICT platform enabling participation and collaboration of informal carers, psychologists and health professionals to collaborate, facilitate training and orientation, offer tele-consulting services and psychosocial support to carers. Based on this platform and its content, we will deploy and report on informal carers' experiences with the wide range of offered service. The poster will present the first experiences and suggest potentials for a service like CarerSupport. PMID:27332409

  7. Culture shift: carer empowerment and cooperative inquiry.

    PubMed

    Lloyd, M; Carson, A

    2005-04-01

    Government policy has directed local services to address the needs of carers as a way of maintaining care in the community. This study was initiated to enable carers to develop an information pack based upon their identified needs. Cooperative inquiry was the method used to ensure full participation of the carers. Group meetings were already in existence through a charity organization who provides a carers support network. The first author participated in a number of carers group meetings. Cooperative inquiry was used to clarify a number of themes identified and reflective cycles ensured that those themes remained relevant. It was found that carers did want to be involved in their relative's care, not as passive recipients but as collaborative care providers. To do this they need to be fully informed of the processes of care provision. Carers need information that is relevant, easily accessible and obtainable in varying degrees of comprehension. This study suggests that a culture shift within mental health nursing is necessary if professionals are to recognize that a perceived lack of support may lead to a breakdown in relationships between the carer, the person being cared for and the professionals.

  8. Physical health nurse consultant role to improve physical health in mental health services: A carer's perspective.

    PubMed

    Happell, Brenda; Wilson, Karen; Platania-Phung, Chris; Stanton, Robert

    2016-06-01

    The physical health of people diagnosed with a mental illness is significantly poorer in comparison with the general population. Awareness of this health disparity is increasing; however, strategies to address the problem are limited. Carers play an important role in the physical health care of people with mental illness, particularly in facilitating navigation of and advocating in the health care system. A specialist physical health nurse consultant position has been suggested as a way to address the physical health care disparity and limited research available suggests that positive outcomes are possible. In the present study, a qualitative exploratory research project was undertaken, involving in-depth interviews with people identifying as mental health carers. Two focus groups and one individual interview were conducted involving a total of 13 carers. The resulting data were analyzed thematically. Views and opinions about the proposed physical health nurse consultant (PHNC) position were sought during these interviews and are reported in this paper. Two main sub-themes were evident relating to characteristics of this role: reliability and consistency; and communication and support. Essentially carers expressed a need for support for themselves and consumers in addressing physical health concerns. Successful implementation of this position would require a consistent and reliable approach. Carers are significant stakeholders in the physical health of consumers of mental health services and their active involvement in identifying and tailoring services, including development of the physical health nurse consultant must be seen as a priority.

  9. [The French carers' association, daily support].

    PubMed

    Leduc, Florence

    2016-03-01

    Structuring the help for carers ensures they can be offered adapted support. A policy plan involving all the organisations who provide this type of assistance has resulted in the creation of get-togethers called "Les Cafés des Aidants" ("Carers' Cafés"), where people caring for a family member with any type of disability can talk and share their experience. PMID:26975684

  10. Carers and confidentiality in mental health care: considering the role of the carer's assessment: a study of service users', carers' and practitioners' views.

    PubMed

    Rapaport, Joan; Bellringer, Sophie; Pinfold, Vanessa; Huxley, Peter

    2006-07-01

    Relatives or carers of people with mental health problems have criticised professionals for their failures to share information with them. This article reports on a multiple method study comprising a policy search, a survey of service users, carers and professionals, and stakeholder interviews and group events. The study found few policies that addressed the principles underpinning information sharing with carers. However, examples of good practice in professional involvement of carers that took account of carer rights and responsibilities emerged from the research. This suggests the relevance of the carer's assessment, a carer's right to an assessment of his or her circumstances and wishes in assisting understanding of the care context and enhancing appropriate information sharing between professionals and carers.

  11. Psychometric properties of carer-reported outcome measures in palliative care: A systematic review

    PubMed Central

    Michels, Charlotte TJ; Boulton, Mary; Adams, Astrid; Wee, Bee; Peters, Michele

    2016-01-01

    Background: Informal carers face many challenges in caring for patients with palliative care needs. Selecting suitable valid and reliable outcome measures to determine the impact of caring and carers’ outcomes is a common problem. Aim: To identify outcome measures used for informal carers looking after patients with palliative care needs, and to evaluate the measures’ psychometric properties. Design: A systematic review was conducted. The studies identified were evaluated by independent reviewers (C.T.J.M., M.B., M.P.). Data regarding study characteristics and psychometric properties of the measures were extracted and evaluated. Good psychometric properties indicate a high-quality measure. Data sources: The search was conducted, unrestricted to publication year, in the following electronic databases: Applied Social Sciences Index and Abstracts, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, EMBASE, PubMed, PsycINFO, Social Sciences Citation Index and Sociological Abstracts. Results: Our systematic search revealed 4505 potential relevant studies, of which 112 studies met the inclusion criteria using 38 carer measures for informal carers of patients with palliative care needs. Psychometric properties were reported in only 46% (n = 52) of the studies, in relation to 24 measures. Where psychometric data were reported, the focus was mainly on internal consistency (n = 45, 87%), construct validity (n = 27, 52%) and/or reliability (n = 14, 27%). Of these, 24 measures, only four (17%) had been formally validated in informal carers in palliative care. Conclusion: A broad range of outcome measures have been used for informal carers of patients with palliative care needs. Little formal psychometric testing has been undertaken. Furthermore, development and refinement of measures in this field is required. PMID:26407683

  12. iCarer: AAL for the Informal Carers of the Elderly.

    PubMed

    Moreno, P A; Garcia-Pacheco, J L; Charvill, J; Lofti, A; Langensiepen, C; Saunders, A; Berckmans, K; Gaspersic, J; Walton, L; Carmona, M; Perez de la Camara, S; Sanchez-de-Madariaga, R; Pozo, J; Muñoz, A; Pascual, M; Gomez, E J

    2015-01-01

    In the context of the long-term care for older adults, informal carers play a key role. Daily competing priorities or a care-skills deficit may lead them to stress, anxiety and/or depression. The iCarer project (AAL-2012-5-239) proposes the design and implementation of a cloud-inspired personalised and adaptive platform which will offer support to informal carers of older adults with cognitive impairment. By means of a holistic approach comprising technologies and services addressing the intelligent and interactive monitoring of activities, knowledge management for personalised guidance and orientation, virtual interaction, e-learning, care coordination facilities and social network services, iCarer aims to reduce the informal carer stress and to enhance the quality of care they provide, thus improving their quality of life. The iCarer platform will be evaluated through a multi-centre non-controlled study (4 months; 48 homes located in England and in Slovenia). Currently the iCarer project is completing the development work. The evaluation trial is expected to start in August 2015. PMID:25991237

  13. iCarer: AAL for the Informal Carers of the Elderly.

    PubMed

    Moreno, P A; Garcia-Pacheco, J L; Charvill, J; Lofti, A; Langensiepen, C; Saunders, A; Berckmans, K; Gaspersic, J; Walton, L; Carmona, M; Perez de la Camara, S; Sanchez-de-Madariaga, R; Pozo, J; Muñoz, A; Pascual, M; Gomez, E J

    2015-01-01

    In the context of the long-term care for older adults, informal carers play a key role. Daily competing priorities or a care-skills deficit may lead them to stress, anxiety and/or depression. The iCarer project (AAL-2012-5-239) proposes the design and implementation of a cloud-inspired personalised and adaptive platform which will offer support to informal carers of older adults with cognitive impairment. By means of a holistic approach comprising technologies and services addressing the intelligent and interactive monitoring of activities, knowledge management for personalised guidance and orientation, virtual interaction, e-learning, care coordination facilities and social network services, iCarer aims to reduce the informal carer stress and to enhance the quality of care they provide, thus improving their quality of life. The iCarer platform will be evaluated through a multi-centre non-controlled study (4 months; 48 homes located in England and in Slovenia). Currently the iCarer project is completing the development work. The evaluation trial is expected to start in August 2015.

  14. Validation of the Verbal and Social Interaction questionnaire: carers' focus in the carer-resident relationship in supported housing facilities for persons with psychiatric disabilities (VSI-SH).

    PubMed

    Brunt, D; Rask, M

    2013-04-01

    A questionnaire to measure the verbal and social interactions between carers and residents in supported housing facilities for persons with psychiatric disabilities has been developed. It is an adaptation of a questionnaire originally used in a forensic psychiatric setting. The aim of the present study was thus to investigate the construct validity and the reliability of this new version of the Verbal and Social Interactions questionnaire for use in supported housing facilities (VSI-SH). Two hundred and twenty-three carers from municipal and privately run housing facilities completed the questionnaire. A factor analysis was performed, which resulted in six factors. The number of items was reduced from the original 47 to 30 in order to minimize factorial complexity and multiple loadings. The reliability was tested with Cronbach's alpha and good internal consistency for the questionnaire and five of the six factors was found. The resulting six factors and the items were compared to the conceptual model and four of the six factors corresponded well with the categories in this original theoretical model. The questionnaire can be a useful contribution to the study of interactions between carers and residents in supported housing facilities for persons with psychiatric disabilities.

  15. Evaluating and Quantifying User and Carer Involvement in Mental Health Care Planning (EQUIP): Co-Development of a New Patient-Reported Outcome Measure

    PubMed Central

    2016-01-01

    International and national health policy seeks to increase service user and carer involvement in mental health care planning, but suitable user-centred tools to assess the success of these initiatives are not yet available. The current study describes the development of a new reliable and valid, interval-scaled service-user and carer reported outcome measure for quantifying user/carer involvement in mental health care planning. Psychometric development reduced a 70-item item bank to a short form questionnaire using a combination of Classical Test, Mokken and Rasch Analyses. Test-retest reliability was calculated using t-tests of interval level scores between baseline and 2–4 week follow-up. Items were worded to be relevant to both service users and carers. Nine items were removed following cognitive debriefing with a service user and carer advisory group. An iterative process of item removal reduced the remaining 61 items to a final 14-item scale. The final scale has acceptable scalability (Ho = .69), reliability (alpha = .92), fit to the Rasch model (χ2(70) = 97.25, p = .02), and no differential item functioning or locally dependent items. Scores remained stable over the 4 week follow-up period, indicating good test-retest reliability. The ‘Evaluating the Quality of User and Carer Involvement in Care Planning (EQUIP)’ scale displays excellent psychometric properties and is capable of unidimensional linear measurement. The scale is short, user and carer-centred and will be of direct benefit to clinicians, services, auditors and researchers wishing to quantify levels of user and carer involvement in care planning. PMID:26963252

  16. Effect of Perceived Stigmatisation on the Quality of Life among Ageing Female Family Carers: A Comparison of Carers of Adults with Intellectual Disability and Carers of Adults with Mental Illness

    ERIC Educational Resources Information Center

    Chou, Y. C.; Pu, C. Y.; Lee, Y. C.; Lin, L. C.; Kroger, T.

    2009-01-01

    Background: Little account has been taken of quality of life (QoL) among family carers of adults with an intellectual disability (ID) and family carers of adults with a mental illness (MI), particularly the female ageing carers' perceived stigma. We explore whether there are differences in the significant predictors of female ageing family carers'…

  17. What do informal carers need from district nursing services?

    PubMed

    Bliss, Julie

    2006-06-01

    More than 5 million informal carers provide support to individuals who wish to remain within their own homes. The role of informal carers in maintaining people within their own homes has been identified as crucial. This article considers the assessment of need of informal carers in the primary care setting, placing particular emphasis on the role of the district nurse as an advocate for informal carers when working with other health and social care service providers. Central to working with informal carers and acting as an advocate is communication, and unless informal carers feel that they are involved in the decision-making process, and listened to, they are unlikely to access appropriate support.

  18. Expressed emotion and attributions in the carers of patients with Alzheimer's disease: the effect on carer burden.

    PubMed

    Tarrier, Nicholas; Barrowclough, Christine; Ward, Jonathan; Donaldson, Catherine; Burns, Alistair; Gregg, Lynsey

    2002-05-01

    Burden of care, expressed emotion (EE), causal attributions, and salivary cortisol were assessed in 100 carers of patients with Alzheimer's disease. Forty-one carers were rated high EE, which was associated with higher scores of carer distress and strain, and greater reports of noncognitive features in the patient, but not with cortisol levels. High EE carers made more attributions personal to, and controllable by, the patient for negative events. Critical carers made more attributions of the patient's behavior that was idiosyncratic. Warmth toward the patient was associated with the opposite of this pattern. Overinvolved carers made attributions of the patient's behavior to causes external to the patient and internal to themselves. Cortisol levels were associated with self-reports of strain and distress. PMID:12003455

  19. A telehealth behavioral coaching intervention for neurocognitive disorder family carers

    PubMed Central

    Gant, Judith R.

    2015-01-01

    Objectives This study examined the differential impact of two telehealth programs for women caring for an older adult with a neurocognitive disorder. Outcomes examined were depressive symptoms, upset following disruptive behaviors, anxious and angry mood states, and caregiving self‐efficacy. Methods Women cohabitating with a family member diagnosed with a neurocognitive disorder were assigned via random allocation to either of the following: (1) a 14‐week behavioral intervention using video instructional materials, workbook and telephone coaching in behavioral management, pleasant events scheduling, and relaxation or (2) a basic education guide and telephone support comparison condition. Telephone assessments were conducted by interviewers blind to treatment condition at pre‐intervention, post‐intervention, and 6 months following intervention. Results For those providing in‐home care at post‐treatment, depressive symptoms, upset following disruptive behaviors, and negative mood states were statistically lower in the behavioral coaching condition than in the basic education and support condition. Reliable change index analyses for Beck Depression Inventory II scores favored the behavioral coaching condition. Caregiving self‐efficacy scores for obtaining respite and for managing patient behavioral disturbances were significantly higher in the coaching condition. Effect sizes were moderate but not maintained at the 6‐month follow‐up. Conclusions This study provides some initial evidence for the efficacy of a telehealth behavioral coaching intervention compared with basic education and telephone support. Carers' abilities to maintain strategy use during progressive disorders such as Alzheimer's disease likely require longer intervention contact than provided in the current study. Dementia carers, including those living in rural areas, can benefit from accessible and empirically supported interventions that can be easily disseminated across distances

  20. [Impact of occupational therapy on the experience of carers].

    PubMed

    Labbaci, Sonia; Gonthier, Régis; Auguste, Nicolas; Achour, Émilie

    2016-03-01

    A study was carried out in 2014 and 2015 analysing the effects of occupational therapy on the carers of patients with Alzheimer's disease or related conditions. The level of "burden" felt by carers was measured before and after this therapy. The results show a real improvement in the quality of their daily life.

  1. Carer involvement with drug services: a qualitative study

    PubMed Central

    Orr, Linda C; Barbour, Rosaline S; Elliott, Lawrie

    2013-01-01

    BackgroundEmpirical research suggests that involving carers brings benefits to families and services. Consequently, drug-related policy and guidance has increasingly encouraged drug services to involve carers at all levels of service provision. ObjectiveTo explore the purpose and scope of carer involvement with adult drug services in North-east Scotland. Design, Setting and ParticipantsA total of 82 participants (20 informal carers, 43 service providers and 19 policy makers) were purposively selected to take part in a qualitative study. Eight focus groups and 32 interviews were conducted between 2007 and 2008. FindingsThree themes were identified through thematic coding: ‘Current levels of involvement’, ‘Use of the term carer’ and ‘Opportunities for change?’ Carer involvement was described as limited, unplanned and unstructured, and consisted largely of information and advice, practical and emotional support, and signposting of services. Although use of the term ‘carer’ was contested within and across the groups, caring in a drug context was considered the ‘same but different’ from caring in other contexts. Carers remained sceptical that services actually wanted to involve them in supporting their relative or to offer carers support in their own right. Many service providers and policy makers regarded carer involvement as an aspiration. ConclusionEncouraging carers, service providers and policy makers to reach a shared understanding of caring in a drug context may help translation of policy into practice. However, there is also a fundamental need for drug services to widen the level and type of involvement activities on offer to carers. PMID:23216899

  2. Manipulating carer number versus brood size: complementary but not equivalent ways of quantifying carer effects on offspring

    PubMed Central

    Browning, L.E.; Russell, A.F.

    2016-01-01

    Experiments designed to quantify the effects of increasing numbers of carers on levels of offspring care are rare in cooperative breeding systems, where offspring are reared by individuals additional to the breeding pair. This paucity might stem from disagreement over the most appropriate manipulations necessary to elucidate these effects. Here, we perform both carer removal and brood enhancement experiments to test the effects of numbers of carers and carer:offspring ratios on provisioning rates in the cooperatively breeding chestnut-crowned babbler (Pomatostomus ruficeps). Removing carers caused linear reductions in overall brood provisioning rates. Further analyses failed to provide evidence that this effect was influenced by territory quality or disruption of group dynamics stemming from the removals. Likewise, adding nestlings to broods caused linear increases in brood provisioning rates, suggesting carers are responsive to increasing offspring demand. However, the 2 experiments did not generate quantitatively equivalent results: Each nestling received more food following brood size manipulation than carer removal, despite comparable carer:offspring ratios in each. Following an at-hatching split-design cross-fostering manipulation to break any links between prehatching maternal effects and posthatching begging patterns, we found that begging intensity increased in larger broods after controlling for metrics of hunger. These findings suggest that manipulation of brood size can, in itself, influence nestling provisioning rates when begging intensity is affected by scramble competition. We highlight that carer number and brood size manipulations are complimentary but not equivalent; adopting both can yield greater overall insight into carer effects in cooperative breeding systems. PMID:27418754

  3. Family carers. 1: Difficulties and levels of support in Sweden.

    PubMed

    Lundh, U

    Sweden has a well developed welfare system and until fairly recently the needs of family carers have received limited attention. However, there is now a growing acceptance of the need to provide better and more sensitive support services. Using questionnaires validated in the UK and translated into Swedish, this series of four articles considers the difficulties, satisfactions and coping mechanisms of a sample of Swedish carers, identifying the implications of the results for the design and delivery of healthcare interventions. This article focuses on carers' perceived difficulties and their satisfaction with existing levels of help.

  4. A dementia first aid course for family carers.

    PubMed

    Pogson, Richard

    Many people with dementia are cared for by family members, who may receive little advice or support. This article describes a course developed to help carers deal with frustrating and challenging behaviour. PMID:26647481

  5. [Supporting carers of persons suffering from an eating disorder].

    PubMed

    Zitarosa, Dino; de Zwaan, Martina; Pfeffer, Meike; Graap, Holmer

    2012-01-01

    The purpose of this article is to describe the background and procedure of a skills training program provided for carers of patients suffering from anorexia or bulimia nervosa. Caring for someone suffering from an eating disorder is associated with psychological distress and may lead to unhelpful interactive behaviours that maintain the illness. Recent investigations in supporting carers, especially skills sharing workshops that target interpersonal maintaining factors are described. A 5-session training concept in teaching basic skills and information about eating disorders to carers in order to improve caregiving burden and reduce interpersonal maintaining factors like expressed emotions (EE) is currently examined in our department. Design and content will be described in detail. Carers' and sufferers' perceptions of the impact of the sessions and acceptance of the provided skills training are reported.

  6. [Supporting carers of persons suffering from an eating disorder].

    PubMed

    Zitarosa, Dino; de Zwaan, Martina; Pfeffer, Meike; Graap, Holmer

    2012-01-01

    The purpose of this article is to describe the background and procedure of a skills training program provided for carers of patients suffering from anorexia or bulimia nervosa. Caring for someone suffering from an eating disorder is associated with psychological distress and may lead to unhelpful interactive behaviours that maintain the illness. Recent investigations in supporting carers, especially skills sharing workshops that target interpersonal maintaining factors are described. A 5-session training concept in teaching basic skills and information about eating disorders to carers in order to improve caregiving burden and reduce interpersonal maintaining factors like expressed emotions (EE) is currently examined in our department. Design and content will be described in detail. Carers' and sufferers' perceptions of the impact of the sessions and acceptance of the provided skills training are reported. PMID:22814922

  7. The intimate mediator: a carer's experience of Alzheimer's.

    PubMed

    Galvin, Kathleen; Todres, Les; Richardson, Mervyn

    2005-03-01

    This research arose out of a collaboration between a service user (M) and two researchers. Following M's invitation to us to explore issues surrounding a carer's experience of Alzheimer's, we jointly agreed a research strategy in which we would engage in a series of interviews with M, with the aim of developing insight into how the intimate carer's complex journey can support and benefit other family caregivers faced with similar challenges. Using a broadly hermeneutic-phenomenological method, three essential themes emerged to describe the carer's journey: (i) something is wrong; (ii) the challenging shared journey: being the carer; (iii) coping through meaning-making: advocacy. We arrive at a position which considers the unique role of an intimate carer as a 'liminal' figure between the private world of an Alzheimer's sufferer and the public world of health and social care systems. The paper concludes with a consideration of how the unique role of the intimate carer as mediator could be more respectfully involved as an ongoing knowledge source for care planning and treatment decisions. Specific areas of consideration in this regard include mechanisms for such user involvement in policy making, day-to-day care delivery, and developments in the support of other carers. We hope to highlight the 'intimacy' of this position and the distinctive benefits and challenges of such intimacy in providing a crucial level of user knowledge and 'evidence' for ongoing treatment decisions. We also hope to highlight the value and power of single-case study in generating useful insights for practice.

  8. What are the roles of carers in decision-making for amyotrophic lateral sclerosis multidisciplinary care?

    PubMed Central

    Hogden, Anne; Greenfield, David; Nugus, Peter; Kiernan, Matthew C

    2013-01-01

    Purpose Family carers of patients with amyotrophic lateral sclerosis (ALS) are presumed to have frequent involvement in decision-making for symptom management and quality of life. To better understand and improve decision-making, we investigated the range and extent of carer participation in decision-making. By focusing on the perspectives of ALS support carers, the study aimed to explore carer participation in decision-making, to identify carer roles, and determine the facilitators and barriers to carer participation in decision-making for ALS multidisciplinary care. Participants and methods An exploratory, in-depth study was conducted with eight carers of ALS patients from two specialized ALS multidisciplinary clinics. Carers participated in semi-structured interviews that were audio recorded and transcribed then coded and analyzed for emergent themes. Results Carers made a significant contribution to ALS decision-making. Their roles were: promoting the patient voice, promoting patient health literacy, and providing emotional support and logistical assistance. Facilitators of carer participation in decision-making were perceived to be: health professional endorsement of patients’ decision-making style; access to credible information sources; evidence-based information from the ALS clinic, ALS support association, and health practitioners; supportive relationships with family and friends; spiritual faith; ease of contact with ALS services; and availability of physical and practical support for carers. Barriers to carer participation included: changes to patient communication and cognition; conflict between respect for patients’ independence and patients’ best interest; communication breakdown between patient, carer, and service providers; the confronting nature of disease information; credibility of Internet sites; carer coping strategies; lack of support for the carer; and the burden of care. Conclusion Carers enhance ALS patient-centered care through their

  9. Supporting carers: a learning resource for community nurses.

    PubMed

    Maskell, Pip; Somerville, Mary; Mathews, Alex

    2015-07-01

    In 2013, as part of the Queen's Nursing Institute (QNI) Carers Project, the QNI asked the 4M Learning Network to test the need for a learning resource to enable community nurses to support carers' health and wellbeing needs. In order to measure the learning needs of community nurses, the QNI undertook a literature review (Laing and Sprung, 2013). The 4M team commenced with desk research and extensive consultation using an online survey and workshops across England. The outcomes of this consultation informed the development of an open-access online learning resource for community nurses, with modules covering different aspects of the nurses' role in relation to carers, as well as a comprehensive resource directory and e-workbook. This resource was launched in March 2014. In response to the enthusiasm and positive feedback from the community nurses, two learning resources were launched in March 2015 for practice nurses and school nurses. An accompanying resource directory mobile application is currently being development and is due to be released in summer 2015. It should be noted that throughout the article, the term carers refers to informal carers, i.e. family or friends caring for a person at home; it does not refer to an employed care assistant or helper. PMID:26140318

  10. Pilot Investigation of the Effectiveness of Respite Care for Carers of an Adult with Mental Illness

    ERIC Educational Resources Information Center

    Jardim, Claudia; Pakenham, Kenneth I.

    2009-01-01

    Informal carers of an adult with mental illness have asked that respite care be an integral component of mental health service provision. The present study involved a pilot investigation of the effectiveness of accessing respite care for carers of individuals with a mental illness. It was hypothesised that compared to carers who have not accessed…

  11. "It's All Changed:" Carers' Experiences of Caring for Adults Who Have Down's Syndrome and Dementia

    ERIC Educational Resources Information Center

    McLaughlin, Katrina; Jones, Aled

    2011-01-01

    A qualitative interview study was undertaken to determine the information and support needs of carers of adults who have Down's syndrome and dementia. The data were analysed thematically. Carers' information and support needs were seen to change at pre-diagnosis, diagnosis and post-diagnosis. Helping carers to manage the changing nature of the…

  12. Carer Knowledge and Perceptions of Healthy Lifestyles for Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Melville, Craig A.; Hamilton, Sarah; Miller, Susan; Boyle, Susan; Robinson, Nicola; Pert, Carol; Hankey, Catherine R.

    2009-01-01

    Background: Carers can have a significant impact supporting people with intellectual disabilities to make healthy lifestyle choices. This study examines carers' training needs on diet and physical activity. Methods: A cross-sectional survey was undertaken of the knowledge and perceptions of carers supporting adults with intellectual disabilities.…

  13. Staff Carers' Understanding of End of Life Care

    ERIC Educational Resources Information Center

    Friedman, Sandra L.; Choueiri, Roula; Gilmore, Dana

    2008-01-01

    Staff carers in pediatric skilled nursing facilities (PSNF) deal directly with dying residents, and are on the forefront of communication with families. These providers have expressed misunderstandings regarding the meaning of resuscitation status and redirection of care. This descriptive study evaluated perceptions and understanding of end of…

  14. Understanding the needs of people with dementia and family carers.

    PubMed

    Bray, Jennifer; Evans, Simon; Thompson, Rachel; Bruce, Mary; Carter, Christine; Brooker, Dawn; Milosevic, Sarah; Coleman, Helen; McSherry, Wilf

    2015-09-01

    This is the first in a short series that presents case study examples of the positive work achieved by trusts who participated in the Royal College of Nursing's development programme to improve dementia care in acute hospitals. When a person with dementia is in hospital, poor understanding of individual needs and preferences can contribute to a lack of person-centred care. Similarly, the needs of family carers can often be overlooked and staff do not always appreciate these needs at such a stressful time. This article illustrates how three NHS trusts have addressed these issues. To help staff get to know patients with dementia, Salford Royal NHS Foundation Trust has implemented a patient passport. Similarly, The Shrewsbury and Telford Hospital NHS Trust has implemented a carer passport that overcomes the restrictions imposed by hospital visiting hours. Royal Devon and Exeter NHS Foundation Trust also focused on carers, holding a workshop to elicit feedback on what was important to them. This was a useful means of engaging with carers and helped staff to realise that even simple changes can have a significant effect.

  15. Enhancing nurse carer partnerships: A self-directed learning approach.

    PubMed

    Cleary, Michelle; Freeman, Adele

    2006-07-01

    For many mental health consumers living in the community, friends or relatives provide day-to-day care and support. Consequently, mental health nurses are increasingly required to work collaboratively with carers and integrate their perspective into patient care. Despite this, research suggests that communication between healthcare workers and carers is poor and training in imparting information to carers effectively and encouraging their involvement has been negligible. In recognition of this, it was deemed important to develop a self-directed learning programme for mental health nurses who wish to enhance their skills in carer partnership. Many nurses are interested in developing their clinical leadership abilities and this programme provides an opportunity to demonstrate expertise through portfolio development in a key area of healthcare delivery. This innovative programme provides educative opportunities to nurses who are frequently busy, work rotating rosters, and have competing demands upon their time. It is open to all nurses irrespective of position or setting and utilises a purpose-designed workbook based on contemporary learning principles. This approach is not without its limitations however. In this paper we share our experiences and hope that it may inform others planning innovations to develop practice through education. PMID:19040881

  16. Collaboration in crisis: Carer perspectives on police and mental health professional's responses to mental health crises.

    PubMed

    Brennan, Alice; Warren, Narelle; Peterson, Violeta; Hollander, Yitzchak; Boscarato, Kara; Lee, Stuart

    2016-10-01

    For many situations involving a mental health crisis, carers (e.g. family or friends) are present and either attempt to help the person overcome the crisis or request assistance from professional services (e.g. mental health or police). Comparatively, little research has explored how carers experience the crisis, the professional response and how the nature of the response, in turn, impacts carers. The current study was conducted to explore these issues during individual interviews with nine carers who had previous contact with police and mental health services during a crisis response. Collected data described the definition and perceived impact of a mental health crisis for carers, how carers had experienced a crisis response from police and mental health services, and how the professional response had impacted on carers. Of importance was the finding that carers were often themselves traumatized by witnessing or being involved in the crisis, however, were rarely offered direct education or support to help them cope or prevent future crises. A number of carers described a reluctance to request assistance from professional services due to previous poor experiences. This highlighted the importance of implementing strategies to deliver more timely, respectful, specialist and collaborative crisis responses to improve carer and consumer outcomes.

  17. Carers' quality of life and experiences of adult social care support in England

    PubMed Central

    Rand, Stacey; Malley, Juliette

    2014-01-01

    Informal carers make a vital contribution to the well-being of the people they care for or look after. Against the policy background in England, the purpose of this study was to explore the views of carers who are in contact with adult social care support services. A qualitative study with 31 carers, who were recruited via local authorities and carers' organisations, was conducted between April and July 2012 to collect data on carers' experiences and perceptions of their quality of life (QoL) with and without adult social care and support for themselves or the person they look after. Through framework analysis, three key themes were identified: (i) definitions of social care services ‘for’ the carer or ‘for’ care recipient and social care outcomes; (ii) carers' access to social care services; and (iii) the meaning and value of informal care. We find that carers' QoL is affected by social care support directed at carers and support directed at those they care for, as well as access to services, the experience of stigma in communities, and in how individual needs and preferences are considered when making decisions about care. While there is much to welcome in the direction of policy in England, this study has shown that there are some gaps in thinking around these areas that will need to be addressed if the lives of carers are to be improved. PMID:24330095

  18. Managing hope, denial or temporal anomie? Informal cancer carers' accounts of spouses' cancer diagnoses.

    PubMed

    Olson, Rebecca Eileen

    2011-09-01

    Carers of cancer patients' emotional responses to cancer diagnoses have been a central focus within psycho-oncology. Some of this literature asserts that the maladaptive coping strategy denial is prevalent amongst carers. Using semi-structured, longitudinal interviews with 32 Australian Capital Territory carers of a spouse with cancer and an interactionist sociology of emotions framework to understanding their emotions, this study aimed to both contribute to the literature on cancer carers' coping strategies and provide a richer sociological depiction of carers' emotional reactions to a cancer diagnosis. The results raise questions about the value of singularly examining denial in cancer carers. Instead, these data suggest that carers use a range of coping strategies in the short-term and do emotion work to adapt to a challenged temporal orientation. The term temporal anomie is offered to describe carers' disrupted orientations in time and facilitate further discussion on the link between time and emotion work. Findings also show the importance of medical professionals' casting of the prognosis, from imminent death to certain future, to this temporal re-orientation and emotion work process. Instead of 'managing hope,' as much of the cancer communication literature describes it, findings suggest that physicians address cancer carers' and patients' temporal anomie. Future research might benefit from moving beyond individualistic conceptualisations of carers' emotions to include the cultural, temporal and interactionist influences.

  19. Collaboration in crisis: Carer perspectives on police and mental health professional's responses to mental health crises.

    PubMed

    Brennan, Alice; Warren, Narelle; Peterson, Violeta; Hollander, Yitzchak; Boscarato, Kara; Lee, Stuart

    2016-10-01

    For many situations involving a mental health crisis, carers (e.g. family or friends) are present and either attempt to help the person overcome the crisis or request assistance from professional services (e.g. mental health or police). Comparatively, little research has explored how carers experience the crisis, the professional response and how the nature of the response, in turn, impacts carers. The current study was conducted to explore these issues during individual interviews with nine carers who had previous contact with police and mental health services during a crisis response. Collected data described the definition and perceived impact of a mental health crisis for carers, how carers had experienced a crisis response from police and mental health services, and how the professional response had impacted on carers. Of importance was the finding that carers were often themselves traumatized by witnessing or being involved in the crisis, however, were rarely offered direct education or support to help them cope or prevent future crises. A number of carers described a reluctance to request assistance from professional services due to previous poor experiences. This highlighted the importance of implementing strategies to deliver more timely, respectful, specialist and collaborative crisis responses to improve carer and consumer outcomes. PMID:27339118

  20. Carers' quality of life and experiences of adult social care support in England.

    PubMed

    Rand, Stacey; Malley, Juliette

    2014-07-01

    Informal carers make a vital contribution to the well-being of the people they care for or look after. Against the policy background in England, the purpose of this study was to explore the views of carers who are in contact with adult social care support services. A qualitative study with 31 carers, who were recruited via local authorities and carers' organisations, was conducted between April and July 2012 to collect data on carers' experiences and perceptions of their quality of life (QoL) with and without adult social care and support for themselves or the person they look after. Through framework analysis, three key themes were identified: (i) definitions of social care services 'for' the carer or 'for' care recipient and social care outcomes; (ii) carers' access to social care services; and (iii) the meaning and value of informal care. We find that carers' QoL is affected by social care support directed at carers and support directed at those they care for, as well as access to services, the experience of stigma in communities, and in how individual needs and preferences are considered when making decisions about care. While there is much to welcome in the direction of policy in England, this study has shown that there are some gaps in thinking around these areas that will need to be addressed if the lives of carers are to be improved.

  1. The Formal Support Experiences of Family Carers of People with an Intellectual Disability Who Also Display Challenging Behaviour and/or Mental Health Issues: What Do Carers Say?

    ERIC Educational Resources Information Center

    James, Neil

    2013-01-01

    This article reports the findings of a literature review of research that has explored the support experiences of family carers of a person with an intellectual disability who displays challenging behaviour and/or has a mental health problem. The purpose of this review is to provide an overview of the reported experiences of family carers from…

  2. Barriers and facilitators for male carers in accessing formal and informal support: A systematic review.

    PubMed

    Greenwood, Nan; Smith, Raymond

    2015-10-01

    Unpaid, informal carers play a vital role in supporting people with long-term conditions. Being a carer can be challenging and carers may need support but they frequently fail to access it. Compared to research investigating the experiences of female carers, research with male carers is underdeveloped. The available evidence suggests male and female carers have many experiences in common but some research suggests that compared to females, male carers are even less likely to access services. The aim of this systematic review was therefore to synthesise research investigating adult male carers' experiences of accessing formal and informal support focussing on the barriers and facilitators. Nine health and social care electronic databases were searched (e.g. PubMed, PsychINFO, CINAHL Plus, Social Policy and Practice, Scopus). Seven studies (five qualitative and two quantitative) fitting the inclusion criteria were identified. All came from North America and most focussed on older carers caring for people with dementia. All seven studies described barriers to accessing support and three highlighted facilitators. Male carers felt committed to their role, seeing it as their responsibility but were often ambivalent about seeking help. Insufficient service information was frequently emphasised. Participants highlighted positive past experiences and professional or voluntary sector support in providing information and helping access services. Research into male carers' experiences in accessing support remains underdeveloped. Research that distinguishes between, for example, the experiences of spouses and sons and with direct comparisons between male and female carers is needed. Whether gender specific services would benefit male carers remains undetermined. PMID:26271710

  3. CARER: Efficient Dynamic Sensing for Continuous Activity Monitoring

    PubMed Central

    Au, Lawrence K.; Bui, Alex A.T.; Batalin, Maxim A.; Xu, Xiaoyu; Kaiser, William J.

    2016-01-01

    Advancement in wireless health sensor systems has triggered rapidly expanding research in continuous activity monitoring for chronic disease management or promotion and assessment of physical rehabilitation. Wireless motion sensing is increasingly important in treatments where remote collection of sensor measurements can provide an in-field objective evaluation of physical activity patterns. The well-known challenge of limited operating lifetime of energy-constrained wireless health sensor systems continues to present a primary limitation for these applications. This paper introduces CARER, a software system that supports a novel algorithm that exploits knowledge of context and dynamically schedules sensor measurement episodes within an energy consumption budget while ensuring classification accuracy. The sensor selection algorithm in the CARER system is based on Partially Observable Markov Decision Process (POMDP). The parameters for the POMDP algorithm can be obtained through standard maximum likelihood estimation. Sensor data are also collected from multiple locations of the subjects body, providing estimation of an individual's daily activity patterns. PMID:22254783

  4. Foster carers influence brood pathogen resistance in ants.

    PubMed

    Purcell, Jessica; Chapuisat, Michel

    2014-10-01

    Social organisms face a high risk of epidemics, and respond to this threat by combining efficient individual and collective defences against pathogens. An intriguing and little studied feature of social animals is that individual pathogen resistance may depend not only on genetic or maternal factors, but also on the social environment during development. Here, we used a cross-fostering experiment to investigate whether the pathogen resistance of individual ant workers was shaped by their own colony of origin or by the colony of origin of their carers. The origin of care-giving workers significantly influenced the ability of newly eclosed cross-fostered Formica selysi workers to resist the fungal entomopathogen Beauveria bassiana. In particular, carers that were more resistant to the fungal entomopathogen reared more resistant workers. This effect occurred in the absence of post-infection social interactions, such as trophallaxis and allogrooming. The colony of origin of eggs significantly influenced the survival of the resulting individuals in both control and pathogen treatments. There was no significant effect of the social organization (i.e. whether colonies contain a single or multiple queens) of the colony of origin of either carers or eggs. Our experiment reveals that social interactions during development play a central role in moulding the resistance of emerging workers.

  5. Interventions for the Carers of Patients With Eating Disorders.

    PubMed

    Treasure, Janet; Nazar, Bruno Palazzo

    2016-02-01

    The aim of this study is to evaluate the recent literature on carers/parenting interventions for people with eating disorders. Interesting and important new findings are highlighted as well as the implications that this may have for treatment. We have reviewed and critically analysed the recent literature. Close others often play an important role in recognising the early signs of eating disorders and accessing and implementing treatment. Their role in helping with recovery is to give support and hold a united front themselves and with the professional team to avoid those common interpersonal reactions that adversely impact on outcome such as accommodating to the illness and reacting with high expressed emotion (overprotection and hostility). Managing this role is difficult, and coping resources are often strained. Carers ask for and are now getting expert training in skills to manage this role. There is an overlap between carer/parenting interventions and family therapies. The interface with close others is critical both for early recognition and access and implementation of treatment. Interventions which equip families and close others with the skills to manage eating disorder behaviours are showing potential at improving outcomes. PMID:26781554

  6. Partnership nursing: influences on involvement of informal carers.

    PubMed

    Casey, A

    1995-12-01

    Factors influencing family involvement in the care of children in hospital were explored in a survey of 243 inpatients in two hospitals. Eighty-five per cent of the children were receiving some or all of their care from a family member, usually the mother. Significant influences on the amount and type of involvement included acuity, type of illness, length of stay and the language spoken by the family. Other social factors, such as distance from the hospital, number of dependent siblings, social class and ethnicity were not significant influencing factors in this population. The influence of language on involvement, and conclusions from related literature, suggest that characteristics of the interaction such as communication and nursing style are more significant than social structural factors. A typology of nursing approaches to informal carers is proposed which could apply beyond the paediatric context. Further work is needed to test the hypothesis that such approaches are characterized by nurses excluding the carer, or permitting, making assumptions about, or negotiating carer involvement.

  7. Paid carers' experiences of caring for mechanically ventilated children at home: implications for services and training.

    PubMed

    Maddox, Christina; Pontin, David

    2013-06-01

    UK survival rates for long-term mechanically ventilated children have increased and paid carers are trained to care for them at home, however there is limited literature on carers' training needs and experience of sharing care. Using a qualitative abductive design, we purposively sampled experienced carers to generate data via diaries, semi-structured interviews, and researcher reflexive notes. Research ethics approval was granted from NHS and University committees. Five analytical themes emerged - Parent as expert; Role definition tensions; Training and Continuing Learning Needs; Mixed Emotions; Support Mechanisms highlighting the challenges of working in family homes for carers and their associated learning needs. Further work on preparing carers to share feelings with parents, using burnout prevention techniques, and building confidence is suggested. Carers highlight the lack of clinical supervision during their night-working hours. One solution may be to provide access to registered nurse support when working out-of-office hours. PMID:23711491

  8. Interactive health communication applications for chronic disease: patient and carer perspectives.

    PubMed

    Kerr, C; Murray, E; Stevenson, F; Gore, C; Nazareth, I

    2005-01-01

    Interactive health communication applications (IHCAs) may be particularly useful to patients and carers managing chronic disease. We have run eight focus groups with patients and two with carers involving a total of 40 participants. The focus groups were designed to seek patients' and carers' requirements of IHCAs and to identify the criteria they would use to assess them. Analysis revealed that many participants saw the value and potential of IHCAs. Even those with modest previous computer experience could use them with little tuition. The findings from this study have policy implications for the development of applications to maximize the potential benefit of IHCAs to patients and carers.

  9. Carers' experiences of dysphagia in people treated for head and neck cancer: a qualitative study.

    PubMed

    Nund, Rebecca L; Ward, Elizabeth C; Scarinci, Nerina A; Cartmill, Bena; Kuipers, Pim; Porceddu, Sandro V

    2014-08-01

    The implication of dysphagia for people treated nonsurgically for head and neck cancer (HNC) and its detrimental effects on functioning and quality of life has been well documented. To date, however, there has been a paucity of research on the effects of dysphagia following HNC on carers, independent of the consequences of a gastrostomy. The objective of this qualitative study was to report on the experiences of carers of people with dysphagia (non-gastrostomy dependent) following nonsurgical treatment for HNC and to identify the support needs of this group. A purposive, maximum-variation sampling technique was adopted to recruit 12 carers of people treated curatively for HNC since 2007. Each participated in an in-depth interview, detailing their experience of caring for someone with dysphagia and the associated impact on their life. Thematic analysis was adopted to search the transcripts for key phases and themes that emerged from the discussions. Analysis of the transcripts revealed four themes: (1) dysphagia disrupts daily life, (2) carers make adjustments to adapt to their partner's dysphagia, (3) the disconnect between carers' expectations and the reality of dysphagia, and (4) experiences of dysphagia-related services and informal supports. Carers generally felt ill-prepared for their role in dysphagia management. The qualitative methodology successfully described the impact of dysphagia on the everyday lives of carers, particularly in regard to meal preparation, social events, and family lifestyle. Clinicians should provide adequate and timely training and support to carers and view carers as copartners in dysphagia management.

  10. A systematic review of psychosocial interventions for family carers of palliative care patients

    PubMed Central

    2010-01-01

    Background Being a family carer to a patient nearing the end of their life is a challenging and confronting experience. Studies show that caregiving can have negative consequences on the health of family carers including fatigue, sleep problems, depression, anxiety and burnout. One of the goals of palliative care is to provide psychosocial support to patients and families facing terminal illness. A systematic review of interventions for family carers of cancer and palliative care patients conducted at the start of this millennium demonstrated that there was a dearth of rigorous inquiry on this topic and consequently limited knowledge regarding the types of interventions likely to be effective in meeting the complex needs of family carers. We wanted to discern whether or not the evidence base to support family carers has improved. Furthermore, undertaking this review was acknowledged as one of the priorities for the International Palliative Care Family Carer Research Collaboration http://www.centreforpallcare.org. Methods A systematic review was undertaken in order to identify developments in family carer support that have occurred over the last decade. The focus of the review was on interventions that targeted improvements in the psychosocial support of family carers of palliative care patients. Studies were graded to assess their quality. Results A total of fourteen studies met the inclusion criteria. The focus of interventions included psycho-education, psychosocial support, carer coping, symptom management, sleep promotion and family meetings. Five studies were randomised controlled trials, three of which met the criteria for the highest quality evidence. There were two prospective studies, five pre-test/post-test projects and two qualitative studies. Conclusions The systematic review identified a slight increase in the quality and quantity of psychosocial interventions conducted for family carers in the last decade. More rigorous intervention research is

  11. Inclusion of carers when confused relatives are admitted to hospital.

    PubMed

    Barber, Jeanette

    2015-06-01

    It is well recognised that many older people have dementia but have never been investigated or received a formal diagnosis. If they are admitted to acute hospitals from their own homes or long-term care settings with confusion and little background information about their usual condition, it can be challenging for staff to determine if they have dementia, delirium, delirium superimposed on pre-existing dementia or confusion with a reversible cause such as vitamin deficiency. A careful history and information seeking from carers or family members about their loved one's pre-admission baseline can inform nursing and medical assessments and help nurses to provide high quality care. PMID:26018488

  12. Family Carers' Experiences Using Support Services in Europe: Empirical Evidence from the EUROFAMCARE Study

    ERIC Educational Resources Information Center

    Lamura, Giovanni; Mnich, Eva; Nolan, Mike; Wojszel, Beata; Krevers, Barbro; Mestheneos, Liz; Dohner, Hanneli

    2008-01-01

    Purpose: This article explores the experiences of family carers of older people in using support services in six European countries: Germany, Greece, Italy, Poland, Sweden, and the UK. Design and Methods: Following a common protocol, data were collected from national samples of approximately 1,000 family carers per country and clustered into…

  13. Development of guidelines to facilitate improved support of South Asian carers by primary health care teams

    PubMed Central

    Katbamna, S; Baker, R; Ahmad, W; Bhakta, P; Parker, G

    2001-01-01

    Background—Evidence based guidelines are regarded as an appropriate basis for providing effective health care, but few guidelines incorporate the views of users such as carers. Aim—To develop guidelines to assist primary health care teams (PHCTs) in their work with carers within South Asian communities. Methods—The guidelines were drawn up by a development group consisting of members of teams in areas with South Asian communities (Leicester and Bradford). The teams were invited to make their recommendations based on a systematic review of literature on minority ethnic carers and the findings of a study of the needs and experiences of local South Asian carers. A grading system was devised to enable the teams and a group of expert peer reviewers to assess the quality of evidence in support of each recommendation. Results—The teams agreed seven recommendations, graded according to available evidence and strength of opinion. External peer review supported the PHCTs' interpretation of evidence and their recommendations. The recommendations included consideration of communication and information for carers, coordination of care within teams, and recognition by team members of the roles of carers and their cultural and religious beliefs. Conclusion—There are particular steps that PHCTs can take to improve their support of South Asian carers. It is possible to develop guidelines that take users' views into account and incorporate evidence from qualitative studies. Key Words: primary health care; South Asian carers; guidelines PMID:11533424

  14. Adults with Intellectual Disabilities and Their Carers as Researchers and Participants in a RCT

    ERIC Educational Resources Information Center

    Turk, Vicky; Leer, Geoffrey; Burchell, Sarah; Khattram, Sukhjinder; Corney, Roslyn; Rowlands, Gill

    2012-01-01

    Background: This article describes the process of including people with intellectual disabilities (ID) and carers of people with ID as researchers and participants in randomised controlled trial (RCT) research. People with ID are rarely involved in research about their health, either as researchers or participants. Carers are often included as…

  15. Effective Communication Training Interventions for Paid Carers Supporting Adults with Learning Disabilities

    ERIC Educational Resources Information Center

    Kyle, Seonaid; Melville, Craig A.; Jones, Andrea

    2010-01-01

    Carer communication skills contribute to the well being of individuals with learning disabilities. Few studies have examined the effectiveness of communication training interventions, and there is a lack of robust measures of outcome. A communication self-efficacy measure relevant to carers supporting adults with learning disabilities was…

  16. Residential Carers' Knowledge and Attitudes towards Physiotherapy Interventions for Adults with Learning Disabilities

    ERIC Educational Resources Information Center

    Stewart, Stephen; Macha, Ruth; Hebblethwaite, Amy; Hames, Annette

    2009-01-01

    Through the use of face-to-face interviews, this article explores residential carers' perceptions and understanding of a physiotherapy service provided to patients with a learning disability, with the aim of highlighting potential areas for improvement in the service. Carers involved in the study reported a good relationship with the…

  17. Mediators of Well-Being in Ageing Family Carers of Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Minnes, Patricia; Woodford, Lynn; Passey, Jennifer

    2007-01-01

    Background: Increasing numbers of adults with an intellectual disability are being cared for at home by ageing parents. The purpose of this study was to determine whether carer resources (i.e. social support and formal service use) and carer appraisals of ageing and stress/burden mediate the relationships between (1) maladaptive behaviour and…

  18. Service Users and Carers: Preparing to Be Involved in Work-Based Practice Assessment

    ERIC Educational Resources Information Center

    Dearnley, Christine; Coulby, Ceridwen; Rhodes, Christine; Taylor, Jill; Coates, Catherine

    2011-01-01

    This paper will provide an overview of the specific issues related to involving service users and carers in work-based practice assessment of health and social care students. The outcomes of a shared workshop that involved service users and carers, practice assessors and students in the development of an interprofessional assessment tool, will be…

  19. Bounded Agency in Young Carers' Lifecourse-Stage Domains and Transitions

    ERIC Educational Resources Information Center

    Hamilton, Myra Giselle; Adamson, Elizabeth

    2013-01-01

    This paper presents the findings from a project investigating the circumstances, experiences, perspectives and service needs of young people caring for a family member with a disability or long-term illness. Using qualitative methods, our research explored the experiences of two cohorts of young carers--younger carers aged 7 to 17 years and young…

  20. Supporting young carers and their families using a whole family approach.

    PubMed

    Frank, Jenny; Slatcher, Christine

    2009-01-01

    Young carers are children and young people who look after family members with illness, disabilities, mental illness or substance misuse. Many of these young carers help with personal nursing care and administration of medication as well as household tasks and care of younger siblings. Inappropriate levels of caring can impact on a child's own emotional and physical health, educational achievement and life chances. There are many reasons why young carers may remain hidden and unsupported including reluctance among some families to acknowledge children's caring roles or involve agencies because they fear family breakup. It is essential to develop proactive practice that will enable families to feel able to ask for support. Health professionals have a responsibility and are in a key position to identify these vulnerable families and mobilise support services. The key to support is the development of a whole family approach to offering co-ordinated assessments and services to support the person with care needs and their family as well as the young carer. The Whole Family Pathway is an online resource directing practitioners to support for young carers and their families. Young carers say that they would like to be listened to, provided with information, supported at school and referred to young carers' projects. The Children's Society Include Project provides training and resources for professionals who work with young carers and their families.

  1. The Internet as Social Support for Older Carers of Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Perkins, Elizabeth A.; LaMartin, Kimberly M.

    2012-01-01

    Social support is a potentially powerful mediator of well-being for family carers. Given that social engagement often decreases with age, the Internet broadens the opportunities for aging carers of individuals with intellectual and developmental disabilities (I/DD) to provide support to one another. This article reviews what constitutes social…

  2. Reporting of Health Problems and Pain by Adults with an Intellectual Disability and by Their Carers

    ERIC Educational Resources Information Center

    Turk, Vicky; Khattran, Sukhjinder; Kerry, Sally; Corney, Roslyn; Painter, Kerry

    2012-01-01

    Background: Information about the health of people with ID is usually obtained from professionals and carers. Little is known about what health problems people with ID report they experience, and whether this differs from their carers' reports. Method: A secondary analysis of health information provided by participants with ID and/or their matched…

  3. Depressive Symptoms in Older Female Carers of Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Chou, Y. C.; Pu, C-Y.; Fu, L-Y.; Kroger, T.

    2010-01-01

    Background: This survey study aims to examine the prevalence and factors associated with depressive symptoms among primary older female family carers of adults with intellectual disabilities (ID). Method: In total, 350 female family carers aged 55 and older took part and completed the interview in their homes. The survey package contained…

  4. Carer Knowledge and Experiences with Menopause in Women with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Willis, Diane S.; Wishart, Jennifer G.; Muir, Walter J.

    2010-01-01

    Overall life expectancy for women with intellectual disabilities (ID) is now significantly extended, and many will live long enough to experience menopause. Little is known about how carers support women with ID through this important stage in their lives. This study investigated carer knowledge of how menopause affects women with ID under their…

  5. A 10-year Plan for Quality Living for People with Disabilities and Their Carers

    ERIC Educational Resources Information Center

    Craig, Jocelyn E.; Cartwright, Collen

    2015-01-01

    Background: The concerns of older carers of an adult with disabilities have been well documented. The sudden incapacity or death of the carer can result in a crisis response rather than a planned transition to a chosen sustainable alternative care arrangement for the person with disability. Building on previous "Futures Planning"…

  6. Attitude to Medication of Parents/Primary Carers of People With Intellectual Disability

    ERIC Educational Resources Information Center

    Rasaratnam, R.; Crouch, K.; Regan, A.

    2004-01-01

    To investigate the influence of attitudes of carers of people with intellectual disability (ID) towards giving medication. Ninety-three carers of service users who are currently attending outpatients clinic (Harrow Learning Disability service) were interviewed, using the RAMS (Rating of Attitude to Medication Scale) interview schedule. A…

  7. The importance of relationship in understanding the experiences of spouse mental health carers.

    PubMed

    Lawn, Sharon; McMahon, Janne

    2014-02-01

    The burden of caring for family members with mental illness has been researched extensively; however, knowledge of spouse carers' experiences is limited. In this article, we explore this from a carers' perspective, with 28 spouse carers, using qualitative open-ended semistructured interviews and a grounded theory approach informed by the social interactionism tradition to collect and analyze the data. We present six interrelated themes around the central theme of this being "a real and genuine relationship." The findings indicate that caring for a spouse with severe mental illness is a unique role compared with other caring roles. First and foremost, spouse carers strive for the relationship with their partner and accommodate mental illness into their lives to protect the relationship. Because of this, they often lead surreal lives marked by significant emotional pressure and isolation. This has implications for how mental health service providers work with and support spouse carers.

  8. 'Confidentiality smokescreens' and carers for people with mental health problems: the perspectives of professionals.

    PubMed

    Gray, Ben; Robinson, Catherine; Seddon, Diane; Roberts, Angela

    2008-07-01

    This paper reports on some of the findings from a collaborative study funded by the Big Lottery and led by Crossroads Caring for Carers about carers for people with mental health problems. The protection and use of information in mental health are firmly rooted in ethics and professional codes, law and policy, as well as values and professional practice. While government initiatives have attempted to augment the role and rights of carers, policy guidance involving information sharing between professionals and carers has failed to deal with the practical dilemmas of patient confidentiality. Professional codes and training neither explore nor develop the moral and ethical ground that stands between the service user's need for privacy and the carer's need for information. Policy and training guidance on confidentiality is scattered, ambiguous, confusing for professionals and inconsistent. There is uncertainty in practice about the information that professionals may share, and many professionals do not take into account carers' rights, not least to basic information to help them care for service users. 'Confidentiality smokescreens' may sometimes lead to information being withheld from carers. Professionals sometimes find it easier and safer to say nothing. In order to explore these issues from the perspectives of professionals, 65 participants were interviewed. The sample included directors and senior staff from the health, social care and voluntary sectors. Respondents were asked to comment at length on their understanding of confidentiality and information sharing with carers. Findings highlight confidentiality smokescreens that erect barriers that limit effective information sharing; issues involving confidentiality, risk management and carers in crisis; examples of good practice; and the need for the training of professionals on confidentiality issues and the rights of carers. This paper explores the challenge of confidentiality smokescreens from the perspective

  9. Living with heart failure; patient and carer perspectives.

    PubMed

    Pattenden, J F; Roberts, H; Lewin, R J P

    2007-12-01

    Patients with heart failure have multiple readmissions to hospital, a poor prognosis and varying quality of life. This paper explores how patients with heart failure and their family carers cope with daily life. 36 patients and 20 family caregivers were interviewed in five centres in the UK. Analysis showed that living with heart failure can be frightening, restrictive and distressing for both patients and their family carers. Patients found most difficulty coping with functional limitation and adapting to living with heart failure, but also reported particular problems due to side effects of medications, co-morbidities and a lack of psychosocial support and rehabilitation services. Those with less socio-economic resources found it harder to cope. Patients from minority ethnic groups held different beliefs about the illness and its treatment, and some had profound problems communicating with health and social care professionals that made managing the disease even more difficult. Caring for a person with heart failure often has a considerable impact on the psychological and physical health of family caregivers. Psychosocial support and rehabilitation services provided at diagnosis and after an acute episode would enable families to better manage living with this syndrome. PMID:17383236

  10. Deliver us from evil: carer burden in Alzheimer's disease.

    PubMed

    Zimmermann, Martina

    2010-12-01

    Alzheimer's disease is the most common neurodegenerative disorder in today's developed world that is also increasingly picked out as a focal theme in fictional literature. In dealing with the subjectivity of human experience, such literature enhances the reader's empathy and is able to teach about moral, emotional and philosophical issues, offering the chance to see situations from a position otherwise possibly never taken by the reader. The understanding and insight so gained may well be unscientific, but the literary approach offers an insight into the whole person's perspective and the particularity and uniqueness of a situation that includes ethical conflicts. A key motif of fictional literature centred around dementia remains the burden the adult-child carer is confronted with, considering the parent's remorseless decline and personality change, the sudden demand for devoted and continuous care, and the constantly changing relationship with the declining parent. In the context of an ever increasing demand for a constructive public discussion regarding end-of-life treatment of demented patients, Christine Devars (Le Piano Désaccordé) and Andrés Barba (Ahora Tocad Música de Baile) illustrate how powerful and burdensome the impact of Alzheimer's disease is on both patient and carer and what extremes may be reached under such truly exceptional circumstances.

  11. Deliver us from evil: carer burden in Alzheimer's disease.

    PubMed

    Zimmermann, Martina

    2010-12-01

    Alzheimer's disease is the most common neurodegenerative disorder in today's developed world that is also increasingly picked out as a focal theme in fictional literature. In dealing with the subjectivity of human experience, such literature enhances the reader's empathy and is able to teach about moral, emotional and philosophical issues, offering the chance to see situations from a position otherwise possibly never taken by the reader. The understanding and insight so gained may well be unscientific, but the literary approach offers an insight into the whole person's perspective and the particularity and uniqueness of a situation that includes ethical conflicts. A key motif of fictional literature centred around dementia remains the burden the adult-child carer is confronted with, considering the parent's remorseless decline and personality change, the sudden demand for devoted and continuous care, and the constantly changing relationship with the declining parent. In the context of an ever increasing demand for a constructive public discussion regarding end-of-life treatment of demented patients, Christine Devars (Le Piano Désaccordé) and Andrés Barba (Ahora Tocad Música de Baile) illustrate how powerful and burdensome the impact of Alzheimer's disease is on both patient and carer and what extremes may be reached under such truly exceptional circumstances. PMID:21393292

  12. Inconsistencies in the Roles of Family- and Paid- Carers in Monitoring Health Issues in People with Learning Disabilities: Some Implications for the Integration of Health and Social Care

    ERIC Educational Resources Information Center

    Willis, Diane S.

    2015-01-01

    Changes in the living circumstances of people with learning disabilities have seen responsibility for their health become the provenance of paid-and family-carers. Thirteen semi-structured interviews were conducted with three family-carers and ten paid-carers. Findings revealed that the role of these carers was undefined, leading to difficulty in…

  13. Carers' opinions and emotional responses following cardiac surgery: cardiac rehabilitation implications for critical care nurses.

    PubMed

    Davies, N

    2000-04-01

    The recent joint position statement made by the RCN Critical Care and Rehabilitation Nursing Forums highlights the need for rehabilitation to commence early. This paper reports the findings of a descriptive survey of 59 carers of cardiac surgery patients and presents implications for cardiac rehabilitation. Data were obtained by postal questionnaire during early recovery (one week following discharge) and six weeks later. The questionnaire explored carers' perceptions about the timing of discharge from hospital; opinions of the information provided by hospital staff; and anxiety and depression measured on the Hospital Anxiety and Depression Scale. The results indicated that carers assumed a heavy burden once the patient had left the specialist cardiac centre. Carers responding at one week were less satisfied with the timing of discharge than those questioned at six weeks. Information provided by nurses was rated more highly than that provided by doctors or physiotherapists. However, there was scope for increasing input. The findings suggest that cardiac rehabilitation needs to be aimed at carers as well as patients. Investment in targeted carer support could facilitate patient recovery and rehabilitation. Strategies aimed at the carer need to begin early and commence during the acute stage of the patients' recovery.

  14. A description of multiple family workshops for carers of people with anorexia nervosa.

    PubMed

    Treasure, Janet; Whitaker, Wendy; Todd, Gill; Whitney, Jenna

    2012-01-01

    Carers of people with eating disorders are uncertain about how best to help and express the need for information. Fifty per cent of carers (usually parents) exhibit clinically significant anxiety and/or depression. This may result from a difficulty coping with the manifestations of anorexia nervosa (AN) in the sufferer. In turn, eating disorder symptoms can be maintained by family reactions to the illness. Thus, carer's own symptoms, plus their uncertainty about how to help, impinge upon the AN sufferer, exacerbating their symptoms and behaviours. In this paper, we describe an intervention which uses cognitive behavioural therapy principles to alleviate carer's depression and anxiety and motivational interviewing to target behaviours that maintain eating disorder symptoms, for example high expressed emotion and poor communication. This is given in the form of an educational workshop for two families.

  15. Saying it in song: music therapy as a carer support intervention.

    PubMed

    O'Kelly, Julian

    2008-06-01

    The burdens experienced by informal caregivers are likely to increase in the context of the UK's ageing demographic, and the movement towards more home-based care for those with long-term, chronic or palliative illnesses. This article combines an overview of our understanding of caregiving and carer support interventions, with an outline of the evidence base for music therapy in palliative care. Case material from the author's experiences of songwriting with a carer is used to provide a practical insight into how this emerging palliative care discipline may have the potential to alleviate carer burden, and enhance wellness. More research to explore the efficacy of music therapy as a carer support intervention is recommended.

  16. A national survey of adult placement schemes in England: recruitment and retention of adult placement carers.

    PubMed

    Bernard, Sylvia

    2005-11-01

    Adult placement (AP) schemes and the carers they support have been, up to now, a largely invisible part of the social care workforce. Carers in particular fail to appear in workforce statistics. They provide a unique form of care to vulnerable people, under-pinned by values of extended family ('kinship') support. Little is known about the range of current activities of AP schemes and the carers they support. This study of AP schemes in England aimed to provide baseline data about the workforce, care provision, qualification levels, training and support issues, and recruitment and retention problems. Questionnaires were sent to all known schemes in England in both statutory and independent sectors. A final database of 130 schemes was compiled and of these, 124 contributed to the survey with complete or partial information. Variables relating to carers, and recruitment and retention problems experienced by schemes were analysed in detail. Age, gender and ethnic profiles of AP carers were described. Anecdotal evidence had suggested that the current regulatory system was leading to a loss of AP carers and/or an increasingly unregulated sector. Results from analyses supported this as the major reason given by schemes for the problems they had experienced in the last 12 months. Estimates of both the current level of registration and the numbers of carers cancelling their registration in the previous 12 months were made. Recently agreed regulatory changes aim to shift the burden of regulation from individual carers to AP schemes, and thereby ensure a consistent standard of assessment, training and support across England. Evidence from the survey provided support for such a move.

  17. Love stories: understanding the caring journeys of aged Greek-Australian carers.

    PubMed

    Horsfall, Debbie; Blignault, Ilse; Perry, Astrid; Antonopoulos, Penny

    2016-03-01

    This article documents the findings of a short-term longitudinal study that explored the caring journeys of aged Greek carers providing in-home care for their spouse. Through a deeper understanding of carers' decisions and decision-making and insights from service providers and community leaders, we aimed to inform policy makers, service managers and providers about how to develop and promote culturally appropriate support services, and negotiate them with carers and care recipients in a timely way. Initially, we conducted three focus groups and one follow-up forum with service providers and Greek community leaders. Then, over a 6-month period, we conducted two in-home interviews and two telephone interviews with 12 older Greek carers. We sought to understand factors influencing carers' decision-making regarding service uptake, and we provided information about services as required. Through our thematic analysis, we found that most carers wanted to remain as independent as possible and to avoid forced separation from the one they loved, through institutionalisation. They placed great value on their caring role which, while a struggle at times, gave them a sense of meaning, purpose and belonging. We also found that carers had great resourcefulness, strength and competence. They were all in long-term relationships, had negotiated coming to a foreign country and establishing themselves and were now in the process of negotiating old age and increasing frailty while at the same time providing care and support to family and friends. Our findings suggest that services need to be communicated in ways which support what carers value, not on outdated assumptions about cultural groups, otherwise providers will perpetuate exclusion. We propose an outreach in-home service model with an emphasis on ageing well and staying at home. This model of service provision is a model of care which emphasises relationships and community, and seeks to build social and cultural capital.

  18. Family carers providing support to a person dying in the home setting: A narrative literature review

    PubMed Central

    Morris, Sara M; King, Claire; Turner, Mary

    2015-01-01

    Background: This study is based on people dying at home relying on the care of unpaid family carers. There is growing recognition of the central role that family carers play and the burdens that they bear, but knowledge gaps remain around how to best support them. Aim: The aim of this study is to review the literature relating to the perspectives of family carers providing support to a person dying at home. Design: A narrative literature review was chosen to provide an overview and synthesis of findings. The following search terms were used: caregiver, carer, ‘terminal care’, ‘supportive care’, ‘end of life care’, ‘palliative care’, ‘domiciliary care’ AND home AND death OR dying. Data sources: During April–May 2013, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Pubmed, Cochrane Reviews and Citation Indexes were searched. Inclusion criteria were as follows: English language, empirical studies and literature reviews, adult carers, perspectives of family carers, articles focusing on family carers providing end-of-life care in the home and those published between 2000 and 2013. Results: A total of 28 studies were included. The overarching themes were family carers’ views on the impact of the home as a setting for end-of-life care, support that made a home death possible, family carer’s views on deficits and gaps in support and transformations to the social and emotional space of the home. Conclusion: Many studies focus on the support needs of people caring for a dying family member at home, but few studies have considered how the home space is affected. Given the increasing tendency for home deaths, greater understanding of the interplay of factors affecting family carers may help improve community services. PMID:25634635

  19. Behavioural and psychological symptoms in dementia and the challenges for family carers: systematic review

    PubMed Central

    Feast, Alexandra; Orrell, Martin; Charlesworth, Georgina; Melunsky, Nina; Poland, Fiona; Moniz-Cook, Esme

    2016-01-01

    Background Tailored psychosocial interventions can help families to manage behavioural and psychological symptoms in dementia (BPSD), but carer responses to their relative's behaviours contribute to the success of support programmes. Aims To understand why some family carers have difficulty in dealing with BPSD, in order to improve the quality of personalised care that is offered. Method A systematic review and meta-ethnographic synthesis was conducted of high-quality quantitative and qualitative studies between 1980 and 2012. Results We identified 25 high-quality studies and two main reasons for behaviours being reported as challenging by family carers: changes in communication and relationships, resulting in ‘feeling bereft’; and perceptions of transgressions against social norms associated with ‘misunderstandings about behaviour’ in the relative with dementia. The underlying belief that their relative had lost, or would inevitably lose, their identity to dementia was a fundamental reason why family carers experienced behaviour as challenging. Conclusions Family carers' perceptions of BPSD as challenging are associated with a sense of a declining relationship, transgressions against social norms and underlying beliefs that people with dementia inevitably lose their ‘personhood’. Interventions for the management of challenging behaviour in family settings should acknowledge unmet psychological need in family carers. PMID:26989095

  20. Health, economic, psychological and social impact of educating carers of patients with advanced pulmonary disease (protocol).

    PubMed

    Sladek, R M; Jones, T; Phillips, P A; Luszcz, M; Rowett, D; Eckermann, S; Woodman, R J; Frith, P

    2011-09-01

    People with advanced pulmonary disease (APD), such as those with chronic obstructive pulmonary disease, have markedly impaired quality of life. Home Oxygen Therapy (HOT) itself is burdensome, although it often improves survival duration and quality of life in these patients. The exact burdens on informal caregivers of these patients are unknown. The central purpose of the pragmatic randomized controlled study described in this protocol is to determine the effectiveness of improving the skills and knowledge of carers of patients with APD who use HOT. Specifically we aimed to estimate the incremental impact of this carer intervention above usual care on health, economic, psychological and social domains for patient and carer dyads relative to the level of current burden. Eligible patients and their carers were recruited through three major hospitals, and randomized to an intervention or control group. The carers in the intervention group received two home-delivered education sessions based on the principles of academic detailing. Participants are currently being followed over 12 months. The primary outcome will be the proportion of patients surviving without a chronic obstructive pulmonary disease-related readmission / residential (non respite) care over 12 months. Carer secondary outcomes include perceived caregiver burden, level of expected and received social support, perceived level of mastery, self esteem, health related quality of life and disability, and ability to conduct domestic chores and household maintenance, social activities and provide service to others, and fatigue. Secondary patient outcomes include health related quality of life and disability, and current respiratory health status.

  1. When one loses empathy: its effect on carers of patients with dementia.

    PubMed

    Hsieh, Sharpley; Irish, Muireann; Daveson, Naomi; Hodges, John R; Piguet, Olivier

    2013-09-01

    The effects of empathy loss in frontotemporal dementia (FTD) and Alzheimer disease (AD) on carer symptomatology were investigated. Carers of patients with 2 clinical subtypes of FTD (behavioral-variant FTD [bvFTD] = 18; semantic dementia [SD] = 14) and AD (n = 18) completed the Interpersonal Reactivity Index (IRI), a standardized questionnaire of empathy as well as a measure of perceived burden (Zarit Burden Interview) and the quality of the marital relationship (Intimate Bond Measure). Patient ratings were also obtained on the IRI. Loss of empathy was most striking in the bvFTD group with a marked discrepancy observed between carer and patient ratings for change in emotional warmth and the ability to take the perspective of others. Empathy loss in bvFTD was associated with a loss of a caring marital relationship. Empathic deficits in SD were milder by comparison to bvFTD and correlated with disease severity and increased perceived carer burden. The behavioral pattern observed in AD differed from the FTD syndromes; deficits were observed only for measures of personal distress with carers reporting that patients were less able to handle emotionally evocative situations. Results highlight that changes in aspects of empathy differ across dementia syndromes and are associated with differing carer and clinical variables. These findings might be explained by the progression of atrophy in regions that are known to be critical for empathy and social behavior and has implications for the delivery and planning of services in dementia. PMID:23857888

  2. When one loses empathy: its effect on carers of patients with dementia.

    PubMed

    Hsieh, Sharpley; Irish, Muireann; Daveson, Naomi; Hodges, John R; Piguet, Olivier

    2013-09-01

    The effects of empathy loss in frontotemporal dementia (FTD) and Alzheimer disease (AD) on carer symptomatology were investigated. Carers of patients with 2 clinical subtypes of FTD (behavioral-variant FTD [bvFTD] = 18; semantic dementia [SD] = 14) and AD (n = 18) completed the Interpersonal Reactivity Index (IRI), a standardized questionnaire of empathy as well as a measure of perceived burden (Zarit Burden Interview) and the quality of the marital relationship (Intimate Bond Measure). Patient ratings were also obtained on the IRI. Loss of empathy was most striking in the bvFTD group with a marked discrepancy observed between carer and patient ratings for change in emotional warmth and the ability to take the perspective of others. Empathy loss in bvFTD was associated with a loss of a caring marital relationship. Empathic deficits in SD were milder by comparison to bvFTD and correlated with disease severity and increased perceived carer burden. The behavioral pattern observed in AD differed from the FTD syndromes; deficits were observed only for measures of personal distress with carers reporting that patients were less able to handle emotionally evocative situations. Results highlight that changes in aspects of empathy differ across dementia syndromes and are associated with differing carer and clinical variables. These findings might be explained by the progression of atrophy in regions that are known to be critical for empathy and social behavior and has implications for the delivery and planning of services in dementia.

  3. Schizophrenia through the carers' eyes: results of a European cross-sectional survey.

    PubMed

    Svettini, A; Johnson, B; Magro, C; Saunders, J; Jones, K; Silk, S; Hargarter, L; Schreiner, A

    2015-09-01

    Schizophrenia is a serious mental disorder affecting approximately 29 million people worldwide. The ideal treatment and care of patients with schizophrenia should be provided by a multidisciplinary 'team' involving psychiatrists, nurses and other healthcare professionals, together with carers and patients. In light of the key role carers play in the care of patients with schizophrenia, the present survey was designed to assess the opinions of family members and friends of patients with schizophrenia across Europe and to ascertain their attitudes towards the illness, medication and adherence to medication. Among carers participating in this survey, there was widespread awareness of the issues involved in supporting patients with schizophrenia and the importance of their role in improving poor adherence to medication. Three differences in opinion emerged between the views of carers and psychiatrists; psychiatrists rely more on the patient themselves when assessing adherence than carers would recommend; in contrast to psychiatrists, many carers believe the illness itself contributes to non-adherence; two thirds of carers think that schizophrenia medication damages health (higher than estimated by psychiatrists). The findings from the present survey, taken together with the results from the Adherencia Terapéutica en la Esquizofrenia surveys of psychiatrists and nurses, support the need for a collaborative approach to the issue of treatment nonadherence. In particular, healthcare professionals should recognize the valuable contribution that family carers can make to improve treatment adherence and consequently clinical outcomes for patients with schizophrenia. Schizophrenia carries a significant burden for families providing care. The Adherencia Terapéutica en la Esquizofrenia (ADHES) carers' survey was designed to assess the opinions of family and friends of patients with schizophrenia across Europe and ascertain their attitudes towards the illness, medication and

  4. Schizophrenia through the carers' eyes: results of a European cross-sectional survey.

    PubMed

    Svettini, A; Johnson, B; Magro, C; Saunders, J; Jones, K; Silk, S; Hargarter, L; Schreiner, A

    2015-09-01

    Schizophrenia is a serious mental disorder affecting approximately 29 million people worldwide. The ideal treatment and care of patients with schizophrenia should be provided by a multidisciplinary 'team' involving psychiatrists, nurses and other healthcare professionals, together with carers and patients. In light of the key role carers play in the care of patients with schizophrenia, the present survey was designed to assess the opinions of family members and friends of patients with schizophrenia across Europe and to ascertain their attitudes towards the illness, medication and adherence to medication. Among carers participating in this survey, there was widespread awareness of the issues involved in supporting patients with schizophrenia and the importance of their role in improving poor adherence to medication. Three differences in opinion emerged between the views of carers and psychiatrists; psychiatrists rely more on the patient themselves when assessing adherence than carers would recommend; in contrast to psychiatrists, many carers believe the illness itself contributes to non-adherence; two thirds of carers think that schizophrenia medication damages health (higher than estimated by psychiatrists). The findings from the present survey, taken together with the results from the Adherencia Terapéutica en la Esquizofrenia surveys of psychiatrists and nurses, support the need for a collaborative approach to the issue of treatment nonadherence. In particular, healthcare professionals should recognize the valuable contribution that family carers can make to improve treatment adherence and consequently clinical outcomes for patients with schizophrenia. Schizophrenia carries a significant burden for families providing care. The Adherencia Terapéutica en la Esquizofrenia (ADHES) carers' survey was designed to assess the opinions of family and friends of patients with schizophrenia across Europe and ascertain their attitudes towards the illness, medication and

  5. Supporting South Asian carers and those they care for: the role of the primary health care team.

    PubMed Central

    Katbamna, Savita; Bhakta, Padma; Ahmad, Waqar; Baker, Richard; Parker, Gillian

    2002-01-01

    BACKGROUND: Demographic and socioeconomic changes have increased policy interest in informal carers. However, despite the multicultural nature of British society, most research in this field has been in majority communities. AIM: To explore the role of the primary health care team (PHCT) in supporting carers from British South Asian communities. DESIGN OF STUDY: Qualitative study. SETTING: Four South Asian communities in Leicestershire and West Yorkshire. METHODS: Focus groups and in-depth interviews were used to assess male and female carers, supported by a literature review. RESULTS: Failure to recognise carers' needs, gaps in service provision, and communication and language issues compromised carers' ability to care. While some carers were positive about the PHCT role, the main weaknesses concerned poor consultation, PHCT attitudes towards carers, and access to appropriate services. CONCLUSION: South Asian carers' experiences largely parallel those of others, but there are some issues that are distinct, namely, language and communication barriers, culturally inappropriate services, and implicit or explicit racism. The multi-ethnic nature of Great Britain requires that professional practice enhances the ability of minority ethnic communities to provide informal care. The findings underline the important role of the PHCT in ensuring that carers' needs are taken seriously and that appropriate services reach them. PMID:11942447

  6. [The reliability of reliability].

    PubMed

    Blancas Espejo, A

    1991-01-01

    The author critically analyzes an article by Rodolfo Corona Vazquez that questions the reliability of the preliminary results of the Eleventh Census of Population and Housing, conducted in Mexico in March 1990. The need to define what constitutes "reliability" for preliminary results is stressed. PMID:12317739

  7. Reaching out or missing out: approaches to outreach with family carers in social care organisations

    PubMed Central

    Moriarty, Jo; Manthorpe, Jill; Cornes, Michelle

    2015-01-01

    Outreach is advocated as a way of improving the uptake of services among underserved populations and of filling the gaps between mainstream services and the populations they are intended to support. Despite the policy emphasis on providing better help for family carers, research consistently shows that many of those providing unpaid care to a family member or friend report difficulties in finding out about the assistance to which they are entitled. This article presents results from a concurrent mixed-methods study, which aimed to describe different ways of working with family carers in adult social care departments and to collect the views of a range of stakeholders about the advantages and disadvantages of the approaches that were identified. A total of 86 semi-structured face-to-face interviews were undertaken with a purposive sample of funders, carers' workers, representatives of voluntary organisations and family carers based in four contrasting localities. An email survey was sent to all local councils in England with social care responsibilities and resulted in a 53% response rate. Data collection took place in 2012, with a small number of interviews being completed in 2011. Our approach to data analysis combined methodological, data and theoretical triangulation. The findings presented here mainly draw on the interview data to highlight the different models of outreach that we identified. The article highlights important differences between outreach and the provision of information. It concludes that organisations providing support for carers need to consider the advantages and disadvantages of different models of outreach as they develop carers' support and the extent to which different models might be more effective than others in reaching particular types of carer. PMID:25331912

  8. Dying from cancer in community hospitals or a hospice: closest lay carers' perceptions.

    PubMed Central

    Seamark, D A; Williams, S; Hall, M; Lawrence, C J; Gilbert, J

    1998-01-01

    BACKGROUND: Despite there being around 400 community hospitals in the United Kingdom, there is little published research on the quality of service provided by these hospitals. AIM: To compare the quality of terminal cancer care in community hospitals with a hospice as assessed by patients' closest lay carer (relative or friend). METHOD: Structured interview (or questionnaire based on the interview proforma) with closest lay carers of all patients dying over one year in 12 community hospitals in east Devon and a purpose-built hospice in the city of Exeter. RESULTS: A total of 292 cases (176 in community hospitals and 116 in a hospice) were identified, resulting in 238 carers being eligible for interview or questionnaire survey. Overall, 106 successful interviews and 55 questionnaires were completed, giving a response rate of 67.6%. Carers gave a near unanimous vote of excellence for the total care given by the hospice, while around 40% of carers of patients in community hospitals considered that improvements were possible. Community hospitals attracted more negative comments than hospices, with criticism being directed at problems of communication, lack of nursing staff, and lack of support in bereavement. Carers of hospice patients were significantly more likely to be present at the time of death than those of community hospital patients [45/70 (64%) vs. 31/89 (35%); chi 2 = 13.6, P < 0.001], an observation possibly because nursing staff in community hospitals are less experienced at dealing with terminally ill patients and such hospitals have fewer adequate facilities. CONCLUSIONS: Lay carers indicated great satisfaction with care given in the hospice and less satisfaction with care given in the community hospitals. However, the community hospitals are non-specialist units with far lower levels of trained staff. Improvements in terms of the communication skills of doctors and nurses, specific training for nurses in palliative care, and structured bereavement care

  9. Interprofessional teamwork in stroke care: Is it visible or important to patients and carers?

    PubMed

    Hewitt, Gillian; Sims, Sarah; Greenwood, Nan; Jones, Fiona; Ross, Fiona; Harris, Ruth

    2015-01-01

    Interprofessional teamwork is seen in healthcare policy and practice as a key strategy for providing safe, efficient and holistic healthcare and is an accepted part of evidence-based stroke care. The impact of interprofessional teamwork on patient and carer experience(s) of care is unknown, although some research suggests a relationship might exist. This study aimed to explore patient and carer perceptions of good and poor teamwork and its impact on experiences of care. Critical incident interviews were conducted with 50 patients and 33 carers in acute, inpatient rehabilitation and community phases of care within two UK stroke care pathways. An analytical framework, derived from a realist synthesis of 13 'mechanisms' (processes) of interprofessional teamwork, was used to identify positive and negative 'indicators' of teamwork. Participants identified several mechanisms of teamwork, but it was not a subject most talked about readily. This suggests that interprofessional teamwork is not a concept that is particularly important to stroke patients and carers; they do not readily perceive any impacts of teamwork on their experiences. These findings are a salient reminder that what might be expected by healthcare professionals to be important influences on experience may not be perceived to be so by patients and carers.

  10. Evaluation of quality of life of carers of Italian spinoni with idiopathic epilepsy

    PubMed Central

    De Risio, Luisa; Freeman, Julia; Shea, Anita

    2016-01-01

    The carers of all UK Kennel Club registered Italian spinoni (IS) born between January 1, 2000 and December 31, 2011 were invited to participate in the study. The carers of 47 of 63 IS diagnosed with idiopathic epilepsy (IE) returned the questionnaire, which included numerous questions on various aspects of IE including the effect of IE on the dog's carer's quality of life. Median epileptic seizure number in the three months before study end or death was five epileptic seizures, 72 per cent of dogs had cluster seizures, 94 per cent of dogs were administered one or more antiepileptic medications and 36 per cent of dogs were euthanased due to poorly controlled IE. Seventy-one per cent and 65 per cent of the participants were moderately to extremely worried about the frequency and severity of their dog's epileptic seizures, respectively. Caring for an IS with IE caused conflict with the carer's work, education or daily activity often or very often in 50 per cent of the participants. Overall the limitations on the carer's life due to caring for an IS with IE were considered as very to extremely bothersome in 29 per cent of the participants, a little to moderately bothersome in 40 per cent of the participants and not at all bothersome in 31 per cent of the participants. PMID:27403328

  11. Evaluation of quality of life of carers of Italian spinoni with idiopathic epilepsy.

    PubMed

    De Risio, Luisa; Freeman, Julia; Shea, Anita

    2016-01-01

    The carers of all UK Kennel Club registered Italian spinoni (IS) born between January 1, 2000 and December 31, 2011 were invited to participate in the study. The carers of 47 of 63 IS diagnosed with idiopathic epilepsy (IE) returned the questionnaire, which included numerous questions on various aspects of IE including the effect of IE on the dog's carer's quality of life. Median epileptic seizure number in the three months before study end or death was five epileptic seizures, 72 per cent of dogs had cluster seizures, 94 per cent of dogs were administered one or more antiepileptic medications and 36 per cent of dogs were euthanased due to poorly controlled IE. Seventy-one per cent and 65 per cent of the participants were moderately to extremely worried about the frequency and severity of their dog's epileptic seizures, respectively. Caring for an IS with IE caused conflict with the carer's work, education or daily activity often or very often in 50 per cent of the participants. Overall the limitations on the carer's life due to caring for an IS with IE were considered as very to extremely bothersome in 29 per cent of the participants, a little to moderately bothersome in 40 per cent of the participants and not at all bothersome in 31 per cent of the participants.

  12. Skilled interaction among professional carers in special accommodations for adult people with learning disabilities.

    PubMed

    Antonsson, H; Aström, S; Lundström, M; Graneheim, U H

    2013-09-01

    Communicative difficulties affect interactions between people with learning disabilities and their carers. Despite such difficulties, however, some carers seem to interact successfully with people who have limited ability to communicate verbally and exhibit challenging behaviour. This study aims to illuminate skilled interaction among carers working in special accommodations for people with learning disabilities. Interactions between 16 caregivers and 11 residents with learning disabilities were recorded on video. Verbal and non-verbal interaction skills among the carers were identified. Four caring situations with people with learning disabilities were chosen to illuminate skilled interaction. The transcribed text was subjected to qualitative content analysis and core stories were created. The results show that skilled interaction between the carers and the people with learning disabilities is based upon being confirming, sharing daily life experience, giving time and space, and using congruent and distinct language. In this paper we present examples that offer concrete suggestions of how to promote successful interaction and create meaning in the shared day-to-day life in special accommodations for people with learning disabilities.

  13. Risk factor characteristics in carers who physically abuse or neglect their elderly dependants.

    PubMed

    Reay, A M; Browne, K D

    2001-02-01

    This study investigates the prevalence of, and differences in, risk factor characteristics in a sample of two select populations of carers, one of which physically abused their elderly dependants and one of which neglected them. Nineteen carers (nine who had physically abused and 10 who had neglected their elderly relatives), who were referred to clinical psychology by either their general practitioner or their psychiatrist, were invited to take part in this study. A detailed history of risk factors was obtained, including history of alcohol dependency, type and history of mental ill health, history of maltreatment earlier in life, who they were caring for, how long they had been a carer and whether they felt isolated as a carer. Subjects were then given five assessments to determine whether there were any differences between the two groups. These were the Conflict Tactic Scale, Strain Scale, Beck Depression Inventory, Beck Anxiety Inventory and Cost of Care Index. An examination of the risk factors suggests that heavy alcohol consumption and past childhood abuse by fathers were likely to lead to physical abuse. Significantly higher conflict and depression scores were also present in the physical abuse group, while the neglect group had significantly higher anxiety scores. It is suggested that these findings should be incorporated into an assessment of future risk of abuse or neglect by the carer. PMID:11513015

  14. Why carers use adult day respite: a mixed method case study

    PubMed Central

    2014-01-01

    Background We need to improve our understanding of the complex interactions between family carers’ emotional relationships with care-recipients and carers use of support services. This study assessed carer’s expectations and perceptions of adult day respite services and their commitment to using services. Methods A mixed-method case study approach was used with psychological contract providing a conceptual framework. Data collection was situated within an organisational case study, and the total population of carers from the organisation’s day respite service were approached. Fifty respondents provided quantitative and qualitative data through an interview survey. The conceptual framework was expanded to include Maslow’s hierarchy of needs during analysis. Results Carers prioritised benefits for and experiences of care-recipients when making day respite decisions. Respondents had high levels of trust in the service and perceived that the major benefits for care-recipients were around social interaction and meaningful activity with resultant improved well-being. Carers wanted day respite experiences to include all levels of Maslow’s hierarchy of needs from the provision of physiological care and safety through to the higher levels of belongingness, love and esteem. Conclusion The study suggests carers need to trust that care-recipients will have quality experiences at day respite. This study was intended as a preliminary stage for further research and while not generalizable it does highlight key considerations in carers’ use of day respite services. PMID:24906239

  15. Stressors and common mental disorder in informal carers – An analysis of the English Adult Psychiatric Morbidity Survey 2007

    PubMed Central

    Stansfeld, Stephen; Smuk, Melanie; Onwumere, Juliana; Clark, Charlotte; Pike, Cleo; McManus, Sally; Harris, Jenny; Bebbington, Paul

    2014-01-01

    This study investigates potential explanations of the association between caring and common mental disorder, using the English Adult Psychiatric Morbidity Survey 2007. We examined whether carers are more exposed to other stressors additional to caring – such as domestic violence and debt – and if so whether this explains their elevated rates of mental disorder. We analysed differences between carers and non-carers in common mental disorders (CMD), suicidal thoughts, suicidal attempts, recent stressors, social support, and social participation. We used multivariate models to investigate whether differences between carers and non-carers in identifiable stressors and supports explained the association between caring and CMD, as measured by the revised Clinical Interview Schedule. The prevalence of CMD (OR = 1.64 95% CI 1.37–1.97), suicidal thoughts in the last week (OR = 2.71 95% CI 1.31–5.62) and fatigue (OR = 1.33 95% CI 1.14–1.54) was increased in carers. However, caring remained independently associated with CMD (OR = 1.58 1.30–1.91) after adjustment for other stressors and social support. Thus caring itself is associated with increased risk of CMD that is not explained by other identified social stressors. Carers should be recognized as being at increased risk of CMD independent of the other life stressors they have to deal with. Interventions aimed at a direct reduction of the stressfulness of caring are indicated. However, carers also reported higher rates of debt problems and domestic violence and perceived social support was slightly lower in carers than in non-carers. So carers are also more likely to experience stressors other than caring and it is likely that they will need support not only aimed at their caring role, but also at other aspects of their lives. PMID:25259657

  16. Feasibility study of a self-guided cognitive behaviour therapy internet intervention for cancer carers.

    PubMed

    Scott, Karen; Beatty, Lisa

    2013-01-01

    Despite the evidence base for Internet-delivered self-help programmes, their application to cancer carers has not been reported. This feasibility study evaluated a 6-week internet cognitive behaviour therapy (CBT) programme for early stage cancer carers. The study participants comprised 13 carers who were recruited over a 17-month period. Measures included distress, quality of life and programme engagement. Changes over time were measured using effect sizes (Cohen's d), whereas acceptibility was assessed using qualitative feedback. Low enrolment and high attrition rates resulted in a failure to demonstrate feasibility. Large improvements in negative affect (d=0.88) and emotional functioning (d=0.62) were found. For treatment completers, the intervention holds promise in reducing distress. However, in light of the serious challenges with recruitment and retention, further research is needed to resolve participation barriers. PMID:23796231

  17. What knowledge and attitudes do paid carers of people with a learning disability have about cancer?

    PubMed

    Wyatt, D; Talbot, P

    2013-05-01

    The purpose of this study was to explore the knowledge and attitudes of paid carers of people with a learning disability regarding cancer. A questionnaire was utilised to gather information from carers involved in the social care of adults with learning disabilities within the independent sector. A total of 324 questionnaires were returned. Subjects were asked to provide words that they associated with cancer to provide data on their attitude to cancer. Knowledge-based questions examined their knowledge on the possibility of recovery from cancer, the likelihood of cancer (particularly in relation to people with learning disabilities), types of cancer, risk reduction and early signs and detection. Subjects were also asked for their views regarding the adequacy of their knowledge and training needs. The findings indicated that the carers had some knowledge regarding cancer, but strategies for preventing and detecting cancer with adults with learning disabilities were not clearly elucidated.

  18. The Experience of Carers in Supporting People with Intellectual Disabilities through the Process of Bereavement: An Interpretative Phenomenological Analysis

    ERIC Educational Resources Information Center

    Handley, Emily; Hutchinson, Nick

    2013-01-01

    Background: This study explored the personal experiences of family carers and residential care staff in supporting adults with intellectual disabilities through the process of bereavement. Method: A semi-structured interview was used to interview 11 carers on their experience of supporting adults with intellectual disabilities through the process…

  19. Levels of Psychological Distress Experienced by Family Carers of Children and Adolescents with Intellectual Disabilities in an Urban Conurbation

    ERIC Educational Resources Information Center

    Emerson, Eric; Robertson, Janet; Wood, Justin

    2004-01-01

    Background: The aim of the present study was to identify factors associated with the level of psychological distress reported by family carers of children with intellectual disability living in a large urban conurbation. Method: Information was collected by postal questionnaire (or interview for family carers who did not have English as their…

  20. Support for Family Carers of Children and Young People with Developmental Disabilities and Challenging Behaviour: What Stops It Being Helpful?

    ERIC Educational Resources Information Center

    Wodehouse, G.; McGill, P.

    2009-01-01

    Background: Many family carers find the support they receive in respect of their child's challenging behaviour unhelpful. This study sought to identify carer perceptions of the ways in which support is unhelpful and how it could be more helpful. Methods: Thirteen mothers, caring for a child with intellectual disability and challenging behaviour,…

  1. A systematic review of the economic evidence for interventions for family carers of stroke patients

    PubMed Central

    Heslin, Margaret; Forster, Anne; Healey, Andy; Patel, Anita

    2016-01-01

    Objectives: To examine the economic evidence for interventions aimed at family carers of stroke patients. Data sources: Searches (limited to those published in English since 1990) were performed in key databases along with hand searches of relevant papers. Review methods: Papers were restricted to studies including any economic data (broadly defined) for any intervention targeting carers explicitly or explicitly referring to a carer element, beyond involving carers in the care or intervention for patients (i.e. more than just carers being invited to observe an intervention targeted at the patient). Two reviewers independently screened full papers and extracted data using guidance from the National Institute for Health and Care Excellence, and quality assessment using the Newcastle-Ottawa Quality Assessment Scale (cohort studies), the Delphi list (randomised controlled trials) and guidelines on economic quality from the British Medical Journal. Data were reviewed descriptively as meta analyses were inappropriate due to non-comparability of studies. Results: Ten papers were included in the review. These were heterogeneous in their design, intervention and economic analyses making comparison difficult. Only three of the ten papers included economic evaluations. All three reported that the intervention was less costly and had better or equivalent outcomes than the control comparator although two of these were based on the same intervention using the same dataset. Conclusion: There is some limited evidence that interventions for family carers of stroke patients are effective and cost effective. However, due to variation in the types of interventions examined, little can be concluded regarding implications for clinical practice. PMID:25758943

  2. Self-reported physical and mental health of Australian carers: a cross-sectional study

    PubMed Central

    Hussain, Rafat; Dillon, Gina; Ryan, Peta

    2016-01-01

    Objective To report on self-reported physical and mental health of informal carers in rural regions of New South Wales, Australia. Methods A cross-sectional community-based sample (n=222) of carers completed a questionnaire incorporating self-reported measures of health from validated international instruments including Medical Outcomes Study Scale (SF-36), the Centre for Epidemiology-Depression (CES-D) and Kessler-10 (K-10) Psychological Distress Scales, along with information on participant demographics and other key caregiving characteristics such as health condition of care recipient. Results Rural carers’ self-reported health was poor as evident on the SF-36 Physical and Mental Health component scores as well as each individual domain of the SF-36. Results from the CES-D and K-10 scores indicated very high rates of depressive symptoms and psychological distress. Over 70% of carers within the current study had CES-D scores indicative of depressive symptoms. Scores on the K-10 indicate almost half the carers were experiencing high levels of psychological distress, which is over 4 times the rate reported in the general Australian population. Conclusions and implications Results from this study were compared to Australian population normative data and were found to be significantly below Australian age-matched population norms for SF-36, CES-D and K-10. These findings illustrate the poor health profile of informal carers relative to the general Australian population, especially in terms of depressive symptoms and psychological distress. This highlights the need for additional support for rural carers in order to ease the accumulated mental and physical health burdens of this group. PMID:27625059

  3. How family carers engage with technical health procedures in the home: a grounded theory study

    PubMed Central

    McDonald, Janet; McKinlay, Eileen; Keeling, Sally; Levack, William

    2015-01-01

    Objectives To explore the experiences of family carers who manage technical health procedures at home and describe their learning process. Design A qualitative study using grounded theory. Participants New Zealand family carers (21 women, 5 men) who managed technical health procedures such as enteral feeding, peritoneal dialysis, tracheostomy care, a central venous line or urinary catheter. In addition, 15 health professionals involved in teaching carers were interviewed. Methods Semistructured interviews were coded soon after completion and preliminary analysis influenced subsequent interviews. Additional data were compared with existing material and as analysis proceeded, initial codes were grouped into higher order concepts until a core concept was described. Interviewing continued until no new ideas emerged and concepts were well defined. Results The response of carers to the role of managing technical health procedures in the home is presented in terms of five dispositions: (1) Embracing care, (2) Resisting, (3) Reluctant acceptance, (4) Relinquishing and (5) Being overwhelmed. These dispositions were not static and carers commonly changed between them. Embracing care included cognitive understanding of the purpose and benefits of a procedure; accepting a ‘technical’ solution; practical management; and an emotional response. Accepting embrace is primarily motivated by perceived benefits for the recipient. It may also be driven by a lack of alternatives. Resisting or reluctant acceptance results from a lack of understanding about the procedure or willingness to manage it. Carers need adequate support to avoid becoming overwhelmed, and there are times when it is appropriate to encourage them to relinquish care for the sake of their own needs. Conclusions The concept of embracing care encourages health professionals to extend their attention beyond simply the practical aspects of technical procedures to assessing and addressing carers’ emotional and

  4. Palliative care for people with HIV/AIDS: views of patients, carers and providers.

    PubMed

    Butters, E; Higginson, I; George, R; McCarthy, M

    1993-01-01

    This study compared the views of palliative care reported by patients, informal carers and the Community Care Team (CCT), a multidisciplinary team caring for people with late stage HIV/AIDS illness. Patients and their carers were interviewed at home, 3-4 weeks after referral to CCT. They rated nine items of the Support Team Assessment Schedule (STAS), a standardized measure of palliative care. Items included current problems such as pain and symptom control, anxiety and service needs. Satisfaction with health services was also recorded. CCT separately recorded the severity of 17 STAS items as part of a continuing audit of care. Relatively few patients (19) and carers (8) were interviewed. Main reasons for non-interview of (105) patients were: 57 too ill and 30 less than 4 weeks in care. CCT's audit showed that non-interviewed patients had significantly more severe problems for five out of 17 STAS items. Patients and CCT identified continuing problems with symptom control, pain control, patient and family anxiety, and communication from professionals. Agreement between patient, carer and CCT ratings was reasonable. Patients and CCT ratings were significantly correlated (Spearman rho = 0.66, p < 0.005). However, patients rated pain as significantly more severe than did CCT (p < 0.05, Wilcoxon Z = -2.45). All patients and seven carers rated the care given by CCT as good or excellent. There were negative comments about communication with other professionals. Studies of palliative care which rely on data gained by patient interview may be biased to include patients with fewer problems. To overcome this providers may wish to audit their care. This study indicates that the views of palliative teams are a reasonable reflection of patients' and carers' experiences, and that the STAS is a valid tool, which we hope will be useful for those wishing to audit their work.

  5. Parents' and carers' views about emollients for childhood eczema: qualitative interview study

    PubMed Central

    Muller, I; Yardley, L; Lewis-Jones, S; Ersser, S; Little, P

    2016-01-01

    Objective Leave-on emollients form the mainstay of eczema treatment, but adherence is poor. We aimed to explore parents’/carers' views on effectiveness and acceptability of leave-on emollients for childhood eczema through secondary analysis of data from 2 qualitative data sets. Setting Study 1 recruited through mail-out from 6 general practices in southern England. Study 2 recruited from a feasibility trial of an intervention to support eczema self-care in 31 practices in the same area. Participants Study 1 included 28 interviews with carers of children aged ≤5 years with eczema. Study 2 included 26 interviews with carers of children aged ≤5 years with eczema. Methods Interviews followed semistructured guides: study 1 explored carers' understandings around eczema treatments in order to develop a web-based self-care support intervention; study 2 explored carers' understandings of eczema and eczema treatments after using the intervention. Interviews were carried out face to face or by telephone, audio-recorded and transcribed. Secondary analysis of data from both studies focused on views and experiences of emollient use. Data were analysed using an inductive thematic approach facilitated by NVivo V.10 software. Results In study 1, most participants felt emollients improved eczema but held mixed views about long-term use to prevent flare-ups. In study 2, where carers had used the web-based intervention, all participants held positive views about long-term emollient use. In both studies, participants expressed a range of preferences about emollient ‘thickness’; some felt that ‘thick’ emollients (ointments) were most effective, while others found these difficult to use. Carers described a process of ‘trial and error’, trying emollients suggested by professionals, friends and family, or bought over-the-counter. Carers expressed a need for understanding differences between products and their effective use. Conclusions Providing a rationale for long

  6. The influence of carer fear and self-blame when supporting a loved one with an eating disorder.

    PubMed

    Stillar, Amanda; Strahan, Erin; Nash, Patricia; Files, Natasha; Scarborough, Jennifer; Mayman, Shari; Henderson, Katherine; Gusella, Joanne; Connors, Laura; Orr, Emily S; Marchand, Patricia; Dolhanty, Joanne; Lafrance Robinson, Adèle

    2016-01-01

    Carers often feel disempowered and engage in behaviours that inadvertently enable their loved one's ED symptoms and yet little is known regarding these processes. This study examined the relationships among fear, self-blame, self-efficacy, and accommodating and enabling behaviours in 137 carers of adolescents and adults with ED. The results revealed that fear and self-blame predicted low carer self-efficacy in supporting their loved one's recovery as well as the extent to which carers reported engaging in recovery-interfering behaviours. The relevance of these findings are discussed in the context of family-oriented ED therapies and highlight the importance for clinicians to attend to and help to process strong emotions in carers, in order to improve their supportive efforts and, ultimately, ED outcomes. PMID:26766773

  7. An investigation into the usability of the STAR training and re-skilling website for carers of persons with dementia.

    PubMed

    Boyd, Kyle; Nugent, Chris; Donnelly, Mark; Bond, Raymond; Sterritt, Roy; Hartin, Phillip

    2014-01-01

    Due to the successes in medical science people are now beginning to live much longer. With this brings increased problems associated with ageing, with one exemplar being dementia. Persons with dementia require care with activities of daily living, for example, with washing, dressing and eating. This requires additional care, which is usually provided by family and friends who assume the role of informal carers. Provision of care by informal carers brings irreversible changes to their lives that can lead to depression and feelings of loneliness. In part, these changes are linked with carers having insufficient understanding and training with dementia. The EU funded STAR project created an web portal that aims to provide the necessary online training that carers need, however, the usability of such a provision warrants investigation. This paper presents the findings of a usability test conducted on five carers of people with dementia while using the STAR Training Website. For the 21 usability issues identified, the paper outlines proposed solutions.

  8. Family Carers and the Prevention of Heroin Overdose Deaths: Unmet Training Need and Overlooked Intervention Opportunity of Resuscitation Training and Supply of Naloxone

    ERIC Educational Resources Information Center

    Strang, John; Manning, Victoria; Mayet, Soraya; Titherington, Emily; Offor, Liz; Semmler, Claudia; Williams, Anna

    2008-01-01

    Aim: To assess (a) carers' experiences of witnessing overdose; (b) their training needs; and (c) their interest in receiving training in overdose management. Design: Postal questionnaire distributed through consenting participating local carer group coordinators in England. Sample: 147 carers attending local support groups for friends and families…

  9. Changes in Attributions as a Consequence of Training for Challenging and Complex Behaviour for Carers of People with Learning Disabilities: A Systematic Review

    ERIC Educational Resources Information Center

    Williams, Sophie; Dagnan, Dave; Rodgers, Jacqui; McDowell, Kathryn

    2012-01-01

    Aim: This paper reviews the evidence for changes in carers' attributions regarding the behaviour of people with intellectual disabilities as a consequence of carer training in challenging and complex behaviour. Method: Papers were included in the review if they reported outcomes for carer training on the behaviour of people with intellectual…

  10. Carers' assessment, skills and information sharing: theoretical framework and trial protocol for a randomised controlled trial evaluating the efficacy of a complex intervention for carers of inpatients with anorexia nervosa.

    PubMed

    Goddard, Elizabeth; Raenker, Simone; Macdonald, Pamela; Todd, Gillian; Beecham, Jennifer; Naumann, Ulrike; Bonin, Eva-Maria; Schmidt, Ulrike; Landau, Sabine; Treasure, Janet

    2013-01-01

    Experienced Carers Helping Others (ECHO) is a guided self-help intervention for carers of people with eating disorders to reduce distress and ameliorate interpersonal maintaining factors to improve patient outcomes. The aim of this paper is to describe the theoretical background and protocol of a randomised controlled trial that will establish whether ECHO has a significant beneficial effect for carers and the person they care for. Individuals with anorexia nervosa and carers will be recruited from eating disorder inpatient/day patient hospital services in the UK. Primary outcomes are time until relapse post-discharge (patient) and distress (carer) at 12 months post-discharge. Secondary outcomes are body mass index, eating disorder symptoms, psychosocial measures and health economic data for patients and carers. Carers will be randomised (stratified by site and illness severity) to receive ECHO (in addition to treatment as usual) or treatment as usual only. Potential difficulties in participant recruitment and delivery of the intervention are discussed.

  11. Patients' and carers' views and expectations about intensive management for moderate rheumatoid arthritis: a qualitative study.

    PubMed

    Prothero, L; Georgopoulou, S; Galloway, J; Williams, R; Bosworth, A; Lempp, H

    2016-12-01

    Intensive management for rheumatoid arthritis (RA) involves frequent hospital visits and adjusted doses or combinations of medication. Research is currently underway to test whether or not intensive management strategies are valuable in moderately active disease, however, patient views on intensive management in this disease group are unknown. The objectives of this study were to explore the views and expectations of patients with moderately active RA and of carers of patients with moderately active RA. We conducted focus groups and one-to-one interviews in 2014 with 14 participants (9 patients, 5 carers) from 4 rheumatology clinics across 3 London Hospital NHS Trusts. Non-English-speaking patients were included with the assistance of a professional translator. Focus groups and interviews were audio recorded and transcribed and transcripts analysed using a framework analysis approach. Four main themes were identified: 'Hopes and Expectations of Intensive Management', 'Acceptability of Intensive Management', 'Patient Education' and 'The Importance of Continuity of Care'. Our main findings were that attendance at frequent clinic appointments was largely acceptable to patients and carers. Views on taking higher doses of medication depended on how stable patients were on their current treatment regime. Continuity of care from the rheumatologist and the provision of written/verbal information about intensive management were important to patients and carers. PMID:26586500

  12. Impact of Policy Shifts on South Asian Carers in the United Kingdom

    ERIC Educational Resources Information Center

    Hensel, Elizabeth; Krishnan, Mya; Saunders, Katie; Durrani, Nazia; Rose, John

    2005-01-01

    The aim of this study was to assess how the introduction of new service policies in the United Kingdom--such as person-centered planning and the active development of support networks--was impacting the lives of carers of people with intellectual disability from South Asian backgrounds. Using a semistructured interview schedule, 19 families of…

  13. Carers' Responses to Challenging Behaviour: A Comparison of Responses to Named and Unnamed Vignettes

    ERIC Educational Resources Information Center

    Dagnan, Dave

    2012-01-01

    Background: The evidence supporting the application of Weiner's motivational model of helping to the behaviour of carers' of people with intellectual disabilities and challenging behaviour is inconsistent. One suggested reason for this is that many studies use stimuli that might generate different responses from those to actual instances of…

  14. Menopause Experiences and Attitudes in Women with Intellectual Disability and in Their Family Carers

    ERIC Educational Resources Information Center

    Chou, Yueh-Ching; Lu, Zxy-Yann Jane; Pu, Cheng-Yun

    2013-01-01

    Background: Little is known about how middle-aged and older women with intellectual disability (ID) cope with life transitions such as perimenopause and postmenopause. Method: A mixed methods approach was employed to explore the attitudes toward and experiences of menopause among women with ID and their family carers in one city in Taiwan.…

  15. Shared decision-making in dementia: A review of patient and family carer involvement.

    PubMed

    Miller, Lyndsey M; Whitlatch, Carol J; Lyons, Karen S

    2016-09-01

    This paper reviews empirical findings concerning the decision-making process of persons with dementia and their family carers, with a particular focus on the extent and determinants of involvement of persons with dementia in the decision-making process. To be included in this review, studies needed to be published in peer-reviewed journals between 1999 and 2014, report empirical data from participants with dementia and/or their family carers, and pertain to the involvement of persons with dementia and their family carers in decisions about everyday care, medical care and treatment, or long-term care. A total of 36 studies were included. Results indicated that not all persons with dementia are excluded from participating in the decision-making process, but there is a broad spectrum of what constitutes shared decision-making in dementia. Studies concerning the determinants of shared decision-making mostly focused on non-modifiable factors. Future research is needed to better promote shared decision-making among persons with dementia and their family carers.

  16. An Exploration of Issues around Menstruation for Women with Down Syndrome and Their Carers

    ERIC Educational Resources Information Center

    Mason, Linda; Cunningham, Cliff

    2008-01-01

    Background: There is little research on issues related to menstruation for women with Down syndrome, yet they may experience menstruation in a qualitatively different way from normal women, which impacts on their quality of life and that of their families and carers. The aim of this qualitative study was to explore issues with the women and/or…

  17. Listening to carers talking about the subjects of continence and toileting.

    PubMed

    Forbat, Liz

    Toilets and continence play critical roles in the lives of people who care for a relative at home. Issues around toileting are central to the relationship between the carer and the person being cared for, with the bathroom often becoming the most important place in the house. PMID:14768154

  18. 'Am I damaging my own family?': Relational changes between foster carers and their birth children.

    PubMed

    Thompson, Hayley; McPherson, Susan; Marsland, Louise

    2016-01-01

    Foster placements are more likely to break down where the foster carers already have birth children. Studies that explore the impact of fostering on foster carers and their birth children have suggested that relational changes occur, but these changes have not been examined in depth. This study aimed to explore the impact of fostering on parent-child relationships within foster families. Nine foster carers (including three couples) were interviewed separately, and the data were analysed using constructivist grounded theory methods. Analysis indicated that birth children may attribute particular importance to their position in the family (e.g. oldest child, youngest child) and that this is a key element of the way in which they relate to their parents. Emotional security and parent-child relationships can therefore be strained by a foster placement not taking this into account. Foster children also introduce significant competition for parental resources, putting a strain on relationships. Foster carers seem to prioritise, consciously or not, the preservation of relationships within the biological family. Reflecting on relationships and making changes to maximise potential improvements in relationships can lead to positive outcomes, and this can have an impact on whether families continue fostering or not.

  19. Teaching Intensive Interaction to Paid Carers: Using the "Communities of Practice" Model to Inform Training

    ERIC Educational Resources Information Center

    Rayner, Kelly; Bradley, Samantha; Johnson, Gemma; Mrozik, Jennifer H.; Appiah, Afua; Nagra, Maninder K.

    2016-01-01

    The engagement of people with learning disabilities in social communication is crucial to the development of relationships with others, a sense of social inclusion and self-worth. Intensive Interaction is an approach that can help carers develop their skills to engage people with severe and profound learning disabilities in personally relevant…

  20. Hearing Parents' and Carers' Voices: Experiences of Accessing Quality Long Day Care in Northern Regional Australia

    ERIC Educational Resources Information Center

    Harris, Nonie; Tinning, Beth

    2012-01-01

    This article explores parents' and carers' experiences of accessing quality long day care in northern regional Australia. The data was gathered in 2009, after the collapse of ABC Developmental Learning Centres (herein referred to as ABC Learning) and before the implementation of the "National Quality Framework," and provides a snapshot of…

  1. Gender Differences in Self-Silencing and Psychological Distress in Informal Cancer Carers

    ERIC Educational Resources Information Center

    Ussher, Jane M.; Perz, Janette

    2010-01-01

    This study examined gender differences in self-silencing, the relationship between self-silencing and psychological distress, and reasons for self-silencing in informal cancer carers (329 women, 155 men), using a mixed-method design. Men reported greater self-silencing than women on the Silencing the Self Scale; however, women reported higher…

  2. Determining Research Questions on Health Risks by People with Learning Disabilities, Carers and Care-Workers

    ERIC Educational Resources Information Center

    Young, Anita F.; Chesson, Rosemary A.

    2008-01-01

    Here we describe the process by which research questions were developed for reducing health risks for people with learning disabilities. A participatory approach was used to give service users and carers a clear voice in "deciding" questions, thereby setting the research agenda. Audio-taped interviews and focus groups were used. Forty people (20…

  3. The Caring Child: An Evaluative Case Study of the Cornwall Young Carers Project

    ERIC Educational Resources Information Center

    Butler, Allister H.; Astbury, Gaynor

    2005-01-01

    This paper reports on an evaluation of the Cornwall Young Carers project (jointly funded by social services and the Cornwall and Isles of Scilly Health Action Zone), conducted during the period 2000-2002. A diverse range of methodological approaches were adopted (comparative national statistics, local pilot study, monthly and quarterly data…

  4. End-of-Life Care for People with Intellectual Disabilities: Paid Carer Perspectives

    ERIC Educational Resources Information Center

    Ryan, Karen; Guerin, Suzanne; Dodd, Philip; McEvoy, John

    2011-01-01

    Background: Little is known of paid carers' perspectives when caring for people with intellectual disabilities at the end-of-life. Materials and methods: Sixty four individuals from intellectual disability services took part in 12 focus groups. Interviews were analysed using framework analysis. Results: Participants wanted to provide palliative…

  5. Tracking an Elusive Population: Family Carers of Older Adults with Intellectual Disabilities in Romandy (Switzerland)

    ERIC Educational Resources Information Center

    Jecker-Parvex, Maurice; Breitenbach, Nancy

    2012-01-01

    Despite a long-standing tradition of institutional placement in Switzerland, many older adults with intellectual disabilities continue to be supported by aging parents and siblings. For various reasons, these carers and the adults concerned have been overlooked up to now. To find out how many such families are providing housing and care of this…

  6. Juxtapositioning Geriatrics and Art: The Essence of Caring, Carer, and Cared-For in Films

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Carungcong, Bobbie Jo H.; Castillo, Jasper Q.; Castillo, Joyce Anne A.; Castro, Jenelyn S.

    2009-01-01

    The need to revolutionize geriatric nursing is dawning. However, there is a negative view regarding this nursing field. The dearth of literature on the use of theatrical films to surface universal realities in a care-driven profession has led to this attempt of bringing to reality the essences of caring, carer, and cared-for and their interactions…

  7. Does the Covert Nature of Caring Prohibit the Development of Effective Services for Young Carers?

    ERIC Educational Resources Information Center

    Banks, Pauline; Cogan, Nicola; Deeley, Susan; Hill, Malcolm; Riddell, Sheila; Tisdall, Kay

    2002-01-01

    Reviews the literature relating to young carers and pays particular attention to the adoption of a caring role, the impact of caring on education, and the location and type of services provided. The findings of a small-scale study carried out in Scotland are presented in order to highlight some of the issues raised in the literature. (Contains 30…

  8. Attendance, Achievement and Participation: Young Carers' Experiences of School in Australia

    ERIC Educational Resources Information Center

    Moore, Tim; McArthur, Morag; Morrow, Ros

    2009-01-01

    Schools play an important part in the lives of children and young people who have caring responsibilities for a family member with an illness, disability, alcohol or other drug problem or mental health condition but many of these "young carers" report difficulty in attending, achieving and participating in education. This qualitative research…

  9. How can we help family carers manage pain medicines for patients with advanced cancer? A systematic review of intervention studies

    PubMed Central

    Latter, Sue; Hopkinson, Jane B; Richardson, Alison; Hughes, Jane A; Lowson, Elizabeth; Edwards, Deborah

    2016-01-01

    Background Family carers play a significant role in managing pain and associated medicines for people with advanced cancer. Research indicates that carers often feel inadequately prepared for the tasks involved, which may impact on carers’ and patients’ emotional state as well as the achievement of optimal pain control. However, little is known about effective methods of supporting family carers with cancer pain medicines. Aims To systematically identify and review studies of interventions to help carers manage medicines for pain in advanced cancer. To identify implications for practice and research. Method A systematic literature search of databases (MEDLINE, CINAHL, PsycINFO and AMED) was carried out to identify studies of pain medication management interventions that involved family carers of patients with advanced cancer, and reported specific outcomes for family carers. Patient pain outcomes were also sought. Studies were quality appraised; key aspects of study design, interventions and outcomes were compared and a narrative synthesis of findings developed. Results 8 studies were included; all had significant methodological limitations. The majority reported improvements in family carer knowledge and/or self-efficacy for managing pain medicines; no effect on patient pain outcomes; and no adverse effects. It was not possible to discern any association between particular intervention characteristics and family carer outcomes. Conclusions Current evidence is limited, but overall suggests face-to-face educational interventions supported by written and/or other resources have potential to improve carers’ knowledge and self-efficacy for pain management. Further research is needed to identify how best to help family carers manage pain medicines for patients with advanced cancer. PMID:27150294

  10. Adapting a SSKIN bundle for carers to aid identification of pressure damage and ulcer risks in the community.

    PubMed

    McCoulough, Siobhan

    2016-06-01

    If pressure damage is identified and addressed at an early stage, it may be reversed. Otherwise, it may quickly progress into a serious deep tissue injury. In the community, most daily skin care is undertaken by formal and informal carers. They therefore need to know how to identify signs that pressure ulcers may develop and what immediate actions to take. NICE guidance on pressure ulcer prevention is too extensive to be a simple tool for carers, so a SSKIN bundle was adapted for community use. This ensures carers know how to prevent and identify pressure damage, and includes skin care, repositioning and use of equipment. Carers need training. This is the responsibility of all involved with the patient, including health-care and local authority services.

  11. The impact of volunteer mentoring schemes on carers of people with dementia and volunteer mentors: a systematic review.

    PubMed

    Smith, Raymond; Greenwood, Nan

    2014-02-01

    This systematic review aims to examine the differences and similarities between the various types of volunteer mentoring (befriending, mentoring and peer support) and to identify the benefits for carers and volunteers. Literature searching was performed using 8 electronic databases, gray literature, and reference list searching of relevant systematic reviews. Searches were carried out in January 2013. Four studies fitted the inclusion criteria, with 3 investigating peer support and 1 befriending for carers. Quantitative findings highlighted a weak but statistically significant (P =.04) reduction in depression after 6 months of befriending. Qualitative findings highlighted the value carers placed on the volunteer mentors' experiential similarity. Matching was not essential for the development of successful volunteer mentoring relationships. In conclusion, the lack of need for matching and the importance of experiential similarity deserve further investigation. However, this review highlights a lack of demonstrated efficacy of volunteer mentoring for carers of people with dementia.

  12. Adapting a SSKIN bundle for carers to aid identification of pressure damage and ulcer risks in the community.

    PubMed

    McCoulough, Siobhan

    2016-06-01

    If pressure damage is identified and addressed at an early stage, it may be reversed. Otherwise, it may quickly progress into a serious deep tissue injury. In the community, most daily skin care is undertaken by formal and informal carers. They therefore need to know how to identify signs that pressure ulcers may develop and what immediate actions to take. NICE guidance on pressure ulcer prevention is too extensive to be a simple tool for carers, so a SSKIN bundle was adapted for community use. This ensures carers know how to prevent and identify pressure damage, and includes skin care, repositioning and use of equipment. Carers need training. This is the responsibility of all involved with the patient, including health-care and local authority services. PMID:27297573

  13. Eliciting views of patients with head and neck cancer and carers on professionally derived standards for care

    PubMed Central

    Birchall, M; Richardson, A; Lee, L

    2002-01-01

    Objectives To examine views of patients and carers on the process of care for people with head and neck cancer; to assess whether focus groups are useful in this setting; to compare priorities and standards identified with those published by healthcare professionals; and to incorporate the expressed views into existing national standards. Design Multicentre study of nine regional focus groups. Setting Area covered by two regional health authorities. Participants 40 patients who had had head and neck cancer and 18 carers. Main outcome measures Views of individuals and groups on standards. Applicability of the method for patients whose appearance and ability to communicate was altered and for recently bereaved carers. Ease of incorporation of views into national and regional standards. Results Patients and carers participated in discussions on all the principal questions. Opinions were expressed on waiting times, information available to patients, coordination of care, and crisis management. Professionally derived standards were substantially improved by the incorporation of the views of patients and carers. There were no technical problems in carrying out this study on patients with communication difficulties or altered appearance nor with recently bereaved carers. Occasionally, participants said that the meetings were therapeutic. Conclusions Professionally facilitated and analysed focus groups are effective in assessing views of patients with cancer and carers on professionally derived standards for care and can be applied in settings traditionally viewed as difficult. Views expressed by patients and carers are powerful motivators for change in the delivery of cancer care. What is already known on this topicPatients with head and neck cancer require complex multidisciplinary careProfessional standards exist for much of thisIncorporating the views of patients and carers is often recommendedWhat this study addsFocus groups are an effective and efficient means of

  14. Time to care? Health of informal older carers and time spent on health related activities: an Australian survey

    PubMed Central

    2013-01-01

    Background Little is known about the time spent on specific health related activities by older adult informal carers who assist people with chronic illness. Research has not yet addressed the association between carer health status and their care demands. Such information could inform policy and health system efforts to manage chronic illness. Methods We conducted an Australia wide survey using recall questionnaires to record time use. The study asked how much time is spent on “most days” for the most common activities like taking medication, self-treatment and testing, and how much time in the last month on less common activities like attending a physician or shopping associated with health needs. The survey was mailed to 5,000 members of National Seniors Australia; 2,500 registrants on the National Diabetes Services Scheme; and 3,100 members of the Australian Lung Foundation. A total of 2519 people responded, including 313 people who identified as informal carers. Statistical analysis was undertaken using Stata 11. Standard errors and confidence intervals were derived using bootstrapping techniques within Stata 11. Results Most carers (96.2%) had chronic illness themselves, and those with greater numbers of chronic illnesses were those who faced the greatest overall time demands. The top decile of carers devoted between 8.5 and 10 hours a day to personal and caring health related activities. Informal carers with chronic illness spent more time managing their own health than people with chronic illness who were not informal carers. These carers spent more time on caring for others than on caring for their own health. High levels of caring responsibility were associated with poorer reported carer health. Conclusions Policy and health care services will need to adapt to recognise and reduce the time burden on carers who themselves have chronic illness. More carefully targeted investment in the social infrastructure of formal care would free up carers for other

  15. “It’s alright to ask for help”: findings from a qualitative study exploring the information and support needs of family carers at the end of life

    PubMed Central

    2014-01-01

    Background Family carers play an essential role in providing end-of-life care to their relatives but have been found to experience uncertainty and a lack of confidence in fulfilling their caregiving roles, prompting recent calls for educational or information based resources to be developed for carers. Methods We carried out four focus groups with Clinical Nurse Specialists, healthcare assistants, former and current carers at a hospice in the UK, to explore the information and support needs of family carers. Results Our findings support previous research by highlighting a number of care situations where carers experience uncertainty and could seemingly benefit from greater information or instruction. Three main themes were identified which reflected carer experiences and needs in relation to potential information giving or educational interventions. These have been described as the knowledge and competence of carers; the preparedness of carers and low levels of carer identification with, and confidence in their roles as ‘carers’, which influences help seeking behaviours; and in turn how potential supportive interventions might be received by carers. Conclusions Family carers experience multiple needs for information and education, but meeting these needs remains a challenge. Our results suggest three domains which could underpin this type of intervention: developing knowledge and competence; facilitating preparedness; supporting role recognition and confidence building. We recommend an integrated information giving approach which addresses these domains by combining a resource pack for carers with a more explicit acknowledging role for health professionals. Together these could provide key information and also build confidence amongst family carers to ask for further support and advice as needed. PMID:24742046

  16. Service User- and Carer-Reported Measures of Involvement in Mental Health Care Planning: Methodological Quality and Acceptability to Users

    PubMed Central

    Gibbons, Chris J.; Bee, Penny E.; Walker, Lauren; Price, Owen; Lovell, Karina

    2014-01-01

    Background: Increasing service user and carer involvement in mental health care planning is a key healthcare priority but one that is difficult to achieve in practice. To better understand and measure user and carer involvement, it is crucial to have measurement questionnaires that are both psychometrically robust and acceptable to the end user. Methods: We conducted a systematic review using the terms “care plan$,” “mental health,” “user perspective$,” and “user participation” and their linguistic variants as search terms. Databases were searched from inception to November 2012, with an update search at the end of September 2014. We included any articles that described the development, validation or use of a user and/or carer-reported outcome measures of involvement in mental health care planning. We assessed the psychometric quality of each instrument using the “Evaluating the Measurement of Patient-Reported Outcomes” (EMPRO) criteria. Acceptability of each instrument was assessed using novel criteria developed in consultation with a mental health service user and carer consultation group. Results: We identified eleven papers describing the use, development, and/or validation of nine user/carer-reported outcome measures. Psychometric properties were sparsely reported and the questionnaires met few service user/carer-nominated attributes for acceptability. Where reported, basic psychometric statistics were of good quality, indicating that some measures may perform well if subjected to more rigorous psychometric tests. The majority were deemed to be too long for use in practice. Discussion: Multiple instruments are available to measure user/carer involvement in mental health care planning but are either of poor quality or poorly described. Existing measures cannot be considered psychometrically robust by modern standards, and cannot currently be recommended for use. Our review has identified an important knowledge gap, and an urgent need to

  17. Experiences with using information and communication technology to build a multi-municipal support network for informal carers.

    PubMed

    Torp, Steffen; Bing-Jonsson, Pia C; Hanson, Elizabeth

    2013-09-01

    This multi-municipal intervention study explored whether informal carers of frail older people and disabled children living at home made use of information and communication technology (ICT) to gain knowledge about caring and to form informal support networks, thereby improving their health. Seventy-nine informal carers accessed web-based information about caring and an e-based discussion forum via their personal computers. They were able to maintain contact with each other using a web camera and via normal group meetings. After the first 12 months, 17 informal carers participated in focus group interviews and completed a short questionnaire. Four staff members were also interviewed. Participant carers who had prior experiences with a similar ICT-based support network reported greater satisfaction and more extensive use of the network than did participants with no such prior experience. It seems that infrequent usage of the service may be explained by too few other carers to identify with and inappropriate recruitment procedures. Nevertheless, carers of disabled children reported that the intervention had resulted in improved services across the participant municipalities. To achieve optimal effects of an ICT-based support network due attention must be given to recruitment processes and social environment building for which care practitioners require training and support. PMID:23245624

  18. Experiences with using information and communication technology to build a multi-municipal support network for informal carers.

    PubMed

    Torp, Steffen; Bing-Jonsson, Pia C; Hanson, Elizabeth

    2013-09-01

    This multi-municipal intervention study explored whether informal carers of frail older people and disabled children living at home made use of information and communication technology (ICT) to gain knowledge about caring and to form informal support networks, thereby improving their health. Seventy-nine informal carers accessed web-based information about caring and an e-based discussion forum via their personal computers. They were able to maintain contact with each other using a web camera and via normal group meetings. After the first 12 months, 17 informal carers participated in focus group interviews and completed a short questionnaire. Four staff members were also interviewed. Participant carers who had prior experiences with a similar ICT-based support network reported greater satisfaction and more extensive use of the network than did participants with no such prior experience. It seems that infrequent usage of the service may be explained by too few other carers to identify with and inappropriate recruitment procedures. Nevertheless, carers of disabled children reported that the intervention had resulted in improved services across the participant municipalities. To achieve optimal effects of an ICT-based support network due attention must be given to recruitment processes and social environment building for which care practitioners require training and support.

  19. Barriers to Co-Designing Mobile Technology with Persons with Dementia and Their Carers.

    PubMed

    O'Connor, Siobhan; Bouamrane, Matt-Mouley; O'Donnell, Catherine A; Mair, Frances S

    2016-01-01

    Mobile applications can be used to help manage different aspects of long-term illnesses but many are not designed to meet the specific needs of people with dementia or their carers. This case study explores the barriers experienced when co-producing a memory and reminiscence app. A focus group and interviews were conducted with patient/carer dyads, an occupational therapist, project manager and software engineer involved in the design of the app. Data was analysed thematically using the framework approach. Several limitations such as poor technical knowledge and skills, negative attitudes and inaccurate perceptions of people with dementia slowed down or changed how the mobile app was developed. Compromises also had to be made over the final design of the app. More research to explore how mobile apps are co-designed with patients is needed. PMID:27332466

  20. Conversations between carers and people with schizophrenia: a qualitative analysis using leximancer.

    PubMed

    Cretchley, Julia; Gallois, Cindy; Chenery, Helen; Smith, Andrew

    2010-12-01

    We examined conversations between people with schizophrenia (PwS) and family or professional carers with whom they interacted frequently. We allocated PwS to one of two communication profiles: Low-activity communicators talked much less than their conversational partners, whereas high-activity communicators talked much more. We used Leximancer text analytics software to analyze the conversations. We found that carers used different strategies to accommodate to the PwS's behavior, depending on the PwS's communication profile and their relationship. These findings indicate that optimal communication strategies depend on the PwS's conversational tendencies and the relationship context. They also suggest new opportunities for qualitative assessment via intelligent text analytics technologies.

  1. Conversations between carers and people with schizophrenia: a qualitative analysis using leximancer.

    PubMed

    Cretchley, Julia; Gallois, Cindy; Chenery, Helen; Smith, Andrew

    2010-12-01

    We examined conversations between people with schizophrenia (PwS) and family or professional carers with whom they interacted frequently. We allocated PwS to one of two communication profiles: Low-activity communicators talked much less than their conversational partners, whereas high-activity communicators talked much more. We used Leximancer text analytics software to analyze the conversations. We found that carers used different strategies to accommodate to the PwS's behavior, depending on the PwS's communication profile and their relationship. These findings indicate that optimal communication strategies depend on the PwS's conversational tendencies and the relationship context. They also suggest new opportunities for qualitative assessment via intelligent text analytics technologies. PMID:20675536

  2. DEFINING SECLUSION AND RESTRAINT: LEGAL AND POLICY DEFINITIONS VERSUS CONSUMER AND CARER PERSPECTIVES.

    PubMed

    Roper, Cath; McSherry, Bernadette; Brophy, Lisa

    2015-12-01

    The practices of seclusion and restraint may be used in a variety of health settings to control behaviour. Laws and policies that seek to regulate these practices define seclusion and restraint in various ways and there are gaps as to which practices are regulated and in what circumstances. This column provides an overview of consumer and carer perspectives as to what is meant by these practices.

  3. Investigating consumers' and informal carers' views and preferences for consumer directed care: A discrete choice experiment.

    PubMed

    Kaambwa, Billingsley; Lancsar, Emily; McCaffrey, Nicola; Chen, Gang; Gill, Liz; Cameron, Ian D; Crotty, Maria; Ratcliffe, Julie

    2015-09-01

    Consumer directed care (CDC) is currently being embraced internationally as a means to promote autonomy and choice for consumers (people aged 65 and over) receiving community aged care services (CACSs). CDC involves giving CACS clients (consumers and informal carers of consumers) control over how CACSs are administered. However, CDC models have largely developed in the absence of evidence on clients' views and preferences. We explored CACS clients' preferences for a variety of CDC attributes and identified factors that may influence these preferences and potentially inform improved design of future CDC models. Study participants were clients of CACSs delivered by five Australian providers. Using a discrete choice experiment (DCE) approach undertaken in a group setting between June and December 2013, we investigated the relative importance to CACS consumers and informal (family) carers of gradations relating to six salient features of CDC (choice of service provider(s), budget management, saving unused/unspent funds, choice of support/care worker(s), support-worker flexibility and level of contact with service coordinator). The DCE data were analysed using conditional, mixed and generalised logit regression models, accounting for preference and scale heterogeneity. Mean ages for 117 study participants were 80 years (87 consumers) and 74 years (30 informal carers). All participants preferred a CDC approach that allowed them to: save unused funds from a CACS package for future use; have support workers that were flexible in terms of changing activities within their CACS care plan and; choose the support workers that provide their day-to-day CACSs. The CDC attributes found to be important to both consumers and informal carers receiving CACSs will inform the design of future CDC models of service delivery. The DCE approach used in this study has the potential for wide applicability and facilitates the assessment of preferences for elements of potential future aged care

  4. Investigating consumers' and informal carers' views and preferences for consumer directed care: A discrete choice experiment.

    PubMed

    Kaambwa, Billingsley; Lancsar, Emily; McCaffrey, Nicola; Chen, Gang; Gill, Liz; Cameron, Ian D; Crotty, Maria; Ratcliffe, Julie

    2015-09-01

    Consumer directed care (CDC) is currently being embraced internationally as a means to promote autonomy and choice for consumers (people aged 65 and over) receiving community aged care services (CACSs). CDC involves giving CACS clients (consumers and informal carers of consumers) control over how CACSs are administered. However, CDC models have largely developed in the absence of evidence on clients' views and preferences. We explored CACS clients' preferences for a variety of CDC attributes and identified factors that may influence these preferences and potentially inform improved design of future CDC models. Study participants were clients of CACSs delivered by five Australian providers. Using a discrete choice experiment (DCE) approach undertaken in a group setting between June and December 2013, we investigated the relative importance to CACS consumers and informal (family) carers of gradations relating to six salient features of CDC (choice of service provider(s), budget management, saving unused/unspent funds, choice of support/care worker(s), support-worker flexibility and level of contact with service coordinator). The DCE data were analysed using conditional, mixed and generalised logit regression models, accounting for preference and scale heterogeneity. Mean ages for 117 study participants were 80 years (87 consumers) and 74 years (30 informal carers). All participants preferred a CDC approach that allowed them to: save unused funds from a CACS package for future use; have support workers that were flexible in terms of changing activities within their CACS care plan and; choose the support workers that provide their day-to-day CACSs. The CDC attributes found to be important to both consumers and informal carers receiving CACSs will inform the design of future CDC models of service delivery. The DCE approach used in this study has the potential for wide applicability and facilitates the assessment of preferences for elements of potential future aged care

  5. [The impact of caring on young carer's lives. An international literature review (1990-2006)].

    PubMed

    Metzing, Sabine; Schnepp, Wilfried

    2007-12-01

    Children growing up with chronically ill parents and those who are involved into the care of their parents are at risk to experience adverse effects on their whole development. This literature study is part of a research project that intends to work out a basis for specific support for young carers and their families in Germany. Questions concerning the impact on young carers, and also experiences of growing up with a chronically ill parent where addressed to the last 15 years' relevant literature. Children experience positive as well as negative effects, but it is difficult to distinguish between caring responsibilities and the impact of growing up with a chronically ill parent. Positive effects are a good sense of self-esteem, maturity, identity, a close relation to the parents, as well as feeling well prepared for further life. Negative effects become apparent for the child's physical, psychosocial and educational development. Not every young carer experiences negative effects, and not every child of a chronically ill parent will necessarily experience disadvantage. Nevertheless, research results refer to the need for action in order to prevent negative consequences for the child's future life. Projects of support need to integrate the whole family and besides supporting the children, the parents need to be stabilised as well.

  6. Long-term Care Insurance and Carers' Labor Supply - A Structural Model.

    PubMed

    Geyer, Johannes; Korfhage, Thorben

    2015-09-01

    In Germany, individuals in need of long-term care receive support through benefits of the long-term care insurance. A central goal of the insurance is to support informal care provided by family members. Care recipients can choose between benefits in kind (formal home care services) and benefits in cash. From a budgetary perspective, family care is often considered a cost-saving alternative to formal home care and to stationary nursing care. However, the opportunity costs resulting from reduced labor supply of the carer are often overlooked. We focus on the labor supply decision of family carers and the incentives set by the long-term care insurance. We estimate a structural model of labor supply and the choice of benefits of family carers. We find that benefits in kind have small positive effects on labor supply. Labor supply elasticities of cash benefits are larger and negative. If both types of benefits increase, negative labor supply effects are offset to a large extent. However, the average effect is significantly negative.

  7. Self stigma in people with intellectual disabilities and courtesy stigma in family carers: a systematic review.

    PubMed

    Ali, Afia; Hassiotis, Angela; Strydom, Andre; King, Michael

    2012-01-01

    People with intellectual disability are one of the most stigmatised groups in society. Despite this, research in this area has been limited. This paper provides a review of studies examining self stigma in people with intellectual disability, and courtesy and affiliate stigma in family carers. An electronic search of studies published between 1990 and February 2012, using four databases and hand searching of journals was conducted. Thirty-seven papers were included in the review: 17 studies examined self stigma and 20 studies examined courtesy or affiliate stigma. The findings indicate that both individuals and family carers experience stigma and that it may have a negative impact on psychological wellbeing. Awareness of stigma in people with intellectual disability appears to be related to the extent to which individuals accept and internalise the label of intellectual disability. Most of the studies were qualitative studies or small descriptive studies. There is a lack of large prevalence studies and longitudinal studies examining the impact of stigma, in both individuals with intellectual disability and their carers.

  8. Professional perspectives on service user and carer involvement in mental health care planning: A qualitative study

    PubMed Central

    Bee, Penny; Brooks, Helen; Fraser, Claire; Lovell, Karina

    2015-01-01

    Background Involving users/carers in mental health care-planning is central to international policy initiatives yet users frequently report feeling excluded from the care planning process. Rigorous explorations of mental health professionals’ experiences of care planning are lacking, limiting our understanding of this important translational gap. Objectives To explore professional perceptions of delivering collaborative mental health care-planning and involving service users and carers in their care. Design Qualitative interviews and focus groups with data combined and subjected to framework analysis. Setting UK secondary care mental health services. Participants 51 multi-disciplinary professionals involved in care planning and recruited via study advertisements. Results Emergent themes identified care-planning as a meaningful platform for user/carer involvement but revealed philosophical tensions between user involvement and professional accountability. Professionals emphasised their individual, relational skills as a core facilitator of involvement, highlighting some important deficiencies in conventional staff training programmes. Conclusions Although internationally accepted on philosophical grounds, user-involved care-planning is poorly defined and lacks effective implementation support. Its full realisation demands greater recognition of both the historical and contemporary contexts in which statutory mental healthcare occurs. PMID:26253574

  9. 'It terrifies me, the thought of the future': listening to the current concerns of informal carers of people with a learning disability.

    PubMed

    Mansell, Ian; Wilson, Christine

    2010-03-01

    The aim of this article is to report findings from a study that asked carers for their views on a wide range of topics. Issues relevant to the current concerns of carers are reported here. A mixed method triangulated design yielded both quantitative and qualitative data. A total of 647 members of a parent/carer federation were sent a questionnaire with a section on 'current concerns'. The response rate was 23 percent (151 participants). Two focus groups were held with 15 carers who had completed the questionnaire. Issues of concern to carers included access to health and social care information and services; quality and quantity of respite care; suitable educational provision; independence and quality of life (for a person with learning disability); and what would happen to the person with learning disability when the carer was no longer able to carry out their caring role. PMID:20630924

  10. Providing general practice needs-based care for carers of people with advanced cancer: a randomised controlled trial

    PubMed Central

    Mitchell, Geoffrey K; Girgis, Afaf; Jiwa, Moyez; Sibbritt, David; Burridge, Letitia H; Senior, Hugh E

    2013-01-01

    Background Carers of patients with advanced cancer often have health and psychosocial needs, which are frequently overlooked. Aim To meet the needs of carers through a GP consultation directed by a self-completed carer needs checklist. Design and setting Randomised controlled trial in general practice with recruitment through specialist oncology clinics, in Brisbane, Australia. Method Intervention was (a) carer–GP consultations directed by a self-completed checklist of needs at baseline and 3 months; and (b) a GP-Toolkit to assist GPs to address carer-identified needs. Control group received usual care. Outcome measures were intensity of needs, anxiety and depression, and quality of life. Results Total recruitment 392. Overall, no significant differences were detected in the number or intensity of need between groups. Compared to controls, intervention participants with baseline clinical anxiety showed improvements in mental wellbeing (P = 0.027), and those with baseline clinical depression had slower development of anxiety (P = 0.044) at 6 months. For those not anxious, physical wellbeing improved at 1 month (P = 0.040). Carers looking after patients with poor functional status had more physical needs (P = 0.037) at 1 month and more psychological and emotional needs at 3 months (P = 0.034). Those caring for less unwell patients showed improved mental wellbeing at 3 months (P = 0.022). Conclusion The intervention did not influence the number or intensity of needs reported by carers of people with advanced cancer. There was limited impact in people with pre-existing clinical anxiety and depression. For the carer of those most severely affected by advanced cancer, it drew attention to the needs arising from the caregiving role. PMID:24152483

  11. Mental health of carers of children affected by HIV attending community-based programmes in South Africa and Malawi.

    PubMed

    Skeen, Sarah; Tomlinson, Mark; Macedo, Ana; Croome, Natasha; Sherr, Lorraine

    2014-01-01

    There is strong evidence that both adults and children infected with and affected by HIV have high levels of mental health burden. Yet there have been few studies investigating carer mental health outcomes in the context of HIV in Malawi and South Africa. The objective of this study was to assess the mental health of carers of children affected by HIV as a part of the Child Community Care study, which aims to generate evidence on the effectiveness of community-based organisation (CBO) services to improve child outcomes. In a cross-sectional study, we interviewed 952 carers of children (aged 4-13 years) attending 28 randomly selected CBOs funded by 11 major donors in South Africa and Malawi. Psychological morbidity was measured using the Shona Symptom Questionnaire and suicidal ideation was measured using an item from the Patient Health Questionnaire. Carers were asked about care-seeking for emotional problems. Overall, 28% of carers scored above the clinical cut-off for current psychological morbidity and 12.2% reported suicidal ideation. We used logistic regression models to test factors associated with poor outcomes. Household unemployment, living with a sick family member and perceived lack of support from the community were associated with both psychological morbidity and suicidal ideation in carers. Reported child food insecurity was also associated with psychological morbidity. In addition, carers living in South Africa were more likely to present with psychological morbidity and suicidal ideation than carers in Malawi. Rates of help-seeking for mental health problems were low. Carers of children affected by HIV are at risk for mental health problems as a result of HIV, socio-economic, care-giving and community factors. We call for increased recognition of the potential role of CBOs in providing mental health care and support for families as a means to improve equity in mental health care. Specifically, we highlight the need for increased training and

  12. Evaluation of a long-term oral health program by carers of children and adults with intellectual disabilities.

    PubMed

    Faulks, D; Hennequin, M

    2000-01-01

    The oral health program presented here was undertaken in three French centers for persons with special needs. The program aimed to educate the carers about dental disease, to motivate them with regard to prevention, and to improve the oral hygiene and oral health of the residents. This study evaluated the impact of the program in terms of change in attitudes and behavior expressed by the carers by means of a questionnaire. Following demonstration of oral hygiene techniques on an individual basis, the number of residents who had their teeth cleaned more than once a day rose from 24% to 52% (p < 0.05). The percentage of carers able to clean both posterior and anterior teeth of their key residents increased from 24% to 60% (p < 0.05), and the percentage finding tooth cleaning easy increased from 36% to 60% (non-significant). The intervention was thus deemed moderately successful, although the carers continued to take better care of their own oral health than that of the residents. The need for ongoing training is emphasized, both for the carers of those with special needs and for the dental profession. The lack of a validated means of measuring the impact of such interventions on care providers for this population is discussed. PMID:11203899

  13. Impact on the individual: what do patients and carers gain, lose and expect from being involved in research?

    PubMed Central

    Ashcroft, Joanne; Wykes, Til; Taylor, Joseph; Crowther, Adam; Szmukler, George

    2016-01-01

    Abstract Background: Study feasibility and deliverability can benefit from involving patients and carers in the research process, known as patient and public involvement (PPI). There is less evidence on the experiences of patients and carers themselves and we require more information across a range of studies, health conditions and research stages. Aims: This study explored how patients and carers in eight diagnostic research specialties have been involved in research, their motivations and the impact involvement had on them. Method: 143 patients and carers across the Clinical Research Network (CRN) responded to an online semi-structured questionnaire (developed using participatory methodology). Quantitative and qualitative data were analysed. Results: A range of benefits were reported, including providing a life focus and an improved relationship with illness. Less positive experiences regarding time and money and lack of acknowledgement were also reported, along with suggestions for improvement. Conclusions: PPI confers many benefits on patients and carers which could increase PPI recruitment if made explicit. More involvement in study recruitment and dissemination would increase the effectiveness of PPI input. Involving a more varied socioeconomic demographic and at an earlier stage is vital. Financial support for lower earners and greater feedback following involvement should also be explored. PMID:26733079

  14. Young carers as social actors: coping strategies of children caring for ailing or ageing guardians in Western Kenya.

    PubMed

    Skovdal, Morten; Ogutu, Vincent O; Aoro, Cellestine; Campbell, Catherine

    2009-08-01

    There is a vast body of research on the impact of HIV/AIDS on children, but little which acknowledges the role of children in providing care and support for ailing parents or ageing guardians. There has been a tendency to downplay the active role and agency of young carers, with young carers often represented as victims of damaging circumstances that compromise their psychosocial well-being. To counter-balance this tendency, and to develop the critical trend that views children as social actors, we explore how young carers cope with challenging circumstances, often with skill and ingenuity, drawing on data collected in Western Kenya in 2007. Forty-eight young carers (aged 11-17) used photography and drawing to provide accounts of their coping strategies. They described 240 of the resulting photographs and drawings in writing. In addition, 34 individual interviews and 2 group discussions were conducted with children to explore the findings further and 10 individual interviews with local adults were conducted to elucidate the dynamics between adults and children. Our data revealed that young carers cope by mobilising social support, engaging in income generating activities and constructing positive social identities around their caring roles. We conclude that children's ability to cope is determined by the extent to which they are able to participate in their community and negotiate support from it.

  15. Qualitative focus group study investigating experiences of accessing and engaging with social care services: perspectives of carers from diverse ethnic groups caring for stroke survivors

    PubMed Central

    Greenwood, Nan; Holley, Jess; Ellmers, Theresa; Mein, Gill; Cloud, Geoffrey

    2016-01-01

    Objectives Informal carers, often family members, play a vital role in supporting stroke survivors with post-stroke disability. As populations age, numbers of carers overall and those from minority ethnic groups in particular, are rising. Carers from all ethnic groups, but especially those from black and minority ethnic groups frequently fail to access support services, making understanding their experiences important. The study therefore explored the experiences of carers of stroke survivors aged 45+ years from 5 ethnic groups in accessing and receiving social care services after hospital discharge. Design This qualitative study used 7 recorded focus groups with informal carers of stroke survivors. Data were analysed thematically focusing on similarities and differences between ethnic groups. Setting Carers were recruited from voluntary sector organisations supporting carers, stroke survivors and black and minority ethnic groups in the UK. Participants 41 carers from 5 ethnic groups (Asian Indian, Asian Pakistani, black African, black Caribbean, white British) participated in the focus groups. Results Several interconnected themes were identified including: the service gap between hospital discharge and home; carers as the best person to care and cultural aspects of caring and using services. Many themes were common to all the included ethnic groups but some related to specific groups. Conclusions Across ethnic groups there were many similarities in the experiences of people caring for stroke survivors with complex, long-term care needs. Accessing services demands effort and persistence on carers’ part. If carers believe services are unsatisfactory or that they, rather than formal services, should be providing support for stroke survivors, they are unlikely to persist in their efforts. Cultural and language differences add to the challenges black and minority ethnic group carers face. PMID:26826148

  16. Interprofessional education in the care of people diagnosed with dementia and their carers: a systematic review

    PubMed Central

    Jackson, Marcus; Pelone, Ferruccio; Reeves, Scott; Hassenkamp, Anne Marie; Emery, Claire; Titmarsh, Kumud; Greenwood, Nan

    2016-01-01

    Objectives This systematic review is linked to the multifaceted social, economic and personal challenges of dementia and the international recognition of the value of interprofessional education (IPE) and its influence on health and social care outcomes. This review therefore aimed to identify, describe and evaluate the impact of IPE interventions on health and social care practitioners (prequalification and postqualification) understanding of dementia, the quality of care for people with dementia and support for their carers. Methods Following PRISMA guidelines, 9 databases were searched (MEDLINE, EMBASE, The Cochrane Library, PsycINFO, CINAHL Plus, Applied Social Sciences Index and Abstracts, Healthcare Management Information Consortium, ERIC and British Education Index). Narrative analysis of the findings was undertaken. Design Systematic review. Results 6 studies meeting the inclusion criteria were identified. The majority of studies were conducted in North America. Participants in 4 studies were health and social care practitioners caring for people with dementia, whereas the remaining studies focused on training graduate or undergraduate students. Diverse IPE activities with varying content, delivery mode and duration were reported. Although some studies reported more positive attitudes to interprofessional working as a result of the interventions, none reported benefits to patients or carers. The quality of the included studies varied. Overall, the evidence for the reported outcomes was considered weak. Conclusions This review identified 6 studies describing IPE interventions intended to improve collaborative knowledge, skills, interprofessional practice and organisational awareness of dementia and dementia care. The small number of studies, their varied nature, scope and settings combined with poor quality of evidence limits our understanding of the effectiveness of IPE on the care and support of people with dementia and their carers. Further research is

  17. Health Status, Social Support, and Quality of Life among Family Carers of Adults with Profound Intellectual and Multiple Disabilities (PIMD) in Taiwan

    ERIC Educational Resources Information Center

    Chou, Yueh-Ching; Chiao, Chi; Fu, Li-Yeh

    2011-01-01

    Background: Primary family carers of adults with profound intellectual and multiple disabilities (PIMD) experience a range of considerable demands. Method: A census survey was conducted in a city of Taiwan; 796 family carers of adults (aged 18 or older) diagnosed with intellectual disability and/or with multiple disabilities living with the family…

  18. Developing services for the carers of young adults with early-onset psychosis - implementing evidence-based practice on psycho-educational family intervention.

    PubMed

    Sin, J; Moone, N; Newell, J

    2007-05-01

    This paper describes a series of practice and service development initiatives to incorporate the family-inclusive approach into the newly established Early Intervention in Psychosis Service in Berkshire, England. Following a local study on carers' experiences and needs from those who cared for a young adult with a first-episode psychosis (FEP), a series of flexible services for this group of carers has been developed incorporating the much-researched psycho-educational family interventions. The findings of our local phenomenological study on the carers for young adults with FEP clearly specified the unique needs of this group of carers and that well-established approaches in family work and carers support facilities may have to be adapted to meet such needs. This paper reports the service development process through which a series of specially designed carers' services were set up for carers caring for a young adult with FEP. These services were developed to address carers' needs for knowledge, skills and support to cope with their caring roles and situation, from the stressful beginning of a potentially long caring journey. PMID:17430452

  19. Self-efficacy and health-related quality of life in family carers of people with dementia: a systematic review

    PubMed Central

    Crellin, Nadia E.; Orrell, Martin; McDermott, Orii; Charlesworth, Georgina

    2014-01-01

    Objectives: This review aims to explore the role of self-efficacy (SE) in the health-related quality of life (QoL) of family carers of people with dementia. Methods: A systematic review of literature identified a range of qualitative and quantitative studies. Search terms related to caring, SE, and dementia. Narrative synthesis was adopted to synthesise the findings. Results: Twenty-two studies met the full inclusion criteria, these included 17 quantitative, four qualitative, and one mixed-method study. A model describing the role of task/domain-specific SE beliefs in family carer health-related QoL was constructed. This model was informed by review findings and discussed in the context of existing conceptual models of carer adaptation and empirical research. Review findings offer support for the application of the SE theory to caring and for the two-factor view of carer appraisals and well-being. Findings do not support the independence of the negative and positive pathways. The review was valuable in highlighting methodological challenges confronting this area of research, particularly the conceptualisation and measurement issues surrounding both SE and health-related QoL. Conclusions: The model might have theoretical implications in guiding future research and advancing theoretical models of caring. It might also have clinical implications in facilitating the development of carer support services aimed at improving SE. The review highlights the need for future research, particularly longitudinal research, and further exploration of domain/task-specific SE beliefs, the influence of carer characteristics, and other mediating/moderating variables. PMID:24943873

  20. Unmet Needs of People with Severe Multiple Sclerosis and Their Carers: Qualitative Findings for a Home-Based Intervention

    PubMed Central

    Borreani, Claudia; Bianchi, Elisabetta; Pietrolongo, Erika; Rossi, Ilaria; Cilia, Sabina; Giuntoli, Miranda; Giordano, Andrea; Confalonieri, Paolo; Lugaresi, Alessandra; Patti, Francesco; Grasso, Maria Grazia; de Carvalho, Laura Lopes; Palmisano, Lucia; Zaratin, Paola; Battaglia, Mario Alberto; Solari, Alessandra

    2014-01-01

    Background Few data on services for people with severe multiple sclerosis (MS) are available. The Palliative Network for Severely Affected Adults with MS in Italy (PeNSAMI) developed a home palliative care program for MS patients and carers, preceded by a literature review and qualitative study (here reported). Objective To identify unmet needs of people with severe MS living at home by qualitative research involving key stakeholders, and theorize broad areas of intervention to meet those needs. Method Data were collected from: at least 10 personal interviews with adults with severe MS (primary/secondary progressive, EDSS≥8.0); three focus group meetings (FGs) of carers of people with severe MS; and two FGs of health professionals (HPs). Grounded theory guided the analysis of interview and FG transcripts, from which the areas of intervention were theorized. Results Between October 2012 and May 2013, 22 MS patients, 30 carers and 18 HPs participated. Forty-eight needs themes were identified, grouped into 14 categories and four domains. Seven, highly interdependent intervention areas were theorized. Patients had difficulties expressing needs; experiences of burden and loneliness were prominent, chiefly in dysfunctional, less affluent families, and among parent carers. Needs differed across Italy with requirements for information and access to services highest in the South. All participants voiced a strong need for qualified personnel and care coordination in day-to-day home care. Personal hygiene emerged as crucial, as did the need for a supportive network and preservation of patient/carer roles within family and community. Conclusions Unmet needs transcended medical issues and embraced organizational and psychosocial themes, as well as health policies. The high interdependence of the seven intervention areas theorized is in line with the multifaceted approach of palliative care. At variance with typical palliative contexts, coping with disability rather than end

  1. Reliability training

    NASA Technical Reports Server (NTRS)

    Lalli, Vincent R. (Editor); Malec, Henry A. (Editor); Dillard, Richard B.; Wong, Kam L.; Barber, Frank J.; Barina, Frank J.

    1992-01-01

    Discussed here is failure physics, the study of how products, hardware, software, and systems fail and what can be done about it. The intent is to impart useful information, to extend the limits of production capability, and to assist in achieving low cost reliable products. A review of reliability for the years 1940 to 2000 is given. Next, a review of mathematics is given as well as a description of what elements contribute to product failures. Basic reliability theory and the disciplines that allow us to control and eliminate failures are elucidated.

  2. Construct and empirical validity of the Self-As-Carer Inventory.

    PubMed

    Geden, E; Taylor, S

    1991-01-01

    The Self-As-Carer Inventory was designed to permit individuals to express their perceived capacity to care for self. In the first phase of the study, a 44-item questionnaire was developed and tested through factor analysis primarily using a college population (Geden & Taylor, 1988). After the instrument was revised, a second study, reported here, was conducted with a more heterogeneous population. The age range of the respondents was broadened and the variability of health state and ethnicity was increased. Factor analysis with rotation was conducted on 589 completed inventories using the revised 40-item questionnaire. The 4-factor Promax solution accounted for 52% of the variance. Retention of factors with eigenvalues greater than 1 led to a 6-factor solution accounting for 58% of the variance. Significant positive correlations were found between total scores on the Self-As-Carer Inventory and ratings of health in general (r = .29, p = .0001), health at this moment (r = .25, p = .0001), and an estimate; of the amount of their own self-care provided (r = .36, p = .0001). No differences were found in total scores across health state, defined as respondents' reports of being sick-at-home (n = 130), hospitalized (n = 259), or well (n = 200).

  3. The emotional overlay: older person and carer perspectives on negotiating aging and care in rural Ontario.

    PubMed

    Herron, Rachel V; Skinner, Mark W

    2013-08-01

    This paper extends the burgeoning interest in emotion, health and place by investigating the emotionally complex experiences of aging and care in rural settings. Featuring a thematic analysis of 44 semi-structured interviews and two focus groups with older people and their carers in rural Ontario (Canada) we examine the importance and implications of emotions within and across multiple scales at which care relationships, expectations and responsibilities are negotiated. With the aim of broadening the discussion surrounding geographical dimensions of ethical care, our approach draws on feminist care ethics to understand the multifaceted ways in which emotions shape and are shaped by experiences of aging and caring at the interpersonal, household and community scales. The findings reveal how emotions are central, yet often-overlooked and even hidden within care relationships among older rural people and their carers. We argue that ethical care is contingent on recognizing and valuing the situated emotions involved in doing care work, sustaining care relationships and asking for care. In doing so, we demonstrate how qualitative research on the emotional geographies of care can contribute to the development of informed policies that are contextually sensitive and, ultimately, have the potential to build more ethical rural conditions of care.

  4. Construct and empirical validity of the Self-As-Carer Inventory.

    PubMed

    Geden, E; Taylor, S

    1991-01-01

    The Self-As-Carer Inventory was designed to permit individuals to express their perceived capacity to care for self. In the first phase of the study, a 44-item questionnaire was developed and tested through factor analysis primarily using a college population (Geden & Taylor, 1988). After the instrument was revised, a second study, reported here, was conducted with a more heterogeneous population. The age range of the respondents was broadened and the variability of health state and ethnicity was increased. Factor analysis with rotation was conducted on 589 completed inventories using the revised 40-item questionnaire. The 4-factor Promax solution accounted for 52% of the variance. Retention of factors with eigenvalues greater than 1 led to a 6-factor solution accounting for 58% of the variance. Significant positive correlations were found between total scores on the Self-As-Carer Inventory and ratings of health in general (r = .29, p = .0001), health at this moment (r = .25, p = .0001), and an estimate; of the amount of their own self-care provided (r = .36, p = .0001). No differences were found in total scores across health state, defined as respondents' reports of being sick-at-home (n = 130), hospitalized (n = 259), or well (n = 200). PMID:1987556

  5. "Stroppy" or "Confident"? Do Carers and Professionals View the Impact of Transition Support on Young People Differently?

    ERIC Educational Resources Information Center

    Kaehne, Axel; Beyer, Stephen

    2011-01-01

    The study examined the effects of transition employment support to two cohorts of young people who were in their last year in school or college in 2005/2006 and 2006/2007. This paper reports the views of carers, teachers and support workers of the impact this additional support made to the young people. Analysis of the data reveals a difference…

  6. Exploring comprehensibility and manageability in palliative home care: an interview study of dying cancer patients' informal carers.

    PubMed

    Milberg, Anna; Strang, Peter

    2004-09-01

    The presence of an informal carer is often a prerequisite for successful palliative home care, and the staff's ability to support informal carers' coping in such situations is important. Recent research has revealed that it is possible to achieve positive psychological states in palliative care despite the burdening situation. As there is a lack of theory-based coping studies, the aim of this study was to describe, within the context of palliative home care, two concepts in Antonovsky's theory of Sense of Coherence: comprehensibility (a perception that the challenge is understood) and manageability (a perception that the resources to cope are available). Tape-recorded semi-structured interviews with 19 informal carers during ongoing palliative home care were transcribed and analysed with a qualitative hermeneutic approach. Elements that facilitated comprehensibility included open information, symbolic information, basic life assumptions and previous knowledge. These were important for creating a congruent inner reality (as opposed to chaos). Resources contributing to manageability dealt with power, support, competence and accessibility, which on a more abstract level resulted in a feeling of togetherness (as opposed to isolation). The findings are discussed in relation to the complexity of communication between staff and carers within palliative care. PMID:15334529

  7. Professional carers' knowledge and response to depression among their aged-care clients: the care recipients' perspective.

    PubMed

    Mellor, David; Davison, Tanya; McCabe, Marita; George, Kuruvilla

    2008-05-01

    Depression is an under-diagnosed disorder among the elderly, even in those who are in receipt of aged-care services. One factor associated with this under diagnosis has been identified as a reluctance amongst the elderly to discuss their mood and emotions with their medical practitioners. The current study focused on why depression is not recognised and acted on by those providing residential or home-based care to older people. We interviewed 15 elderly people residing in high-level or low-level aged-care facilities, and three elderly people who were receiving personal care in their homes. All participants had been identified by their care agencies as depressed. Participants reported their perceptions of their personal carers' knowledge and practices in managing the residents' depression. Although the participants described their carers in positive terms, they were critical of their knowledge and skills in recognising depression, and indicated that the communication between personal carers and care recipients about depressive symptomatology was seriously flawed. Training for personal carers in these areas, and efforts to change organisational culture are recommended. PMID:18728953

  8. Professional carers' knowledge and response to depression among their aged-care clients: the care recipients' perspective.

    PubMed

    Mellor, David; Davison, Tanya; McCabe, Marita; George, Kuruvilla

    2008-05-01

    Depression is an under-diagnosed disorder among the elderly, even in those who are in receipt of aged-care services. One factor associated with this under diagnosis has been identified as a reluctance amongst the elderly to discuss their mood and emotions with their medical practitioners. The current study focused on why depression is not recognised and acted on by those providing residential or home-based care to older people. We interviewed 15 elderly people residing in high-level or low-level aged-care facilities, and three elderly people who were receiving personal care in their homes. All participants had been identified by their care agencies as depressed. Participants reported their perceptions of their personal carers' knowledge and practices in managing the residents' depression. Although the participants described their carers in positive terms, they were critical of their knowledge and skills in recognising depression, and indicated that the communication between personal carers and care recipients about depressive symptomatology was seriously flawed. Training for personal carers in these areas, and efforts to change organisational culture are recommended.

  9. The demographic characteristics and economic activity patterns of carers over 50: evidence from the English Longitudinal Study of Ageing.

    PubMed

    Vlachantoni, Athina

    2010-01-01

    Studies on informal care provision have often focused on the provision of care for persons with a long term physical or mental ill-health or disability, or problems related to old age. However, the provision of care and support more broadly, for example in the form of childcare for grandchildren, can also impact on various aspects of a carer's life, such as their employment (if under the state retirement age), lifetime earnings and, by extension, pension income in later life. This article uses data from Wave 3 of the English Longitudinal Study of Ageing (ELSA) to explore the demographic characteristics, caring patterns, health status and economic activity patterns of carers aged over 50 in England. The results suggest that the nature of care provision differs across age groups, and that caring can be quite a different experience for older men and women. This article also sheds light on the characteristics of 'round-the-clock' carers, a relatively under-researched group which makes up just over one fifth of all carers aged 50 and over. PMID:20927029

  10. Consumers and carers as partners in mental health research: reflections on the experience of two project teams in Victoria, Australia.

    PubMed

    Callander, Rosemary; Ning, Lei; Crowley, Anna; Childs, Bianca; Brisbane, Pam; Salter, Tony

    2011-08-01

    A successful working partnership in research between a consumer project team from the Victorian Mental Illness Awareness Council and a carer project team from the Victorian Mental Health Carers Network was forged during their collaborative involvement in an innovative 2-year pilot project funded by the Victorian Government of Australia. This project trialled new ways of capturing consumer and carer experiences of mental health services, and that feedback was integrated into service quality improvement. Towards the end of the project, an external facilitator was used to enable the two teams to reflect on their experience of working together so that their joint story could be shared with others and used to promote further use of this approach in the mental health field. Main findings included the importance of having strong support and belief at leadership levels, opportunities to build the relationship and develop mutual trust and respect, a common vision and a clearly articulated set of values, targeted training appropriate to the needs of the team members, independent work bases, and mutual support to overcome challenges encountered during the project. The experience forged a close working relationship between the two teams and has set the scene for further participation of consumers and carers in research and innovative quality-improvement processes in the mental health field.

  11. A qualitative analysis of changes in relationship dynamics and roles between people with cancer and their primary informal carer.

    PubMed

    Ussher, Jane M; Tim Wong, W K; Perz, Janette

    2011-11-01

    It is widely accepted that cancer is an intersubjective experience that impacts upon the psychological well-being of people with cancer and informal carers, as well as on couple relationships. This qualitative study examined the nature and consequences of cancer on the relationship between informal carers and the person with cancer, from the perspective of Australian cancer carers. Sixty-two carers (42 women and 20 men), across a range of cancer types, stages and relationship dyads took part in semi-structured interviews. Participants reported that cancer had precipitated a change in roles and in the dynamics of the relationship, including having to take on quasi-medical tasks and decisions, neglecting self and other relationships, changes to the emotions or personality of the person with cancer, changed patterns of communication, and changes to sexuality and intimacy. The impact of the changed relationship included sadness, anger and frustration, as well as feelings of love and being closer together, resulting in relationship enhancement. Women were more likely to report changes in the person with cancer and to mourn the previous relationship, while more men reported relationship enhancement.

  12. Carer-Reported Contemporary Health Problems in People with Severe and Profound Intellectual Disability and Genetic Syndromes

    ERIC Educational Resources Information Center

    Berg, Katy; Arron, Kate; Burbidge, Cheryl; Moss, Joanna; Oliver, Chris

    2007-01-01

    Identifying health problems in people with severe and profound disabilities and genetic syndromes can be problematic, and unidentified or unmanaged health problems may adversely impact an individual's quality of life. The authors studied carer-reported contemporary health problems in three genetic syndromes (Angelman, Cornelia de Lange, and Cri du…

  13. The experience of family carers attending a joint reminiscence group with people with dementia: A thematic analysis

    PubMed Central

    Melunsky, Nina; Crellin, Nadia; Dudzinski, Emma; Orrell, Martin; Wenborn, Jennifer; Poland, Fiona; Woods, Bob

    2015-01-01

    Reminiscence therapy has the potential to improve quality of life for people with dementia. In recent years reminiscence groups have extended to include family members, but carers’ experience of attending joint sessions is undocumented. This qualitative study explored the experience of 18 family carers attending ‘Remembering Yesterday Caring Today’ groups. Semi-structured interviews were transcribed and subjected to thematic analysis. Five themes were identified: experiencing carer support; shared experience; expectations (met and unmet), carer perspectives of the person with dementia’s experience; and learning and comparing. Family carers’ experiences varied, with some experiencing the intervention as entirely positive whereas others had more mixed feelings. Negative aspects included the lack of respite from their relative, the lack of emphasis on their own needs, and experiencing additional stress and guilt through not being able to implement newly acquired skills. These findings may explain the failure of a recent trial of joint reminiscence groups to replicate previous findings of positive benefit. More targeted research within subgroups of carers is required to justify the continued use of joint reminiscence groups in dementia care. PMID:24381218

  14. Life skills profile of patients with schizophrenia and its correlation to a feeling of rejection among key family carers

    PubMed Central

    Manickam, L.S.S; Chandran, R. Satheesh

    2005-01-01

    Background: The behaviour of patients with schizophrenia is of great concern to key family carers. Life skills profile (LSP) is the measure that has considerable importance in assessing the functioning of people with schizophrenia in the community. Aim: To assess the sociodemographic correlates of LSP, and to find the correlation between LSP and the rejection response of key family carers. Methods: The LSP of 48 patients with chronic schizophrenia (29 men and 19 women) was assessed. The rejection responses of key family carers (28 men and 20 women) were evaluated using the Patient Rejection Scale. Results: The LSP did not significantly differ on the variables of gender, income level or attendance of day-care centre. However, there were differences between patients from urban and rural areas. A new dimension of family harmony, added as a subscale to LSP, also did not show any significant difference on the above variables. The rejection responses of key family carers were found to be significantly related to the LSP of the patients and, among the subscales, family harmony and communication were positively related to rejection. Conclusion: Though family interventions have been found to have positive implications on relapse and social functioning of patients with schizophrenia, a model of a family intervention programme for families of patients with schizophrenia needs to be developed. PMID:20711289

  15. The Application of the Theory of Planned Behaviour to Diet in Carers of People with an Intellectual Disability

    ERIC Educational Resources Information Center

    Jenkins, Catherine M.; McKenzie, Karen

    2011-01-01

    Background: The utility of the theory of planned behaviour (TPB) in predicting the intentions of care staff to encourage healthy eating behaviour in those they supported was examined. Method: A quantitative, within-participant, questionnaire based design was used with 112 carers to assess the performance of two TPB models. The first contained the…

  16. Health Status and Coping Strategies among Older Parent-Carers of Adults with Intellectual Disabilities in an Australian Sample

    ERIC Educational Resources Information Center

    Llewellyn, Gwynnyth; McConnell, David; Gething, Lindsay; Cant, Rosemary; Kendig, Hal

    2010-01-01

    Background: Older parent-carers in Australia are the subject of increasing policy and practice attention due to concerns about their ongoing ability to care in the light of their own ageing and the ageing of their adult son or daughter. This paper examines health status and the coping strategies of a group of older Australian parents caring for an…

  17. Living with Dementia in Rural and Remote Scotland: Diverse Experiences of People with Dementia and Their Carers

    ERIC Educational Resources Information Center

    Blackstock, K. L.; Innes, A.; Cox, S.; Smith, A.; Mason, A.

    2006-01-01

    There is a lack of research into people's experiences of using services as dementia sufferers themselves, or because they care for someone with dementia, in rural areas. This article explores their experiences in the context of rural Scotland, drawing on data gathered from both people with dementia and their carers. Our research suggests that…

  18. Advance Care Planning in Dementia: Do Family Carers Know the Treatment Preferences of People with Early Dementia?

    PubMed Central

    King, Michael; Jones, Louise; Vickestaff, Victoria; Sampson, Elizabeth L.

    2016-01-01

    Background and Aims When a person with dementia (PWD) has lost the ability to make treatment decisions, clinicians often rely on family carers to know and articulate these preferences with assumed accuracy. This study used the Life Support Preferences Questionnaire (LSPQ) to explore whether family carers’ choices show agreement with the end of life care preferences of the person with dementia for whom they care and what factors influence this. Methods A cross-sectional study interviewing 60 dyads (a person with early dementia and preserved capacity and their family carer) each completing a modified LSPQ. We assessed how closely carers’ choices resembled the PWD’s preferences for treatment in three proposed health states: the here and now; severe stroke with coma; terminal cancer. Agreement between the PWD and their family carer responses was assessed using Kappa and Prevalence-Adjusted Bias-Adjusted Kappa (PABAK) statistics. We examined whether carer burden and distress, and relationship quality, influenced agreement. Results In interviews PWD were able to indicate their treatment preferences across all three scenarios. In the here-and-now most wanted antibiotics (98%), fewer cardio-pulmonary resuscitation (CPR) (50%) and tube feeding (47%). In severe stroke and coma antibiotics remained the more preferred treatment (88%), followed by CPR (57%) and tube feeding (30%). In advanced cancer PWD expressed lower preferences for all treatments (antibiotics 68%; CPR 50%; tube feeding 37%). Carers’ choices were similar to the PWDs’ preferences in the here-and-now (71% (k = 0.03; PABAK = 0.4) with less agreement for future hypothetical health states. In severe stroke and coma carers tended wrongly to suggest that the PWD preferred more intervention (antibiotic, 67%; k = -0.022; PABAK = -0.60; CPR, 73%; k = 0.20; PABAK = -0.20, tube feeding, 66%; k = 0.25; PABAK = -0.12). In advanced cancer the agreement between PWD and carers was low (antibiotics; k = -0.03; PABAK

  19. Developing a primary care-based stroke model: the prevalence of longer-term problems experienced by patients and carers.

    PubMed Central

    Murray, Jenni; Young, John; Forster, Anne; Ashworth, Robert

    2003-01-01

    BACKGROUND: Over the last two decades, the need for a longer-term perspective to stroke management has become increasingly recognised. This paper reports a component of a larger project aimed at developing a systematic, primary care-based service for stroke aftercare. AIM: To identify the types and prevalence of longer-term problems experienced by stroke patients and their carers in the United Kingdom (UK). METHOD: Systematically identified quantitative surveys reporting the prevalence of long-term stroke-related problems were reviewed and the findings extracted and interpreted against a patient and carer defined classification system, identified during an earlier review of the qualitative stroke literature. RESULTS: Twenty-seven UK surveys, including approximately 6000 patients and 3000 carers, and two literature reviews were identified by the search methods. Most of the problem areas identified in the qualitative stroke literature review were reported in the quantitative surveys and an additional two problems were identified (falls and sexual problems). The prevalence of problems in each of the areas was as follows: 19% to 62% for emotional problems; 18% to 46% for social problems; 13% to 77% for service issues; 18% to 88% for poor communication; 33% to 100% for transfer of care; and 10% to 73% for other areas. CONCLUSION: This review confirms the findings and recommendations from earlier work about the need for a longer-term holistic approach to the rehabilitation of stroke patients and support for carers. Having established the nature and frequency of the main problems experienced by stroke patients and their carers, the appropriate evidence-based interventions need to be identified and consolidated into a stroke service, facilitated by a robust patient-assessment process. PMID:14601359

  20. Looking after the mouth - Evaluation of a pilot for a new approach to training care home carers in Kent, Surrey and Sussex.

    PubMed

    Eaton, K A; Lloyd, H A; Wheeler, M; Sullivan, J; Klass, C; Allen, Y; Lambert-Humble, S

    2016-07-01

    Objective This pilot study aimed to produce and evaluate training resources and training in oral health care, including oral hygiene, for carers in care homes in Surrey and Medway.Methods During two training days, for carers from these homes, short, interactive presentations were given on a range of topics relevant to oral health care and oral hygiene of older people, followed by practical training. Prior to any training all attendees completed a 39 question questionnaire to establish their baseline knowledge of oral health and hygiene. At the end of the training day they completed an evaluation form. Fourteen weeks later, they were visited at their place of work and completed the same questionnaire again. Differences in responses between baseline and after 14 weeks were statistically tested using the chi-squared test.Results Sixty-six carers attended the training sessions and 44 were followed up 14 weeks later. The results showed an improvement in carer knowledge at follow up. The majority of carers (36/44) spoke English as their first language. They had a mean age of 41 years, 37 were female and 7 male. They had worked as carers for a mean of 10.9 years (range 4 months-34 years). Over 90% stated that the training day fully met or exceeded their requirements and expectations.Conclusions The results indicated improvements in carer knowledge. However, the carers were atypical of carers in general, as they were self-selected and well-motivated. Nevertheless the content of the training day and the questionnaire should inform future work in this area.

  1. Barriers to access and minority ethnic carers' satisfaction with social care services in the community: a systematic review of qualitative and quantitative literature

    PubMed Central

    Greenwood, Nan; Habibi, Ruth; Smith, Raymond; Manthorpe, Jill

    2015-01-01

    As populations age, the numbers of carers overall and numbers of carers from minority ethnic groups in particular are rising. Evidence suggests that carers from all sections of the community and particularly carers from minority groups often fail to access care services. This may relate to barriers in accessing services and service dissatisfaction. The aim of this systematic review was to identify and summarise minority ethnic carers' perceptions of barriers to accessing community social care services and their satisfaction with these services if accessed. The following databases were searched from their start until July 2013: Social Care Online, Social Policy and Research, Scopus, PsychINFO, HMIC, ASSIA, MEDLINE, Embase, CINAHL Plus and AMED. Thirteen studies met the inclusion criteria. Most investigated either barriers to access or satisfaction levels, although three explored both. Only 4 studies investigated minority ethnic carers' satisfaction with social care, although 12 studies reported perceived barriers to accessing services. Few studies compared minority ethnic carers' perceptions with majority ethnic groups, making it difficult to identify issues specific to minority groups. Most barriers described were potentially relevant to all carers, irrespective of ethnic group. They included attitudinal barriers such as not wanting to involve outsiders or not seeing the need for services and practical barriers such as low awareness of services and service availability. Issues specific to minority ethnic groups included language barriers and concerns about services' cultural or religious appropriateness. Studies investigating satisfaction with services reported a mixture of satisfaction and dissatisfaction. Barriers common to all groups should not be underestimated and a better understanding of the relationship between perceived barriers to accessing services and dissatisfaction with services is needed before the experiences of all carers can be improved. PMID

  2. Partners in care?: views and experiences of carers from a cohort study of the early implementation of the Mental Health (Care & Treatment) (Scotland) Act 2003.

    PubMed

    Ridley, Julie; Hunter, Susan; Rosengard, Ann

    2010-09-01

    Carers are seen as legitimate stakeholders in wider policy processes and increasingly as 'co-producers' and key providers of care. Mental health carers, however, especially those caring for relatives subject to compulsory care and treatment, often feel overlooked and marginalised, caring in complex circumstances with little or no professional support. The Mental Health (Care & Treatment) (Scotland) Act 2003 (MHCT Act) implemented in 2005 aspired to change this for the better. This article focuses specifically on findings from seven focus groups and 10 individual interviews with 33 carers from three Health Board areas and the State Hospital in Scotland. Interviews were conducted at two stages during 2007 and 2008 as part of a wider study. Participating carers were supporting relatives who were under different compulsory measures and so had experience of new procedures under the MHCT Act. The data were gathered as part of a cohort study exploring service users', carers' and professionals' early experiences of the Act's implementation. A topic guide was used to explore the impact of compulsion on carers; the 'Named Person' role; Mental Health Tribunals; the principles underpinning the MHCT Act; and suggestions for improving the law. The study found that new provisions, in particular the Named Person role and Mental Health Tribunals, had resulted in positive change. However, many carers still felt isolated and unsupported. They remained critical of the lack of consultation and involvement at both individual and collective levels. Few were aware of their right to a carer's assessment and many were sceptical that this would make any difference. Acknowledging the study's limitations, we discuss the implications for practice in light of broader policy agendas of personalisation, recovery, recognition for carers and promotion of more community-based mental health services.

  3. Barriers to access and minority ethnic carers' satisfaction with social care services in the community: a systematic review of qualitative and quantitative literature.

    PubMed

    Greenwood, Nan; Habibi, Ruth; Smith, Raymond; Manthorpe, Jill

    2015-01-01

    As populations age, the numbers of carers overall and numbers of carers from minority ethnic groups in particular are rising. Evidence suggests that carers from all sections of the community and particularly carers from minority groups often fail to access care services. This may relate to barriers in accessing services and service dissatisfaction. The aim of this systematic review was to identify and summarise minority ethnic carers' perceptions of barriers to accessing community social care services and their satisfaction with these services if accessed. The following databases were searched from their start until July 2013: Social Care Online, Social Policy and Research, Scopus, PsychINFO, HMIC, ASSIA, MEDLINE, Embase, CINAHL Plus and AMED. Thirteen studies met the inclusion criteria. Most investigated either barriers to access or satisfaction levels, although three explored both. Only 4 studies investigated minority ethnic carers' satisfaction with social care, although 12 studies reported perceived barriers to accessing services. Few studies compared minority ethnic carers' perceptions with majority ethnic groups, making it difficult to identify issues specific to minority groups. Most barriers described were potentially relevant to all carers, irrespective of ethnic group. They included attitudinal barriers such as not wanting to involve outsiders or not seeing the need for services and practical barriers such as low awareness of services and service availability. Issues specific to minority ethnic groups included language barriers and concerns about services' cultural or religious appropriateness. Studies investigating satisfaction with services reported a mixture of satisfaction and dissatisfaction. Barriers common to all groups should not be underestimated and a better understanding of the relationship between perceived barriers to accessing services and dissatisfaction with services is needed before the experiences of all carers can be improved.

  4. Informal carers: a Marxist analysis of social, political, and economic forces underpinning the role.

    PubMed

    Bridges, J M; Lynam, M J

    1993-03-01

    Increasingly, families are being called to provide care to their elderly family members. Nursing has an important role to play in enabling families to assume such responsibilities. In this article, however, it is argued that nursing needs to examine its goals for nursing care and approaches to care delivery in their broader social, political, and economic context. Marxist theory is introduced and used to raise questions about taken-for-granted aspects of nursing practice and trends in health policy as they relate to family carers for the elderly. The article specifically examines assumptions about family, women, and household economies that are inherent in traditional nursing theory. It is argued that nursing needs to move its focus of action beyond work at the individual and family level to include work at system and policy levels. To do so, nursing must examine theoretical perspectives that enable such an inquiry into practice. PMID:8434902

  5. Singing modulates mood, stress, cortisol, cytokine and neuropeptide activity in cancer patients and carers

    PubMed Central

    Fancourt, Daisy; Williamon, Aaron; Carvalho, Livia A; Steptoe, Andrew; Dow, Rosie; Lewis, Ian

    2016-01-01

    There is growing evidence that psychosocial interventions can have psychological benefits for people affected by cancer, including improved symptoms of mental health and wellbeing and optimised immune responses. However, despite growing numbers of music interventions, particularly singing, in cancer care, there is less research into their impact. We carried out a multicentre single-arm preliminary study to assess the impact of singing on mood, stress and immune response in three populations affected by cancer: carers (n = 72), bereaved carers (n = 66) and patients (n = 55). Participants were excluded if pregnant or if they were currently being treated with chemotherapy, radiotherapy or oral immunosuppressive drugs. Participants were regular participants in five choirs across South Wales and took part in one hour of group singing. Before and after singing, visual analogue mood scales, stress scales and saliva samples testing for cortisol, beta-endorphin, oxytocin and ten cytokines were taken. Across all five centres and in all four participant groups, singing was associated with significant reductions in negative affect and increases in positive affect (p < .01) alongside significant increases in cytokines including GM-CSF, IL17, IL2, IL4 and sIL-2rα (all p < .01). In addition, singing was associated with reductions in cortisol, beta-endorphin and oxytocin levels. This study provides preliminary evidence that singing improves mood state and modulates components of the immune system. Further work is needed to ascertain how this differs for more specific patient groups and whether repeat exposure could lead to meaningful, longitudinal effects. PMID:27170831

  6. Singing modulates mood, stress, cortisol, cytokine and neuropeptide activity in cancer patients and carers.

    PubMed

    Fancourt, Daisy; Williamon, Aaron; Carvalho, Livia A; Steptoe, Andrew; Dow, Rosie; Lewis, Ian

    2016-01-01

    There is growing evidence that psychosocial interventions can have psychological benefits for people affected by cancer, including improved symptoms of mental health and wellbeing and optimised immune responses. However, despite growing numbers of music interventions, particularly singing, in cancer care, there is less research into their impact. We carried out a multicentre single-arm preliminary study to assess the impact of singing on mood, stress and immune response in three populations affected by cancer: carers (n = 72), bereaved carers (n = 66) and patients (n = 55). Participants were excluded if pregnant or if they were currently being treated with chemotherapy, radiotherapy or oral immunosuppressive drugs. Participants were regular participants in five choirs across South Wales and took part in one hour of group singing. Before and after singing, visual analogue mood scales, stress scales and saliva samples testing for cortisol, beta-endorphin, oxytocin and ten cytokines were taken. Across all five centres and in all four participant groups, singing was associated with significant reductions in negative affect and increases in positive affect (p < .01) alongside significant increases in cytokines including GM-CSF, IL17, IL2, IL4 and sIL-2rα (all p < .01). In addition, singing was associated with reductions in cortisol, beta-endorphin and oxytocin levels. This study provides preliminary evidence that singing improves mood state and modulates components of the immune system. Further work is needed to ascertain how this differs for more specific patient groups and whether repeat exposure could lead to meaningful, longitudinal effects. PMID:27170831

  7. Alzheimer's disease in the United Kingdom: developing patient and carer support strategies to encourage care in the community.

    PubMed Central

    Hunter, R; McGill, L; Bosanquet, N; Johnson, N

    1997-01-01

    Alzheimer's disease is a growing challenge for care providers and purchasers. With the shift away from the provision of long term institutional care in most developed countries, there is a growing tendency for patients with Alzheimer's disease to be cared for at home. In the United Kingdom, this change of direction contrasts with the policies of the 1980s and 90s which focused more attention on controlling costs than on assessment of the needs of the patient and carer and patient management. In recent years, the resources available for management of Alzheimer's disease have focused on institutional care, coupled with drug treatment to control difficult behaviour as the disease progresses. For these reasons, the current system has led to crisis management rather than preventive support--that is, long term care for a few rather than assistance in the home before the crises occur and institutional care is needed. Despite recent innovations in the care of patients with Alzheimer's disease, the nature of the support that patients and carers receive is poorly defined and sometimes inadequate. As a result of the shift towards care in the community, the informal carer occupies an increasingly central role in the care of these patients and the issue of how the best quality of care may be defined and delivered is an issue which is now ripe for review. The objective of this paper is to redefine the type of support that patients and carers should receive so that the disease can be managed more effectively in the community. The needs of patients with Alzheimer's disease and their carers are many and this should be taken into account in defining the quality and structure of healthcare support. This paper shows how new initiatives, combined with recently available symptomatic drug treatment, can allow patients with Alzheimer's disease to be maintained at home for longer. This will have the dual impact of raising the quality of care for patients and improving the quality of life

  8. Reliability Prediction

    NASA Technical Reports Server (NTRS)

    1993-01-01

    RELAV, a NASA-developed computer program, enables Systems Control Technology, Inc. (SCT) to predict performance of aircraft subsystems. RELAV provides a system level evaluation of a technology. Systems, the mechanism of a landing gear for example, are first described as a set of components performing a specific function. RELAV analyzes the total system and the individual subsystem probabilities to predict success probability, and reliability. This information is then translated into operational support and maintenance requirements. SCT provides research and development services in support of government contracts.

  9. Acquiring a Pet Dog Significantly Reduces Stress of Primary Carers for Children with Autism Spectrum Disorder: A Prospective Case Control Study

    ERIC Educational Resources Information Center

    Wright, H. F.; Hall, S.; Hames, A.; Hardiman, J.; Mills, R.; Mills, D. S.

    2015-01-01

    This study describes the impact of pet dogs on stress of primary carers of children with Autism Spectrum Disorder (ASD). Stress levels of 38 primary carers acquiring a dog and 24 controls not acquiring a dog were sampled at: Pre-intervention (17 weeks before acquiring a dog), post-intervention (3-10 weeks after acquisition) and follow-up…

  10. The placement of a social service care manager in a GP surgery as a way to improve carer access to services and improve liaison between statutory agencies.

    PubMed

    Lankshear, G.; Giarchi, G. G.; Hodges, V.

    1999-05-01

    This paper reports on a pilot project funded jointly by South and West Devon Health Authority and Devon Social Service department which sought to overcome some of the problems encountered with liaison between services, and to improve carer experience and access to social services. This involved the placement in a Plymouth general practitioner (GP) surgery of a social service care manager who worked from the surgery and was allocated extra hours for carer support work. The project was evaluated and compared with the current experience of carers in the more 'traditional' setting. The experience and attitude of GPs in two other surgeries were also explored. The traditional model of work seen in Surgery B and C, the comparison surgeries, was a crisis intervention model which was regarded as adequate by the GPs involved, who had no experience of any other way of working. They directed the carers to telephone or write to social services themselves, or in a few cases the GP contacted social services on their behalf. However, the data showed that carers were less satisfied with this traditional model and preferred the more 'instant' access to support, made possible through the pilot worker in Surgery A. In the pilot project a short and informal visit to the pilot worker on request was seen as a relief by the carers. They had avoided the gate-keeping and bureaucracy involved in the 'normal' process. The drawing together of the various strands of the research showed conclusively that the pilot project in Surgery A was successful in meeting the majority of objectives set out for it. It has been a success in the perception of the carers and all of the professionals and staff involved. Staff involved all agreed that cross service collaboration between social services and the GP surgery had been improved, and that this had improved the service available to patients and carers.

  11. Accessibility and equity of health and social care services: exploring the views and experiences of Bangladeshi carers in South Wales, UK.

    PubMed

    Merrell, Joy; Kinsella, Faye; Murphy, Fiona; Philpin, Sue; Ali, Amina

    2006-05-01

    There is a paucity of information regarding the extent and nature of caring provided by minority ethnic communities. The proportion of older people from these communities will dramatically increase in the next 20 years, which will be accompanied by increasing health and social care needs and an increased demand for carers. A qualitative, exploratory study was conducted to identify the health and social care needs of informal carers, who were caring for a dependent adult from a Bangladeshi community in South Wales, UK. This paper focuses on Bangladeshi carers' access to formal support services provided by the statutory, private and voluntary sectors to assist them with their caring responsibilities. The findings are based on data collected using face-to-face, focused interviews with 20 Bangladeshi carers. Purposive and snowball sampling were used to recruit the sample. The data were analysed using thematic content analysis. The dimensions of accessibility and equity of quality of care were drawn upon to aid understanding of the findings. Bangladeshi carers faced a number of barriers in accessing health and social service provision, which impeded uptake of these services. Additionally, there was evidence of inequity in service provision. Recommendations for improving the accessibility of health and social care services are proposed, which may assist in promoting more equitable services for carers from the Bangladeshi community.

  12. ‘You are just left to get on with it’: qualitative study of patient and carer experiences of the transition to secondary progressive multiple sclerosis

    PubMed Central

    Davies, F; Edwards, A; Brain, K; Edwards, M; Jones, R; Wallbank, R; Robertson, N P; Wood, F

    2015-01-01

    Objectives Although the transition to secondary progressive multiple sclerosis (SPMS) is known to be a period of uncertainty for clinicians, who may find progressive disease challenging to objectively identify, little research has explored the experiences of patients and carers specifically during this transition period. Our objective was to explore what patients and their carers understand about their disease stage and describe their experiences and perspectives on the transition to SPMS. Design Semistructured qualitative interviews and subsequent validation focus groups were analysed using inductive thematic analysis. Setting South East Wales, UK. Participants 20 patients with MS and 13 carers were interviewed. Eight patients and two carers participated in focus groups. Results Four main themes around disease progression were identified. ‘Realisation’ describes how patients came to understand they had SPMS while ‘reaction’ describes their response to this realisation. The ‘realities’ of living with SPMS, including dealing with the healthcare system during this period, were described along with ‘future challenges’ envisaged by patients and carers. Conclusions Awareness that the transition to SPMS has occurred, and subsequent emotional reactions and coping strategies, varied widely between patients and their carers. The process of diagnosing the transition was often not transparent and some individuals wanted information to help them understand what the transition to SPMS meant for them. PMID:26201723

  13. Discrimination and Other Barriers to Accessing Health Care: Perspectives of Patients with Mild and Moderate Intellectual Disability and Their Carers

    PubMed Central

    Ali, Afia; Scior, Katrina; Ratti, Victoria; Strydom, Andre; King, Michael; Hassiotis, Angela

    2013-01-01

    Background People with intellectual disability have a higher prevalence of physical health problems but often experience disparities in accessing health care. In England, a number of legislative changes, policies and recommendations have been introduced to improve health care access for this population. The aim of this qualitative study was to examine the extent to which patients with intellectual disability and their carers experience discrimination or other barriers in accessing health services, and whether health care experiences have improved over the last decade years. Method and Main Findings Twenty nine participants (14 patient and carer dyads, and one carer) took part in semi-structured interviews. The interviews were audio-taped and transcribed and analysed using thematic analysis. Eight themes were identified. Half the participants thought that the patient had been treated unfairly or had been discriminated against by health services. There were accounts of negative staff attitudes and behaviour, and failure of services to make reasonable adjustments. Other barriers included problems with communication, and accessing services because of lack of knowledge of local services and service eligibility issues; lack of support and involvement of carers; and language problems in participants from minority ethnic groups. Most participants were able to report at least one example of good practice in health care provision. Suggestions for improving services are presented. Conclusion Despite some improvements to services as a result of health policies and recommendations, more progress is required to ensure that health services make reasonable adjustments to reduce both direct and indirect discrimination of people with intellectual disability. PMID:23951026

  14. Coping strategies and styles of family carers of persons with enduring mental illness: a mixed methods analysis.

    PubMed

    Kartalova-O'Doherty, Yulia; Doherty, Donna Tedstone

    2008-03-01

    A qualitative exploratory study investigated the experiences and needs of family carers of persons with enduring mental illness in Ireland. The current mixed-methods secondary study used content analysis and statistical procedures to identify and explore the coping strategies emerging from the original interviews. The majority of family carers reported use of active behavioural coping strategies, sometimes combined with active cognitive or avoidance strategies. The percentage of cares reporting use of active cognitive strategies was the lowest among those whose ill relative lived in their home, and the highest among those whose relative lived independently. Participants with identified active cognitive strategies often reported that their relative was employed or in training. Participants who reported use of avoidance strategies were significantly younger than participants who did not report use of such strategies. The lowest percentage of avoidance strategies was among participants whose ill relative lived independently, whereas the highest was among carers whose relative lived in their home. The findings of this study highlight the importance of a contextual approach to studying coping styles and processes. Further research questions and methodological implications are discussed.

  15. From Provider to Enabler of Care? Reconfiguring Local Authority Support for Older People and Carers in Leeds, 2008 to 2013

    PubMed Central

    Yeandle, Sue

    2016-01-01

    Abstract This article explores developments in the support available to older people and carers (i.e., caregivers) in the city of Leeds, United Kingdom, and examines provision changes during a period characterized by unprecedented resource constraint and new developments in national-local governance. Using documentary evidence, official statistics, and findings from recent studies led by the author, the effects of these changes on service planning and delivery and the approach taken by local actors to mitigate their impact are highlighted. The statistical data show a marked decline in some types of services for older people during a 5-year period during which the city council took steps to mobilize citizens and develop new services and system improvements. The analysis focuses on theories of social quality as a framework for analysis of the complex picture of change related to service provision. It concludes that although citizen involvement and consultations exerted a positive influence in delivering support to some older people and carers, research over a longer timescale is needed to show if these changes are adequate to protect older people and carers from the effects of ongoing budgetary constraints. PMID:27019540

  16. Strain and its correlates among carers of people with dementia in low-income and middle-income countries. A 10/66 Dementia Research Group population-based survey

    PubMed Central

    Prince, Martin; Brodaty, Henry; Uwakwe, Richard; Acosta, Daisy; Ferri, Cleusa P; Guerra, Mariella; Huang, Yueqin; Jacob, KS; Llibre Rodriguez, Juan J; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph D; Jotheeswaran, AT; Liu, Zhaorui

    2012-01-01

    Objectives In a multi-site population-based study in several middle-income countries, we aimed to investigate relative contributions of care arrangements and characteristics of carers and care recipients to strain among carers of people with dementia. Based on previous research, hypotheses focused on carer sex, care inputs, behavioural and psychological symptoms (BPSD) and socioeconomic status, together with potential buffering effects of informal support and employing paid carers. Methods In population-based catchment area surveys in 11 sites in Latin America, India and China, we analysed data collected from people with dementia and care needs, and their carers. Carer strain was assessed with the Zarit Burden Interview. Results With 673 care recipient/carer dyads interviewed (99% of those eligible), mean Zarit Burden Interview scores ranged between 17.1 and 27.9 by site. Women carers reported more strain than men. The most substantial correlates of carer strain were primary stressors BPSD, dementia severity, needs for care and time spent caring. Socioeconomic status was not associated with carer strain. Those cutting back on work experienced higher strain. There was tentative evidence for a protective effect of having additional informal or paid support. Conclusions Our findings underline the global impact of caring for a person with dementia and support the need for scaling up carer support, education and training. That giving up work to care was prevalent and associated with substantial increased strain emphasizes the economic impact of caring on the household. Carer benefits, disability benefits for people with dementia and respite care should all be considered. Copyright © 2012 John Wiley & Sons, Ltd. PMID:22460403

  17. Identifying changes in the support networks of end-of-life carers using social network analysis.

    PubMed

    Leonard, Rosemary; Horsfall, Debbie; Noonan, Kerrie

    2015-06-01

    End-of-life caring is often associated with reduced social networks for both the dying person and for the carer. However, those adopting a community participation and development approach, see the potential for the expansion and strengthening of networks. This paper uses Knox, Savage and Harvey's definitions of three generations social network analysis to analyse the caring networks of people with a terminal illness who are being cared for at home and identifies changes in these caring networks that occurred over the period of caring. Participatory network mapping of initial and current networks was used in nine focus groups. The analysis used key concepts from social network analysis (size, density, transitivity, betweenness and local clustering) together with qualitative analyses of the group's reflections on the maps. The results showed an increase in the size of the networks and that ties between the original members of the network strengthened. The qualitative data revealed the importance between core and peripheral network members and the diverse contributions of the network members. The research supports the value of third generation social network analysis and the potential for end-of-life caring to build social capital.

  18. Cultural safety, diversity and the servicer user and carer movement in mental health research.

    PubMed

    Cox, Leonie G; Simpson, Alan

    2015-12-01

    This study will be of interest to anyone concerned with a critical appraisal of mental health service users' and carers' participation in research collaboration and with the potential of the postcolonial paradigm of cultural safety to contribute to the service user research (SUR) movement. The history and nature of the mental health field and its relationship to colonial processes provokes a consideration of whether cultural safety could focus attention on diversity, power imbalance, cultural dominance and structural inequality, identified as barriers and tensions in SUR. We consider these issues in the context of state-driven approaches towards SUR in planning and evaluation and the concurrent rise of the SUR movement in the UK and Australia, societies with an intimate involvement in processes of colonisation. We consider the principles and motivations underlying cultural safety and SUR in the context of the policy agenda informing SUR. We conclude that while both cultural safety and SUR are underpinned by social constructionism constituting similarities in principles and intent, cultural safety has additional dimensions. Hence, we call on researchers to use the explicitly political and self-reflective process of cultural safety to think about and address issues of diversity, power and social justice in research collaboration.

  19. Evaluation of the Digital Alzheimer Center: Testing Usability and Usefulness of an Online Portal for Patients with Dementia and Their Carers

    PubMed Central

    Droes, Rose-Marie; Sikkes, Sietske; Oostra, Ellen; Lemstra, Afina W

    2016-01-01

    Background Dementia is a progressive and highly disabling neurodegenerative disease that will likely become highly prevalent in the future due to the globally aging population. To improve health care efficiency and quality for dementia care, eHealth could help with, for example, an online portal, such as the Digital Alzheimer Center (DAC) of the Vrije Universiteit Medical Center Amsterdam. It provides up-to-date disease information, peer-to-peer contact, and methods for contacting the hospital and health professionals. Objective We aimed to investigate the usability and usefulness of the DAC for patients with dementia and carers to get insight into the feasibility and value of this eHealth app in dementia care and to recommend potential improvements. Methods A descriptive study among patients, carers, and health care professionals was performed. Mixed methods were used, consisting of observations (n=10, 4 people with dementia, 6 carers), an online survey (n=287; 88 patients, 199 carers), and semistructured interviews (n=18; 6 patients, 6 carers, 6 health care professionals). During the observations, participants performed a set of five different prescribed tasks on the portal. Speed, number of errors, and navigation were noted. The online survey aimed to assess users’ opinions on the portal’s usability and usefulness. Semistructured interviews were conducted in a subsample of patients, carers, and health care professionals to gain more in-depth information. Results In the usability assessment, eight categories of errors were distinguished, of which three were of critical, two of medium, and three of low severity. In the survey, 45% (40/88) of the patients and 53% (105/199) of the carers indicated they used the portal. In all, 33% (12/36) of patients and 61% (62/102) of carers found it easy to learn to work with the portal. Most considered the DAC generally useful: 65% (17/26) of patients and 78% (67/86) of carers found the DAC useful, especially for

  20. Quality end-of-life care for dementia: What have family carers told us so far? A narrative synthesis

    PubMed Central

    Maio, Laura; Rait, Greta; Iliffe, Steve

    2014-01-01

    Background: People with dementia do not always receive good quality end-of-life care, with undertreated pain, aggressive medical interventions and limited access to hospice care being common. Family carers often provide the majority of informal care for people with dementia, therefore may be best placed to comment on quality of care. Aim: We explored what quality end-of-life care for dementia is from the perspective of family carers. Design: A review of qualitative evidence taking a systematic approach using a narrative synthesis with tabulation, textual description of studies and thematic analysis as tools, following the guidelines from the Economic and Social Research Council. Data sources: Keywords and subject headings were searched in MEDLINE, EMBASE, CINAHL, SCIE and PsycINFO for studies from 1990 in April 2012 and updated in May 2013. Reference lists were checked and citation searches undertaken. Results: Eight studies were included. There was an overarching theme of ‘A family’s belief of death and their choice of treatment’. Three further themes were then identified to explain family carers’ beliefs: the relationship with professionals as a core component of care quality; emotional and commitment pressures of caring and finally, family carers’ ability to think about death and dying. Conclusion: It is difficult to define what constitutes high-quality end-of-life care for people with dementia from the perspective of family carers. Their views expressed in the literature appear to demonstrate more variation of preference of care and treatment and their uncertainty of this. PMID:24625567

  1. Exploring the views of GPs, people with dementia and their carers on assistive technology: a qualitative study

    PubMed Central

    Newton, Lisa; Dickinson, Claire; Gibson, Grant; Brittain, Katie; Robinson, Louise

    2016-01-01

    Objectives To explore the views and experiences of people with dementia, their family carers and general practitioners (GPs) on their knowledge and experience of accessing information about, and use of, assistive technology (AT) in dementia care. Design Qualitative methods with semistructured interviews and thematic analysis. Participants 56 participants comprising 17 GPs, 13 people with dementia and 26 family carers. Setting Community care settings in the North East of England. Results 4 main themes emerged: awareness and experience of AT; accessing information on AT; roles and responsibilities in the current care system and the future commissioning of AT services. All participants had practical experience of witnessing AT being used in practice. For people with dementia and their families, knowledge was usually gained from personal experience rather than from health and social care professionals. For GPs, knowledge was largely gained through experiential, patient-led learning. All groups acknowledged the important role of the voluntary sector but agreed a need for clear information pathways for AT; such pathways were perceived to be essential to both service providers and service commissioners. Conclusions People with dementia and their family carers appear to be mainly responsible for driving a gradual increase in both awareness and the use of AT in dementia care. GPs should be equipped with the relevant knowledge to ensure families living with dementia receive appropriate information and support to enable them to live independently for as long as possible. There is an urgent need to simplify current complex community care pathways; as demonstrated in other chronic health conditions, a single point of access and a named lead professional may improve future care. PMID:27178978

  2. Measuring the Impact of Cognitive Prosthetics on the Daily Life of People with Dementia and Their Carers

    NASA Astrophysics Data System (ADS)

    Meiland, Franka; Dröes, Rose-Marie; Sävenstedt, Stefan

    Assistive technologies to support persons with dementia and their carers are used increasingly often. However, little is known about the effectiveness of most assistive devices. Much technology is put on the market without having been properly tested with potential end-users. To increase the chance that an assistive device is well accepted and useful for the target group, it is important, especially in the case of disabled persons, to involve potential users in the development process and to evaluate the impact of using the device on them before implementing it in the daily care and support. When evaluating the impact, decisions have to be made regarding the selection of measuring instruments. Important considerations in the selection process are the underlying domains to be addressed by the assistive technology, the target group and the availability of standardized instruments with good psychometric properties. In this chapter the COGKNOW project is used as a case example to explain how the impact of cognitive prosthetics on the daily lives of people with dementia and their carers can be measured. In COGKNOW a cognitive prosthetic device is being developed to improve the quality of life and autonomy of persons with dementia and to help them to remember and remind, to have social contact, to perform daily activities and to enhance feelings of safety. For all these areas, potential measuring instruments are described. Besides (standardized) measuring instruments, other data collection methods are used as well, such as semi-structured interviews and observations, diaries and in situ measurement. Within the COGKNOW project a first uncontrolled small-scale impact measurement takes place during the development process of the assistive device. However, it is recommended to perform a larger randomized controlled study as soon as the final product is ready to evaluate the impact of the device on persons with dementia and carers before it is released on the market.

  3. Illness careers and continuity of care in mental health services: a qualitative study of service users and carers.

    PubMed

    Jones, Ian Rees; Ahmed, Nilufar; Catty, Jocelyn; McLaren, Susan; Rose, Diana; Wykes, Til; Burns, Tom

    2009-08-01

    Continuity of care is considered by patients and clinicians as an essential feature of good quality care in long-term disorders, yet there is general agreement that it is a complex concept and the lack of clarity in its conceptualisation and operationalisation has been linked to a deficit of user involvement. In this paper we utilise the concept of the 'patient career' to frame patient accounts of their experiences of the mental health care system. We aimed to capture the experiences and views of users and carers focusing on the meanings associated with particular (dis)continuities and transitional episodes that occurred over their illness career. As part of a large longitudinal study of continuity of care in mental health a sub-sample of 31 users was selected together with 14 of their carers. Qualitative interviews framed around the service user's illness career explored general experiences of relationship with services, care, continuity and transition from both user and carer perspectives. Five key themes emerged: relational (dis)continuity; depersonalised transitions; invisibility and crisis; communicative gaps and social vulnerability. One of the important findings was the fragility of continuity and its relationship to levels of satisfaction. Supportive, long-term relationships could be quickly undermined by a range of factors and satisfaction levels were often closely related to moments of transition where these relationships were vulnerable. Examples of continuity and well managed transitions highlighted the importance of professionals personalising transitions and situating them in the context of the daily life of service users. Further research is required to identify how best to negotiate these key points of transition in the future. PMID:19577834

  4. Dying from cancer in developed and developing countries: lessons from two qualitative interview studies of patients and their carers

    PubMed Central

    Murray, Scott A; Grant, Elizabeth; Grant, Angus; Kendall, Marilyn

    2003-01-01

    Objective To describe the experiences of illness and needs and use of services in two groups of patients with incurable cancer, one in a developed country and the other in a developing country. Design Scotland: longitudinal study with qualitative interviews. Kenya: cross sectional study with qualitative interviews. Settings Lothian region, Scotland, and Meru District, Kenya. Participants Scotland: 20 patients with inoperable lung cancer and their carers. Kenya: 24 patients with common advanced cancers and their main informal carers. Main outcome measures Descriptions of experiences, needs, and available services. Results 67 interviews were conducted in Scotland and 46 in Kenya. The emotional pain of facing death was the prime concern of Scottish patients and their carers, while physical pain and financial worries dominated the lives of Kenyan patients and their carers. In Scotland, free health and social services (including financial assistance) were available, but sometimes underused. In Kenya, analgesia, essential equipment, suitable food, and assistance in care were often inaccessible and unaffordable, resulting in considerable unmet physical needs. Kenyan patients thought that their psychological, social, and spiritual needs were met by their families, local community, and religious groups. Some Scottish patients thought that such non-physical needs went unmet. Conclusions In patients living in developed and developing countries there are differences not only in resources available for patients dying from cancer but also in their lived experience of illness. The expression of needs and how they are met in different cultural contexts can inform local assessment of needs and provide insights for initiatives in holistic cancer care. What is already known on this topic?Cancer treatment is a priority and is well developed in the United KingdomThere is an increasing burden on inadequately funded health services in developing countriesWhat this study adds

  5. "It is always HIV/AIDS and TB": Home-based carers' perspectives on epilepsy in Cape Town, South Africa.

    PubMed

    Keikelame, Mpoe Johannah; Swartz, Leslie

    2016-01-01

    The study highlights the complex cultural religious factors affecting epilepsy and a need for integrated home-based care services. Two focus group discussions exploring home-based carers' (HBCs) perspectives on epilepsy were conducted using a semi-structured focus group interview guide, which was based on Kleinman's explanatory model framework. The audio-recorded data were transcribed verbatim, and a thematic analysis was done. The three main themes were epilepsy names and metaphors, religious beliefs about the cause and treatment of epilepsy, and HBCs' perceived roles and strategies for engaging in epilepsy care. Findings provide some insights for research, policy, and practice. PMID:27258583

  6. Peer support for family carers of people with dementia, alone or in combination with group reminiscence in a factorial design: study protocol for a randomised controlled trial

    PubMed Central

    2011-01-01

    Background Peer support interventions can improve carer wellbeing and interventions that engage both the carer and person with dementia can have significant mutual benefits. Existing research has been criticised for inadequate rigour of design or reporting. This paper describes the protocol for a complex trial that evaluates one-to-one peer support and a group reminiscence programme, both separately and together, in a factorial design. Design A 2 × 2 factorial multi-site randomised controlled trial of individual peer support and group reminiscence interventions for family carers and people with dementia in community settings in England, addressing both effectiveness and cost-effectiveness. Discussion The methods described in this protocol have implications for research into psychosocial interventions, particularly complex interventions seeking to test both individual and group approaches. Trial Registration ISRCTN37956201 PMID:21917187

  7. Intimacy--meeting needs and respecting privacy in the care of elderly people: what is a good moral attitude on the part of the nurse/carer?

    PubMed

    Mattiasson, A C; Hemberg, M

    1998-11-01

    This article explores notions of intimacy in the caring context. The aspects discussed are: privacy and intimacy; intimacy as emotional and/or physical closeness; intimacy as touch; sexual intimacy and normal ageing; sexual intimacy and patients suffering from dementia; and intimacy as trust. Examples are given and problems are identified, with reflection on the attitude and behaviour of the carer. It is suggested that when trying to make moral decisions in concrete situations it is imperative that the carer is aware of the values upon which his or her own thinking is based. It is argued that the guiding principle should be the moral assumption that the carer's responsibility can never be interpreted as a right to disregard the wishes of the patient. Hence, the key word in daily care is 'respect'. PMID:9856070

  8. Electronic tracking for people with dementia: an exploratory study of the ethical issues experienced by carers in making decisions about usage.

    PubMed

    White, Eleanor Bantry; Montgomery, Paul

    2014-03-01

    Electronic tracking through GPS (global positioning system) is being used to monitor and locate people with dementia who are vulnerable to becoming lost. Through a review of the literature and an original study, this article examined ethical issues associated with use in a domestic setting. The qualitative study consisted of in-depth interviews with 10 carers who were using electronic tracking. The study explored the values, beliefs and contextual factors that motivated carers to use electronic tracking. It examined the extent of involvement of the person with dementia in decision-making and it explored the various ethical dilemmas encountered by carers when introducing the tracking system. As an issue that emerged from the interviews, specific attention was paid to exploring covert usage. From the study findings, recommendations have been made for research and practice about the use of electronic tracking in dementia care.

  9. Acquiring a Pet Dog Significantly Reduces Stress of Primary Carers for Children with Autism Spectrum Disorder: A Prospective Case Control Study.

    PubMed

    Wright, H F; Hall, S; Hames, A; Hardiman, J; Mills, R; Mills, D S

    2015-08-01

    This study describes the impact of pet dogs on stress of primary carers of children with Autism Spectrum Disorder (ASD). Stress levels of 38 primary carers acquiring a dog and 24 controls not acquiring a dog were sampled at: Pre-intervention (17 weeks before acquiring a dog), post-intervention (3-10 weeks after acquisition) and follow-up (25-40 weeks after acquisition), using the Parenting Stress Index. Analysis revealed significant improvements in the intervention compared to the control group for Total Stress, Parental Distress and Difficult Child. A significant number of parents in the intervention group moved from clinically high to normal levels of Parental Distress. The results highlight the potential of pet dogs to reduce stress in primary carers of children with an ASD. PMID:25832799

  10. Caring Situation, Health, Self-efficacy, and Stress in Young Informal Carers of Family and Friends with Mental Illness in Sweden.

    PubMed

    Ali, Lilas; Krevers, Barbro; Skärsäter, Ingela

    2015-06-01

    This study compared the caring situation, health, self-efficacy, and stress of young (16-25) informal carers (YICs) supporting a family member with mental illness with that of YICs supporting a friend. A sample of 225 carers, assigned to a family group (n = 97) or a friend group (n = 128) completed the questionnaire. It was found that the family group experiences a lower level of support and friends experienced a lower positive value of caring. No other differences in health, general self-efficacy and stress were found. YICs endure different social situations, which is why further study of the needs of YICs, especially those supporting friends, is urgently needed.

  11. Recovery from Borderline Personality Disorder: A Systematic Review of the Perspectives of Consumers, Clinicians, Family and Carers

    PubMed Central

    Ng, Fiona Y. Y.; Bourke, Marianne E.; Grenyer, Brin F. S.

    2016-01-01

    Purpose Longitudinal studies support that symptomatic remission from Borderline Personality Disorder (BPD) is common, but recovery from the disorder probably involves a broader set of changes in psychosocial function over and above symptom relief. A systematic review of literature on both symptomatic and personal recovery from BPD was conducted including the views of consumers, clinicians, family and carers. Materials and Methods A PRISMA guided systematic search identified research examining the process of recovery from BPD. Longitudinal studies with a follow-up period of five or more years were included to avoid treatment effects. Results There were 19 studies, representing 11 unique cohorts (1,122 consumers) meeting the review criteria. There was a limited focus on personal recovery and the views of family and carers were absent from the literature. Rates of remission and recovery differ depending upon individual and methodological differences between studies. Data on symptomatic remission, recurrence and diagnosis retainment suggests that BPD is a stable condition, where symptomatic remission is possible and the likelihood of recurrence following a period of remission is low. Conclusion Symptomatic remission from BPD is common. However, recovery including capacities such as engaging in meaningful work was seldom described. Future research needs broader measures of recovery as a sub-syndromal experience, monitoring consumer engagement in meaningful vocation and relationships, with or without the limitations of BPD. PMID:27504634

  12. United States - The Leukemia & Lymphoma Society: Working with patients, carers and hospital professionals to improve awareness, treatment and patient choice.

    PubMed

    2014-01-01

    By working locally with patients and carers from diagnosis and treatment through to aftercare, helping professionals to improve their knowledge and awareness about blood cancers and best practice treatment, while also advocating at the national level, the Leukemia & Lymphoma Society (LLS) is working to strengthen coordination between patients, carers and professionals along the whole care pathway. By helping patients to become more engaged and empowered to make informed choices, improve treatment for blood cancers through education, LLS is working to enhance patient-centred care in a largely privatized and fragmented health services system in the United States. By providing web-based resources and a free national helpline, alongside a face to face local support network, LLS is helping patients to learn more about their condition, treatment choices and the care pathways they can access. Free professional development and education seminars are also offered to nurses, oncologists and social workers in hospitals, highlighting new approaches to treatment and care with a patient-centred approach.

  13. Working family carers in Portugal: between the duty and the burden of caring for old vulnerable people.

    PubMed

    Fonseca, António M; Gonçalves, Daniela C; Pereira, Sandra M

    2010-10-01

    This paper intends to reflect on some of the predominant traits of caring for older vulnerable people in Portugal, where the most common care model is a mix of informal home-based provision and support from the public and private sectors. We shall address some issues concerning the risks and limits of informal caretaking of older dependent people based on a case study of a woman who has to fulfil multiple roles, pushing her to the limit of her ability to cope. Evidence indicates that solutions to the challenges of caring for an ageing population, especially those in a vulnerable condition, require a consideration of material, social, cultural, and psychological measures. On the basis of the nature of the links between these areas, the quality of the care provided and the consequences for the working family carers, we can define standards of caring solutions for older people and hence derive policies for preventive and optimized interventions. Our final aim is to emphasize the importance of palliative care settings to improve the quality of life and minimize the suffering of both older people and their carers.

  14. People with dementia and carers' experiences of dementia care and services: Outcomes of a focus group study.

    PubMed

    Sutcliffe, Caroline L; Roe, Brenda; Jasper, Rowan; Jolley, David; Challis, David J

    2015-11-01

    An ageing population and an associated increase in the prevalence of dementia are of increasing concern in the United Kingdom and worldwide. Recently, the United Kingdom and other European countries implemented national dementia strategies to address this. This paper reports on the outcomes of a focus group study involving people with dementia and carers on their experiences of dementia care and support services in relation to government and third sector agencies' objectives and recommendations. Three focus groups comprising carers and people with dementia (n = 27) were undertaken covering topics related to experiences, service receipt, information sharing and service development. Some participants experienced difficulties or delays in receiving a dementia diagnosis and in accessing appropriate care. The provision of training, timeliness of information, access to appropriate advice, and consistent and flexible services were deemed important. The findings suggest that some issues raised by participants were highlighted in earlier policy objectives and recommendations but remain of central concern. The projected growth in the number of people with dementia coupled with reduced availability of informal care and increased demand for services emphasises the need to transform dementia care in the United Kingdom.

  15. Reliability model generator

    NASA Technical Reports Server (NTRS)

    McMann, Catherine M. (Inventor); Cohen, Gerald C. (Inventor)

    1991-01-01

    An improved method and system for automatically generating reliability models for use with a reliability evaluation tool is described. The reliability model generator of the present invention includes means for storing a plurality of low level reliability models which represent the reliability characteristics for low level system components. In addition, the present invention includes means for defining the interconnection of the low level reliability models via a system architecture description. In accordance with the principles of the present invention, a reliability model for the entire system is automatically generated by aggregating the low level reliability models based on the system architecture description.

  16. A General Practice-Based Prevalence Study of Epilepsy among Adults with Intellectual Disabilities and of Its Association with Psychiatric Disorder, Behaviour Disturbance and Carer Stress

    ERIC Educational Resources Information Center

    Matthews, T.; Weston, N.; Baxter, H.; Felce, D.; Kerr, M.

    2008-01-01

    Background: Although the elevated occurrence of epilepsy in people with intellectual disabilities (ID) is well recognized, the nature of seizures and their association with psychopathology and carer strain are less clearly understood. The aims were to determine the prevalence and features of epilepsy in a community-based population of adults with…

  17. Psycho-educational support for relatives of people with a recent diagnosis of mild to moderate dementia: an evaluation of a 'Course for Carers'.

    PubMed

    Milne, Alisoun; Guss, Reinhard; Russ, Andrew

    2014-11-01

    Currently there are 820,000 people with dementia in the UK, a figure projected to reach 1.7 million by 2050. Policy and practice emphasis on early intervention in dementia and support of family carers foreground a need to explore service efficacy for relatives of those with a recent diagnosis. Existing evidence suggests that psycho-educational interventions can significantly enhance carer well being especially when well targeted and group based. A rolling programme of seven psycho-educational Courses for 'new carers' in one area of England was the subject of a systematic evaluation incorporating a quantitative rating scale and qualitative data. Findings suggest that the Courses achieved a number of intersecting aims: they provided psychological support; offered advice; enhanced coping skills; boosted confidence; increased knowledge; and prepared the carer for the future. That the Courses were designed and delivered by specialist staff - primarily psychologists, offered a social dimension, were time limited and free are noteworthy features. The evaluation suggests that as a model the Course has considerable short and longer term preventive potential; also that it could be replicated elsewhere in the country and achieve similar outcomes. PMID:24339082

  18. The Mutual Benefits of Listening to Young People in Care, with a Particular Focus on Grief and Loss: An Irish Foster Carer's Perspective

    ERIC Educational Resources Information Center

    Murphy, Deirdre; Jenkinson, Hilary

    2012-01-01

    This article explores the mutual benefits for social workers and young people of active listening within a collaborative partnership incorporating foster carers, allowing the possibility to create a virtuous circle. The benefits for young people of increased self-esteem, positive identity and resilience among others are explored. The benefits for…

  19. "It Is Hard to Stay in England": Itineraries, Routes, and Dead Ends--An (Im)mobility Study of Nurses Who Became Carers

    ERIC Educational Resources Information Center

    Cuban, Sondra

    2010-01-01

    This article presents findings from an Economic Social Research Council (ESRC) study on the roles of education in the trajectories of health care professionals who migrated to England and became carers. The study looks at the downward mobility and deskilling of these women, and their struggles to reverse their bungled career paths. The author maps…

  20. Caring for a Child with Autism Spectrum Disorder and Parents' Quality of Life: Application of the CarerQol

    ERIC Educational Resources Information Center

    Hoefman, Renske; Payakachat, Nalin; van Exel, Job; Kuhlthau, Karen; Kovacs, Erica; Pyne, Jeffrey; Tilford, J. Mick

    2014-01-01

    This study describes the impact of caregiving on parents of children with autism spectrum disorders (ASDs). Secondly, we investigate construct validation of the care-related quality of life instrument (CarerQol) measuring impact of caregiving. Primary caregivers of children with ASDs were included. Many parents experienced considerable problems…

  1. Brief Report: Impact of Applied Behaviour Analysis (ABA) on Carer Burden and Community Participation in Challenging Behaviour--Results from a Randomised Controlled Trial

    ERIC Educational Resources Information Center

    Hassiotis, A.; Robotham, D.; Canagasabey, A.; Marston, L.; Thomas, B.; King, M.

    2012-01-01

    Background: Applied behaviour analysis (ABA) reduces challenging behaviour in people with intellectual disability. There is interest, however, in whether such interventions reduce carer burden and increase community participation in this group. Methods: A 6-month randomised controlled trial was followed by a longer-term naturalistic follow-up of…

  2. A qualitative study into the use of formal services for dementia by carers from culturally and linguistically diverse (CALD) communities

    PubMed Central

    2012-01-01

    Background People with dementia and their family carers need to be able to access formal services in the community to help maintain their wellbeing and independence. While knowing about and navigating one’s way through service systems is difficult for most people, it is particularly difficult for people from culturally and linguistically diverse (CALD) communities. This study addresses a lack of literature on the use of formal services for dementia by people from CALD backgrounds by examining the experiences and perceptions of dementia caregiving within four CALD communities – Italian, Chinese, Spanish and Arabic-speaking – in south western Sydney, Australia. Methods The study used a qualitative design and the methods included focus groups with family carers and one-to-one interviews with bilingual/bicultural community workers, bilingual general practitioners and geriatricians. A total of 121 family carers participated in 15 focus groups and interviews were held with 60 health professionals. All fieldwork was audiotaped, transcribed and subjected to thematic analysis. Results People from CALD communities are often unfamiliar with the concept of formal services and there may be strong cultural norms about maintaining care within the family, rather than relying on external services. CALD communities often have limited knowledge of services. There is a preference for services that will allow families to keep their relative at home, for safety as well as cultural reasons, and they are particularly reluctant to use residential care. While there is a preference for ethno-specific or multicultural services, mainstream services also need to ensure they are more flexible in providing culturally appropriate care. Positive outcomes occur when ethno-specific services work in partnership with mainstream programs. Dementia service providers need to develop a trusting relationship with their local CALD communities and promote their services in a way that is understandable

  3. Reliability Generalization: "Lapsus Linguae"

    ERIC Educational Resources Information Center

    Smith, Julie M.

    2011-01-01

    This study examines the proposed Reliability Generalization (RG) method for studying reliability. RG employs the application of meta-analytic techniques similar to those used in validity generalization studies to examine reliability coefficients. This study explains why RG does not provide a proper research method for the study of reliability,…

  4. Can There Be Reliability without "Reliability?"

    ERIC Educational Resources Information Center

    Mislevy, Robert J.

    2004-01-01

    An "Educational Researcher" article by Pamela Moss (1994) asks the title question, "Can there be validity without reliability?" Yes, she answers, if by reliability one means "consistency among independent observations intended as interchangeable" (Moss, 1994, p. 7), quantified by internal consistency indices such as KR-20 coefficients and…

  5. HELIOS Critical Design Review: Reliability

    NASA Technical Reports Server (NTRS)

    Benoehr, H. C.; Herholz, J.; Prem, H.; Mann, D.; Reichert, L.; Rupp, W.; Campbell, D.; Boettger, H.; Zerwes, G.; Kurvin, C.

    1972-01-01

    This paper presents Helios Critical Design Review Reliability form October 16-20, 1972. The topics include: 1) Reliability Requirement; 2) Reliability Apportionment; 3) Failure Rates; 4) Reliability Assessment; 5) Reliability Block Diagram; and 5) Reliability Information Sheet.

  6. Perceived barriers and facilitators to positive therapeutic change for people with intellectual disabilities: Client, carer and clinical psychologist perspectives.

    PubMed

    Ramsden, Sarah; Tickle, Anna; Dawson, David L; Harris, Samantha

    2016-09-01

    Studies have highlighted successful outcomes of psychological therapies for people with intellectual disabilities. However, processes underlying these outcomes are uncertain. Thematic analysis was used to explore the perceptions of three clinical psychologists, six clients and six carers of barriers and facilitators to therapeutic change for people with intellectual disabilities. Six themes were identified relating to: what the client brings as an individual and with regard to their wider system; therapy factors, including the therapeutic relationship and adaptations; psychologists acting as a 'mental health GP' to coordinate care; systemic dependency; and the concept of the revolving door in intellectual disability services. The influence of barriers and facilitators to change is complex, with facilitators overcoming barriers and yet simultaneously creating more barriers. Given their potential impact on the psychologists' roles and access to therapy for people with intellectual disabilities, findings suggest these factors should be formulated as part of the therapeutic process.

  7. The involvement of users and carers in health and social research: the realities of inclusion and engagement.

    PubMed

    Read, Sue; Maslin-Prothero, Sian

    2011-05-01

    In this article we explore the challenges to researchers intending to involve vulnerable populations in health and social care research, and provide evidence-based recommendations to support the proactive inclusion of these populations in the research process. We provide a rationale for the study, followed by the introduction and descriptions of our research experiences (presented as two case studies) to provide a contextual backcloth for the discussion.We highlight the inherent challenges in empowering vulnerable populations in research, based on the combination of our own and other people's experiences. Collectively, these illustrate and underpin practice issues, relate theory to practice in a meaningful way, and facilitate the recognition of the realities in future development in this important area of involving users and carers. We conclude by providing recommendations for future practice and research development from a wider, international perspective. PMID:21172921

  8. Assuring reliability program effectiveness.

    NASA Technical Reports Server (NTRS)

    Ball, L. W.

    1973-01-01

    An attempt is made to provide simple identification and description of techniques that have proved to be most useful either in developing a new product or in improving reliability of an established product. The first reliability task is obtaining and organizing parts failure rate data. Other tasks are parts screening, tabulation of general failure rates, preventive maintenance, prediction of new product reliability, and statistical demonstration of achieved reliability. Five principal tasks for improving reliability involve the physics of failure research, derating of internal stresses, control of external stresses, functional redundancy, and failure effects control. A final task is the training and motivation of reliability specialist engineers.

  9. Human Reliability Program Overview

    SciTech Connect

    Bodin, Michael

    2012-09-25

    This presentation covers the high points of the Human Reliability Program, including certification/decertification, critical positions, due process, organizational structure, program components, personnel security, an overview of the US DOE reliability program, retirees and academia, and security program integration.

  10. Power electronics reliability analysis.

    SciTech Connect

    Smith, Mark A.; Atcitty, Stanley

    2009-12-01

    This report provides the DOE and industry with a general process for analyzing power electronics reliability. The analysis can help with understanding the main causes of failures, downtime, and cost and how to reduce them. One approach is to collect field maintenance data and use it directly to calculate reliability metrics related to each cause. Another approach is to model the functional structure of the equipment using a fault tree to derive system reliability from component reliability. Analysis of a fictitious device demonstrates the latter process. Optimization can use the resulting baseline model to decide how to improve reliability and/or lower costs. It is recommended that both electric utilities and equipment manufacturers make provisions to collect and share data in order to lay the groundwork for improving reliability into the future. Reliability analysis helps guide reliability improvements in hardware and software technology including condition monitoring and prognostics and health management.

  11. Reliable Design Versus Trust

    NASA Technical Reports Server (NTRS)

    Berg, Melanie; LaBel, Kenneth A.

    2016-01-01

    This presentation focuses on reliability and trust for the users portion of the FPGA design flow. It is assumed that the manufacturer prior to hand-off to the user tests FPGA internal components. The objective is to present the challenges of creating reliable and trusted designs. The following will be addressed: What makes a design vulnerable to functional flaws (reliability) or attackers (trust)? What are the challenges for verifying a reliable design versus a trusted design?

  12. Reliability in aposematic signaling

    PubMed Central

    2010-01-01

    In light of recent work, we will expand on the role and variability of aposematic signals. The focus of this review will be the concepts of reliability and honesty in aposematic signaling. We claim that reliable signaling can solve the problem of aposematic evolution, and that variability in reliability can shed light on the complexity of aposematic systems. PMID:20539774

  13. Viking Lander reliability program

    NASA Technical Reports Server (NTRS)

    Pilny, M. J.

    1978-01-01

    The Viking Lander reliability program is reviewed with attention given to the development of the reliability program requirements, reliability program management, documents evaluation, failure modes evaluation, production variation control, failure reporting and correction, and the parts program. Lander hardware failures which have occurred during the mission are listed.

  14. Reliability as Argument

    ERIC Educational Resources Information Center

    Parkes, Jay

    2007-01-01

    Reliability consists of both important social and scientific values and methods for evidencing those values, though in practice methods are often conflated with the values. With the two distinctly understood, a reliability argument can be made that articulates the particular reliability values most relevant to the particular measurement situation…

  15. Reliability model generator specification

    NASA Technical Reports Server (NTRS)

    Cohen, Gerald C.; Mccann, Catherine

    1990-01-01

    The Reliability Model Generator (RMG), a program which produces reliability models from block diagrams for ASSIST, the interface for the reliability evaluation tool SURE is described. An account is given of motivation for RMG and the implemented algorithms are discussed. The appendices contain the algorithms and two detailed traces of examples.

  16. 'Singing for the Brain': A qualitative study exploring the health and well-being benefits of singing for people with dementia and their carers.

    PubMed

    Osman, Sara Eldirdiry; Tischler, Victoria; Schneider, Justine

    2014-11-24

    Dementia has detrimental effects on cognitive, psychological and behavioural functioning, as well as significant impact on those who provide care. There is a need to find suitable psychosocial interventions to help manage the condition, enhance well-being, and to provide support for caregivers. This study explored the impact of Singing for the Brain™, an intervention based on group singing activities developed by The Alzheimer's Society for people with dementia and their carers. This qualitative study used semi-structured interviews with people with dementia and their carers. Ten interviews involving 20 participants were analysed thematically. Social inclusiveness and improvements in relationships, memory and mood were found to be especially important to participants. As well as enjoying the sessions, participants found that attending Singing for the Brain™ helped in accepting and coping with dementia. PMID:25425445

  17. Managing people with mental health presentations in emergency departments--a service exploration of the issues surrounding responsiveness from a mental health care consumer and carer perspective.

    PubMed

    Morphet, Julia; Innes, Kelli; Munro, Ian; O'Brien, Anthony; Gaskin, Cadeyrn J; Reed, Fiona; Kudinoff, Teresa

    2012-08-01

    Mainstreaming of mental health services (MHS) within the Australian medical system has generated a fundamental transformation in the way consumers and carers access emergency MHS. People present to the Emergency Department (ED) with many health issues which can often include the management of their mental illness, physical co morbidity, or substance use. This paper discusses the issues surrounding access to EDs for clients, families and staff in the context of presentations for mental health problems at a southern metropolitan hospital in Victoria. The pilot project utilised focus groups with mental health care consumers and carers to collaboratively focus on and document the mental health client's 'journey of care' in the ED. There is evidence to suggest from this project that the ED mental health client journey needs continuous improvement and evaluation.

  18. Dementia and Robotics: People with Advancing Dementia and Their Carers Driving an Exploration into an Engineering Solution to Maintaining Safe Exercise Regimes.

    PubMed

    Cooper, Carol; Penders, Jacques; Procter, Paula M

    2016-01-01

    The merging of the human world and the information technology world is advancing at a pace, even for those with dementia there are many useful smart 'phone applications including reminders, family pictures display, GPS functions and video communications. This paper will report upon initial collaborative work developing a robotic solution to engaging individuals with advancing dementia in safe exercise regimes. The research team has been driven by the needs of people with advancing dementia and their carers through a focus group methodology, the format, discussions and outcomes of these groups will be reported. The plans for the next stage of the research will be outlined including the continuing collaboration with advancing dementia and their carers. PMID:27332260

  19. REMCARE: Pragmatic Multi-Centre Randomised Trial of Reminiscence Groups for People with Dementia and their Family Carers: Effectiveness and Economic Analysis

    PubMed Central

    Orrell, Martin; Bruce, Errollyn; Edwards, Rhiannon T.; Hounsome, Barry; Keady, John; Orgeta, Vasiliki; Rees, Janice

    2016-01-01

    Background Joint reminiscence groups, involving people with dementia and family carers together, are popular, but the evidence-base is limited. This study aimed to assess the effectiveness and cost-effectiveness of joint reminiscence groups as compared to usual care. Methods This multi-centre, pragmatic randomised controlled trial had two parallel arms: intervention group and usual-care control group. A restricted dynamic method of randomisation was used, with an overall allocation ratio of 1:1, restricted to ensure viable sized intervention groups. Assessments, blind to treatment allocation, were carried out at baseline, three months and ten months (primary end-point), usually in the person's home. Participants were recruited in eight centres, mainly through NHS Memory Clinics and NHS community mental health teams. Included participants were community resident people with mild to moderate dementia (DSM-IV), who had a relative or other care-giver in regular contact, to act as informant and willing and able to participate in intervention. 71% carers were spouses. 488 people with dementia (mean age 77.5)were randomised: 268 intervention, 220 control; 350 dyads completed the study (206 intervention, 144 control). The intervention evaluated was joint reminiscence groups (with up to 12 dyads) weekly for twelve weeks; monthly maintenance sessions for further seven months. Sessions followed a published treatment manual and were held in a variety of community settings. Two trained facilitators in each centre were supported by volunteers. Primary outcome measures were self-reported quality of life for the person with dementia (QoL-AD), psychological distress for the carer (General Health Questionnaire, GHQ-28). Secondary outcome measures included: autobiographical memory and activities of daily living for the person with dementia; carer stress for the carer; mood, relationship quality and service use and costs for both. Results The intention to treat analysis (ANCOVA

  20. "I Can't Go to School and Leave Her in so Much Pain": Educational Shortfalls among Adolescent "Young Carers" in the South African AIDS Epidemic

    ERIC Educational Resources Information Center

    Cluver, L.; Operario, D.; Lane, T.; Kganakga, M.

    2012-01-01

    "I go to the hospital with my mother when she is sick. I can't go to school and leave her in so much pain. I won't concentrate." Millions of adolescents live with AIDS-affected parents or primary caregivers. Little is known about educational impacts of living in an AIDS-affected home, or of acting as a "young carer" in the context of AIDS. This…

  1. Qualitative process evaluation of a problem-solving guided self-help manual for family carers of young people with first-episode psychosis

    PubMed Central

    2014-01-01

    Background Caring for a young person experiencing first-episode psychosis is challenging and can affect carers’ well-being adversely. While some face-to-face approaches have achieved promising outcomes, they are costly and resource-intensive to provide, restricting their reach and penetration. Guided self-help in book-form (or bibliotherapy) is an alternative but untested approach in these circumstances. In this study, we aimed to evaluate carers’ beliefs about the usefulness of problem-solving guided self-help manual for primary carers of young people with first-episode psychosis. Methods A qualitative process evaluation nested in a randomised controlled trial, conducted across two early intervention psychosis services in Melbourne, Australia. 124 carers were randomised to problem-solving guided self-help intervention or treatment as usual. We also undertook a qualitative process evaluation, using individual interviews, with a random sample of 24 of the intervention group. A thematic analysis of the qualitative data was undertaken, which is the subject of this paper. Interviews were conducted between January 2009 and September 2010. Results Three themes were abstracted from the data, reflecting carers’ beliefs about the usefulness of the manual: promoting carers’ well-being, increasing carers’ understanding of and support for the young person with first-episode psychosis, and accessibility and delivery modes of the programme. Conclusion This process evaluation highlights that guided self-help is useful in informing and supporting carers of affected young people. While there is scope for broadening the delivery modes, the approach is easy to use and accessible, and can be used as a cost-effective adjunct to standard support provided to carers, by community mental health nurses and other clinicians. Trial registration ACTRN12609000064202 PMID:24906392

  2. Perceptions of heatwave risks to health: results of an qualitative interview study with older people and their carers in Freiburg, Germany

    PubMed Central

    Bittner, Martin-Immanuel; Stößel, Ulrich

    2012-01-01

    Aims and objectives: Heatwaves can pose a severe threat to health, especially to older people. However, warnings do not necessarily lead to preventive action. This study aims at exploring individual risk perception and adaptive measures of older people and their carers. Their views are explored, taking into account personal backgrounds. Methods: Questionnaire-based interviews were administered to 20 men and women (64–94 years, living in their own homes or nursing homes) and 13 carers. A qualitative analysis following a framework approach was performed. Results: The majority of respondents stated that older people might be compromised by heatwaves; however, a large proportion of respondents saw themselves as less affected than the average population. Most respondents adopted preventive measures during heatwaves and a majority received warnings or pieces of information. The role of general practitioners in direct warning situations was judged controversial. Survey respondents displayed resistance to the use of technical devices to monitor potentially dangerous situations. In addition, the results support many previous findings. In particular, the relative concepts of ageing, variety of information channels used, and control orientations could be confirmed. Conclusions: General practitioners hold a position of trust and play a central role in the promotion of preventive action, but there are also limitations to their outreach. Many respondents could be classified as socially active, which has implications for preventive information campaigns. Information campaigns using different channels and targeting a larger audience should be considered. The degree of information of carers can partly be improved. PMID:23082104

  3. Human reliability analysis

    SciTech Connect

    Dougherty, E.M.; Fragola, J.R.

    1988-01-01

    The authors present a treatment of human reliability analysis incorporating an introduction to probabilistic risk assessment for nuclear power generating stations. They treat the subject according to the framework established for general systems theory. Draws upon reliability analysis, psychology, human factors engineering, and statistics, integrating elements of these fields within a systems framework. Provides a history of human reliability analysis, and includes examples of the application of the systems approach.

  4. Reliability of fluid systems

    NASA Astrophysics Data System (ADS)

    Kopáček, Jaroslav; Fojtášek, Kamil; Dvořák, Lukáš

    2016-03-01

    This paper focuses on the importance of detection reliability, especially in complex fluid systems for demanding production technology. The initial criterion for assessing the reliability is the failure of object (element), which is seen as a random variable and their data (values) can be processed using by the mathematical methods of theory probability and statistics. They are defined the basic indicators of reliability and their applications in calculations of serial, parallel and backed-up systems. For illustration, there are calculation examples of indicators of reliability for various elements of the system and for the selected pneumatic circuit.

  5. Operational safety reliability research

    SciTech Connect

    Hall, R.E.; Boccio, J.L.

    1986-01-01

    Operating reactor events such as the TMI accident and the Salem automatic-trip failures raised the concern that during a plant's operating lifetime the reliability of systems could degrade from the design level that was considered in the licensing process. To address this concern, NRC is sponsoring the Operational Safety Reliability Research project. The objectives of this project are to identify the essential tasks of a reliability program and to evaluate the effectiveness and attributes of such a reliability program applicable to maintaining an acceptable level of safety during the operating lifetime at the plant.

  6. Reasons for measles cases not being vaccinated with MMR: investigation into parents' and carers' views following a large measles outbreak.

    PubMed

    McHale, P; Keenan, A; Ghebrehewet, S

    2016-03-01

    Uptake rates for the combined measles, mumps and rubella (MMR) vaccine have been below the required 95% in the UK since a retracted and discredited article linking the MMR vaccine with autism and inflammatory bowel disease was released in 1998. This study undertook semi-structured telephone interviews among parents or carers of 47 unvaccinated measles cases who were aged between 13 months and 9 years, during a large measles outbreak in Merseyside. Results showed that concerns over the specific links with autism remain an important cause of refusal to vaccinate, with over half of respondents stating this as a reason. A quarter stated child illness during scheduled vaccination time, while other reasons included general safety concerns and access issues. Over half of respondents felt that more information or a discussion with a health professional would help the decision-making process, while a third stated improved access. There was clear support for vaccination among respondents when asked about current opinions regarding MMR vaccine. The findings support the hypothesis that safety concerns remain a major barrier to MMR vaccination, and also support previous evidence that experience of measles is an important determinant in the decision to vaccinate.

  7. Facilitators and barriers in the implementation of the meeting centres model for people with dementia and their carers.

    PubMed

    Meiland, Franka J M; Dröes, Rose-Marie; de Lange, Jacomine; Vernooij-Dassen, Myrra J F J

    2005-02-01

    The implementation of care innovations that have been proven effective is not matter-of-course. In this study, we traced facilitating and impeding factors in the implementation of thirteen meeting centres for people with dementia and their carers in five different regions in The Netherlands. To guide the data collection and analyses, a theoretical model was developed that distinguishes different phases of implementation, and factors at the level of characteristics of the innovation and other preconditions. Qualitative methods were used, including interviews with 23 key figures and other written materials gathered. The interview data were double coded and analyzed, using the computer programme NVivo. Several factors proved to play a facilitating role in all phases of implementation, for example: motivated people, financial resources, continuous and varied PR-activities, and cooperation between organizations. Other important facilitating characteristics of the meeting centres were: the surplus value of the integrated support programme as compared to the local support offer, and the fact that several centres were already available as an example for new initiators. The findings were used, among other things, to develop an implementation guide, to facilitate the implementation of meeting centres. PMID:15607386

  8. Reasons for measles cases not being vaccinated with MMR: investigation into parents' and carers' views following a large measles outbreak.

    PubMed

    McHale, P; Keenan, A; Ghebrehewet, S

    2016-03-01

    Uptake rates for the combined measles, mumps and rubella (MMR) vaccine have been below the required 95% in the UK since a retracted and discredited article linking the MMR vaccine with autism and inflammatory bowel disease was released in 1998. This study undertook semi-structured telephone interviews among parents or carers of 47 unvaccinated measles cases who were aged between 13 months and 9 years, during a large measles outbreak in Merseyside. Results showed that concerns over the specific links with autism remain an important cause of refusal to vaccinate, with over half of respondents stating this as a reason. A quarter stated child illness during scheduled vaccination time, while other reasons included general safety concerns and access issues. Over half of respondents felt that more information or a discussion with a health professional would help the decision-making process, while a third stated improved access. There was clear support for vaccination among respondents when asked about current opinions regarding MMR vaccine. The findings support the hypothesis that safety concerns remain a major barrier to MMR vaccination, and also support previous evidence that experience of measles is an important determinant in the decision to vaccinate. PMID:26265115

  9. The needs of older people with mental health problems: a particular focus on dementia patients and their carers.

    PubMed

    Passos, Joaquim; Sequeira, Carlos; Fernandes, Lia

    2012-01-01

    The problems and needs of older people are often associated with mental illness, characterized by a set of clinical manifestations, which constitute important domains for investigation and clinical practice. This paper presents the results of a pilot study whose main purpose was to identify met and unmet needs and to analyze the relationship between those needs, psychopathology and functionality in older people with mental health problems. A sample of 75 patients aged 65 or over, of both sexes, diagnosed with mental illness using ICD-9. The main diagnoses were depression (36%) and dementia (29.3%). Most patients had cognitive impairment (MMSE, 52%; CDT, 66.7%), depression (GDS, 61.3%), anxiety (ZAS, 81.3%), and moderate dependence (BI, 49.3% and LI, 77.3%). The main unmet needs found were daytime activities (40%), social benefits (13.3%), company (10.7%), psychological distress (9.3%), and continence (8%). The majority of these unmet needs occur with dementia patients. The majority of the carers of these patients had global needs (met and unmet) in terms of psychological distress. Findings also reveal that a low level of functionality is associated with dementia diagnoses. The association analyses suggest that dementia is an important determinant of the functional status and needs.

  10. The Needs of Older People with Mental Health Problems: A Particular Focus on Dementia Patients and Their Carers

    PubMed Central

    Passos, Joaquim; Sequeira, Carlos; Fernandes, Lia

    2012-01-01

    The problems and needs of older people are often associated with mental illness, characterized by a set of clinical manifestations, which constitute important domains for investigation and clinical practice. This paper presents the results of a pilot study whose main purpose was to identify met and unmet needs and to analyze the relationship between those needs, psychopathology and functionality in older people with mental health problems. A sample of 75 patients aged 65 or over, of both sexes, diagnosed with mental illness using ICD-9. The main diagnoses were depression (36%) and dementia (29.3%). Most patients had cognitive impairment (MMSE, 52%; CDT, 66.7%), depression (GDS, 61.3%), anxiety (ZAS, 81.3%), and moderate dependence (BI, 49.3% and LI, 77.3%). The main unmet needs found were daytime activities (40%), social benefits (13.3%), company (10.7%), psychological distress (9.3%), and continence (8%). The majority of these unmet needs occur with dementia patients. The majority of the carers of these patients had global needs (met and unmet) in terms of psychological distress. Findings also reveal that a low level of functionality is associated with dementia diagnoses. The association analyses suggest that dementia is an important determinant of the functional status and needs. PMID:23193496

  11. First Aid Recommendations for Psychosis: Using the Delphi Method to Gain Consensus Between Mental Health Consumers, Carers, and Clinicians

    PubMed Central

    Langlands, Robyn L.; Jorm, Anthony F.; Kelly, Claire M.; Kitchener, Betty A.

    2008-01-01

    Background: Members of the general public often lack the knowledge and skills to intervene effectively to help someone who may be developing a psychotic illness before appropriate professional help is received. Methods: We used the Delphi method to determine recommendations on first aid for psychosis. An international panel of 157 mental health consumers, carers, and clinicians completed a 146-item questionnaire about how a member of the public could help someone who may be experiencing psychosis. The panel members rated each questionnaire item according to whether they believed the statement should be included in the first aid recommendations. The results were analyzed by comparing consensus rates across the 3 groups. Three rounds of ratings were required to consolidate consensus levels. Results: Eighty-nine items were endorsed by ≥80% of panel members from all 3 groups as essential or important for psychosis first aid. These items were grouped under the following 9 headings: how to know if someone is experiencing psychosis; how to approach someone who may be experiencing psychosis; how to be supportive; how to deal with delusions and hallucinations; how to deal with communication difficulties; whether to encourage the person to seek professional help; what to do if the person does not want help; what to do in a crisis situation when the person has become acutely unwell; what to do if the person becomes aggressive. Conclusions: These recommendations will improve the provision of first aid to individuals who are developing a psychotic disorder by informing the content of training courses. PMID:17768307

  12. Germany’s First Young Carers Project’s Impact on the Children: Relieving the Entire Family. A Qualitative Evaluation

    PubMed Central

    Schlarmann, Jörg große; Metzing, Sabine; Schoppmann, Susanne; Schnepp, Wilfried

    2011-01-01

    Background: In 2009, the first German young carers project “SupaKids” was implemented in a large German city. The project’s concept was mainly based on findings of a prior Grounded Theory study, and the concept’s aim was to focus on supporting enrolled families (especially the children) in order to prevent negative effects. Quantitative as well as qualitative data have been assessed for the project’s evaluation. In this paper, first results on the mainly qualitative evaluation concerning the project’s impact are presented. Results: The project has an impact on the entire family. Both parents and children perceive the project as a kind of shelter, where they a) are allowed to be as they are, b) don’t have to explain themselves, c) meet others in similar situations, d) may deposit their sorrows, e) have a first port of call for any problem, f) experience a hiatus from the domestic situation, and g) find friends and peers. All enrolled families value this shelter as a copious relief. Conclusions: The project’s concept has delivered an optimal performance in practice: the family-orientation seems to be appropriate, the concept’s modules seem to be all-embracing, and the modular body of the concept has been confirmed. The project relieves the entire family. Trial Registration Number: NCT00734942. PMID:22135716

  13. Hawaii electric system reliability.

    SciTech Connect

    Silva Monroy, Cesar Augusto; Loose, Verne William

    2012-09-01

    This report addresses Hawaii electric system reliability issues; greater emphasis is placed on short-term reliability but resource adequacy is reviewed in reference to electric consumers' views of reliability %E2%80%9Cworth%E2%80%9D and the reserve capacity required to deliver that value. The report begins with a description of the Hawaii electric system to the extent permitted by publicly available data. Electrical engineering literature in the area of electric reliability is researched and briefly reviewed. North American Electric Reliability Corporation standards and measures for generation and transmission are reviewed and identified as to their appropriateness for various portions of the electric grid and for application in Hawaii. Analysis of frequency data supplied by the State of Hawaii Public Utilities Commission is presented together with comparison and contrast of performance of each of the systems for two years, 2010 and 2011. Literature tracing the development of reliability economics is reviewed and referenced. A method is explained for integrating system cost with outage cost to determine the optimal resource adequacy given customers' views of the value contributed by reliable electric supply. The report concludes with findings and recommendations for reliability in the State of Hawaii.

  14. Bayesian methods in reliability

    NASA Astrophysics Data System (ADS)

    Sander, P.; Badoux, R.

    1991-11-01

    The present proceedings from a course on Bayesian methods in reliability encompasses Bayesian statistical methods and their computational implementation, models for analyzing censored data from nonrepairable systems, the traits of repairable systems and growth models, the use of expert judgment, and a review of the problem of forecasting software reliability. Specific issues addressed include the use of Bayesian methods to estimate the leak rate of a gas pipeline, approximate analyses under great prior uncertainty, reliability estimation techniques, and a nonhomogeneous Poisson process. Also addressed are the calibration sets and seed variables of expert judgment systems for risk assessment, experimental illustrations of the use of expert judgment for reliability testing, and analyses of the predictive quality of software-reliability growth models such as the Weibull order statistics.

  15. The impact of the carer support needs assessment tool (CSNAT) in community palliative care using a stepped wedge cluster trial.

    PubMed

    Aoun, Samar M; Grande, Gunn; Howting, Denise; Deas, Kathleen; Toye, Chris; Troeung, Lakkhina; Stajduhar, Kelli; Ewing, Gail

    2015-01-01

    Family caregiving towards the end-of-life entails considerable emotional, social, financial and physical costs for caregivers. Evidence suggests that good support can improve caregiver psychological outcomes. The primary aim of this study was to investigate the impact of using the carer support needs assessment tool (CSNAT), as an intervention to identify and address support needs in end of life home care, on family caregiver outcomes. A stepped wedge design was used to trial the CSNAT intervention in three bases of Silver Chain Hospice Care in Western Australia, 2012-14. The intervention consisted of at least two visits from nurses (2-3 weeks apart) to identify, review and address caregivers' needs. The outcome measures for the intervention and control groups were caregiver strain and distress as measured by the Family Appraisal of Caregiving Questionnaire (FACQ-PC), caregiver mental and physical health as measured by SF-12v2, and caregiver workload as measured by extent of caregiver assistance with activities of daily living, at baseline and follow up. Total recruitment was 620. There was 45% attrition for each group between baseline and follow-up mainly due to patient deaths resulting in 322 caregivers completing the study (233 in the intervention group and 89 in the control group). At follow-up, the intervention group showed significant reduction in caregiver strain relative to controls, p=0.018, d=0.348 (95% CI 0.25 to 0.41). Priority support needs identified by caregivers included knowing what to expect in the future, having time for yourself in the day and dealing with your feelings and worries. Despite the challenges at the clinician, organisational and trial levels, the CSNAT intervention led to an improvement in caregiver strain. Effective implementation of an evidence-informed and caregiver-led tool represents a necessary step towards helping palliative care providers better assess and address caregiver needs, ensuring adequate family caregiver support

  16. Multidisciplinary System Reliability Analysis

    NASA Technical Reports Server (NTRS)

    Mahadevan, Sankaran; Han, Song; Chamis, Christos C. (Technical Monitor)

    2001-01-01

    The objective of this study is to develop a new methodology for estimating the reliability of engineering systems that encompass multiple disciplines. The methodology is formulated in the context of the NESSUS probabilistic structural analysis code, developed under the leadership of NASA Glenn Research Center. The NESSUS code has been successfully applied to the reliability estimation of a variety of structural engineering systems. This study examines whether the features of NESSUS could be used to investigate the reliability of systems in other disciplines such as heat transfer, fluid mechanics, electrical circuits etc., without considerable programming effort specific to each discipline. In this study, the mechanical equivalence between system behavior models in different disciplines are investigated to achieve this objective. A new methodology is presented for the analysis of heat transfer, fluid flow, and electrical circuit problems using the structural analysis routines within NESSUS, by utilizing the equivalence between the computational quantities in different disciplines. This technique is integrated with the fast probability integration and system reliability techniques within the NESSUS code, to successfully compute the system reliability of multidisciplinary systems. Traditional as well as progressive failure analysis methods for system reliability estimation are demonstrated, through a numerical example of a heat exchanger system involving failure modes in structural, heat transfer and fluid flow disciplines.

  17. What do we know about partnership with service users and carers in social work education and how robust is the evidence base?

    PubMed

    Taylor, Imogen; Le Riche, Pat

    2006-09-01

    Partnership work with service users and carers in social work education is a policy requirement, and it is also central to the anti-oppressive and rights-based values of social work. This paper reports research findings which are drawn from an educational context, but are also relevant to the wider field of health and social care. The research team undertook a systematic knowledge review using the Evidence for Policy and Practice Information and Coordinating Centre system, which had been used in health and education, but which had not previously been used in social care and social work. This involved an extensive search of electronic databases and rigorous screening to identify studies which had sufficient relevance to be subjected to detailed analysis. The research team also undertook a practice survey of the teaching, learning and assessment of partnership in prequalifying programmes in England, Wales and Northern Ireland. This involved three stages: a document search; telephone interviews; and focus groups held with students, academic staff, and service users and carers. Throughout the research process, the interdisciplinary team was advised and supported by a stakeholder group which consisted of service users and carers, students, and employer representatives. In the second part of the paper, subsequent discussion explores key findings from the research, including the disputed nature of the concept of partnership, models of partnership work within social work education and the dearth of research on partnership outcomes. Five related questions are identified as a means of interrogating the robustness of the research process and findings. The paper concludes by arguing for work to be done to theorise partnership, and to develop effective strategies for improving the quality of partnership working in education, and health and social care practice.

  18. What do we know about partnership with service users and carers in social work education and how robust is the evidence base?

    PubMed

    Taylor, Imogen; Le Riche, Pat

    2006-09-01

    Partnership work with service users and carers in social work education is a policy requirement, and it is also central to the anti-oppressive and rights-based values of social work. This paper reports research findings which are drawn from an educational context, but are also relevant to the wider field of health and social care. The research team undertook a systematic knowledge review using the Evidence for Policy and Practice Information and Coordinating Centre system, which had been used in health and education, but which had not previously been used in social care and social work. This involved an extensive search of electronic databases and rigorous screening to identify studies which had sufficient relevance to be subjected to detailed analysis. The research team also undertook a practice survey of the teaching, learning and assessment of partnership in prequalifying programmes in England, Wales and Northern Ireland. This involved three stages: a document search; telephone interviews; and focus groups held with students, academic staff, and service users and carers. Throughout the research process, the interdisciplinary team was advised and supported by a stakeholder group which consisted of service users and carers, students, and employer representatives. In the second part of the paper, subsequent discussion explores key findings from the research, including the disputed nature of the concept of partnership, models of partnership work within social work education and the dearth of research on partnership outcomes. Five related questions are identified as a means of interrogating the robustness of the research process and findings. The paper concludes by arguing for work to be done to theorise partnership, and to develop effective strategies for improving the quality of partnership working in education, and health and social care practice. PMID:16918834

  19. How Could Hospitalisations at the End of Life Have Been Avoided? A Qualitative Retrospective Study of the Perspectives of General Practitioners, Nurses and Family Carers

    PubMed Central

    De Korte-Verhoef, Maria C.; Pasman, H. Roeline W.; Schweitzer, Bart P. M.; Francke, Anneke L.; Onwuteaka-Philipsen, Bregje D.; Deliens, Luc

    2015-01-01

    Background Although many patients prefer to stay and die at home at the end of life, many are hospitalised. Little is known about how to avoid hospitalisations for patients living at home. Aim To describe how hospitalisation at the end of life can be avoided, from the perspective of the GPs, nurses and family carers. Method A qualitative design with face-to-face interviews was used. Taking 30 cases of patients who died non-suddenly, 26 GPs, 15 nurses and 18 family carers were interviewed in depth. Of the 30 patients, 20 were hospitalised and 10 were not hospitalised in the last three months of life. Results Five key themes that could help avoid hospitalisation at the end of life emerged from the interviews. The key themes were: 1) marking the approach of death, and shifting the mindset; 2) being able to provide acute treatment and care at home; 3) anticipatory discussions and interventions to deal with expected severe problems; 4) guiding and monitoring the patient and family in a holistic way through the illness trajectory; 5) continuity of treatment and care at home. If these five key themes are adopted in an interrelated way, this could help avoid hospitalisations, according to GPs, nurses and family carers. Conclusions The five key themes described in this study can be seen as strategies that could help in avoiding hospitalisation at the end of life. It is recommended that for all patients residing at home, GPs and community nurses work together as a team from the moment that it is marked that death is approaching up to the end of life. PMID:25756184

  20. [The personalized health care process in oncosexology: a new health care offer in the service of both patients and health carers].

    PubMed

    Bondil, Pierre; Habold, Daniel; Damiano, Tony; Champsavoir, Paul

    2012-04-01

    The sexual problematic linked to both cancers and their treatments remains underestimated by health carers especially since patients dare not speak about it. The oncosexology is a new offer of health care responding to an epidemiological reality, a strong demand, a care quality process and a societal demand of ethical, technical and humanist medicine. It aims at conciliating the oncological and quality of life objectives because sexual health belongs to oncological care and quality of life belongs to well-being for a majority of people/couple. By comparison to the pain situation of 20 years ago, a proactive politics is necessary to change the individual level to a collective one by modifying the attitudes of patients and… health carers, that is, by breaking the silence, by legitimating the demand and by allowing all the actors to be open about it. The optimal strategy for actualizing the "software" of physicians, who are the main factor of resistance, consists in simplifying and professionalizing the oncosexology by responding to the needs for information and offer visibility for all, and training for the most sensitized or involved carers. The term oncosexology should not shock. This new competence in supportive care corrects a real inequality of access to health care and fits in with a medical humanism by promoting a more personalized approach as much initially as in follow-up: a) to inform about sexual risks and sequels is an ethical and legal duty, b) the therapeutic strategy may be influenced by the iatrogenic sexual risk, which is frequently treatment-dependant, c) the impact and demand evolve throughout the health care process, d) multidisciplinary solutions exist according to the demand and its simple or complex nature, e) the impact is often positive for the patient/couple. PMID:22450353

  1. Patient and carer experience of hospital-based rehabilitation from intensive care to hospital discharge: mixed methods process evaluation of the RECOVER randomised clinical trial

    PubMed Central

    Ramsay, Pam; Huby, Guro; Merriweather, Judith; Salisbury, Lisa; Rattray, Janice; Griffith, David; Walsh, Timothy

    2016-01-01

    Objectives To explore and compare patient/carer experiences of rehabilitation in the intervention and usual care arms of the RECOVER trial (ISRCTN09412438); a randomised controlled trial of a complex intervention of post-intensive care unit (ICU) acute hospital-based rehabilitation following critical illness. Design Mixed methods process evaluation including comparison of patients' and carers' experience of usual care versus the complex intervention. We integrated and compared quantitative data from a patient experience questionnaire (PEQ) with qualitative data from focus groups with patients and carers. Setting Two university-affiliated hospitals in Scotland. Participants 240 patients discharged from ICU who required ≥48 hours of mechanical ventilation were randomised into the trial (120 per trial arm). Exclusion criteria comprised: primary neurologic diagnosis, palliative care, current/planned home ventilation and age <18 years. 182 patients completed the PEQ at 3 months postrandomisation. 22 participants (14 patients and 8 carers) took part in focus groups (2 per trial group) at >3 months postrandomisation. Interventions A complex intervention of post-ICU acute hospital rehabilitation, comprising enhanced physiotherapy, nutritional care and information provision, case-managed by dedicated rehabilitation assistants (RAs) working within existing ward-based clinical teams, delivered between ICU discharge and hospital discharge. Comparator was usual care. Outcome measures A novel PEQ capturing patient-reported aspects of quality care. Results The PEQ revealed statistically significant between-group differences across 4 key intervention components: physiotherapy (p=0.039), nutritional care (p=0.038), case management (p=0.045) and information provision (p<0.001), suggesting greater patient satisfaction in the intervention group. Focus group data strongly supported and helped explain these findings. Specifically, case management by dedicated RAs facilitated

  2. "Functional electrical stimulation (FES) impacted on important aspects of my life": a qualitative exploration of chronic stroke patients' and carers' perceptions of FES in the management of dropped foot.

    PubMed

    Wilkie, Katie M; Shiels, Jane E; Bulley, Cathy; Salisbury, Lisa G

    2012-01-01

    Our purpose was to explore the impact of functional electrical stimulation (FES), as applied in the management of dropped foot, on patients with chronic stroke and their carers. A qualitative phenomenological study was undertaken. Participants were recruited from the Lothian FES clinic. Data were collected by using semistructured face-to-face interviews and analysed by using the framework of interpretative phenomenological analysis (IPA). Thirteen patients and nine carers consented to participate in the study. The overarching theme that emerged from the data was that "FES impacted on important aspects of my life." Four subthemes were identified: 1) "Walking with FES is much better"; 2) "FES helped regain control of life"; 3) "Feeling good comes with using FES"; and 4) "FES is not perfect but it is of value." This study provides insights into the perceptions of patients and carers of the impact of FES. These results have implications for clinicians delivering an FES service for the management of dropped foot after stroke.

  3. Statistical modelling of software reliability

    NASA Technical Reports Server (NTRS)

    Miller, Douglas R.

    1991-01-01

    During the six-month period from 1 April 1991 to 30 September 1991 the following research papers in statistical modeling of software reliability appeared: (1) A Nonparametric Software Reliability Growth Model; (2) On the Use and the Performance of Software Reliability Growth Models; (3) Research and Development Issues in Software Reliability Engineering; (4) Special Issues on Software; and (5) Software Reliability and Safety.

  4. Orbiter Autoland reliability analysis

    NASA Technical Reports Server (NTRS)

    Welch, D. Phillip

    1993-01-01

    The Space Shuttle Orbiter is the only space reentry vehicle in which the crew is seated upright. This position presents some physiological effects requiring countermeasures to prevent a crewmember from becoming incapacitated. This also introduces a potential need for automated vehicle landing capability. Autoland is a primary procedure that was identified as a requirement for landing following and extended duration orbiter mission. This report documents the results of the reliability analysis performed on the hardware required for an automated landing. A reliability block diagram was used to evaluate system reliability. The analysis considers the manual and automated landing modes currently available on the Orbiter. (Autoland is presently a backup system only.) Results of this study indicate a +/- 36 percent probability of successfully extending a nominal mission to 30 days. Enough variations were evaluated to verify that the reliability could be altered with missions planning and procedures. If the crew is modeled as being fully capable after 30 days, the probability of a successful manual landing is comparable to that of Autoland because much of the hardware is used for both manual and automated landing modes. The analysis indicates that the reliability for the manual mode is limited by the hardware and depends greatly on crew capability. Crew capability for a successful landing after 30 days has not been determined yet.

  5. Photovoltaic module reliability workshop

    SciTech Connect

    Mrig, L.

    1990-01-01

    The paper and presentations compiled in this volume form the Proceedings of the fourth in a series of Workshops sponsored by Solar Energy Research Institute (SERI/DOE) under the general theme of photovoltaic module reliability during the period 1986--1990. The reliability Photo Voltaic (PV) modules/systems is exceedingly important along with the initial cost and efficiency of modules if the PV technology has to make a major impact in the power generation market, and for it to compete with the conventional electricity producing technologies. The reliability of photovoltaic modules has progressed significantly in the last few years as evidenced by warranties available on commercial modules of as long as 12 years. However, there is still need for substantial research and testing required to improve module field reliability to levels of 30 years or more. Several small groups of researchers are involved in this research, development, and monitoring activity around the world. In the US, PV manufacturers, DOE laboratories, electric utilities and others are engaged in the photovoltaic reliability research and testing. This group of researchers and others interested in this field were brought together under SERI/DOE sponsorship to exchange the technical knowledge and field experience as related to current information in this important field. The papers presented here reflect this effort.

  6. Proposed reliability cost model

    NASA Technical Reports Server (NTRS)

    Delionback, L. M.

    1973-01-01

    The research investigations which were involved in the study include: cost analysis/allocation, reliability and product assurance, forecasting methodology, systems analysis, and model-building. This is a classic example of an interdisciplinary problem, since the model-building requirements include the need for understanding and communication between technical disciplines on one hand, and the financial/accounting skill categories on the other. The systems approach is utilized within this context to establish a clearer and more objective relationship between reliability assurance and the subcategories (or subelements) that provide, or reenforce, the reliability assurance for a system. Subcategories are further subdivided as illustrated by a tree diagram. The reliability assurance elements can be seen to be potential alternative strategies, or approaches, depending on the specific goals/objectives of the trade studies. The scope was limited to the establishment of a proposed reliability cost-model format. The model format/approach is dependent upon the use of a series of subsystem-oriented CER's and sometimes possible CTR's, in devising a suitable cost-effective policy.

  7. The effectiveness of training and support for carers and other professionals on the physical and emotional health and well-being of looked-after children and young people: a systematic review.

    PubMed

    Everson-Hock, E S; Jones, R; Guillaume, L; Clapton, J; Goyder, E; Chilcott, J; Payne, N; Duenas, A; Sheppard, L M; Swann, C

    2012-03-01

    Looked-after children and young people (LACYP) are recognized as a high-risk group for behavioural and emotional problems, and additional specialist training for foster carers may reduce such problems. This systematic review aimed to identify and synthesize evidence on the effectiveness of additional training and support provided to approved carers, professionals and volunteers on the physical and emotional health and well-being of LACYP (including problem behaviours and placement stability). Searches of health and social science databases were conducted and records were screened for inclusion criteria. Citation and reference list searches were conducted on included studies. Included studies were synthesized and critically appraised. Six studies were included (five randomized controlled trials and one prospective cohort study), all of which focused on foster carers. Three studies reported a benefit of training and three reported no benefit but no detriment. Those reporting a benefit of training were conducted in the USA, and had longer-duration training, shorter follow-up assessment and recruited carers of younger children than studies that reported no benefit of training, which were conducted in the UK. Whether the difference in results is due to the type of training or to cultural or population differences is unclear. The findings suggest a mixed effect of training for foster carers on problem behaviours of LACYP. The evidence identified appears to suggest that longer-duration training programmes have a beneficial effect on the behaviour problems of LACYP, although future research should examine the impact of training durations and intensity on short-medium and longer-term outcomes of LACYP of different ages. Only training and support for foster carers was identified.

  8. Software reliability perspectives

    NASA Technical Reports Server (NTRS)

    Wilson, Larry; Shen, Wenhui

    1987-01-01

    Software which is used in life critical functions must be known to be highly reliable before installation. This requires a strong testing program to estimate the reliability, since neither formal methods, software engineering nor fault tolerant methods can guarantee perfection. Prior to the final testing software goes through a debugging period and many models have been developed to try to estimate reliability from the debugging data. However, the existing models are poorly validated and often give poor performance. This paper emphasizes the fact that part of their failures can be attributed to the random nature of the debugging data given to these models as input, and it poses the problem of correcting this defect as an area of future research.

  9. Reliability Centered Maintenance - Methodologies

    NASA Technical Reports Server (NTRS)

    Kammerer, Catherine C.

    2009-01-01

    Journal article about Reliability Centered Maintenance (RCM) methodologies used by United Space Alliance, LLC (USA) in support of the Space Shuttle Program at Kennedy Space Center. The USA Reliability Centered Maintenance program differs from traditional RCM programs because various methodologies are utilized to take advantage of their respective strengths for each application. Based on operational experience, USA has customized the traditional RCM methodology into a streamlined lean logic path and has implemented the use of statistical tools to drive the process. USA RCM has integrated many of the L6S tools into both RCM methodologies. The tools utilized in the Measure, Analyze, and Improve phases of a Lean Six Sigma project lend themselves to application in the RCM process. All USA RCM methodologies meet the requirements defined in SAE JA 1011, Evaluation Criteria for Reliability-Centered Maintenance (RCM) Processes. The proposed article explores these methodologies.

  10. Gearbox Reliability Collaborative Update (Presentation)

    SciTech Connect

    Sheng, S.

    2013-10-01

    This presentation was given at the Sandia Reliability Workshop in August 2013 and provides information on current statistics, a status update, next steps, and other reliability research and development activities related to the Gearbox Reliability Collaborative.

  11. Materials reliability issues in microelectronics

    SciTech Connect

    Lloyd, J.R. ); Yost, F.G. ); Ho, P.S. )

    1991-01-01

    This book covers the proceedings of a MRS symposium on materials reliability in microelectronics. Topics include: electromigration; stress effects on reliability; stress and packaging; metallization; device, oxide and dielectric reliability; new investigative techniques; and corrosion.

  12. Acceptability and feasibility of self-help Cognitive Remediation Therapy for anorexia nervosa delivered in collaboration with carers: a qualitative preliminary evaluation study.

    PubMed

    Lang, Katie; Treasure, Janet; Tchanturia, Kate

    2015-02-28

    Anorexia nervosa (AN) is an eating disorder without a recommended first-line treatment. Cognitive Remediation Therapy (CRT) is showing great promise in helping patients reduce cognitive inflexibility and excessive detail focus, thinking styles that could make engaging in psychological therapies difficult. CRT has shown to be effective, feasible and acceptable in both individual and group formats, and positive qualitative data has been gathered from both service users and clinicians. The aim of the current study was to assess the use of CRT as a self-help treatment for individuals with AN delivered in collaboration with carers. Six families underwent a six-week self-help CRT intervention. Feedback was gathered from qualitative interviews and analysed using thematic analysis. Neuropsychological outcomes were also collected. Participant feedback regarding the intervention was generally positive, with participants describing a number of benefits such as it creating a space for families to spend time together outside of the eating disorder, acting as a 'gateway' for more emotional work and helping participants to gain insight into their cognitive profiles. These preliminary findings suggest that self-help CRT delivered in collaboration with carers is an acceptable form of treatment, and adds to the growing literature supporting CRT for AN.

  13. Quantifying Human Performance Reliability.

    ERIC Educational Resources Information Center

    Askren, William B.; Regulinski, Thaddeus L.

    Human performance reliability for tasks in the time-space continuous domain is defined and a general mathematical model presented. The human performance measurement terms time-to-error and time-to-error-correction are defined. The model and measurement terms are tested using laboratory vigilance and manual control tasks. Error and error-correction…

  14. Grid reliability management tools

    SciTech Connect

    Eto, J.; Martinez, C.; Dyer, J.; Budhraja, V.

    2000-10-01

    To summarize, Consortium for Electric Reliability Technology Solutions (CERTS) is engaged in a multi-year program of public interest R&D to develop and prototype software tools that will enhance system reliability during the transition to competitive markets. The core philosophy embedded in the design of these tools is the recognition that in the future reliability will be provided through market operations, not the decisions of central planners. Embracing this philosophy calls for tools that: (1) Recognize that the game has moved from modeling machine and engineering analysis to simulating markets to understand the impacts on reliability (and vice versa); (2) Provide real-time data and support information transparency toward enhancing the ability of operators and market participants to quickly grasp, analyze, and act effectively on information; (3) Allow operators, in particular, to measure, monitor, assess, and predict both system performance as well as the performance of market participants; and (4) Allow rapid incorporation of the latest sensing, data communication, computing, visualization, and algorithmic techniques and technologies.

  15. Parametric Mass Reliability Study

    NASA Technical Reports Server (NTRS)

    Holt, James P.

    2014-01-01

    The International Space Station (ISS) systems are designed based upon having redundant systems with replaceable orbital replacement units (ORUs). These ORUs are designed to be swapped out fairly quickly, but some are very large, and some are made up of many components. When an ORU fails, it is replaced on orbit with a spare; the failed unit is sometimes returned to Earth to be serviced and re-launched. Such a system is not feasible for a 500+ day long-duration mission beyond low Earth orbit. The components that make up these ORUs have mixed reliabilities. Components that make up the most mass-such as computer housings, pump casings, and the silicon board of PCBs-typically are the most reliable. Meanwhile components that tend to fail the earliest-such as seals or gaskets-typically have a small mass. To better understand the problem, my project is to create a parametric model that relates both the mass of ORUs to reliability, as well as the mass of ORU subcomponents to reliability.

  16. Software reliability report

    NASA Technical Reports Server (NTRS)

    Wilson, Larry

    1991-01-01

    There are many software reliability models which try to predict future performance of software based on data generated by the debugging process. Unfortunately, the models appear to be unable to account for the random nature of the data. If the same code is debugged multiple times and one of the models is used to make predictions, intolerable variance is observed in the resulting reliability predictions. It is believed that data replication can remove this variance in lab type situations and that it is less than scientific to talk about validating a software reliability model without considering replication. It is also believed that data replication may prove to be cost effective in the real world, thus the research centered on verification of the need for replication and on methodologies for generating replicated data in a cost effective manner. The context of the debugging graph was pursued by simulation and experimentation. Simulation was done for the Basic model and the Log-Poisson model. Reasonable values of the parameters were assigned and used to generate simulated data which is then processed by the models in order to determine limitations on their accuracy. These experiments exploit the existing software and program specimens which are in AIR-LAB to measure the performance of reliability models.

  17. Reliable solar cookers

    SciTech Connect

    Magney, G.K.

    1992-12-31

    The author describes the activities of SERVE, a Christian relief and development agency, to introduce solar ovens to the Afghan refugees in Pakistan. It has provided 5,000 solar cookers since 1984. The experience has demonstrated the potential of the technology and the need for a durable and reliable product. Common complaints about the cookers are discussed and the ideal cooker is described.

  18. Reliability of photovoltaic modules

    NASA Technical Reports Server (NTRS)

    Ross, R. G., Jr.

    1986-01-01

    In order to assess the reliability of photovoltaic modules, four categories of known array failure and degradation mechanisms are discussed, and target reliability allocations have been developed within each category based on the available technology and the life-cycle-cost requirements of future large-scale terrestrial applications. Cell-level failure mechanisms associated with open-circuiting or short-circuiting of individual solar cells generally arise from cell cracking or the fatigue of cell-to-cell interconnects. Power degradation mechanisms considered include gradual power loss in cells, light-induced effects, and module optical degradation. Module-level failure mechanisms and life-limiting wear-out mechanisms are also explored.

  19. Reliability and durability problems

    NASA Astrophysics Data System (ADS)

    Bojtsov, B. V.; Kondrashov, V. Z.

    The papers presented in this volume focus on methods for determining the stress-strain state of structures and machines and evaluating their reliability and service life. Specific topics discussed include a method for estimating the service life of thin-sheet automotive structures, stressed state at the tip of small cracks in anisotropic plates under biaxial tension, evaluation of the elastic-dissipative characteristics of joints by vibrational diagnostics methods, and calculation of the reliability of ceramic structures for arbitrary long-term loading programs. Papers are also presented on the effect of prior plastic deformation on fatigue damage kinetics, axisymmetric and local deformation of cylindrical parts during finishing-hardening treatments, and adhesion of polymers to diffusion coatings on steels.

  20. Human Reliability Program Workshop

    SciTech Connect

    Landers, John; Rogers, Erin; Gerke, Gretchen

    2014-05-18

    A Human Reliability Program (HRP) is designed to protect national security as well as worker and public safety by continuously evaluating the reliability of those who have access to sensitive materials, facilities, and programs. Some elements of a site HRP include systematic (1) supervisory reviews, (2) medical and psychological assessments, (3) management evaluations, (4) personnel security reviews, and (4) training of HRP staff and critical positions. Over the years of implementing an HRP, the Department of Energy (DOE) has faced various challenges and overcome obstacles. During this 4-day activity, participants will examine programs that mitigate threats to nuclear security and the insider threat to include HRP, Nuclear Security Culture (NSC) Enhancement, and Employee Assistance Programs. The focus will be to develop an understanding of the need for a systematic HRP and to discuss challenges and best practices associated with mitigating the insider threat.

  1. Reliable broadcast protocols

    NASA Technical Reports Server (NTRS)

    Joseph, T. A.; Birman, Kenneth P.

    1989-01-01

    A number of broadcast protocols that are reliable subject to a variety of ordering and delivery guarantees are considered. Developing applications that are distributed over a number of sites and/or must tolerate the failures of some of them becomes a considerably simpler task when such protocols are available for communication. Without such protocols the kinds of distributed applications that can reasonably be built will have a very limited scope. As the trend towards distribution and decentralization continues, it will not be surprising if reliable broadcast protocols have the same role in distributed operating systems of the future that message passing mechanisms have in the operating systems of today. On the other hand, the problems of engineering such a system remain large. For example, deciding which protocol is the most appropriate to use in a certain situation or how to balance the latency-communication-storage costs is not an easy question.

  2. Space Shuttle Propulsion System Reliability

    NASA Technical Reports Server (NTRS)

    Welzyn, Ken; VanHooser, Katherine; Moore, Dennis; Wood, David

    2011-01-01

    This session includes the following sessions: (1) External Tank (ET) System Reliability and Lessons, (2) Space Shuttle Main Engine (SSME), Reliability Validated by a Million Seconds of Testing, (3) Reusable Solid Rocket Motor (RSRM) Reliability via Process Control, and (4) Solid Rocket Booster (SRB) Reliability via Acceptance and Testing.

  3. Spacecraft transmitter reliability

    NASA Technical Reports Server (NTRS)

    1980-01-01

    A workshop on spacecraft transmitter reliability was held at the NASA Lewis Research Center on September 25 and 26, 1979, to discuss present knowledge and to plan future research areas. Since formal papers were not submitted, this synopsis was derived from audio tapes of the workshop. The following subjects were covered: users' experience with space transmitters; cathodes; power supplies and interfaces; and specifications and quality assurance. A panel discussion ended the workshop.

  4. ATLAS reliability analysis

    SciTech Connect

    Bartsch, R.R.

    1995-09-01

    Key elements of the 36 MJ ATLAS capacitor bank have been evaluated for individual probabilities of failure. These have been combined to estimate system reliability which is to be greater than 95% on each experimental shot. This analysis utilizes Weibull or Weibull-like distributions with increasing probability of failure with the number of shots. For transmission line insulation, a minimum thickness is obtained and for the railgaps, a method for obtaining a maintenance interval from forthcoming life tests is suggested.

  5. Compact, Reliable EEPROM Controller

    NASA Technical Reports Server (NTRS)

    Katz, Richard; Kleyner, Igor

    2010-01-01

    A compact, reliable controller for an electrically erasable, programmable read-only memory (EEPROM) has been developed specifically for a space-flight application. The design may be adaptable to other applications in which there are requirements for reliability in general and, in particular, for prevention of inadvertent writing of data in EEPROM cells. Inadvertent writes pose risks of loss of reliability in the original space-flight application and could pose such risks in other applications. Prior EEPROM controllers are large and complex and do not provide all reasonable protections (in many cases, few or no protections) against inadvertent writes. In contrast, the present controller provides several layers of protection against inadvertent writes. The controller also incorporates a write-time monitor, enabling determination of trends in the performance of an EEPROM through all phases of testing. The controller has been designed as an integral subsystem of a system that includes not only the controller and the controlled EEPROM aboard a spacecraft but also computers in a ground control station, relatively simple onboard support circuitry, and an onboard communication subsystem that utilizes the MIL-STD-1553B protocol. (MIL-STD-1553B is a military standard that encompasses a method of communication and electrical-interface requirements for digital electronic subsystems connected to a data bus. MIL-STD- 1553B is commonly used in defense and space applications.) The intent was to both maximize reliability while minimizing the size and complexity of onboard circuitry. In operation, control of the EEPROM is effected via the ground computers, the MIL-STD-1553B communication subsystem, and the onboard support circuitry, all of which, in combination, provide the multiple layers of protection against inadvertent writes. There is no controller software, unlike in many prior EEPROM controllers; software can be a major contributor to unreliability, particularly in fault

  6. Software reliability studies

    NASA Technical Reports Server (NTRS)

    Hoppa, Mary Ann; Wilson, Larry W.

    1994-01-01

    There are many software reliability models which try to predict future performance of software based on data generated by the debugging process. Our research has shown that by improving the quality of the data one can greatly improve the predictions. We are working on methodologies which control some of the randomness inherent in the standard data generation processes in order to improve the accuracy of predictions. Our contribution is twofold in that we describe an experimental methodology using a data structure called the debugging graph and apply this methodology to assess the robustness of existing models. The debugging graph is used to analyze the effects of various fault recovery orders on the predictive accuracy of several well-known software reliability algorithms. We found that, along a particular debugging path in the graph, the predictive performance of different models can vary greatly. Similarly, just because a model 'fits' a given path's data well does not guarantee that the model would perform well on a different path. Further we observed bug interactions and noted their potential effects on the predictive process. We saw that not only do different faults fail at different rates, but that those rates can be affected by the particular debugging stage at which the rates are evaluated. Based on our experiment, we conjecture that the accuracy of a reliability prediction is affected by the fault recovery order as well as by fault interaction.

  7. General Aviation Aircraft Reliability Study

    NASA Technical Reports Server (NTRS)

    Pettit, Duane; Turnbull, Andrew; Roelant, Henk A. (Technical Monitor)

    2001-01-01

    This reliability study was performed in order to provide the aviation community with an estimate of Complex General Aviation (GA) Aircraft System reliability. To successfully improve the safety and reliability for the next generation of GA aircraft, a study of current GA aircraft attributes was prudent. This was accomplished by benchmarking the reliability of operational Complex GA Aircraft Systems. Specifically, Complex GA Aircraft System reliability was estimated using data obtained from the logbooks of a random sample of the Complex GA Aircraft population.

  8. Clinical effectiveness of a manual based coping strategy programme (START, STrAtegies for RelaTives) in promoting the mental health of carers of family members with dementia: pragmatic randomised controlled trial

    PubMed Central

    Barber, Julie; Rapaport, Penny; Knapp, Martin; Griffin, Mark; King, Derek; Mummery, Cath; Walker, Zuzana; Hoe, Juanita; Sampson, Elizabeth L; Cooper, Claudia

    2013-01-01

    Objective To assess whether a manual based coping strategy compared with treatment as usual reduces depression and anxiety symptoms in carers of family members with dementia. Design Randomised, parallel group, superiority trial. Setting Three mental health community services and one neurological outpatient dementia service in London and Essex, UK. Participants 260 carers of family members with dementia. Intervention A manual based coping intervention comprising eight sessions and delivered by supervised psychology graduates to carers of family members with dementia. The programme consisted of psychoeducation about dementia, carers’ stress, and where to get emotional support; understanding behaviours of the family member being cared for, and behavioural management techniques; changing unhelpful thoughts; promoting acceptance; assertive communication; relaxation; planning for the future; increasing pleasant activities; and maintaining skills learnt. Carers practised these techniques at home, using the manual and relaxation CDs. Main outcome measures Affective symptoms (hospital anxiety and depression total score) at four and eight months. Secondary outcomes were depression and anxiety caseness on the hospital anxiety and depression scale; quality of life of both the carer (health status questionnaire, mental health) and the recipient of care (quality of life-Alzheimer’s disease); and potentially abusive behaviour by the carer towards the recipient of care (modified conflict tactics scale). Results 260 carers were recruited; 173 were randomised to the intervention and 87 to treatment as usual. Mean total scores on the hospital anxiety and depression scale were lower in the intervention group than in the treatment as usual group over the eight month evaluation period: adjusted difference in means −1.80 points (95% confidence interval −3.29 to −0.31; P=0.02) and absolute difference in means −2.0 points. Carers in the intervention group were less likely to

  9. Ultimately Reliable Pyrotechnic Systems

    NASA Technical Reports Server (NTRS)

    Scott, John H.; Hinkel, Todd

    2015-01-01

    This paper presents the methods by which NASA has designed, built, tested, and certified pyrotechnic devices for high reliability operation in extreme environments and illustrates the potential applications in the oil and gas industry. NASA's extremely successful application of pyrotechnics is built upon documented procedures and test methods that have been maintained and developed since the Apollo Program. Standards are managed and rigorously enforced for performance margins, redundancy, lot sampling, and personnel safety. The pyrotechnics utilized in spacecraft include such devices as small initiators and detonators with the power of a shotgun shell, detonating cord systems for explosive energy transfer across many feet, precision linear shaped charges for breaking structural membranes, and booster charges to actuate valves and pistons. NASA's pyrotechnics program is one of the more successful in the history of Human Spaceflight. No pyrotechnic device developed in accordance with NASA's Human Spaceflight standards has ever failed in flight use. NASA's pyrotechnic initiators work reliably in temperatures as low as -420 F. Each of the 135 Space Shuttle flights fired 102 of these initiators, some setting off multiple pyrotechnic devices, with never a failure. The recent landing on Mars of the Opportunity rover fired 174 of NASA's pyrotechnic initiators to complete the famous '7 minutes of terror.' Even after traveling through extreme radiation and thermal environments on the way to Mars, every one of them worked. These initiators have fired on the surface of Titan. NASA's design controls, procedures, and processes produce the most reliable pyrotechnics in the world. Application of pyrotechnics designed and procured in this manner could enable the energy industry's emergency equipment, such as shutoff valves and deep-sea blowout preventers, to be left in place for years in extreme environments and still be relied upon to function when needed, thus greatly enhancing

  10. Blade reliability collaborative :

    SciTech Connect

    Ashwill, Thomas D.; Ogilvie, Alistair B.; Paquette, Joshua A.

    2013-04-01

    The Blade Reliability Collaborative (BRC) was started by the Wind Energy Technologies Department of Sandia National Laboratories and DOE in 2010 with the goal of gaining insight into planned and unplanned O&M issues associated with wind turbine blades. A significant part of BRC is the Blade Defect, Damage and Repair Survey task, which will gather data from blade manufacturers, service companies, operators and prior studies to determine details about the largest sources of blade unreliability. This report summarizes the initial findings from this work.

  11. Fault Tree Reliability Analysis and Design-for-reliability

    1998-05-05

    WinR provides a fault tree analysis capability for performing systems reliability and design-for-reliability analyses. The package includes capabilities for sensitivity and uncertainity analysis, field failure data analysis, and optimization.

  12. On Component Reliability and System Reliability for Space Missions

    NASA Technical Reports Server (NTRS)

    Chen, Yuan; Gillespie, Amanda M.; Monaghan, Mark W.; Sampson, Michael J.; Hodson, Robert F.

    2012-01-01

    This paper is to address the basics, the limitations and the relationship between component reliability and system reliability through a study of flight computing architectures and related avionics components for NASA future missions. Component reliability analysis and system reliability analysis need to be evaluated at the same time, and the limitations of each analysis and the relationship between the two analyses need to be understood.

  13. Incorporating patient preferences into drug development and regulatory decision making: Results from a quantitative pilot study with cancer patients, carers, and regulators.

    PubMed

    Postmus, D; Mavris, M; Hillege, H L; Salmonson, T; Ryll, B; Plate, A; Moulon, I; Eichler, H-G; Bere, N; Pignatti, F

    2016-05-01

    Currently, patient preference studies are not required to be included in marketing authorization applications to regulatory authorities, and the role and methodology for such studies have not been agreed upon. The European Medicines Agency (EMA) conducted a pilot study to gain experience on how the collection of individual preferences can inform the regulatory review. Using a short online questionnaire, ordinal statements regarding the desirability of different outcomes in the treatment of advanced cancer were elicited from 139 participants (98 regulators, 29 patient or carers, and 12 healthcare professionals). This was followed by face-to-face meetings to gather feedback and validate the individual responses. In this article we summarize the EMA pilot study and discuss the role of patient preference studies within the regulatory review. Based on the results, we conclude that our preference elicitation instrument was easy to implement and sufficiently precise to learn about the distribution of the participants' individual preferences. PMID:26715217

  14. Improve relief valve reliability

    SciTech Connect

    Nelson, W.E.

    1993-01-01

    This paper reports on careful evaluation of safety relief valves and their service conditions which can improve reliability and permit more time between testing. Some factors that aid in getting long-run results are: Use of valves suitable for service, Attention to design of the relieving system (including use of block valves) and Close attention to repair procedures. Use these procedures for each installation, applying good engineering practices. The Clean Air Act of 1990 and other legislation limiting allowable fugitive emissions in a hydrocarbon processing plant will greatly impact safety relief valve installations. Normal leakage rate from a relief valve will require that it be connected to a closed vent system connected to a recovery or control device. Tying the outlet of an existing valve into a header system can cause accelerated corrosion and operating difficulties. Reliability of many existing safety relief valves may be compromised when they are connected to an outlet header without following good engineering practices. The law has been enacted but all the rules have not been promulgated.

  15. Integrated circuit reliability testing

    NASA Technical Reports Server (NTRS)

    Buehler, Martin G. (Inventor); Sayah, Hoshyar R. (Inventor)

    1990-01-01

    A technique is described for use in determining the reliability of microscopic conductors deposited on an uneven surface of an integrated circuit device. A wafer containing integrated circuit chips is formed with a test area having regions of different heights. At the time the conductors are formed on the chip areas of the wafer, an elongated serpentine assay conductor is deposited on the test area so the assay conductor extends over multiple steps between regions of different heights. Also, a first test conductor is deposited in the test area upon a uniform region of first height, and a second test conductor is deposited in the test area upon a uniform region of second height. The occurrence of high resistances at the steps between regions of different height is indicated by deriving the measured length of the serpentine conductor using the resistance measured between the ends of the serpentine conductor, and comparing that to the design length of the serpentine conductor. The percentage by which the measured length exceeds the design length, at which the integrated circuit will be discarded, depends on the required reliability of the integrated circuit.

  16. Integrated circuit reliability testing

    NASA Technical Reports Server (NTRS)

    Buehler, Martin G. (Inventor); Sayah, Hoshyar R. (Inventor)

    1988-01-01

    A technique is described for use in determining the reliability of microscopic conductors deposited on an uneven surface of an integrated circuit device. A wafer containing integrated circuit chips is formed with a test area having regions of different heights. At the time the conductors are formed on the chip areas of the wafer, an elongated serpentine assay conductor is deposited on the test area so the assay conductor extends over multiple steps between regions of different heights. Also, a first test conductor is deposited in the test area upon a uniform region of first height, and a second test conductor is deposited in the test area upon a uniform region of second height. The occurrence of high resistances at the steps between regions of different height is indicated by deriving the measured length of the serpentine conductor using the resistance measured between the ends of the serpentine conductor, and comparing that to the design length of the serpentine conductor. The percentage by which the measured length exceeds the design length, at which the integrated circuit will be discarded, depends on the required reliability of the integrated circuit.

  17. Reliable Entanglement Verification

    NASA Astrophysics Data System (ADS)

    Arrazola, Juan; Gittsovich, Oleg; Donohue, John; Lavoie, Jonathan; Resch, Kevin; Lütkenhaus, Norbert

    2013-05-01

    Entanglement plays a central role in quantum protocols. It is therefore important to be able to verify the presence of entanglement in physical systems from experimental data. In the evaluation of these data, the proper treatment of statistical effects requires special attention, as one can never claim to have verified the presence of entanglement with certainty. Recently increased attention has been paid to the development of proper frameworks to pose and to answer these type of questions. In this work, we apply recent results by Christandl and Renner on reliable quantum state tomography to construct a reliable entanglement verification procedure based on the concept of confidence regions. The statements made do not require the specification of a prior distribution nor the assumption of an independent and identically distributed (i.i.d.) source of states. Moreover, we develop efficient numerical tools that are necessary to employ this approach in practice, rendering the procedure ready to be employed in current experiments. We demonstrate this fact by analyzing the data of an experiment where photonic entangled two-photon states were generated and whose entanglement is verified with the use of an accessible nonlinear witness.

  18. Load Control System Reliability

    SciTech Connect

    Trudnowski, Daniel

    2015-04-03

    This report summarizes the results of the Load Control System Reliability project (DOE Award DE-FC26-06NT42750). The original grant was awarded to Montana Tech April 2006. Follow-on DOE awards and expansions to the project scope occurred August 2007, January 2009, April 2011, and April 2013. In addition to the DOE monies, the project also consisted of matching funds from the states of Montana and Wyoming. Project participants included Montana Tech; the University of Wyoming; Montana State University; NorthWestern Energy, Inc., and MSE. Research focused on two areas: real-time power-system load control methodologies; and, power-system measurement-based stability-assessment operation and control tools. The majority of effort was focused on area 2. Results from the research includes: development of fundamental power-system dynamic concepts, control schemes, and signal-processing algorithms; many papers (including two prize papers) in leading journals and conferences and leadership of IEEE activities; one patent; participation in major actual-system testing in the western North American power system; prototype power-system operation and control software installed and tested at three major North American control centers; and, the incubation of a new commercial-grade operation and control software tool. Work under this grant certainly supported the DOE-OE goals in the area of “Real Time Grid Reliability Management.”

  19. Understanding the Elements of Operational Reliability: A Key for Achieving High Reliability

    NASA Technical Reports Server (NTRS)

    Safie, Fayssal M.

    2010-01-01

    This viewgraph presentation reviews operational reliability and its role in achieving high reliability through design and process reliability. The topics include: 1) Reliability Engineering Major Areas and interfaces; 2) Design Reliability; 3) Process Reliability; and 4) Reliability Applications.

  20. Patient and carer experiences of clinical uncertainty and deterioration, in the face of limited reversibility: A comparative observational study of the AMBER care bundle

    PubMed Central

    Bristowe, Katherine; Carey, Irene; Hopper, Adrian; Shouls, Susanna; Prentice, Wendy; Caulkin, Ruth; Higginson, Irene J; Koffman, Jonathan

    2015-01-01

    Background: Clinical uncertainty is emotionally challenging for patients and carers and creates additional pressures for those clinicians in acute hospitals. The AMBER care bundle was designed to improve care for patients identified as clinically unstable, deteriorating, with limited reversibility and at risk of dying in the next 1–2 months. Aim: To examine the experience of care supported by the AMBER care bundle compared to standard care in the context of clinical uncertainty, deterioration and limited reversibility. Design: A comparative observational mixed-methods study using semi-structured qualitative interviews and a followback survey. Setting/participants: Three large London acute tertiary National Health Service hospitals. Nineteen interviews with 23 patients and carers (10 supported by AMBER care bundle and 9 standard care). Surveys completed by next of kin of 95 deceased patients (59 AMBER care bundle and 36 standard care). Results: The AMBER care bundle was associated with increased frequency of discussions about prognosis between clinicians and patients (χ2 = 4.09, p = 0.04), higher awareness of their prognosis by patients (χ2 = 4.29, p = 0.04) and lower clarity in the information received about their condition (χ2 = 6.26, p = 0.04). Although the consistency and quality of communication were not different between the two groups, those supported by the AMBER care bundle described more unresolved concerns about caring for someone at home. Conclusion: Awareness of prognosis appears to be higher among patients supported by the AMBER care bundle, but in this small study this was not translated into higher quality communication, and information was judged less easy to understand. Adequately powered comparative evaluation is urgently needed. PMID:25829443

  1. EXPERTS 1—experiences of long-term life-limiting conditions among patients and carers: protocol for a qualitative meta-synthesis and conceptual modelling study

    PubMed Central

    May, Carl R; Masters, Jayne; Welch, Lindsay; Hunt, Katherine; Pope, Catherine; Myall, Michelle; Griffiths, Peter; Roderick, Paul; Glanville, Julie; Richardson, Alison

    2015-01-01

    Introduction Increasing numbers of the population are living with long-term life-limiting conditions with a significant proportion characterised by multimorbidity. Patients with these conditions often experience high volumes of clinical interaction involving them, their caregivers and healthcare providers in complex patterns of organising, coordinating, negotiating and managing care. A better understanding of the sources of experienced complexity and multimorbidity, from the patient perspective is paramount to improve capacity and manage workload to promote improved experience of illness, more effective healthcare utilisation and improved healthcare outcomes. To better understand the sources of complexity we will undertake an evidence synthesis of qualitative studies of patient and informal carer experiences of three common long-term life-limiting conditions. We will investigate what is known about these diseases at different stages in disease progression, treatment regimens and places of care. Method and analysis We will include qualitative studies of patients’ and carers’ (aged >18) accounts of their experiences of healthcare provision in a range of settings and healthcare systems. We will conduct an extensive electronic database search of publications in English between 2000 and 2014. Results and discussions sections of the papers will be regarded as formal data using the constant comparison method of qualitative analysis. From the meta-synthesis results, we will build a conceptual model of mechanisms and processes that shape patients’ journeys towards end of life to suggest where in the patient journey new interventions to improve patient and carer experience can be developed and delivered. The study is being conducted between 1 December 2014 and 31 December 2015. Ethics and dissemination No human subjects or personal data are involved and no ethical issues are anticipated. An important element of dissemination is informing user communities about the

  2. Ethical issues arising from a research, technology and development project to support frail older people and their family carers at home.

    PubMed

    Magnusson, Lennart; Hanson, Elizabeth Jane

    2003-09-01

    The present paper provides an overview of the application of the key ethical issues which arose in an EU-funded research, technology and development project, Assisting Carers using Telematics Interventions to meet Older Persons' Needs (ACTION). The primary aim of the ACTION project was to support frail older people and their family carers in their own homes across England, Northern Ireland, the Republic of Ireland, Sweden and Portugal via the use of user-friendly information and communication technology. Ethical guidelines were developed in the project and used as a tool to enable the multidisciplinary project team to increase their awareness of ethical issues in their everyday work, and to act as a useful ethical framework for regular team discussions at international and local meetings across the partner countries. A range of ethical issues arose during the field-study phases of the project when the ACTION services were introduced into a number of families' own homes. It can be argued that these ethical issues reflect factors relating both to the application of research into practice, as well as those relating more directly to the use of new technology by families and care professionals. Key issues centre upon the ethical concepts of autonomy, independence, quality of life, beneficence, non-maleficence and justice, and more specifically, on ethical issues of security, privacy and confidentiality, increased expectations, and withdrawal of the service. This paper is intended to facilitate dialogue and debate in the area of enabling (assistive) technology in home care for older people and their families.

  3. Business of reliability

    NASA Astrophysics Data System (ADS)

    Engel, Pierre

    1999-12-01

    The presentation is organized around three themes: (1) The decrease of reception equipment costs allows non-Remote Sensing organization to access a technology until recently reserved to scientific elite. What this means is the rise of 'operational' executive agencies considering space-based technology and operations as a viable input to their daily tasks. This is possible thanks to totally dedicated ground receiving entities focusing on one application for themselves, rather than serving a vast community of users. (2) The multiplication of earth observation platforms will form the base for reliable technical and financial solutions. One obstacle to the growth of the earth observation industry is the variety of policies (commercial versus non-commercial) ruling the distribution of the data and value-added products. In particular, the high volume of data sales required for the return on investment does conflict with traditional low-volume data use for most applications. Constant access to data sources supposes monitoring needs as well as technical proficiency. (3) Large volume use of data coupled with low- cost equipment costs is only possible when the technology has proven reliable, in terms of application results, financial risks and data supply. Each of these factors is reviewed. The expectation is that international cooperation between agencies and private ventures will pave the way for future business models. As an illustration, the presentation proposes to use some recent non-traditional monitoring applications, that may lead to significant use of earth observation data, value added products and services: flood monitoring, ship detection, marine oil pollution deterrent systems and rice acreage monitoring.

  4. Testing for PV Reliability (Presentation)

    SciTech Connect

    Kurtz, S.; Bansal, S.

    2014-09-01

    The DOE SUNSHOT workshop is seeking input from the community about PV reliability and how the DOE might address gaps in understanding. This presentation describes the types of testing that are needed for PV reliability and introduces a discussion to identify gaps in our understanding of PV reliability testing.

  5. Making Reliability Arguments in Classrooms

    ERIC Educational Resources Information Center

    Parkes, Jay; Giron, Tilia

    2006-01-01

    Reliability methodology needs to evolve as validity has done into an argument supported by theory and empirical evidence. Nowhere is the inadequacy of current methods more visible than in classroom assessment. Reliability arguments would also permit additional methodologies for evidencing reliability in classrooms. It would liberalize methodology…

  6. Factor reliability into load management

    SciTech Connect

    Feight, G.R.

    1983-07-01

    Hardware reliability is a major factor to consider when selecting a direct-load-control system. The author outlines a method of estimating present-value costs associated with system reliability. He points out that small differences in receiver reliability make a significant difference in owning cost. 4 figures.

  7. Optimum Reliability of Gain Scores.

    ERIC Educational Resources Information Center

    Sharma, K. K.; Gupta, J. K.

    1986-01-01

    This paper gives a mathematical treatment to findings of Zimmerman and Williams and establishes a minimum reliability for gain scores when the pretest and posttest have equal reliabilities and equal standard deviations. It discusses the behavior of the reliability of gain scores in terms of variations in other test parameters. (Author/LMO)

  8. Nuclear weapon reliability evaluation methodology

    SciTech Connect

    Wright, D.L.

    1993-06-01

    This document provides an overview of those activities that are normally performed by Sandia National Laboratories to provide nuclear weapon reliability evaluations for the Department of Energy. These reliability evaluations are first provided as a prediction of the attainable stockpile reliability of a proposed weapon design. Stockpile reliability assessments are provided for each weapon type as the weapon is fielded and are continuously updated throughout the weapon stockpile life. The reliability predictions and assessments depend heavily on data from both laboratory simulation and actual flight tests. An important part of the methodology are the opportunities for review that occur throughout the entire process that assure a consistent approach and appropriate use of the data for reliability evaluation purposes.

  9. Lithium battery safety and reliability

    NASA Astrophysics Data System (ADS)

    Levy, Samuel C.

    Lithium batteries have been used in a variety of applications for a number of years. As their use continues to grow, particularly in the consumer market, a greater emphasis needs to be placed on safety and reliability. There is a useful technique which can help to design cells and batteries having a greater degree of safety and higher reliability. This technique, known as fault tree analysis, can also be useful in determining the cause of unsafe behavior and poor reliability in existing designs.

  10. The challenges of uncertainty and interprofessional collaboration in palliative care for non-cancer patients in the community: A systematic review of views from patients, carers and health-care professionals

    PubMed Central

    Murtagh, Fliss EM

    2014-01-01

    Background: Primary care has the potential to play significant roles in providing effective palliative care for non-cancer patients. Aim: To identify, critically appraise and synthesise the existing evidence on views on the provision of palliative care for non-cancer patients by primary care providers and reveal any gaps in the evidence. Design: Standard systematic review and narrative synthesis. Data sources: MEDLINE, Embase, CINAHL, PsycINFO, Applied Social Science Abstract and the Cochrane library were searched in 2012. Reference searching, hand searching, expert consultations and grey literature searches complemented these. Papers with the views of patients/carers or professionals on primary palliative care provision to non-cancer patients in the community were included. The amended Hawker’s criteria were used for quality assessment of included studies. Results: A total of 30 studies were included and represent the views of 719 patients, 605 carers and over 400 professionals. In all, 27 studies are from the United Kingdom. Patients and carers expect primary care physicians to provide compassionate care, have appropriate knowledge and play central roles in providing care. The roles of professionals are unclear to patients, carers and professionals themselves. Uncertainty of illness trajectory and lack of collaboration between health-care professionals were identified as barriers to effective care. Conclusions: Effective interprofessional work to deal with uncertainty and maintain coordinated care is needed for better palliative care provision to non-cancer patients in the community. Research into and development of a best model for effective interdisciplinary work are needed. PMID:24821710

  11. A fourth generation reliability predictor

    NASA Technical Reports Server (NTRS)

    Bavuso, Salvatore J.; Martensen, Anna L.

    1988-01-01

    A reliability/availability predictor computer program has been developed and is currently being beta-tested by over 30 US companies. The computer program is called the Hybrid Automated Reliability Predictor (HARP). HARP was developed to fill an important gap in reliability assessment capabilities. This gap was manifested through the use of its third-generation cousin, the Computer-Aided Reliability Estimation (CARE III) program, over a six-year development period and an additional three-year period during which CARE III has been in the public domain. The accumulated experience of the over 30 establishments now using CARE III was used in the development of the HARP program.

  12. Patient and carer experience of obtaining regular prescribed medication for chronic disease in the English National Health Service: a qualitative study

    PubMed Central

    2013-01-01

    Background The increasing burden of chronic disease is recognised globally. Within the English National Health Service, patients with chronic disease comprise of half of all consultations in primary care, and 70% of inpatient bed days. The cost of prescribing long-term medications for those with physical chronic diseases is rising and there is a drive to reduce medicine wastage and costs. While current policies in England are focused on the latter, there has been little previous research on patient experience of ordering and obtaining regular medication for their chronic disease. This paper presents findings from England of a qualitative study and survey of patients and their carers’ experiences of community and primary care based services for physical chronic diseases. Although not the primary focus of the study, the results highlighted particular issues around service delivery of repeat prescriptions. Methods We conducted 21 qualitative in-depth interviews with 30 patients and family carers’ in two Primary Care Trusts in England. Participants were receiving community based care for diabetes, respiratory, neurological or complex co-morbidities, and ranged in age from 39–92 years old. We used a broadly inductive approach to enable themes around patient experience to emerge from the data. Results While the study sought to gain an overview of patient experience, the findings suggested that the processes associated with ordering and obtaining regular medication – the repeat prescription, was most frequently described as a recurring hassle of managing a long-term condition. Issues for patients and carers included multiple journeys to the surgery and pharmacy, lack of synchrony and dissatisfaction with the length of prescriptions. Conclusion Much literature exists around medication waste and cost, which led to encouragement from the NHS in England to reduce dosage units to a 28-day supply. While there has been an acknowledgement that longer supplies may be

  13. ‘The living death of Alzheimer's’ versus ‘Take a walk to keep dementia at bay’: representations of dementia in print media and carer discourse

    PubMed Central

    Peel, Elizabeth

    2014-01-01

    Understanding dementia is a pressing social challenge. This article draws on the ‘Dementia talking: care conversation and communication’ project which aims to understand how talk about, and to people living with dementia is constructed. In this article I draw on the construction of dementia manifest in two data sets – a corpus of 350 recent UK national newspaper articles and qualitative data derived from in-depth interviews with informal carers. These data were analysed using a thematic discursive approach. A ‘panic-blame’ framework was evident in much of the print media coverage. Dementia was represented in catastrophic terms as a ‘tsunami’ and ‘worse than death’, juxtaposed with coverage of individualistic behavioural change and lifestyle recommendations to ‘stave off’ the condition. Contrary to this media discourse, in carers' talk there was scant use of hyperbolic metaphor or reference to individual responsibility for dementia, and any corresponding blame and accountability. I argue that the presence of individualistic dementia ‘preventative’ behaviour in media discourse is problematic, especially in comparison to other more ‘controllable’ and treatable chronic conditions. Engagement with, and critique of, the nascent panic-blame cultural context may be fruitful in enhancing positive social change for people diagnosed with dementia and their carers. PMID:24935028

  14. Stirling Convertor Fasteners Reliability Quantification

    NASA Technical Reports Server (NTRS)

    Shah, Ashwin R.; Korovaichuk, Igor; Kovacevich, Tiodor; Schreiber, Jeffrey G.

    2006-01-01

    Onboard Radioisotope Power Systems (RPS) being developed for NASA s deep-space science and exploration missions require reliable operation for up to 14 years and beyond. Stirling power conversion is a candidate for use in an RPS because it offers a multifold increase in the conversion efficiency of heat to electric power and reduced inventory of radioactive material. Structural fasteners are responsible to maintain structural integrity of the Stirling power convertor, which is critical to ensure reliable performance during the entire mission. Design of fasteners involve variables related to the fabrication, manufacturing, behavior of fasteners and joining parts material, structural geometry of the joining components, size and spacing of fasteners, mission loads, boundary conditions, etc. These variables have inherent uncertainties, which need to be accounted for in the reliability assessment. This paper describes these uncertainties along with a methodology to quantify the reliability, and provides results of the analysis in terms of quantified reliability and sensitivity of Stirling power conversion reliability to the design variables. Quantification of the reliability includes both structural and functional aspects of the joining components. Based on the results, the paper also describes guidelines to improve the reliability and verification testing.

  15. Issues in Modeling System Reliability

    NASA Astrophysics Data System (ADS)

    Cruse, Thomas A.; Annis, Chuck; Booker, Jane; Robinson, David; Sues, Rob

    2002-10-01

    This paper discusses various issues in modeling system reliability. The topics include: 1) Statistical formalisms versus pragmatic numerics; 2) Language; 3) Statistical methods versus reliability-based design methods; 4) Professional bias; and 5) Real issues that need to be identified and resolved prior to certifying designs. This paper is in viewgraph form.

  16. Avionics design for reliability bibliography

    NASA Technical Reports Server (NTRS)

    1976-01-01

    A bibliography with abstracts was presented in support of AGARD lecture series No. 81. The following areas were covered: (1) program management, (2) design for high reliability, (3) selection of components and parts, (4) environment consideration, (5) reliable packaging, (6) life cycle cost, and (7) case histories.

  17. Photovoltaic performance and reliability workshop

    SciTech Connect

    Mrig, L.

    1993-12-01

    This workshop was the sixth in a series of workshops sponsored by NREL/DOE under the general subject of photovoltaic testing and reliability during the period 1986--1993. PV performance and PV reliability are at least as important as PV cost, if not more. In the US, PV manufacturers, DOE laboratories, electric utilities, and others are engaged in the photovoltaic reliability research and testing. This group of researchers and others interested in the field were brought together to exchange the technical knowledge and field experience as related to current information in this evolving field of PV reliability. The papers presented here reflect this effort since the last workshop held in September, 1992. The topics covered include: cell and module characterization, module and system testing, durability and reliability, system field experience, and standards and codes.

  18. Statistical modeling of software reliability

    NASA Technical Reports Server (NTRS)

    Miller, Douglas R.

    1992-01-01

    This working paper discusses the statistical simulation part of a controlled software development experiment being conducted under the direction of the System Validation Methods Branch, Information Systems Division, NASA Langley Research Center. The experiment uses guidance and control software (GCS) aboard a fictitious planetary landing spacecraft: real-time control software operating on a transient mission. Software execution is simulated to study the statistical aspects of reliability and other failure characteristics of the software during development, testing, and random usage. Quantification of software reliability is a major goal. Various reliability concepts are discussed. Experiments are described for performing simulations and collecting appropriate simulated software performance and failure data. This data is then used to make statistical inferences about the quality of the software development and verification processes as well as inferences about the reliability of software versions and reliability growth under random testing and debugging.

  19. Oral histories of HIV/AIDS support group members, NGO workers and home-based carers in KwaZulu-Natal.

    PubMed

    Denis, Philippe

    2016-01-01

    The purpose of this paper is to bring to the attention of the AIDS research community the existence of an oral history project known as the Memories of AIDS Project. The project focused on HIV/AIDS support group members, non-governmental organisation (NGO) workers and home-based carers in the Umgungundlovu (Pietermaritzburg) District Municipality, South Africa. The project was carried out by the Sinomlando Centre for Oral History and Memory Work, a research and community development centre of the University of KwaZulu-Natal, over a period of three years (2011-2013). Sixty-five individual oral history interviews of 1 to 4 hours duration and 11 focus group sessions were recorded, transcribed and translated from isiZulu into English when necessary. The life stories of community workers and support group members documented in the interviews show, on the part of the informants, a remarkable degree of agency and assertiveness in matters of sexuality, gender relations and religious beliefs. They found innovative ways of navigating through the conflicting claims of biomedicine, Christianity and African traditional religion. As much as the epidemic caused grief and suffering, it opened the door to new knowledge and new opportunities. PMID:27002356

  20. Calculating system reliability with SRFYDO

    SciTech Connect

    Morzinski, Jerome; Anderson - Cook, Christine M; Klamann, Richard M

    2010-01-01

    SRFYDO is a process for estimating reliability of complex systems. Using information from all applicable sources, including full-system (flight) data, component test data, and expert (engineering) judgment, SRFYDO produces reliability estimates and predictions. It is appropriate for series systems with possibly several versions of the system which share some common components. It models reliability as a function of age and up to 2 other lifecycle (usage) covariates. Initial output from its Exploratory Data Analysis mode consists of plots and numerical summaries so that the user can check data entry and model assumptions, and help determine a final form for the system model. The System Reliability mode runs a complete reliability calculation using Bayesian methodology. This mode produces results that estimate reliability at the component, sub-system, and system level. The results include estimates of uncertainty, and can predict reliability at some not-too-distant time in the future. This paper presents an overview of the underlying statistical model for the analysis, discusses model assumptions, and demonstrates usage of SRFYDO.

  1. Aerospace reliability applied to biomedicine.

    NASA Technical Reports Server (NTRS)

    Lalli, V. R.; Vargo, D. J.

    1972-01-01

    An analysis is presented that indicates that the reliability and quality assurance methodology selected by NASA to minimize failures in aerospace equipment can be applied directly to biomedical devices to improve hospital equipment reliability. The Space Electric Rocket Test project is used as an example of NASA application of reliability and quality assurance (R&QA) methods. By analogy a comparison is made to show how these same methods can be used in the development of transducers, instrumentation, and complex systems for use in medicine.

  2. Reliability analysis of interdependent lattices

    NASA Astrophysics Data System (ADS)

    Limiao, Zhang; Daqing, Li; Pengju, Qin; Bowen, Fu; Yinan, Jiang; Zio, Enrico; Rui, Kang

    2016-06-01

    Network reliability analysis has drawn much attention recently due to the risks of catastrophic damage in networked infrastructures. These infrastructures are dependent on each other as a result of various interactions. However, most of the reliability analyses of these interdependent networks do not consider spatial constraints, which are found important for robustness of infrastructures including power grid and transport systems. Here we study the reliability properties of interdependent lattices with different ranges of spatial constraints. Our study shows that interdependent lattices with strong spatial constraints are more resilient than interdependent Erdös-Rényi networks. There exists an intermediate range of spatial constraints, at which the interdependent lattices have minimal resilience.

  3. Integrating reliability analysis and design

    SciTech Connect

    Rasmuson, D. M.

    1980-10-01

    This report describes the Interactive Reliability Analysis Project and demonstrates the advantages of using computer-aided design systems (CADS) in reliability analysis. Common cause failure problems require presentations of systems, analysis of fault trees, and evaluation of solutions to these. Results have to be communicated between the reliability analyst and the system designer. Using a computer-aided design system saves time and money in the analysis of design. Computer-aided design systems lend themselves to cable routing, valve and switch lists, pipe routing, and other component studies. At EG and G Idaho, Inc., the Applicon CADS is being applied to the study of water reactor safety systems.

  4. (Centralized Reliability Data Organization (CRDO))

    SciTech Connect

    Haire, M J

    1987-04-21

    One of the primary goals of the Centralized Reliability Data Organization (CREDO) is to be an international focal point for the collection, analysis, and dissemination of liquid metal reactor (LMR) component reliability, availability, and maintainability (RAM) data. During FY-1985, the Department of Energy (DOE) entered into a Specific Memorandum of Agreement (SMA) with Japan's Power Reactor and Nuclear Fuel Development Corporation (PNC) regarding cooperative data exchange efforts. This agreement was CREDO's first step toward internationalization and represented an initial realization of the previously mentioned goal. DOE's interest in further internationalization of the CREDO system was the primary motivation for the traveler's attendance at the Reliability '87 conference.

  5. Reliability and Maintainability (RAM) Training

    NASA Technical Reports Server (NTRS)

    Lalli, Vincent R. (Editor); Malec, Henry A. (Editor); Packard, Michael H. (Editor)

    2000-01-01

    The theme of this manual is failure physics-the study of how products, hardware, software, and systems fail and what can be done about it. The intent is to impart useful information, to extend the limits of production capability, and to assist in achieving low-cost reliable products. In a broader sense the manual should do more. It should underscore the urgent need CI for mature attitudes toward reliability. Five of the chapters were originally presented as a classroom course to over 1000 Martin Marietta engineers and technicians. Another four chapters and three appendixes have been added, We begin with a view of reliability from the years 1940 to 2000. Chapter 2 starts the training material with a review of mathematics and a description of what elements contribute to product failures. The remaining chapters elucidate basic reliability theory and the disciplines that allow us to control and eliminate failures.

  6. Failure Analysis for Improved Reliability

    NASA Technical Reports Server (NTRS)

    Sood, Bhanu

    2016-01-01

    Outline: Section 1 - What is reliability and root cause? Section 2 - Overview of failure mechanisms. Section 3 - Failure analysis techniques (1. Non destructive analysis techniques, 2. Destructive Analysis, 3. Materials Characterization). Section 4 - Summary and Closure

  7. An experiment in software reliability

    NASA Technical Reports Server (NTRS)

    Dunham, J. R.; Pierce, J. L.

    1986-01-01

    The results of a software reliability experiment conducted in a controlled laboratory setting are reported. The experiment was undertaken to gather data on software failures and is one in a series of experiments being pursued by the Fault Tolerant Systems Branch of NASA Langley Research Center to find a means of credibly performing reliability evaluations of flight control software. The experiment tests a small sample of implementations of radar tracking software having ultra-reliability requirements and uses n-version programming for error detection, and repetitive run modeling for failure and fault rate estimation. The experiment results agree with those of Nagel and Skrivan in that the program error rates suggest an approximate log-linear pattern and the individual faults occurred with significantly different error rates. Additional analysis of the experimental data raises new questions concerning the phenomenon of interacting faults. This phenomenon may provide one explanation for software reliability decay.

  8. Accelerator Availability and Reliability Issues

    SciTech Connect

    Steve Suhring

    2003-05-01

    Maintaining reliable machine operations for existing machines as well as planning for future machines' operability present significant challenges to those responsible for system performance and improvement. Changes to machine requirements and beam specifications often reduce overall machine availability in an effort to meet user needs. Accelerator reliability issues from around the world will be presented, followed by a discussion of the major factors influencing machine availability.

  9. MEMS reliability: coming of age

    NASA Astrophysics Data System (ADS)

    Douglass, Michael R.

    2008-02-01

    In today's high-volume semiconductor world, one could easily take reliability for granted. As the MOEMS/MEMS industry continues to establish itself as a viable alternative to conventional manufacturing in the macro world, reliability can be of high concern. Currently, there are several emerging market opportunities in which MOEMS/MEMS is gaining a foothold. Markets such as mobile media, consumer electronics, biomedical devices, and homeland security are all showing great interest in microfabricated products. At the same time, these markets are among the most demanding when it comes to reliability assurance. To be successful, each company developing a MOEMS/MEMS device must consider reliability on an equal footing with cost, performance and manufacturability. What can this maturing industry learn from the successful development of DLP technology, air bag accelerometers and inkjet printheads? This paper discusses some basic reliability principles which any MOEMS/MEMS device development must use. Examples from the commercially successful and highly reliable Digital Micromirror Device complement the discussion.

  10. Gender differentials on the health consequences of care-giving to people with AIDS-related illness among older informal carers in two slums in Nairobi, Kenya.

    PubMed

    Chepngeno-Langat, Gloria; Madise, Nyovani; Evandrou, Maria; Falkingham, Jane

    2011-12-01

    Informal caregivers, most often older people, provide valuable care and support for people ill due to AIDS, especially in poor-resource settings with inadequate health care systems and limited access to antiretroviral therapy. The negative health consequences associated with care-giving may vary depending on various factors that act to mediate the extent of the effects on the caregiver. This paper investigates the association between care-giving and poor health among older carers to people living with AIDS, and examines potential within-gender differences in reporting poor health. Data from 1429 men and women aged 50 years or older living in two slum areas of Nairobi are used to compare AIDS-caregivers with other caregivers and non-caregivers based on self-reported health using the World Health Organization disability assessment (WHODAS) score and the presence of a severe health problem. Women AIDS-caregivers reported higher disability scores for mobility and the lowest scores in self-care and life activities domains while men AIDS-caregivers reported higher scores in all domains (except interpersonal interaction) compared with other caregivers and non-caregivers. Multiple regression analysis is used to examine the association of providing care with health outcomes while controlling for other confounders. Consistently across all the health measures, no significant differences were observed between female AIDS-caregivers and female non-caregivers. Male AIDS-caregivers were however significantly more likely to report disability and having a severe health problem compared with male non-caregivers. This finding highlights a gendered variation in outcome and is possibly an indication of the differences in care-giving gender-role expectations and coping strategies. This study highlights the relatively neglected role of older men as caregivers and recommends comprehensive interventions to mitigate the impact of HIV and AIDS on caregivers that embrace men as well as women.

  11. Measurement, estimation, and prediction of software reliability

    NASA Technical Reports Server (NTRS)

    Hecht, H.

    1977-01-01

    Quantitative indices of software reliability are defined, and application of three important indices is indicated: (1) reliability measurement, (2) reliability estimation, and (3) reliability prediction. State of the art techniques for each of these procedures are presented together with considerations of data acquisition. Failure classifications and other documentation for comprehensive software reliability evaluation are described.

  12. Electronics reliability and measurement technology

    NASA Technical Reports Server (NTRS)

    Heyman, Joseph S. (Editor)

    1987-01-01

    A summary is presented of the Electronics Reliability and Measurement Technology Workshop. The meeting examined the U.S. electronics industry with particular focus on reliability and state-of-the-art technology. A general consensus of the approximately 75 attendees was that "the U.S. electronics industries are facing a crisis that may threaten their existence". The workshop had specific objectives to discuss mechanisms to improve areas such as reliability, yield, and performance while reducing failure rates, delivery times, and cost. The findings of the workshop addressed various aspects of the industry from wafers to parts to assemblies. Key problem areas that were singled out for attention are identified, and action items necessary to accomplish their resolution are recommended.

  13. Reliability model for planetary gear

    NASA Technical Reports Server (NTRS)

    Savage, M.; Paridon, C. A.; Coy, J. J.

    1982-01-01

    A reliability model is presented for planetary gear trains in which the ring gear is fixed, the Sun gear is the input, and the planet arm is the output. The input and output shafts are coaxial and the input and output torques are assumed to be coaxial with these shafts. Thrust and side loading are neglected. This type of gear train is commonly used in main rotor transmissions for helicopters and in other applications which require high reductions in speed. The reliability model is based on the Weibull distribution of the individual reliabilities of the transmission components. The transmission's basic dynamic capacity is defined as the input torque which may be applied for one million input rotations of the Sun gear. Load and life are related by a power law. The load life exponent and basic dynamic capacity are developed as functions of the component capacities.

  14. A Review of Score Reliability: Contemporary Thinking on Reliability Issues

    ERIC Educational Resources Information Center

    Rosen, Gerald A.

    2004-01-01

    Bruce Thompson's edited volume begins with a basic principle, one might call it a basic truth, "reliability is a property that applies to scores, and not immutably across all conceivable uses everywhere of a given measure." (p. 3). The author claims that this principle is little known and-or little understood. While that is an arguable point, the…

  15. Designing magnetic systems for reliability

    SciTech Connect

    Heitzenroeder, P.J.

    1991-01-01

    Designing magnetic system is an iterative process in which the requirements are set, a design is developed, materials and manufacturing processes are defined, interrelationships with the various elements of the system are established, engineering analyses are performed, and fault modes and effects are studied. Reliability requires that all elements of the design process, from the seemingly most straightforward such as utilities connection design and implementation, to the most sophisticated such as advanced finite element analyses, receives a balanced and appropriate level of attention. D.B. Montgomery's study of magnet failures has shown that the predominance of magnet failures tend not to be in the most intensively engineered areas, but are associated with insulation, leads, ad unanticipated conditions. TFTR, JET, JT-60, and PBX are all major tokamaks which have suffered loss of reliability due to water leaks. Similarly the majority of causes of loss of magnet reliability at PPPL has not been in the sophisticated areas of the design but are due to difficulties associated with coolant connections, bus connections, and external structural connections. Looking towards the future, the major next-devices such as BPX and ITER are most costly and complex than any of their predecessors and are pressing the bounds of operating levels, materials, and fabrication. Emphasis on reliability is a must as the fusion program enters a phase where there are fewer, but very costly devices with the goal of reaching a reactor prototype stage in the next two or three decades. This paper reviews some of the magnet reliability issues which PPPL has faced over the years the lessons learned from them, and magnet design and fabrication practices which have been found to contribute to magnet reliability.

  16. Mechanically reliable scales and coatings

    SciTech Connect

    Tortorelli, P.F.; Alexander, K.B.

    1995-07-01

    As the first stage in examining the mechanical reliability of protective surface oxides, the behavior of alumina scales formed on iron-aluminum alloys during high-temperature cyclic oxidation was characterized in terms of damage and spallation tendencies. Scales were thermally grown on specimens of three iron-aluminum composition using a series of exposures to air at 1000{degrees}C. Gravimetric data and microscopy revealed substantially better integrity and adhesion of the scales grown on an alloy containing zirconium. The use of polished (rather than just ground) specimens resulted in scales that were more suitable for subsequent characterization of mechanical reliability.

  17. Metrological Reliability of Medical Devices

    NASA Astrophysics Data System (ADS)

    Costa Monteiro, E.; Leon, L. F.

    2015-02-01

    The prominent development of health technologies of the 20th century triggered demands for metrological reliability of physiological measurements comprising physical, chemical and biological quantities, essential to ensure accurate and comparable results of clinical measurements. In the present work, aspects concerning metrological reliability in premarket and postmarket assessments of medical devices are discussed, pointing out challenges to be overcome. In addition, considering the social relevance of the biomeasurements results, Biometrological Principles to be pursued by research and innovation aimed at biomedical applications are proposed, along with the analysis of their contributions to guarantee the innovative health technologies compliance with the main ethical pillars of Bioethics.

  18. Reliability in the design phase

    SciTech Connect

    Siahpush, A.S.; Hills, S.W.; Pham, H. ); Majumdar, D. )

    1991-12-01

    A study was performed to determine the common methods and tools that are available to calculated or predict a system's reliability. A literature review and software survey are included. The desired product of this developmental work is a tool for the system designer to use in the early design phase so that the final design will achieve the desired system reliability without lengthy testing and rework. Three computer programs were written which provide the first attempt at fulfilling this need. The programs are described and a case study is presented for each one. This is a continuing effort which will be furthered in FY-1992. 10 refs.

  19. Reliability in the design phase

    SciTech Connect

    Siahpush, A.S.; Hills, S.W.; Pham, H.; Majumdar, D.

    1991-12-01

    A study was performed to determine the common methods and tools that are available to calculated or predict a system`s reliability. A literature review and software survey are included. The desired product of this developmental work is a tool for the system designer to use in the early design phase so that the final design will achieve the desired system reliability without lengthy testing and rework. Three computer programs were written which provide the first attempt at fulfilling this need. The programs are described and a case study is presented for each one. This is a continuing effort which will be furthered in FY-1992. 10 refs.

  20. Photovoltaic power system reliability considerations

    NASA Technical Reports Server (NTRS)

    Lalli, V. R.

    1980-01-01

    An example of how modern engineering and safety techniques can be used to assure the reliable and safe operation of photovoltaic power systems is presented. This particular application is for a solar cell power system demonstration project designed to provide electric power requirements for remote villages. The techniques utilized involve a definition of the power system natural and operating environment, use of design criteria and analysis techniques, an awareness of potential problems via the inherent reliability and FMEA methods, and use of fail-safe and planned spare parts engineering philosophy.

  1. Cost effectiveness of a manual based coping strategy programme in promoting the mental health of family carers of people with dementia (the START (STrAtegies for RelaTives) study): a pragmatic randomised controlled trial

    PubMed Central

    King, Derek; Romeo, Renee; Schehl, Barbara; Barber, Julie; Griffin, Mark; Rapaport, Penny; Livingston, Debbie; Mummery, Cath; Walker, Zuzana; Hoe, Juanita; Sampson, Elizabeth L; Cooper, Claudia; Livingston, Gill

    2013-01-01

    Objective To assess whether the START (STrAtegies for RelatTives) intervention added to treatment as usual is cost effective compared with usual treatment alone. Design Cost effectiveness analysis nested within a pragmatic randomised controlled trial. Setting Three mental health and one neurological outpatient dementia service in London and Essex, UK. Participants Family carers of people with dementia. Intervention Eight session, manual based, coping intervention delivered by supervised psychology graduates to family carers of people with dementia added to usual treatment, compared with usual treatment alone. Primary outcome measures Costs measured from a health and social care perspective were analysed alongside the Hospital Anxiety and Depression Scale total score (HADS-T) of affective symptoms and quality adjusted life years (QALYs) in cost effectiveness analyses over eight months from baseline. Results Of the 260 participants recruited to the study, 173 were randomised to the START intervention, and 87 to usual treatment alone. Mean HADS-T scores were lower in the intervention group than the usual treatment group over the 8 month evaluation period (mean difference −1.79 (95% CI −3.32 to −0.33)), indicating better outcomes associated with the START intervention. There was a small improvement in health related quality of life as measured by QALYs (0.03 (−0.01 to 0.08)). Costs were no different between the intervention and usual treatment groups (£252 (−28 to 565) higher for START group). The cost effectiveness calculations suggested that START had a greater than 99% chance of being cost effective compared with usual treatment alone at a willingness to pay threshold of £30 000 per QALY gained, and a high probability of cost effectiveness on the HADS-T measure. Conclusions The manual based coping intervention START, when added to treatment as usual, was cost effective compared with treatment as usual alone by reference to both outcome measures

  2. Wanted: A Solid, Reliable PC

    ERIC Educational Resources Information Center

    Goldsborough, Reid

    2004-01-01

    This article discusses PC reliability, one of the most pressing issues regarding computers. Nearly a quarter century after the introduction of the first IBM PC and the outset of the personal computer revolution, PCs have largely become commodities, with little differentiating one brand from another in terms of capability and performance. Most of…

  3. Web Awards: Are They Reliable?

    ERIC Educational Resources Information Center

    Everhart, Nancy; McKnight, Kathleen

    1997-01-01

    School library media specialists recommend quality Web sites to children based on evaluations and Web awards. This article examines three types of Web awards and who grants them, suggests ways to determine their reliability, and discusses specific award sites. Includes a bibliography of Web sites. (PEN)

  4. Becoming a high reliability organization

    PubMed Central

    2011-01-01

    Aircraft carriers, electrical power grids, and wildland firefighting, though seemingly different, are exemplars of high reliability organizations (HROs) - organizations that have the potential for catastrophic failure yet engage in nearly error-free performance. HROs commit to safety at the highest level and adopt a special approach to its pursuit. High reliability organizing has been studied and discussed for some time in other industries and is receiving increasing attention in health care, particularly in high-risk settings like the intensive care unit (ICU). The essence of high reliability organizing is a set of principles that enable organizations to focus attention on emergent problems and to deploy the right set of resources to address those problems. HROs behave in ways that sometimes seem counterintuitive - they do not try to hide failures but rather celebrate them as windows into the health of the system, they seek out problems, they avoid focusing on just one aspect of work and are able to see how all the parts of work fit together, they expect unexpected events and develop the capability to manage them, and they defer decision making to local frontline experts who are empowered to solve problems. Given the complexity of patient care in the ICU, the potential for medical error, and the particular sensitivity of critically ill patients to harm, high reliability organizing principles hold promise for improving ICU patient care. PMID:22188677

  5. The Reliability of College Grades

    ERIC Educational Resources Information Center

    Beatty, Adam S.; Walmsley, Philip T.; Sackett, Paul R.; Kuncel, Nathan R.; Koch, Amanda J.

    2015-01-01

    Little is known about the reliability of college grades relative to how prominently they are used in educational research, and the results to date tend to be based on small sample studies or are decades old. This study uses two large databases (N > 800,000) from over 200 educational institutions spanning 13 years and finds that both first-year…

  6. Averaging Internal Consistency Reliability Coefficients

    ERIC Educational Resources Information Center

    Feldt, Leonard S.; Charter, Richard A.

    2006-01-01

    Seven approaches to averaging reliability coefficients are presented. Each approach starts with a unique definition of the concept of "average," and no approach is more correct than the others. Six of the approaches are applicable to internal consistency coefficients. The seventh approach is specific to alternate-forms coefficients. Although the…

  7. Photovoltaic performance and reliability workshop

    SciTech Connect

    Kroposki, B

    1996-10-01

    This proceedings is the compilation of papers presented at the ninth PV Performance and Reliability Workshop held at the Sheraton Denver West Hotel on September 4--6, 1996. This years workshop included presentations from 25 speakers and had over 100 attendees. All of the presentations that were given are included in this proceedings. Topics of the papers included: defining service lifetime and developing models for PV module lifetime; examining and determining failure and degradation mechanisms in PV modules; combining IEEE/IEC/UL testing procedures; AC module performance and reliability testing; inverter reliability/qualification testing; standardization of utility interconnect requirements for PV systems; need activities to separate variables by testing individual components of PV systems (e.g. cells, modules, batteries, inverters,charge controllers) for individual reliability and then test them in actual system configurations; more results reported from field experience on modules, inverters, batteries, and charge controllers from field deployed PV systems; and system certification and standardized testing for stand-alone and grid-tied systems.

  8. Reliability Analysis of Money Habitudes

    ERIC Educational Resources Information Center

    Delgadillo, Lucy M.; Bushman, Brittani S.

    2015-01-01

    Use of the Money Habitudes exercise has gained popularity among various financial professionals. This article reports on the reliability of this resource. A survey administered to young adults at a western state university was conducted, and each Habitude or "domain" was analyzed using Cronbach's alpha procedures. Results showed all six…

  9. Becoming a high reliability organization.

    PubMed

    Christianson, Marlys K; Sutcliffe, Kathleen M; Miller, Melissa A; Iwashyna, Theodore J

    2011-01-01

    Aircraft carriers, electrical power grids, and wildland firefighting, though seemingly different, are exemplars of high reliability organizations (HROs)--organizations that have the potential for catastrophic failure yet engage in nearly error-free performance. HROs commit to safety at the highest level and adopt a special approach to its pursuit. High reliability organizing has been studied and discussed for some time in other industries and is receiving increasing attention in health care, particularly in high-risk settings like the intensive care unit (ICU). The essence of high reliability organizing is a set of principles that enable organizations to focus attention on emergent problems and to deploy the right set of resources to address those problems. HROs behave in ways that sometimes seem counterintuitive--they do not try to hide failures but rather celebrate them as windows into the health of the system, they seek out problems, they avoid focusing on just one aspect of work and are able to see how all the parts of work fit together, they expect unexpected events and develop the capability to manage them, and they defer decision making to local frontline experts who are empowered to solve problems. Given the complexity of patient care in the ICU, the potential for medical error, and the particular sensitivity of critically ill patients to harm, high reliability organizing principles hold promise for improving ICU patient care.

  10. Wind turbine reliability database update.

    SciTech Connect

    Peters, Valerie A.; Hill, Roger Ray; Stinebaugh, Jennifer A.; Veers, Paul S.

    2009-03-01

    This report documents the status of the Sandia National Laboratories' Wind Plant Reliability Database. Included in this report are updates on the form and contents of the Database, which stems from a fivestep process of data partnerships, data definition and transfer, data formatting and normalization, analysis, and reporting. Selected observations are also reported.

  11. Compound estimation procedures in reliability

    NASA Technical Reports Server (NTRS)

    Barnes, Ron

    1990-01-01

    At NASA, components and subsystems of components in the Space Shuttle and Space Station generally go through a number of redesign stages. While data on failures for various design stages are sometimes available, the classical procedures for evaluating reliability only utilize the failure data on the present design stage of the component or subsystem. Often, few or no failures have been recorded on the present design stage. Previously, Bayesian estimators for the reliability of a single component, conditioned on the failure data for the present design, were developed. These new estimators permit NASA to evaluate the reliability, even when few or no failures have been recorded. Point estimates for the latter evaluation were not possible with the classical procedures. Since different design stages of a component (or subsystem) generally have a good deal in common, the development of new statistical procedures for evaluating the reliability, which consider the entire failure record for all design stages, has great intuitive appeal. A typical subsystem consists of a number of different components and each component has evolved through a number of redesign stages. The present investigations considered compound estimation procedures and related models. Such models permit the statistical consideration of all design stages of each component and thus incorporate all the available failure data to obtain estimates for the reliability of the present version of the component (or subsystem). A number of models were considered to estimate the reliability of a component conditioned on its total failure history from two design stages. It was determined that reliability estimators for the present design stage, conditioned on the complete failure history for two design stages have lower risk than the corresponding estimators conditioned only on the most recent design failure data. Several models were explored and preliminary models involving bivariate Poisson distribution and the

  12. Power Quality and Reliability Project

    NASA Technical Reports Server (NTRS)

    Attia, John O.

    2001-01-01

    One area where universities and industry can link is in the area of power systems reliability and quality - key concepts in the commercial, industrial and public sector engineering environments. Prairie View A&M University (PVAMU) has established a collaborative relationship with the University of'Texas at Arlington (UTA), NASA/Johnson Space Center (JSC), and EP&C Engineering and Technology Group (EP&C) a small disadvantage business that specializes in power quality and engineering services. The primary goal of this collaboration is to facilitate the development and implementation of a Strategic Integrated power/Systems Reliability and Curriculum Enhancement Program. The objectives of first phase of this work are: (a) to develop a course in power quality and reliability, (b) to use the campus of Prairie View A&M University as a laboratory for the study of systems reliability and quality issues, (c) to provide students with NASA/EPC shadowing and Internship experience. In this work, a course, titled "Reliability Analysis of Electrical Facilities" was developed and taught for two semesters. About thirty seven has benefited directly from this course. A laboratory accompanying the course was also developed. Four facilities at Prairie View A&M University were surveyed. Some tests that were performed are (i) earth-ground testing, (ii) voltage, amperage and harmonics of various panels in the buildings, (iii) checking the wire sizes to see if they were the right size for the load that they were carrying, (iv) vibration tests to test the status of the engines or chillers and water pumps, (v) infrared testing to the test arcing or misfiring of electrical or mechanical systems.

  13. Future Care Planning for patients approaching end-of-life with advanced heart disease: an interview study with patients, carers and healthcare professionals exploring the content, rationale and design of a randomised clinical trial

    PubMed Central

    Denvir, Martin A; Highet, Gill; Robertson, Shirley; Cudmore, Sarah; Reid, Janet; Ness, Andrea; Hogg, Karen; Weir, Christopher; Murray, Scott; Boyd, Kirsty

    2014-01-01

    Objective To explore the optimal content and design of a clinical trial of an end-of-life intervention for advanced heart disease with patients, carers and healthcare professionals. Design Qualitative interview and focus group study. Setting Community and hospital-based focus groups and interviews. Participants Stable community-dwelling patients, informal carers (PC, n=15) and primary and secondary care based healthcare professionals (HCP, n=11). Results PC highlighted fragmentation of services and difficulty in accessing specialist care as key barriers to good care. They felt that time for discussion with HCP was inadequate within current National Health Service (NHS) healthcare systems. HCP highlighted uncertainty of prognosis, explaining mortality risk to patients and switching from curative to palliative approaches as key challenges. Patient selection, nature of the intervention and relevance of trial outcomes were identified by HCP as key challenges in the design of a clinical trial. Conclusions PC and HCP expressed a number of concerns relevant to the nature and content of an end-of-life intervention for patients with advanced heart disease. The findings of this study are being used to support a phase II randomised clinical trial of Future Care Planning in advanced heart disease. PMID:25023130

  14. On-orbit spacecraft reliability

    NASA Technical Reports Server (NTRS)

    Bloomquist, C.; Demars, D.; Graham, W.; Henmi, P.

    1978-01-01

    Operational and historic data for 350 spacecraft from 52 U.S. space programs were analyzed for on-orbit reliability. Failure rates estimates are made for on-orbit operation of spacecraft subsystems, components, and piece parts, as well as estimates of failure probability for the same elements during launch. Confidence intervals for both parameters are also given. The results indicate that: (1) the success of spacecraft operation is only slightly affected by most reported incidents of anomalous behavior; (2) the occurrence of the majority of anomalous incidents could have been prevented piror to launch; (3) no detrimental effect of spacecraft dormancy is evident; (4) cycled components in general are not demonstrably less reliable than uncycled components; and (5) application of product assurance elements is conductive to spacecraft success.

  15. Radioactive Reliability of Programmable Memories

    NASA Astrophysics Data System (ADS)

    Loncar, Boris; Osmokrovic, Predrag; Stojanovic, Marko; Stankovic, Srboljub

    2001-02-01

    In this study, we examine the reliability of erasable programmable read only memory (EPROM) and electrically erasable programmable read only memory (EEPROM) components under the influence of gamma radiation. This problem has significance in military industry and space technology. Total dose results are presented for the JL 27C512D EPROM and 28C64C EEPROM components. There is evidence that EPROM components have better radioactive reliability than EEPROM components. Also, the changes to the EPROM are reversible, and after erasing and reprogramming all EPROM components are functional. On the other hand, changes to the EEPROM are irreversible, and under the influence of gamma radiation, all EEPROM components became permanently nonfunctional. The obtained results are analyzed and explained via the interaction of gamma radiation with oxide layers.

  16. What makes a family reliable?

    NASA Technical Reports Server (NTRS)

    Williams, James G.

    1992-01-01

    Asteroid families are clusters of asteroids in proper element space which are thought to be fragments from former collisions. Studies of families promise to improve understanding of large collision events and a large event can open up the interior of a former parent body to view. While a variety of searches for families have found the same heavily populated families, and some searches have found the same families of lower population, there is much apparent disagreement between proposed families of lower population of different investigations. Indicators of reliability, factors compromising reliability, an illustration of the influence of different data samples, and a discussion of how several investigations perceived families in the same region of proper element space are given.

  17. Three approaches to reliability analysis

    NASA Technical Reports Server (NTRS)

    Palumbo, Daniel L.

    1989-01-01

    It is noted that current reliability analysis tools differ not only in their solution techniques, but also in their approach to model abstraction. The analyst must be satisfied with the constraints that are intrinsic to any combination of solution technique and model abstraction. To get a better idea of the nature of these constraints, three reliability analysis tools (HARP, ASSIST/SURE, and CAME) were used to model portions of the Integrated Airframe/Propulsion Control System architecture. When presented with the example problem, all three tools failed to produce correct results. In all cases, either the tool or the model had to be modified. It is suggested that most of the difficulty is rooted in the large model size and long computational times which are characteristic of Markov model solutions.

  18. Gearbox Reliability Collaborative Bearing Calibration

    SciTech Connect

    van Dam, J.

    2011-10-01

    NREL has initiated the Gearbox Reliability Collaborative (GRC) to investigate the root cause of the low wind turbine gearbox reliability. The GRC follows a multi-pronged approach based on a collaborative of manufacturers, owners, researchers and consultants. The project combines analysis, field testing, dynamometer testing, condition monitoring, and the development and population of a gearbox failure database. At the core of the project are two 750kW gearboxes that have been redesigned and rebuilt so that they are representative of the multi-megawatt gearbox topology currently used in the industry. These gearboxes are heavily instrumented and are tested in the field and on the dynamometer. This report discusses the bearing calibrations of the gearboxes.

  19. Assessment of NDE Reliability Data

    NASA Technical Reports Server (NTRS)

    Yee, B. G. W.; Chang, F. H.; Covchman, J. C.; Lemon, G. H.; Packman, P. F.

    1976-01-01

    Twenty sets of relevant Nondestructive Evaluation (NDE) reliability data have been identified, collected, compiled, and categorized. A criterion for the selection of data for statistical analysis considerations has been formulated. A model to grade the quality and validity of the data sets has been developed. Data input formats, which record the pertinent parameters of the defect/specimen and inspection procedures, have been formulated for each NDE method. A comprehensive computer program has been written to calculate the probability of flaw detection at several confidence levels by the binomial distribution. This program also selects the desired data sets for pooling and tests the statistical pooling criteria before calculating the composite detection reliability. Probability of detection curves at 95 and 50 percent confidence levels have been plotted for individual sets of relevant data as well as for several sets of merged data with common sets of NDE parameters.

  20. Some Reliability Estimates for Computerized Adaptive Tests.

    ERIC Educational Resources Information Center

    Nicewander, W. Alan; Thomasson, Gary L.

    1999-01-01

    Derives three reliability estimates for the Bayes modal estimate (BME) and the maximum-likelihood estimate (MLE) of theta in computerized adaptive tests (CATs). Computes the three reliability estimates and the true reliabilities of both BME and MLE for seven simulated CATs. Results show the true reliabilities for BME and MLE to be nearly identical…

  1. Vulcain engine tests prove reliability

    NASA Astrophysics Data System (ADS)

    Covault, Craig

    1994-04-01

    The development of the oxygen/hydrogen Vulcain first-stage engine for the Ariane 5 involves more than 30 European companies and $1.19-billion. These companies are using existing technology to produce a low-cost system with high thrust and reliability. This article describes ground test of this engine, and provides a comparison of the Vulcain's capabilities with the capabilities of other systems. A list of key Vulcain team members is also given.

  2. Defining Requirements for Improved Photovoltaic System Reliability

    SciTech Connect

    Maish, A.B.

    1998-12-21

    Reliable systems are an essential ingredient of any technology progressing toward commercial maturity and large-scale deployment. This paper defines reliability as meeting system fictional requirements, and then develops a framework to understand and quantify photovoltaic system reliability based on initial and ongoing costs and system value. The core elements necessary to achieve reliable PV systems are reviewed. These include appropriate system design, satisfactory component reliability, and proper installation and servicing. Reliability status, key issues, and present needs in system reliability are summarized for four application sectors.

  3. Reliability Models and Attributable Risk

    NASA Technical Reports Server (NTRS)

    Jarvinen, Richard D.

    1999-01-01

    The intention of this report is to bring a developing and extremely useful statistical methodology to greater attention within the Safety, Reliability, and Quality Assurance Office of the NASA Johnson Space Center. The statistical methods in this exposition are found under the heading of attributable risk. Recently the Safety, Reliability, and Quality Assurance Office at the Johnson Space Center has supported efforts to introduce methods of medical research statistics dealing with the survivability of people to bear on the problems of aerospace that deal with the reliability of component hardware used in the NASA space program. This report, which describes several study designs for which attributable risk is used, is in concert with the latter goals. The report identifies areas of active research in attributable risk while briefly describing much of what has been developed in the theory of attributable risk. The report, which largely is a report on a report, attempts to recast the medical setting and language commonly found in descriptions of attributable risk into the setting and language of the space program and its component hardware.

  4. Reliability in individual monitoring service.

    PubMed

    Mod Ali, N

    2011-03-01

    As a laboratory certified to ISO 9001:2008 and accredited to ISO/IEC 17025, the Secondary Standard Dosimetry Laboratory (SSDL)-Nuclear Malaysia has incorporated an overall comprehensive system for technical and quality management in promoting a reliable individual monitoring service (IMS). Faster identification and resolution of issues regarding dosemeter preparation and issuing of reports, personnel enhancement, improved customer satisfaction and overall efficiency of laboratory activities are all results of the implementation of an effective quality system. Review of these measures and responses to observed trends provide continuous improvement of the system. By having these mechanisms, reliability of the IMS can be assured in the promotion of safe behaviour at all levels of the workforce utilising ionising radiation facilities. Upgradation of in the reporting program through a web-based e-SSDL marks a major improvement in Nuclear Malaysia's IMS reliability on the whole. The system is a vital step in providing a user friendly and effective occupational exposure evaluation program in the country. It provides a higher level of confidence in the results generated for occupational dose monitoring of the IMS, thus, enhances the status of the radiation protection framework of the country.

  5. Reliability in individual monitoring service.

    PubMed

    Mod Ali, N

    2011-03-01

    As a laboratory certified to ISO 9001:2008 and accredited to ISO/IEC 17025, the Secondary Standard Dosimetry Laboratory (SSDL)-Nuclear Malaysia has incorporated an overall comprehensive system for technical and quality management in promoting a reliable individual monitoring service (IMS). Faster identification and resolution of issues regarding dosemeter preparation and issuing of reports, personnel enhancement, improved customer satisfaction and overall efficiency of laboratory activities are all results of the implementation of an effective quality system. Review of these measures and responses to observed trends provide continuous improvement of the system. By having these mechanisms, reliability of the IMS can be assured in the promotion of safe behaviour at all levels of the workforce utilising ionising radiation facilities. Upgradation of in the reporting program through a web-based e-SSDL marks a major improvement in Nuclear Malaysia's IMS reliability on the whole. The system is a vital step in providing a user friendly and effective occupational exposure evaluation program in the country. It provides a higher level of confidence in the results generated for occupational dose monitoring of the IMS, thus, enhances the status of the radiation protection framework of the country. PMID:21147789

  6. Interrater Reliability of Risk Matrix 2000/s.

    PubMed

    Wakeling, Helen C; Mann, Ruth E; Milner, Rebecca J

    2011-01-01

    Actuarial risk assessment instruments for sexual offenders are often used in high-stakes decision making and therefore should be subject to stringent reliability and validity testing. Furthermore, those involved in the risk assessment of sexual offenders should be aware of the factors that may affect the reliability of these instruments. The present study examined the interrater reliability of the Risk Matrix 2000/s between one field rater and one independent rater with a sample of more than 100 sexual offenders. The results indicated good interrater reliability of the tool, although reliability varies from item to item. A number of factors were identified that seem to reduce the reliability of scoring. The present findings are strengthened by examining interrater reliability of the tool in the usual practitioner context and by calculating a range of reliability statistics. Strategies are suggested to increase reliability in the use of actuarial tools in routine practice. PMID:21216783

  7. Interrater reliability of Risk Matrix 2000/s.

    PubMed

    Wakeling, Helen C; Mann, Ruth E; Milner, Rebecca J

    2011-12-01

    Actuarial risk assessment instruments for sexual offenders are often used in high-stakes decision making and therefore should be subject to stringent reliability and validity testing. Furthermore, those involved in the risk assessment of sexual offenders should be aware of the factors that may affect the reliability of these instruments. The present study examined the interrater reliability of the Risk Matrix 2000/s between one field rater and one independent rater with a sample of more than 100 sexual offenders. The results indicated good interrater reliability of the tool, although reliability varies from item to item. A number of factors were identified that seem to reduce the reliability of scoring. The present findings are strengthened by examining interrater reliability of the tool in the usual practitioner context and by calculating a range of reliability statistics. Strategies are suggested to increase reliability in the use of actuarial tools in routine practice. PMID:22114173

  8. Apogee motor rocketry reliability improvements

    NASA Technical Reports Server (NTRS)

    Behm, J.; Dowler, W.; Gin, W.

    1974-01-01

    Since 1963, solid propellant apogee motors have been placing satellites into geosynchronous orbits. Major technological breakthroughs are not required to satisfy future mission requirements; however, there is a need to improve reliability to enhance cost effectiveness. Several management test options are discussed. A summary of results and conclusions derived from review of missions, where failure of a solid motor was inferred, and correlation of system factors with failures are reported. Highlights of a solid motor diagnostic instrumentation study are presented. Finally, recommendations are provided for areas of future apogee motor upgrade, which will increase project cost effectiveness by reducing the potential for future flight failures.

  9. Reliability-based casing design

    SciTech Connect

    Maes, M.A.; Gulati, K.C.; Johnson, R.C.; McKenna, D.L.; Brand, P.R.; Lewis, D.B.

    1995-06-01

    The present paper describes the development of reliability-based design criteria for oil and/or gas well casing/tubing. The approach is based on the fundamental principles of limit state design. Limit states for tubulars are discussed and specific techniques for the stochastic modeling of loading and resistance variables are described. Zonation methods and calibration techniques are developed which are geared specifically to the characteristic tubular design for both hydrocarbon drilling and production applications. The application of quantitative risk analysis to the development of risk-consistent design criteria is shown to be a major and necessary step forward in achieving more economic tubular design.

  10. "They Say Every Child Matters, but They Don't": An Investigation into Parental and Carer Perceptions of Access to Leisure Facilities and Respite Care for Children and Young People with Autistic Spectrum Disorder (ASD) or Attention Deficit, Hyperactivity Disorder (ADHD)

    ERIC Educational Resources Information Center

    Thompson, David; Emira, Mahmoud

    2011-01-01

    This paper analyses the experiences and perceptions of parents and carers with respect to children accessing a variety of leisure activities, as well as short breaks and respite care. The children in question have wide-ranging needs and, for example, will be across the Autistic Spectrum Disorder (ASD). The findings are based upon focus group…

  11. Reliability of steam generator tubing

    SciTech Connect

    Kadokami, E.

    1997-02-01

    The author presents results on studies made of the reliability of steam generator (SG) tubing. The basis for this work is that in Japan the issue of defects in SG tubing is addressed by the approach that any detected defect should be repaired, either by plugging the tube or sleeving it. However, this leaves open the issue that there is a detection limit in practice, and what is the effect of nondetectable cracks on the performance of tubing. These studies were commissioned to look at the safety issues involved in degraded SG tubing. The program has looked at a number of different issues. First was an assessment of the penetration and opening behavior of tube flaws due to internal pressure in the tubing. They have studied: penetration behavior of the tube flaws; primary water leakage from through-wall flaws; opening behavior of through-wall flaws. In addition they have looked at the question of the reliability of tubing with flaws during normal plant operation. Also there have been studies done on the consequences of tube rupture accidents on the integrity of neighboring tubes.

  12. Reliable vision-guided grasping

    NASA Technical Reports Server (NTRS)

    Nicewarner, Keith E.; Kelley, Robert B.

    1992-01-01

    Automated assembly of truss structures in space requires vision-guided servoing for grasping a strut when its position and orientation are uncertain. This paper presents a methodology for efficient and robust vision-guided robot grasping alignment. The vision-guided grasping problem is related to vision-guided 'docking' problems. It differs from other hand-in-eye visual servoing problems, such as tracking, in that the distance from the target is a relevant servo parameter. The methodology described in this paper is hierarchy of levels in which the vision/robot interface is decreasingly 'intelligent,' and increasingly fast. Speed is achieved primarily by information reduction. This reduction exploits the use of region-of-interest windows in the image plane and feature motion prediction. These reductions invariably require stringent assumptions about the image. Therefore, at a higher level, these assumptions are verified using slower, more reliable methods. This hierarchy provides for robust error recovery in that when a lower-level routine fails, the next-higher routine will be called and so on. A working system is described which visually aligns a robot to grasp a cylindrical strut. The system uses a single camera mounted on the end effector of a robot and requires only crude calibration parameters. The grasping procedure is fast and reliable, with a multi-level error recovery system.

  13. Reliable vision-guided grasping

    NASA Technical Reports Server (NTRS)

    Nicewarner, Keith E.; Kelley, Robert B.

    1992-01-01

    Automated assembly of truss structures in space requires vision-guided servoing for grasping a strut when its position and orientation are uncertain. This paper presents a methodology for efficient and robust vision-guided robot grasping alignment. The vision-guided grasping problem is related to vision-guided 'docking' problems. It differs from other hand-in-eye visual servoing problems such as tracking in that the distance from the target is a relevant servo parameter. The methodology described in this paper is a hierarchy of levels in which the vision/robot interface is decreasingly 'intelligent', and increasingly fast. Speed is achieved primarily by information reduction. This reduction exploits the use of region-of-interest windows in the image plane and feature motion prediction. These reductions invariably require stringent assumptions about the image. Therefore, at a higher level, these assumptions are verified using slower, more reliable methods. This hierarchy provides for robust error recovery in that when a lower-level routine fails, the next-higher routine will be called and so on. A working system is described which visually aligns a robot to grasp a cylindrical strut. The system uses a single camera mounted on the end effector of a robot and requires only crude calibration parameters. The grasping procedure is fast and reliable, with a multi-level error recovery system.

  14. Disclosure analysis procedures: reliability issues.

    PubMed

    Hux, K; Sanger, D; Reid, R; Maschka, A

    1997-01-01

    Performing disclosure analyses to supplement assessment procedures and facilitate intervention planning is only valuable if the observations are reliable. The purpose of the present study was to evaluate and compare four methods of assessing reliability on one discourse analysis procedure--a modified version of Damico's Clinical Discourse Analysis (1985a, 1985b, 1992). The selected methods were: (a) Pearson product-moment correlations, (b) interobserver agreement, (c) Cohen's kappa, and (d) generalizability coefficients. Results showed high correlation coefficients and high percentages of interobserver agreement when error type was not taken into account. However, interobserver agreement percentages obtained solely for target behavior occurrences and Cohen's kappa revealed that much of the agreement between rates was due to chance and the high frequency of target behavior non-occurrence. Generalizability coefficients revealed that the procedure was fair to good for discriminating among persons with differing levels of language competency for some aspects of communication performance but was less than desirable for others; the aggregate score was below recommended standards for differentiating among people for diagnostic purposes.

  15. Recognizing Life-threatening Features of Dengue in Children and Health Seeking Behavior in Dengue Emergency Amongst Parents and Carers: A Cross-sectional study in Gombak District, Malaysia.

    PubMed

    Ariffin, F; Ramli, A S; Naim, N; Selamat, M I; Syed-Jamal, S J

    2014-10-01

    Dengue is life-threatening and the paediatric population is highly susceptible to complications. Deterioration can occur rapidly and ability to recognise early warning signs is crucial. This study aims to determine the knowledge and awareness of parents and carers and to predict their ability in recognising life-threatening symptoms and signs of dengue in children and to assess their health-seeking behaviour in dengue emergency. Methods This is a crosssectional study involving parents and carers of children ≤ 12 years old in schools and kindergartens in the Gombak district. Demographic details, knowledge on life-threatening symptoms and signs of dengue and health-seeking behaviour were collected using a self-administered questionnaire and knowledge scoring was done. The questionnaire was pilot tested with a Cronbach alpha of 0.82. The results were analysed using SPSS version 20.0. Results Total respondents were 866 with 44.8% men and 55.2% women. The mean age was 40.3 years (SD ± 5.7). Knowledge score of dengue life threatening features among respondents were good (30.0%) to average (56.8%). Respondents were able to recognise fever (98.5%), petechial rash (97.1%) and bleeding (65.2%) but were less able to recognise abdominal pain (22.3%) and passing less urine (28.2%) as life threatening dengue features. However, the ability to recognise fever is a poor predictor in recognising life threatening dengue in children compared to all other symptoms which were good predictors. A respondent that recognise stomach pain or neck stiffness were five times more likely to recognise life-threatening dengue. Respondents preferred to bring their children to the clinic (50.8%) or hospital (37.8%) themselves Instead of calling for ambulance. Worryingly, some would give antipyretics (3.6%) or wait for improvements (7.8%). Conclusion Concerted efforts by the schools, healthcare professionals and health authorities are required to educate parents and carers to identify life

  16. 76 FR 42534 - Mandatory Reliability Standards for Interconnection Reliability Operating Limits; System...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-19

    ... Reliability Operating Limits; System Restoration Reliability Standards AGENCY: Federal Energy Regulatory... restoration from Blackstart Resources and require reliability coordinators to establish plans and prepare personnel to enable effective coordination of the system restoration process. The Commission also...

  17. Preliminary Nuclear Electric Propulsion (NEP) reliability study

    NASA Technical Reports Server (NTRS)

    Hsieh, T. M.; Nakashima, A. M.; Mondt, J. F.

    1973-01-01

    A preliminary failure mode, failure effect, and criticality analysis of the major subsystems of nuclear electric propulsion is presented. Simplified reliability block diagrams are also given. A computer program was used to calculate the reliability of the heat rejection subsystem.

  18. 77 FR 26686 - Transmission Planning Reliability Standards

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-07

    ... Energy Regulatory Commission 18 CFR Part 40 Transmission Planning Reliability Standards AGENCY: Federal... Act, the Federal Energy Regulatory Commission remands proposed Transmission Planning (TPL) Reliability... section 215(d) of the Federal Power Act,\\1\\ the Commission remands proposed Transmission Planning...

  19. FDA Warns Ovarian Cancer Tests Not Reliable

    MedlinePlus

    ... medlineplus.gov/news/fullstory_160880.html FDA Warns Ovarian Cancer Tests Not Reliable May delay preventive therapies for ... Sept. 9, 2016 (HealthDay News) -- Screening tests for ovarian cancer are not reliable and should not be used, ...

  20. Reliability and Validity for Neuroscience Nurses.

    PubMed

    Buelow, Janice M; Hinkle, Janice L; McNett, Molly

    2016-10-01

    The concepts of reliability and validity are important for neuroscience nurses to understand, particularly because they evaluate existing literature and integrate common scales or tools into their practice. Nurses must ensure instruments measuring specified concepts are both reliable and valid. This article will review types of reliability and validity-sometimes referred to collectively as a psychometric testing-of an instrument. Relevant examples in neuroscience are included to illustrate the importance of reliability and validity to neuroscience nurses. PMID:27579956

  1. Space transportation architecture: Reliability sensitivities

    NASA Technical Reports Server (NTRS)

    Williams, A. M.

    1992-01-01

    A sensitivity analysis is given of the benefits and drawbacks associated with a proposed Earth to orbit vehicle architecture. The architecture represents a fleet of six vehicles (two existing, four proposed) that would be responsible for performing various missions as mandated by NASA and the U.S. Air Force. Each vehicle has a prescribed flight rate per year for a period of 31 years. By exposing this fleet of vehicles to a probabilistic environment where the fleet experiences failures, downtimes, setbacks, etc., the analysis involves determining the resiliency and costs associated with the fleet of specific vehicle/subsystem reliabilities. The resources required were actual observed data on the failures and downtimes associated with existing vehicles, data based on engineering judgement for proposed vehicles, and the development of a sensitivity analysis program.

  2. Reliability on ISS Talk Outline

    NASA Technical Reports Server (NTRS)

    Misiora, Mike

    2015-01-01

    1. Overview of ISS 2. Space Environment and it effects a. Radiation b. Microgravity 3. How we ensure reliability a. Requirements b. Component Selection i. Note: I plan to stay away from talk about Rad Hardened components and talk about why we use older processors because they are less susceptible to SEUs. c. Testing d. Redundancy / Failure Tolerance e. Sparing strategies 4. Operational Examples a. Multiple MDM Failures on 6A due to hard drive failure In general, my plan is to only talk about data that is currently available via normal internet sources to ensure that I stay away from any topics that would be Export Controlled, ITAR, or NDA-controlled. The operational example has been well-reported on in the media and those are the details that I plan to cover. Additionally I am not planning on using any slides or showing any photos during the talk.

  3. Confidence bounds on structural reliability

    NASA Technical Reports Server (NTRS)

    Mehta, S. R.; Cruse, T. A.; Mahadevan, S.

    1993-01-01

    Different approaches for quantifying physical, statistical, and model uncertainties associated with the distribution parameters which are aimed at determining structural reliability are described. Confidence intervals on the distribution parameters of the input random variables are estimated using four algorithms to evaluate uncertainty of the response. Design intervals are evaluated using either Monte Carlo simulation or an iterative approach. A first order approach can be used to compute a first approximation of the design interval, but its accuracy is not satisfactory. The regression approach which combines the iterative approach with Monte Carlo simulation is capable of providing good results if the performance function can be accurately represented using regression analysis. It is concluded that the design interval-based approach seems to be quite general and takes into account distribution and model uncertainties.

  4. Reliability studies of electrostrictive actuators

    SciTech Connect

    Kumar, U.; Randall, M.; Hock, J.; Ritter, A.

    1994-12-31

    Multilayer electrostrictive actuators have numerous applications. Frequently these applications involve harsh mechanical and electrical loads. Furthermore, it is typically expected that these loads be incurred for >10{sup 8} repetitions (ideally for an infinite number of cycles). This paper describes the electrical and electro-mechanical analyses used at AVX Corporation to assess the performance characteristics of multilayer ceramic actuators, and addresses the effects of electro-mechanical cycling on selected device properties. In this study, lead magnesium niobate based multilayer electrostrictive actuators were subjected to a.c. fields at rated device voltage. Capacitance, dissipation factor, displacement vs. voltage, displacement hysteresis, electro-mechanical quality factor, and resonant frequency were monitored as a function of electro-mechanical cycling. The actuators exhibited highly stable displacements throughout the investigation. Changes observed in other properties indicate a possibility of using them as NDE techniques to assess the actuator reliability.

  5. Confidence bounds on structural reliability

    NASA Astrophysics Data System (ADS)

    Mehta, S. R.; Cruse, T. A.; Mahadevan, S.

    1993-04-01

    Different approaches for quantifying physical, statistical, and model uncertainties associated with the distribution parameters which are aimed at determining structural reliability are described. Confidence intervals on the distribution parameters of the input random variables are estimated using four algorithms to evaluate uncertainty of the response. Design intervals are evaluated using either Monte Carlo simulation or an iterative approach. A first order approach can be used to compute a first approximation of the design interval, but its accuracy is not satisfactory. The regression approach which combines the iterative approach with Monte Carlo simulation is capable of providing good results if the performance function can be accurately represented using regression analysis. It is concluded that the design interval-based approach seems to be quite general and takes into account distribution and model uncertainties.

  6. How Reliable Are Informal Reading Inventories?

    ERIC Educational Resources Information Center

    Spector, Janet E.

    2005-01-01

    Informal Reading Inventories (IRI) are often recommended as instructionally relevant measures of reading. However, they have also been criticized for inattention to technical quality. Examination of reliability evidence in nine recently revised IRIs revealed that fewer than half report reliability. Several appear to have sufficient reliability for…

  7. Space transportation main engine reliability and safety

    NASA Technical Reports Server (NTRS)

    Monk, Jan C.

    1991-01-01

    Viewgraphs are used to illustrate the reliability engineering and aerospace safety of the Space Transportation Main Engine (STME). A technology developed is called Total Quality Management (TQM). The goal is to develop a robust design. Reducing process variability produces a product with improved reliability and safety. Some engine system design characteristics are identified which improves reliability.

  8. Software reliability models for critical applications

    SciTech Connect

    Pham, H.; Pham, M.

    1991-12-01

    This report presents the results of the first phase of the ongoing EG&G Idaho, Inc. Software Reliability Research Program. The program is studying the existing software reliability models and proposes a state-of-the-art software reliability model that is relevant to the nuclear reactor control environment. This report consists of three parts: (1) summaries of the literature review of existing software reliability and fault tolerant software reliability models and their related issues, (2) proposed technique for software reliability enhancement, and (3) general discussion and future research. The development of this proposed state-of-the-art software reliability model will be performed in the second place. 407 refs., 4 figs., 2 tabs.

  9. Software reliability models for critical applications

    SciTech Connect

    Pham, H.; Pham, M.

    1991-12-01

    This report presents the results of the first phase of the ongoing EG G Idaho, Inc. Software Reliability Research Program. The program is studying the existing software reliability models and proposes a state-of-the-art software reliability model that is relevant to the nuclear reactor control environment. This report consists of three parts: (1) summaries of the literature review of existing software reliability and fault tolerant software reliability models and their related issues, (2) proposed technique for software reliability enhancement, and (3) general discussion and future research. The development of this proposed state-of-the-art software reliability model will be performed in the second place. 407 refs., 4 figs., 2 tabs.

  10. 76 FR 66055 - North American Electric Reliability Corporation; Order Approving Interpretation of Reliability...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-25

    ... Operations (TOP) Reliability Standard TOP-002-2a (Normal Operations Planning). This Reliability Standard... the planning required to meet all System Operating Limits and Interconnection Reliability Operating... interpretation of Requirement R10 of Reliability Standard TOP-002-2a (Normal Operations Planning). The...

  11. 75 FR 71613 - Mandatory Reliability Standards for Interconnection Reliability Operating Limits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-24

    ... developing and enforcing mandatory Reliability Standards. The proposed Reliability Standards were designed to... mandatory Reliability Standards.\\2\\ The proposed Reliability Standards were designed to prevent instability..., Order No. 693, 72 FR 16416 (Apr. 4, 2007), FERC Stats. & Regs. ] 31,242, order on reh'g, Order No....

  12. Theory of reliable systems. [reliability analysis and on-line fault diagnosis

    NASA Technical Reports Server (NTRS)

    Meyer, J. F.

    1974-01-01

    Research is reported in the program to refine the current notion of system reliability by identifying and investigating attributes of a system which are important to reliability considerations, and to develop techniques which facilitate analysis of system reliability. Reliability analysis, and on-line fault diagnosis are discussed.

  13. Time-Dependent Reliability Analysis

    1999-10-27

    FRANTIC-3 was developed to evaluate system unreliability using time-dependent techniques. The code provides two major options: to evaluate standby system unavailability or, in addition to the unavailability to calculate the total system failure probability by including both the unavailability of the system on demand as well as the probability that it will operate for an arbitrary time period following the demand. The FRANTIC-3 time dependent reliability models provide a large selection of repair and testingmore » policies applicable to standby or continously operating systems consisting of periodically tested, monitored, and non-repairable (non-testable) components. Time-dependent and test frequency dependent failures, as well as demand stress related failure, test-caused degradation and wear-out, test associated human errors, test deficiencies, test override, unscheduled and scheduled maintenance, component renewal and replacement policies, and test strategies can be prescribed. The conditional system unavailabilities associated with the downtimes of the user specified failed component are also evaluated. Optionally, the code can perform a sensitivity study for system unavailability or total failure probability to the failure characteristics of the standby components.« less

  14. Identifying a reliable boredom induction.

    PubMed

    Markey, Amanda; Chin, Alycia; Vanepps, Eric M; Loewenstein, George

    2014-08-01

    None of the tasks used to induce boredom have undergone rigorous psychometric validation, which creates potential problems for operational equivalence, comparisons across studies, statistical power, and confounding results. This methodological concern was addressed by testing and comparing the effectiveness of six 5-min. computerized boredom inductions (peg turning, audio, video, signature matching, one-back, and an air traffic control task). The tasks were evaluated using standard criteria for emotion inductions: intensity and discreteness. Intensity, the amount of boredom elicited, was measured using a subset of the Multidimensional State Boredom Scale. Discreteness, the extent to which the task elicited boredom and did not elicit other emotions, was measured using a modification of the Differential Emotion Scale. In both a laboratory setting (Study 1; N = 241) and an online setting with Amazon Mechanical Turk workers (Study 2; N = 416), participants were randomly assigned to one of seven tasks (six boredom tasks or a comparison task, a clip from Planet Earth) before rating their boredom using the MSBS and other emotions using the modified DES. In both studies, each task had significantly higher intensity and discreteness than the comparison task, with moderate to large effect sizes. The peg-turning task outperformed the other tasks in both intensity and discreteness, making it the recommended induction. Identification of reliable and valid boredom inductions and systematic comparison of their relative results should help advance state boredom research.

  15. Reliability prediction of corroding pipelines

    SciTech Connect

    Strutt, J.E.; Allsopp, K.; Newman, D.; Trille, C.

    1996-12-01

    Recent data collection studies relating to loss of containment of pipeline and risers indicate that corrosion is now the dominant failure mode for steel pipelines in the North Sea area. As the North Sea pipeline infrastructure ages, it is expected that the proportion of pipelines failing by corrosion will increase further and this raises the question of the relationship between probability of pipeline corrosion failure and the reliability of the corrosion control and monitoring systems used by operators to prevent corrosion failures. This paper describes a methodology for predicting the probability of corrosion failure of a specific submarine pipeline or riser system. The paper illustrates how the model can be used to predict the safe life of a pipeline, given knowledge of the underlying corrosion behavior and corrosion control system and how the time to failure can be updated in the light of inspection and monitoring results enabling inspection policy to be evaluated for its impact on risk. The paper also shows how different assumptions concerning the underlying cause of failure influences the estimation of the probability of failure.

  16. Time-Dependent Reliability Analysis

    SciTech Connect

    Sartori, Enrico

    1999-10-27

    FRANTIC-3 was developed to evaluate system unreliability using time-dependent techniques. The code provides two major options: to evaluate standby system unavailability or, in addition to the unavailability to calculate the total system failure probability by including both the unavailability of the system on demand as well as the probability that it will operate for an arbitrary time period following the demand. The FRANTIC-3 time dependent reliability models provide a large selection of repair and testing policies applicable to standby or continously operating systems consisting of periodically tested, monitored, and non-repairable (non-testable) components. Time-dependent and test frequency dependent failures, as well as demand stress related failure, test-caused degradation and wear-out, test associated human errors, test deficiencies, test override, unscheduled and scheduled maintenance, component renewal and replacement policies, and test strategies can be prescribed. The conditional system unavailabilities associated with the downtimes of the user specified failed component are also evaluated. Optionally, the code can perform a sensitivity study for system unavailability or total failure probability to the failure characteristics of the standby components.

  17. Evaluation of MHTGR fuel reliability

    SciTech Connect

    Wichner, R.P.; Barthold, W.P.

    1992-07-01

    Modular High-Temperature Gas-Cooled Reactor (MHTGR) concepts that house the reactor vessel in a tight but unsealed reactor building place heightened importance on the reliability of the fuel particle coatings as fission product barriers. Though accident consequence analyses continue to show favorable results, the increased dependence on one type of barrier, in addition to a number of other factors, has caused the Nuclear Regulatory Commission (NRC) to consider conservative assumptions regarding fuel behavior. For this purpose, the concept termed ``weak fuel`` has been proposed on an interim basis. ``Weak fuel`` is a penalty imposed on consequence analyses whereby the fuel is assumed to respond less favorably to environmental conditions than predicted by behavioral models. The rationale for adopting this penalty, as well as conditions that would permit its reduction or elimination, are examined in this report. The evaluation includes an examination of possible fuel-manufacturing defects, quality-control procedures for defect detection, and the mechanisms by which fuel defects may lead to failure.

  18. Identifying a reliable boredom induction.

    PubMed

    Markey, Amanda; Chin, Alycia; Vanepps, Eric M; Loewenstein, George

    2014-08-01

    None of the tasks used to induce boredom have undergone rigorous psychometric validation, which creates potential problems for operational equivalence, comparisons across studies, statistical power, and confounding results. This methodological concern was addressed by testing and comparing the effectiveness of six 5-min. computerized boredom inductions (peg turning, audio, video, signature matching, one-back, and an air traffic control task). The tasks were evaluated using standard criteria for emotion inductions: intensity and discreteness. Intensity, the amount of boredom elicited, was measured using a subset of the Multidimensional State Boredom Scale. Discreteness, the extent to which the task elicited boredom and did not elicit other emotions, was measured using a modification of the Differential Emotion Scale. In both a laboratory setting (Study 1; N = 241) and an online setting with Amazon Mechanical Turk workers (Study 2; N = 416), participants were randomly assigned to one of seven tasks (six boredom tasks or a comparison task, a clip from Planet Earth) before rating their boredom using the MSBS and other emotions using the modified DES. In both studies, each task had significantly higher intensity and discreteness than the comparison task, with moderate to large effect sizes. The peg-turning task outperformed the other tasks in both intensity and discreteness, making it the recommended induction. Identification of reliable and valid boredom inductions and systematic comparison of their relative results should help advance state boredom research. PMID:25153752

  19. System and Software Reliability (C103)

    NASA Technical Reports Server (NTRS)

    Wallace, Dolores

    2003-01-01

    Within the last decade better reliability models (hardware. software, system) than those currently used have been theorized and developed but not implemented in practice. Previous research on software reliability has shown that while some existing software reliability models are practical, they are no accurate enough. New paradigms of development (e.g. OO) have appeared and associated reliability models have been proposed posed but not investigated. Hardware models have been extensively investigated but not integrated into a system framework. System reliability modeling is the weakest of the three. NASA engineers need better methods and tools to demonstrate that the products meet NASA requirements for reliability measurement. For the new models for the software component of the last decade, there is a great need to bring them into a form that they can be used on software intensive systems. The Statistical Modeling and Estimation of Reliability Functions for Systems (SMERFS'3) tool is an existing vehicle that may be used to incorporate these new modeling advances. Adapting some existing software reliability modeling changes to accommodate major changes in software development technology may also show substantial improvement in prediction accuracy. With some additional research, the next step is to identify and investigate system reliability. System reliability models could then be incorporated in a tool such as SMERFS'3. This tool with better models would greatly add value in assess in GSFC projects.

  20. Managing Reliability in the 21st Century

    SciTech Connect

    Dellin, T.A.

    1998-11-23

    The rapid pace of change at Ike end of the 20th Century should continue unabated well into the 21st Century. The driver will be the marketplace imperative of "faster, better, cheaper." This imperative has already stimulated a revolution-in-engineering in design and manufacturing. In contrast, to date, reliability engineering has not undergone a similar level of change. It is critical that we implement a corresponding revolution-in-reliability-engineering as we enter the new millennium. If we are still using 20th Century reliability approaches in the 21st Century, then reliability issues will be the limiting factor in faster, better, and cheaper. At the heart of this reliability revolution will be a science-based approach to reliability engineering. Science-based reliability will enable building-in reliability, application-specific products, virtual qualification, and predictive maintenance. The purpose of this paper is to stimulate a dialogue on the future of reliability engineering. We will try to gaze into the crystal ball and predict some key issues that will drive reliability programs in the new millennium. In the 21st Century, we will demand more of our reliability programs. We will need the ability to make accurate reliability predictions that will enable optimizing cost, performance and time-to-market to meet the needs of every market segment. We will require that all of these new capabilities be in place prior to the stint of a product development cycle. The management of reliability programs will be driven by quantifiable metrics of value added to the organization business objectives.

  1. Fundamental mechanisms of micromachine reliability

    SciTech Connect

    DE BOER,MAARTEN P.; SNIEGOWSKI,JEFFRY J.; KNAPP,JAMES A.; REDMOND,JAMES M.; MICHALSKE,TERRY A.; MAYER,THOMAS K.

    2000-01-01

    Due to extreme surface to volume ratios, adhesion and friction are critical properties for reliability of Microelectromechanical Systems (MEMS), but are not well understood. In this LDRD the authors established test structures, metrology and numerical modeling to conduct studies on adhesion and friction in MEMS. They then concentrated on measuring the effect of environment on MEMS adhesion. Polycrystalline silicon (polysilicon) is the primary material of interest in MEMS because of its integrated circuit process compatibility, low stress, high strength and conformal deposition nature. A plethora of useful micromachined device concepts have been demonstrated using Sandia National Laboratories' sophisticated in-house capabilities. One drawback to polysilicon is that in air the surface oxidizes, is high energy and is hydrophilic (i.e., it wets easily). This can lead to catastrophic failure because surface forces can cause MEMS parts that are brought into contact to adhere rather than perform their intended function. A fundamental concern is how environmental constituents such as water will affect adhesion energies in MEMS. The authors first demonstrated an accurate method to measure adhesion as reported in Chapter 1. In Chapter 2 through 5, they then studied the effect of water on adhesion depending on the surface condition (hydrophilic or hydrophobic). As described in Chapter 2, they find that adhesion energy of hydrophilic MEMS surfaces is high and increases exponentially with relative humidity (RH). Surface roughness is the controlling mechanism for this relationship. Adhesion can be reduced by several orders of magnitude by silane coupling agents applied via solution processing. They decrease the surface energy and render the surface hydrophobic (i.e. does not wet easily). However, only a molecular monolayer coats the surface. In Chapters 3-5 the authors map out the extent to which the monolayer reduces adhesion versus RH. They find that adhesion is independent of

  2. Reliability Growth in Space Life Support Systems

    NASA Technical Reports Server (NTRS)

    Jones, Harry W.

    2014-01-01

    A hardware system's failure rate often increases over time due to wear and aging, but not always. Some systems instead show reliability growth, a decreasing failure rate with time, due to effective failure analysis and remedial hardware upgrades. Reliability grows when failure causes are removed by improved design. A mathematical reliability growth model allows the reliability growth rate to be computed from the failure data. The space shuttle was extensively maintained, refurbished, and upgraded after each flight and it experienced significant reliability growth during its operational life. In contrast, the International Space Station (ISS) is much more difficult to maintain and upgrade and its failure rate has been constant over time. The ISS Carbon Dioxide Removal Assembly (CDRA) reliability has slightly decreased. Failures on ISS and with the ISS CDRA continue to be a challenge.

  3. The Reliability of Psychiatric Diagnosis Revisited

    PubMed Central

    Rankin, Eric; France, Cheryl; El-Missiry, Ahmed; John, Collin

    2006-01-01

    Background: The authors reviewed the topic of reliability of psychiatric diagnosis from the turn of the 20th century to present. The objectives of this paper are to explore the reasons of unreliability of psychiatric diagnosis and propose ways to improve the reliability of psychiatric diagnosis. Method: The authors reviewed the literature on the concept of reliability of psychiatric diagnosis with emphasis on the impact of interviewing skills, use of diagnostic criteria, and structured interviews on the reliability of psychiatric diagnosis. Results: Causes of diagnostic unreliability are attributed to the patient, the clinician and psychiatric nomenclature. The reliability of psychiatric diagnosis can be enhanced by using diagnostic criteria, defining psychiatric symptoms and structuring the interviews. Conclusions: The authors propose the acronym ‘DR.SED,' which stands for diagnostic criteria, reference definitions, structuring the interview, clinical experience, and data. The authors recommend that clinicians use the DR.SED paradigm to improve the reliability of psychiatric diagnoses. PMID:21103149

  4. Reliability assurance for regulation of advanced reactors

    SciTech Connect

    Fullwood, R.; Lofaro, R.; Samanta, P.

    1991-01-01

    The advanced nuclear power plants must achieve higher levels of safety than the first generation of plants. Showing that this is indeed true provides new challenges to reliability and risk assessment methods in the analysis of the designs employing passive and semi-passive protection. Reliability assurance of the advanced reactor systems is important for determining the safety of the design and for determining the plant operability. Safety is the primary concern, but operability is considered indicative of good and safe operation. This paper discusses several concerns for reliability assurance of the advanced design encompassing reliability determination, level of detail required in advanced reactor submittals, data for reliability assurance, systems interactions and common cause effects, passive component reliability, PRA-based configuration control system, and inspection, training, maintenance and test requirements. Suggested approaches are provided for addressing each of these topics.

  5. Reliability assurance for regulation of advanced reactors

    SciTech Connect

    Fullwood, R.; Lofaro, R.; Samanta, P.

    1991-12-31

    The advanced nuclear power plants must achieve higher levels of safety than the first generation of plants. Showing that this is indeed true provides new challenges to reliability and risk assessment methods in the analysis of the designs employing passive and semi-passive protection. Reliability assurance of the advanced reactor systems is important for determining the safety of the design and for determining the plant operability. Safety is the primary concern, but operability is considered indicative of good and safe operation. This paper discusses several concerns for reliability assurance of the advanced design encompassing reliability determination, level of detail required in advanced reactor submittals, data for reliability assurance, systems interactions and common cause effects, passive component reliability, PRA-based configuration control system, and inspection, training, maintenance and test requirements. Suggested approaches are provided for addressing each of these topics.

  6. NASCOM network: Ground communications reliability report

    NASA Technical Reports Server (NTRS)

    1973-01-01

    A reliability performance analysis of the NASCOM Network circuits is reported. Network performance narrative summary is presented to include significant changes in circuit configurations, current figures, and trends in each trouble category with notable circuit totals specified. Lost time and interruption tables listing circuits which were affected by outages showing their totals category are submitted. A special analysis of circuits with low reliabilities is developed with tables depicting the performance and graphs for individual reliabilities.

  7. Reliability of the Fermilab Antiproton Source

    SciTech Connect

    Harms, E. Jr.

    1993-05-01

    This paper reports on the reliability of the Fermilab Antiproton source since it began operation in 1985. Reliability of the complex as a whole as well as subsystem performance is summarized. Also discussed is the trending done to determine causes of significant machine downtime and actions taken to reduce the incidence of failure. Finally, results of a study to detect previously unidentified reliability limitations are presented.

  8. Reliability of the Deployment Resiliency Assessment.

    PubMed

    Simon, Samuel E; Stewart, Kate; Kloc, Michelle; Williams, Thomas V; Wilmoth, Margaret C

    2016-07-01

    This article describes the reliability of the instruments embedded in a mental health screening instrument designed to detect risky drinking, depression, and post-traumatic stress disorder among members of the Armed Forces. The instruments were generally reliable, however, the risky drinking screen (Alcohol Use Disorders Identification Test-Consumption) had unacceptable reliability (α = 0.58). This was the first attempt to assess psychometric properties of a screening and assessment instrument widely used for members of the Armed Forces. PMID:27391616

  9. Reliability engineering in solar energy: workshop proceedings

    SciTech Connect

    Gross, G.

    1980-03-01

    A workshop to reveal the scope of reliability-related activities in solar energy conversion projects and in nonsolar segments of industry is described. Two reliability programs, one in heating and cooling and one in photovoltaics, are explicated. This document also presents general suggestions for the establishment of a unified program for reliability, durability, maintainability, and safety (RDM and S) in present and future solar projects.

  10. High Reliability and Excellence in Staffing.

    PubMed

    Mensik, Jennifer

    2015-01-01

    Nurse staffing is a complex issue, with many facets and no one right answer. High-reliability organizations (HROs) strive and succeed in achieving a high degree of safety or reliability despite operating in hazardous conditions. HROs have systems in place that make them extremely consistent in accomplishing their goals and avoiding potential errors. However, the inability to resolve quality issues may very well be related to the lack of adoption of high-reliability principles throughout our organizations.

  11. Signal verification can promote reliable signalling

    PubMed Central

    Broom, Mark; Ruxton, Graeme D.; Schaefer, H. Martin

    2013-01-01

    The central question in communication theory is whether communication is reliable, and if so, which mechanisms select for reliability. The primary approach in the past has been to attribute reliability to strategic costs associated with signalling as predicted by the handicap principle. Yet, reliability can arise through other mechanisms, such as signal verification; but the theoretical understanding of such mechanisms has received relatively little attention. Here, we model whether verification can lead to reliability in repeated interactions that typically characterize mutualisms. Specifically, we model whether fruit consumers that discriminate among poor- and good-quality fruits within a population can select for reliable fruit signals. In our model, plants either signal or they do not; costs associated with signalling are fixed and independent of plant quality. We find parameter combinations where discriminating fruit consumers can select for signal reliability by abandoning unprofitable plants more quickly. This self-serving behaviour imposes costs upon plants as a by-product, rendering it unprofitable for unrewarding plants to signal. Thus, strategic costs to signalling are not a prerequisite for reliable communication. We expect verification to more generally explain signal reliability in repeated consumer–resource interactions that typify mutualisms but also in antagonistic interactions such as mimicry and aposematism. PMID:24068354

  12. NEPP DDR Device Reliability FY13 Report

    NASA Technical Reports Server (NTRS)

    Guertin, Steven M.; Armbar, Mehran

    2014-01-01

    This document reports the status of the NEPP Double Data Rate (DDR) Device Reliability effort for FY2013. The task targeted general reliability of > 100 DDR2 devices from Hynix, Samsung, and Micron. Detailed characterization of some devices when stressed by several data storage patterns was studied, targeting ability of the data cells to store the different data patterns without refresh, highlighting the weakest bits. DDR2, Reliability, Data Retention, Temperature Stress, Test System Evaluation, General Reliability, IDD measurements, electronic parts, parts testing, microcircuits

  13. Maximum phonation time: variability and reliability.

    PubMed

    Speyer, Renée; Bogaardt, Hans C A; Passos, Valéria Lima; Roodenburg, Nel P H D; Zumach, Anne; Heijnen, Mariëlle A M; Baijens, Laura W J; Fleskens, Stijn J H M; Brunings, Jan W

    2010-05-01

    The objective of the study was to determine maximum phonation time reliability as a function of the number of trials, days, and raters in dysphonic and control subjects. Two groups of adult subjects participated in this reliability study: a group of outpatients with functional or organic dysphonia versus a group of healthy control subjects matched by age and gender. Over a period of maximally 6 weeks, three video recordings were made of five subjects' maximum phonation time trials. A panel of five experts were responsible for all measurements, including a repeated measurement of the subjects' first recordings. Patients showed significantly shorter maximum phonation times compared with healthy controls (on average, 6.6 seconds shorter). The averaged interclass correlation coefficient (ICC) over all raters per trial for the first day was 0.998. The averaged reliability coefficient per rater and per trial for repeated measurements of the first day's data was 0.997, indicating high intrarater reliability. The mean reliability coefficient per day for one trial was 0.939. When using five trials, the reliability increased to 0.987. The reliability over five trials for a single day was 0.836; for 2 days, 0.911; and for 3 days, 0.935. To conclude, the maximum phonation time has proven to be a highly reliable measure in voice assessment. A single rater is sufficient to provide highly reliable measurements.

  14. Signal verification can promote reliable signalling.

    PubMed

    Broom, Mark; Ruxton, Graeme D; Schaefer, H Martin

    2013-11-22

    The central question in communication theory is whether communication is reliable, and if so, which mechanisms select for reliability. The primary approach in the past has been to attribute reliability to strategic costs associated with signalling as predicted by the handicap principle. Yet, reliability can arise through other mechanisms, such as signal verification; but the theoretical understanding of such mechanisms has received relatively little attention. Here, we model whether verification can lead to reliability in repeated interactions that typically characterize mutualisms. Specifically, we model whether fruit consumers that discriminate among poor- and good-quality fruits within a population can select for reliable fruit signals. In our model, plants either signal or they do not; costs associated with signalling are fixed and independent of plant quality. We find parameter combinations where discriminating fruit consumers can select for signal reliability by abandoning unprofitable plants more quickly. This self-serving behaviour imposes costs upon plants as a by-product, rendering it unprofitable for unrewarding plants to signal. Thus, strategic costs to signalling are not a prerequisite for reliable communication. We expect verification to more generally explain signal reliability in repeated consumer-resource interactions that typify mutualisms but also in antagonistic interactions such as mimicry and aposematism.

  15. Evaluating Reliability: A Cost-Effectiveness Approach.

    ERIC Educational Resources Information Center

    Hogan, Andrew

    1986-01-01

    This study derives the economic costs of misclassification in nursing home patient classification systems. These costs are then used as weights to estimate the reliability of a functional assessment instrument. Results suggest that reliability must be redefined and remeasured with each substantively new application of an assessment instrument.…

  16. Simulation of reliability in multiserver computer networks

    NASA Astrophysics Data System (ADS)

    Minkevičius, Saulius

    2012-11-01

    The performance in terms of reliability of computer multiserver networks motivates this paper. The probability limit theorem is derived on the extreme queue length in open multiserver queueing networks in heavy traffic and applied to a reliability model for multiserver computer networks where we relate the time of failure of a multiserver computer network to the system parameters.

  17. Scale Reliability Evaluation with Heterogeneous Populations

    ERIC Educational Resources Information Center

    Raykov, Tenko; Marcoulides, George A.

    2015-01-01

    A latent variable modeling approach for scale reliability evaluation in heterogeneous populations is discussed. The method can be used for point and interval estimation of reliability of multicomponent measuring instruments in populations representing mixtures of an unknown number of latent classes or subpopulations. The procedure is helpful also…

  18. Reliability measurement for operational avionics software

    NASA Technical Reports Server (NTRS)

    Thacker, J.; Ovadia, F.

    1979-01-01

    Quantitative measures of reliability for operational software in embedded avionics computer systems are presented. Analysis is carried out on data collected during flight testing and from both static and dynamic simulation testing. Failure rate is found to be a useful statistic for estimating software quality and recognizing reliability trends during the operational phase of software development.

  19. 75 FR 71625 - System Restoration Reliability Standards

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-24

    ... Reliability Standards for the Bulk-Power System, Order No. 693, 72 FR 16416 at P 297 (Apr. 4, 2007), FERC... No. 486, 52 FR 47897 (Dec. 17, 1987), FERC Stats. & Regs. ] 30,783 (1987). \\34\\ 18 CFR 380.4(a)(5... Energy Regulatory Commission 18 CFR Part 40 System Restoration Reliability Standards November 18,...

  20. Immodest Witnesses: Reliability and Writing Assessment

    ERIC Educational Resources Information Center

    Gallagher, Chris W.

    2014-01-01

    This article offers a survey of three reliability theories in writing assessment: positivist, hermeneutic, and rhetorical. Drawing on an interdisciplinary investigation of the notion of "witnessing," this survey emphasizes the kinds of readers and readings each theory of reliability produces and the epistemological grounds on which it…

  1. Coefficient Alpha and Reliability of Scale Scores

    ERIC Educational Resources Information Center

    Almehrizi, Rashid S.

    2013-01-01

    The majority of large-scale assessments develop various score scales that are either linear or nonlinear transformations of raw scores for better interpretations and uses of assessment results. The current formula for coefficient alpha (a; the commonly used reliability coefficient) only provides internal consistency reliability estimates of raw…

  2. 76 FR 30341 - Reliable Storage 1 LLC;

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-25

    ... Reliable Storage 1 LLC; Notice of Preliminary Permit Application Accepted for Filing and Soliciting Comments, Motions to Intervene, and Competing Applications On March 25, 2011, Reliable Storage 1 LLC filed... permission. The proposed pumped storage project would consist of the following: (1) A 70-foot-high,...

  3. Inter-Rater Reliability of the Developmental Behaviour Checklist for Adults in Community Accommodation Settings

    ERIC Educational Resources Information Center

    Mohr, C.; Tonge, B. J.; Taffe, J.; Rymill, A.; Collins, D.; Keating, C.; Einfeld, S. L.

    2011-01-01

    Background: With the publication of the Developmental Behaviour Checklist for Adults (DBC-A), people of all ages with intellectual disability (ID) can now be assessed using a carer-completed screening checklist of emotional and behavioural disturbance. This provides a broad assessment framework across the life span, assists the process of clinical…

  4. Software reliability experiments data analysis and investigation

    NASA Technical Reports Server (NTRS)

    Walker, J. Leslie; Caglayan, Alper K.

    1991-01-01

    The objectives are to investigate the fundamental reasons which cause independently developed software programs to fail dependently, and to examine fault tolerant software structures which maximize reliability gain in the presence of such dependent failure behavior. The authors used 20 redundant programs from a software reliability experiment to analyze the software errors causing coincident failures, to compare the reliability of N-version and recovery block structures composed of these programs, and to examine the impact of diversity on software reliability using subpopulations of these programs. The results indicate that both conceptually related and unrelated errors can cause coincident failures and that recovery block structures offer more reliability gain than N-version structures if acceptance checks that fail independently from the software components are available. The authors present a theory of general program checkers that have potential application for acceptance tests.

  5. Relating design and environmental variables to reliability

    NASA Astrophysics Data System (ADS)

    Kolarik, William J.; Landers, Thomas L.

    The combination of space application and nuclear power source demands high reliability hardware. The possibilities of failure, either an inability to provide power or a catastrophic accident, must be minimized. Nuclear power experiences on the ground have led to highly sophisticated probabilistic risk assessment procedures, most of which require quantitative information to adequately assess such risks. In the area of hardware risk analysis, reliability information plays a key role. One of the lessons learned from the Three Mile Island experience is that thorough analyses of critical components are essential. Nuclear grade equipment shows some reliability advantages over commercial. However, no statistically significant difference has been found. A recent study pertaining to spacecraft electronics reliability, examined some 2500 malfunctions on more than 300 aircraft. The study classified the equipment failures into seven general categories. Design deficiencies and lack of environmental protection accounted for about half of all failures. Within each class, limited reliability modeling was performed using a Weibull failure model.

  6. Reliability of genetic networks is evolvable

    NASA Astrophysics Data System (ADS)

    Braunewell, Stefan; Bornholdt, Stefan

    2008-06-01

    Control of the living cell functions with remarkable reliability despite the stochastic nature of the underlying molecular networks—a property presumably optimized by biological evolution. We ask here to what extent the ability of a stochastic dynamical network to produce reliable dynamics is an evolvable trait. Using an evolutionary algorithm based on a deterministic selection criterion for the reliability of dynamical attractors, we evolve networks of noisy discrete threshold nodes. We find that, starting from any random network, reliability of the attractor landscape can often be achieved with only a few small changes to the network structure. Further, the evolvability of networks toward reliable dynamics while retaining their function is investigated and a high success rate is found.

  7. Estimating the Reliability of a Crewed Spacecraft

    NASA Astrophysics Data System (ADS)

    Lutomski, M. G.; Garza, J.

    2012-01-01

    Now that the Space Shuttle Program has been retired, the Russian Soyuz Launcher and Soyuz Spacecraft are the only means for crew transportation to and from the International Space Station (ISS). Are the astronauts and cosmonauts safer on the Soyuz than the Space Shuttle system? How do you estimate the reliability of such a crewed spacecraft? The recent loss of the 44 Progress resupply flight to the ISS has put these questions front and center. The Soyuz launcher has been in operation for over 40 years. There have been only two Loss of Crew (LOC) incidents and two Loss of Mission (LOM) incidents involving crew missions. Given that the most recent crewed Soyuz launcher incident took place in 1983, how do we determine current reliability of such a system? How do all of the failures of unmanned Soyuz family launchers such as the 44P impact the reliability of the currently operational crewed launcher? Does the Soyuz exhibit characteristics that demonstrate reliability growth and how would that be reflected in future estimates of success? In addition NASA has begun development of the Orion or Multi-Purpose Crewed Vehicle as well as started an initiative to purchase Commercial Crew services from private firms. The reliability targets are currently several times higher than the last Shuttle reliability estimate. Can these targets be compared to the reliability of the Soyuz arguably the highest reliable crewed spacecraft and launcher in the world to determine whether they are realistic and achievable? To help answer these questions this paper will explore how to estimate the reliability of the Soyuz launcher/spacecraft system over its mission to give a benchmark for other human spaceflight vehicles and their missions. Specifically this paper will look at estimating the Loss of Mission (LOM) and Loss of Crew (LOC) probability for an ISS crewed Soyuz launcher/spacecraft mission using historical data, reliability growth, and Probabilistic Risk Assessment (PRA) techniques.

  8. Mission Reliability Estimation for Repairable Robot Teams

    NASA Technical Reports Server (NTRS)

    Trebi-Ollennu, Ashitey; Dolan, John; Stancliff, Stephen

    2010-01-01

    A mission reliability estimation method has been designed to translate mission requirements into choices of robot modules in order to configure a multi-robot team to have high reliability at minimal cost. In order to build cost-effective robot teams for long-term missions, one must be able to compare alternative design paradigms in a principled way by comparing the reliability of different robot models and robot team configurations. Core modules have been created including: a probabilistic module with reliability-cost characteristics, a method for combining the characteristics of multiple modules to determine an overall reliability-cost characteristic, and a method for the generation of legitimate module combinations based on mission specifications and the selection of the best of the resulting combinations from a cost-reliability standpoint. The developed methodology can be used to predict the probability of a mission being completed, given information about the components used to build the robots, as well as information about the mission tasks. In the research for this innovation, sample robot missions were examined and compared to the performance of robot teams with different numbers of robots and different numbers of spare components. Data that a mission designer would need was factored in, such as whether it would be better to have a spare robot versus an equivalent number of spare parts, or if mission cost can be reduced while maintaining reliability using spares. This analytical model was applied to an example robot mission, examining the cost-reliability tradeoffs among different team configurations. Particularly scrutinized were teams using either redundancy (spare robots) or repairability (spare components). Using conservative estimates of the cost-reliability relationship, results show that it is possible to significantly reduce the cost of a robotic mission by using cheaper, lower-reliability components and providing spares. This suggests that the

  9. Scaled CMOS Technology Reliability Users Guide

    NASA Technical Reports Server (NTRS)

    White, Mark

    2010-01-01

    The desire to assess the reliability of emerging scaled microelectronics technologies through faster reliability trials and more accurate acceleration models is the precursor for further research and experimentation in this relevant field. The effect of semiconductor scaling on microelectronics product reliability is an important aspect to the high reliability application user. From the perspective of a customer or user, who in many cases must deal with very limited, if any, manufacturer's reliability data to assess the product for a highly-reliable application, product-level testing is critical in the characterization and reliability assessment of advanced nanometer semiconductor scaling effects on microelectronics reliability. A methodology on how to accomplish this and techniques for deriving the expected product-level reliability on commercial memory products are provided.Competing mechanism theory and the multiple failure mechanism model are applied to the experimental results of scaled SDRAM products. Accelerated stress testing at multiple conditions is applied at the product level of several scaled memory products to assess the performance degradation and product reliability. Acceleration models are derived for each case. For several scaled SDRAM products, retention time degradation is studied and two distinct soft error populations are observed with each technology generation: early breakdown, characterized by randomly distributed weak bits with Weibull slope (beta)=1, and a main population breakdown with an increasing failure rate. Retention time soft error rates are calculated and a multiple failure mechanism acceleration model with parameters is derived for each technology. Defect densities are calculated and reflect a decreasing trend in the percentage of random defective bits for each successive product generation. A normalized soft error failure rate of the memory data retention time in FIT/Gb and FIT/cm2 for several scaled SDRAM generations is

  10. Reliability Analysis and Reliability-Based Design Optimization of Circular Composite Cylinders Under Axial Compression

    NASA Technical Reports Server (NTRS)

    Rais-Rohani, Masoud

    2001-01-01

    This report describes the preliminary results of an investigation on component reliability analysis and reliability-based design optimization of thin-walled circular composite cylinders with average diameter and average length of 15 inches. Structural reliability is based on axial buckling strength of the cylinder. Both Monte Carlo simulation and First Order Reliability Method are considered for reliability analysis with the latter incorporated into the reliability-based structural optimization problem. To improve the efficiency of reliability sensitivity analysis and design optimization solution, the buckling strength of the cylinder is estimated using a second-order response surface model. The sensitivity of the reliability index with respect to the mean and standard deviation of each random variable is calculated and compared. The reliability index is found to be extremely sensitive to the applied load and elastic modulus of the material in the fiber direction. The cylinder diameter was found to have the third highest impact on the reliability index. Also the uncertainty in the applied load, captured by examining different values for its coefficient of variation, is found to have a large influence on cylinder reliability. The optimization problem for minimum weight is solved subject to a design constraint on element reliability index. The methodology, solution procedure and optimization results are included in this report.

  11. Towards cost-effective reliability through visualization of the reliability option space

    NASA Technical Reports Server (NTRS)

    Feather, Martin S.

    2004-01-01

    In planning a complex system's development there can be many options to improve its reliability. Typically their sum total cost exceeds the budget available, so it is necessary to select judiciously from among them. Reliability models can be employed to calculate the cost and reliability implications of a candidate selection.

  12. Relatedness influences signal reliability in evolving robots.

    PubMed

    Mitri, Sara; Floreano, Dario; Keller, Laurent

    2011-02-01

    Communication is an indispensable component of animal societies, yet many open questions remain regarding the factors affecting the evolution and reliability of signalling systems. A potentially important factor is the level of genetic relatedness between signallers and receivers. To quantitatively explore the role of relatedness in the evolution of reliable signals, we conducted artificial evolution over 500 generations in a system of foraging robots that can emit and perceive light signals. By devising a quantitative measure of signal reliability, and comparing independently evolving populations differing in within-group relatedness, we show a strong positive correlation between relatedness and reliability. Unrelated robots produced unreliable signals, whereas highly related robots produced signals that reliably indicated the location of the food source and thereby increased performance. Comparisons across populations also revealed that the frequency for signal production-which is often used as a proxy of signal reliability in empirical studies on animal communication-is a poor predictor of signal reliability and, accordingly, is not consistently correlated with group performance. This has important implications for our understanding of signal evolution and the empirical tools that are used to investigate communication.

  13. Probabilistic fatigue methodology for six nines reliability

    NASA Technical Reports Server (NTRS)

    Everett, R. A., Jr.; Bartlett, F. D., Jr.; Elber, Wolf

    1990-01-01

    Fleet readiness and flight safety strongly depend on the degree of reliability that can be designed into rotorcraft flight critical components. The current U.S. Army fatigue life specification for new rotorcraft is the so-called six nines reliability, or a probability of failure of one in a million. The progress of a round robin which was established by the American Helicopter Society (AHS) Subcommittee for Fatigue and Damage Tolerance is reviewed to investigate reliability-based fatigue methodology. The participants in this cooperative effort are in the U.S. Army Aviation Systems Command (AVSCOM) and the rotorcraft industry. One phase of the joint activity examined fatigue reliability under uniquely defined conditions for which only one answer was correct. The other phases were set up to learn how the different industry methods in defining fatigue strength affected the mean fatigue life and reliability calculations. Hence, constant amplitude and spectrum fatigue test data were provided so that each participant could perform their standard fatigue life analysis. As a result of this round robin, the probabilistic logic which includes both fatigue strength and spectrum loading variability in developing a consistant reliability analysis was established. In this first study, the reliability analysis was limited to the linear cumulative damage approach. However, it is expected that superior fatigue life prediction methods will ultimately be developed through this open AHS forum. To that end, these preliminary results were useful in identifying some topics for additional study.

  14. a Reliability Evaluation System of Association Rules

    NASA Astrophysics Data System (ADS)

    Chen, Jiangping; Feng, Wanshu; Luo, Minghai

    2016-06-01

    In mining association rules, the evaluation of the rules is a highly important work because it directly affects the usability and applicability of the output results of mining. In this paper, the concept of reliability was imported into the association rule evaluation. The reliability of association rules was defined as the accordance degree that reflects the rules of the mining data set. Such degree contains three levels of measurement, namely, accuracy, completeness, and consistency of rules. To show its effectiveness, the "accuracy-completeness-consistency" reliability evaluation system was applied to two extremely different data sets, namely, a basket simulation data set and a multi-source lightning data fusion. Results show that the reliability evaluation system works well in both simulation data set and the actual problem. The three-dimensional reliability evaluation can effectively detect the useless rules to be screened out and add the missing rules thereby improving the reliability of mining results. Furthermore, the proposed reliability evaluation system is applicable to many research fields; using the system in the analysis can facilitate obtainment of more accurate, complete, and consistent association rules.

  15. Reliability Degradation Due to Stockpile Aging

    SciTech Connect

    Robinson, David G.

    1999-04-01

    The objective of this reseach is the investigation of alternative methods for characterizing the reliability of systems with time dependent failure modes associated with stockpile aging. Reference to 'reliability degradation' has, unfortunately, come to be associated with all types of aging analyes: both deterministic and stochastic. In this research, in keeping with the true theoretical definition, reliability is defined as a probabilistic description of system performance as a funtion of time. Traditional reliability methods used to characterize stockpile reliability depend on the collection of a large number of samples or observations. Clearly, after the experiments have been performed and the data has been collected, critical performance problems can be identified. A Major goal of this research is to identify existing methods and/or develop new mathematical techniques and computer analysis tools to anticipate stockpile problems before they become critical issues. One of the most popular methods for characterizing the reliability of components, particularly electronic components, assumes that failures occur in a completely random fashion, i.e. uniformly across time. This method is based primarily on the use of constant failure rates for the various elements that constitute the weapon system, i.e. the systems do not degrade while in storage. Experience has shown that predictions based upon this approach should be regarded with great skepticism since the relationship between the life predicted and the observed life has been difficult to validate. In addition to this fundamental problem, the approach does not recognize that there are time dependent material properties and variations associated with the manufacturing process and the operational environment. To appreciate the uncertainties in predicting system reliability a number of alternative methods are explored in this report. All of the methods are very different from those currently used to assess stockpile

  16. Apollo experience report: Reliability and quality assurance

    NASA Technical Reports Server (NTRS)

    Sperber, K. P.

    1973-01-01

    The reliability of the Apollo spacecraft resulted from the application of proven reliability and quality techniques and from sound management, engineering, and manufacturing practices. Continual assessment of these techniques and practices was made during the program, and, when deficiencies were detected, adjustments were made and the deficiencies were effectively corrected. The most significant practices, deficiencies, adjustments, and experiences during the Apollo Program are described in this report. These experiences can be helpful in establishing an effective base on which to structure an efficient reliability and quality assurance effort for future space-flight programs.

  17. Reliability techniques in the petroleum industry

    NASA Technical Reports Server (NTRS)

    Williams, H. L.

    1971-01-01

    Quantitative reliability evaluation methods used in the Apollo Spacecraft Program are translated into petroleum industry requirements with emphasis on offsetting reliability demonstration costs and limited production runs. Described are the qualitative disciplines applicable, the definitions and criteria that accompany the disciplines, and the generic application of these disciplines to the chemical industry. The disciplines are then translated into proposed definitions and criteria for the industry, into a base-line reliability plan that includes these disciplines, and into application notes to aid in adapting the base-line plan to a specific operation.

  18. Reliability of a Series Pipe Network

    NASA Technical Reports Server (NTRS)

    Harris, Rodney; Chamis, Christopher (Technical Monitor)

    2001-01-01

    The goal of this NASA-funded research is to advance research and education objectives in theoretical and computational probabilistic structural analysis, reliability, and life prediction methods for improved aerospace and aircraft propulsion system components. Reliability methods are used to quantify response uncertainties due to inherent uncertainties in design variables. In this report, several reliability methods are applied to a series pipe network. The observed responses are the head delivered by a main pump and the line head at a desired flow rate. The probability that the flow rate in the line will be less than a specified minimum will be discussed.

  19. Reliability of a Parallel Pipe Network

    NASA Technical Reports Server (NTRS)

    Herrera, Edgar; Chamis, Christopher (Technical Monitor)

    2001-01-01

    The goal of this NASA-funded research is to advance research and education objectives in theoretical and computational probabilistic structural analysis, reliability, and life prediction methods for improved aerospace and aircraft propulsion system components. Reliability methods are used to quantify response uncertainties due to inherent uncertainties in design variables. In this report, several reliability methods are applied to a parallel pipe network. The observed responses are the head delivered by a main pump and the head values of two parallel lines at certain flow rates. The probability that the flow rates in the lines will be less than their specified minimums will be discussed.

  20. B-52 stability augmentation system reliability

    NASA Technical Reports Server (NTRS)

    Bowling, T. C.; Key, L. W.

    1976-01-01

    The B-52 SAS (Stability Augmentation System) was developed and retrofitted to nearly 300 aircraft. It actively controls B-52 structural bending, provides improved yaw and pitch damping through sensors and electronic control channels, and puts complete reliance on hydraulic control power for rudder and elevators. The system has experienced over 300,000 flight hours and has exhibited service reliability comparable to the results of the reliability test program. Development experience points out numerous lessons with potential application in the mechanization and development of advanced technology control systems of high reliability.

  1. WWW media distribution via Hopwise reliable multicast

    SciTech Connect

    Donnelley, J.E.

    1994-12-01

    Repeated access to WWW pages currently makes inefficient use of available network bandwidth. A Distribution Point Model is proposed where large and relatively static sets of pages (e.g. magazines or other such media) are distributed via bulk multicast to LAN distribution points for local access. Some access control issues are discussed. Hopwise Reliable Multicast (HRM) is proposed to simplify reliable multicast of non real time bulk data between LANs. HRM uses TCP for reliability and flow control on a hop by hop basis throughout a multicast distribution tree created by today`s Internet MBone.

  2. Measurement Practices for Reliability and Power Quality

    SciTech Connect

    Kueck, JD

    2005-05-06

    This report provides a distribution reliability measurement ''toolkit'' that is intended to be an asset to regulators, utilities and power users. The metrics and standards discussed range from simple reliability, to power quality, to the new blend of reliability and power quality analysis that is now developing. This report was sponsored by the Office of Electric Transmission and Distribution, U.S. Department of Energy (DOE). Inconsistencies presently exist in commonly agreed-upon practices for measuring the reliability of the distribution systems. However, efforts are being made by a number of organizations to develop solutions. In addition, there is growing interest in methods or standards for measuring power quality, and in defining power quality levels that are acceptable to various industries or user groups. The problems and solutions vary widely among geographic areas and among large investor-owned utilities, rural cooperatives, and municipal utilities; but there is still a great degree of commonality. Industry organizations such as the National Rural Electric Cooperative Association (NRECA), the Electric Power Research Institute (EPRI), the American Public Power Association (APPA), and the Institute of Electrical and Electronics Engineers (IEEE) have made tremendous strides in preparing self-assessment templates, optimization guides, diagnostic techniques, and better definitions of reliability and power quality measures. In addition, public utility commissions have developed codes and methods for assessing performance that consider local needs. There is considerable overlap among these various organizations, and we see real opportunity and value in sharing these methods, guides, and standards in this report. This report provides a ''toolkit'' containing synopses of noteworthy reliability measurement practices. The toolkit has been developed to address the interests of three groups: electric power users, utilities, and regulators. The report will also serve

  3. A reliability measure of protein-protein interactions and a reliability measure-based search engine.

    PubMed

    Park, Byungkyu; Han, Kyungsook

    2010-02-01

    Many methods developed for estimating the reliability of protein-protein interactions are based on the topology of protein-protein interaction networks. This paper describes a new reliability measure for protein-protein interactions, which does not rely on the topology of protein interaction networks, but expresses biological information on functional roles, sub-cellular localisations and protein classes as a scoring schema. The new measure is useful for filtering many spurious interactions, as well as for estimating the reliability of protein interaction data. In particular, the reliability measure can be used to search protein-protein interactions with the desired reliability in databases. The reliability-based search engine is available at http://yeast.hpid.org. We believe this is the first search engine for interacting proteins, which is made available to public. The search engine and the reliability measure of protein interactions should provide useful information for determining proteins to focus on.

  4. Apply reliability centered maintenance to sealless pumps

    SciTech Connect

    Pradhan, S. )

    1993-01-01

    This paper reports on reliability centered maintenance (RCM) which is considered a crucial part of future reliability engineering. RCM determines the maintenance requirements of plants and equipment in their operating context. The RCM method has been applied to the management of critical sealless pumps in fire/toxic risk services, typical of the petrochemical industry. The method provides advantages from a detailed study of any critical engineering system. RCM is a team exercise and fosters team spirit in the plant environment. The maintenance strategy that evolves is based on team decisions and relies on maximizing the inherent reliability built into the equipment. RCM recommends design upgrades where this inherent reliability is being questioned. Sealless pumps of canned motor design are used as main reactor charge pumps in PVC plants. These pumps handle fresh vinyl chloride monomer (VCM), which is both carcinogenic and flammable.

  5. Operational reliability of standby safety systems

    SciTech Connect

    Grant, G.M.; Atwood, C.L.; Gentillon, C.D.

    1995-04-01

    The Idaho National Engineering Laboratory (INEL) is evaluating the operational reliability of several risk-significant standby safety systems based on the operating experience at US commercial nuclear power plants from 1987 through 1993. The reliability assessed is the probability that the system will perform its Probabilistic Risk Assessment (PRA) defined safety function. The quantitative estimates of system reliability are expected to be useful in risk-based regulation. This paper is an overview of the analysis methods and the results of the high pressure coolant injection (HPCI) system reliability study. Key characteristics include (1) descriptions of the data collection and analysis methods, (2) the statistical methods employed to estimate operational unreliability, (3) a description of how the operational unreliability estimates were compared with typical PRA results, both overall and for each dominant failure mode, and (4) a summary of results of the study.

  6. Flight control electronics reliability/maintenance study

    NASA Technical Reports Server (NTRS)

    Dade, W. W.; Edwards, R. H.; Katt, G. T.; Mcclellan, K. L.; Shomber, H. A.

    1977-01-01

    Collection and analysis of data are reported that concern the reliability and maintenance experience of flight control system electronics currently in use on passenger carrying jet aircraft. Two airlines B-747 airplane fleets were analyzed to assess the component reliability, system functional reliability, and achieved availability of the CAT II configuration flight control system. Also assessed were the costs generated by this system in the categories of spare equipment, schedule irregularity, and line and shop maintenance. The results indicate that although there is a marked difference in the geographic location and route pattern between the airlines studied, there is a close similarity in the reliability and the maintenance costs associated with the flight control electronics.

  7. 76 FR 71011 - Reliability Technical Conference Agenda

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-16

    ..., President and CEO, Consolidated Edison Inc., on behalf of Consolidated Edison and the Edison Electric..., North American Electric Reliability Corporation Thomas J. Galloway, President and Chief Executive... Monroe, Executive Vice President and Chief Operating Officer, Southwest Power Pool (SPP) Thomas...

  8. PV Module Reliability Research (Fact Sheet)

    SciTech Connect

    Not Available

    2013-06-01

    This National Center for Photovoltaics sheet describes the capabilities of its PV module reliability research. The scope and core competencies and capabilities are discussed and recent publications are listed.

  9. An Ultra Reliability for Project for NASA

    NASA Technical Reports Server (NTRS)

    Shapiro, Andrew A.

    2005-01-01

    NASA has embarked on a new program designed to improve the reliability of NASA systems. In this context, the goal for ultra reliability is to ultimately improve the systems by an order of magnitude. The approach outlined in this presentation involves five steps: 1. Divide NASA systems into seven sectors; 2. Establish sector champions and representatives from each NASA center; 3. Develop a challenge list for each sector using a team of NASA experts in each area with the sector champion facilitating the effort; 4. Develop mitigation strategies for each of the sectors' challenge lists and rank their importance by holding a workshop with area experts from government (NASA and non-NASA), universities and industry; 5. Develop a set of tasks for each sector in order of importance for improving the reliability of NASA systems. Several NASA-wide workshops have been held, identifying issues for reliability improvement and providing mitigation strategies for these issues.

  10. The reliable multicast protocol application programming interface

    NASA Technical Reports Server (NTRS)

    Montgomery , Todd; Whetten, Brian

    1995-01-01

    The Application Programming Interface for the Berkeley/WVU implementation of the Reliable Multicast Protocol is described. This transport layer protocol is implemented as a user library that applications and software buses link against.

  11. Semiconductor Reliability--Another Field for Physicists.

    ERIC Educational Resources Information Center

    Derman, Samuel; Anderson, Wallace T.

    1994-01-01

    Stresses that an important industrial area is product reliability, especially for semiconductors. Suggests that physics students would benefit from training in semiconductors: the many modes of failure, radiation effects, and electrical contact problems. (MVL)

  12. Reliability for the 21st century

    SciTech Connect

    Keller-McNulty, Sallie; Wilson, A. G.

    2002-01-01

    The sophistication of science and teclinology is growing almost exponentially. Government and industry are relying more and more on science's advanced methods to assess reliability coupled with pcrformance, safety, surety, cost, schedule, etc. Unfortunately, policy, cost, schedule, and other constraints imposed by the real world inhibit the ability of researchers to calculate these metrics efficiently and accurately using traditional methods. Because of such constraints, reliability must undergo an evolutionary change. The first step in this evolution is to reinterpret the concepts and responsibilities of scientists responsible for reliability calculations to meet the new century's needs. The next step is to mount a multidisciplinary approach to the quantification of reliability and its associated metrics using both empirical methods and auxiliary data sources, such as expert knowledge, corporate memory, and mathematical modeling and simulation.

  13. Reliability of chemical analyses of water samples

    SciTech Connect

    Beardon, R.

    1989-11-01

    Ground-water quality investigations require reliable chemical analyses of water samples. Unfortunately, laboratory analytical results are often unreliable. The Uranium Mill Tailings Remedial Action (UMTRA) Project`s solution to this problem was to establish a two phase quality assurance program for the analysis of water samples. In the first phase, eight laboratories analyzed three solutions of known composition. The analytical accuracy of each laboratory was ranked and three laboratories were awarded contracts. The second phase consists of on-going monitoring of the reliability of the selected laboratories. The following conclusions are based on two years experience with the UMTRA Project`s Quality Assurance Program. The reliability of laboratory analyses should not be taken for granted. Analytical reliability may be independent of the prices charged by laboratories. Quality assurance programs benefit both the customer and the laboratory.

  14. Mechanical system reliability and risk assessment

    NASA Astrophysics Data System (ADS)

    Cruse, T. A.; Mahadevan, S.; Huang, Q.; Mehta, S.

    1994-11-01

    A new methodology is reported for the prediction of the reliability of mechanical structures subject to multiple failure modes, including noncritical damage. The reduction of system reliability due to accumulated damage is quantitatively estimated by updating the critical system failure states at each level of damage. Correlated design variables are automatically accounted for in the system reliability calculations. Second-order reliability bounds are reported which are unbiased to the ordering of the events. A system risk assessment methodology is also reported that accounts for the cost of multiple types of failure modes and includes the effect of inspection success on reducing the consequences of system failure. Application of the new technology is illustrated for a simplified system model of an aeropropulsion rotor system. However, the methodology is general and is applicable to any engineering system.

  15. MOV reliability evaluation and periodic verification scheduling

    SciTech Connect

    Bunte, B.D.

    1996-12-01

    The purpose of this paper is to establish a periodic verification testing schedule based on the expected long term reliability of gate or globe motor operated valves (MOVs). The methodology in this position paper determines the nominal (best estimate) design margin for any MOV based on the best available information pertaining to the MOVs design requirements, design parameters, existing hardware design, and present setup. The uncertainty in this margin is then determined using statistical means. By comparing the nominal margin to the uncertainty, the reliability of the MOV is estimated. The methodology is appropriate for evaluating the reliability of MOVs in the GL 89-10 program. It may be used following periodic testing to evaluate and trend MOV performance and reliability. It may also be used to evaluate the impact of proposed modifications and maintenance activities such as packing adjustments. In addition, it may be used to assess the impact of new information of a generic nature which impacts safety related MOVs.

  16. Reliability Issues for Photovoltaic Modules (Presentation)

    SciTech Connect

    Kurtz, S.

    2009-10-01

    Si modules good in field; new designs need reliability testing. CdTe & CIGS modules sensitive to moisture; carefully seal. CPV in product development stage; benefits from expertise in other industries.

  17. Measuring Fear of Death: A Reliability Study.

    ERIC Educational Resources Information Center

    Larrabee, Marva J.

    1978-01-01

    Finds that the test/retest reliability coefficients for the "Collett-Lester Fear of Death Scale" and the "Lester Attitude toward Death Scale" were significant, but only low to moderate in significance. (RL)

  18. Demand Response For Power System Reliability: FAQ

    SciTech Connect

    Kirby, Brendan J

    2006-12-01

    Demand response is the most underutilized power system reliability resource in North America. Technological advances now make it possible to tap this resource to both reduce costs and improve. Misconceptions concerning response capabilities tend to force loads to provide responses that they are less able to provide and often prohibit them from providing the most valuable reliability services. Fortunately this is beginning to change with some ISOs making more extensive use of load response. This report is structured as a series of short questions and answers that address load response capabilities and power system reliability needs. Its objective is to further the use of responsive load as a bulk power system reliability resource in providing the fastest and most valuable ancillary services.

  19. CSP Assembly Reliability: Commercial and Harsh Environments

    NASA Technical Reports Server (NTRS)

    Ghaffarian, R.; Kim, N.; Selk, K.; Bjorndahl, B.; Bonner, J.; Barr, S.

    1999-01-01

    The JPL-led CSP Consortium of enterprises representing government agencies and private companies has jointed together to pool in-kind resources for developing the quality and reliability of chip scale packages (CSPs) for a variety of projects.

  20. CSP/BGA Board level Reliability

    NASA Technical Reports Server (NTRS)

    Ghaffarian, R.

    1998-01-01

    Different aspects of advanced surface mount package technology have been investigated for aerospace applications. Three key areas included the assembly reliability of conventional Surface Mount, Ball Grid Arrays (BGAs), and Chip Scale Packages.

  1. Analyzing network reliability using structural motifs

    NASA Astrophysics Data System (ADS)

    Khorramzadeh, Yasamin; Youssef, Mina; Eubank, Stephen; Mowlaei, Shahir

    2015-04-01

    This paper uses the reliability polynomial, introduced by Moore and Shannon in 1956, to analyze the effect of network structure on diffusive dynamics such as the spread of infectious disease. We exhibit a representation for the reliability polynomial in terms of what we call structural motifs that is well suited for reasoning about the effect of a network's structural properties on diffusion across the network. We illustrate by deriving several general results relating graph structure to dynamical phenomena.

  2. Highly reliable multiprocessors. [for commerical transport aircraft

    NASA Technical Reports Server (NTRS)

    Murray, N. D.; Hopkins, A. L.; Wensley, J. H.

    1977-01-01

    Highly reliable fault-tolerant computer systems are discussed for use in flight-critical avionic and control systems of future commercial transport aircraft. Such aircraft are envisioned to have integrated systems, to be terminally configured, and to be equipped with fly-by-wire flight control systems, all of which require highly reliable, fault-tolerant computers. Two candidate computer architectures are identified as having the potential of satisfying the commercial transport aircraft requirements.

  3. Production Facility System Reliability Analysis Report

    SciTech Connect

    Dale, Crystal Buchanan; Klein, Steven Karl

    2015-10-06

    This document describes the reliability, maintainability, and availability (RMA) modeling of the Los Alamos National Laboratory (LANL) design for the Closed Loop Helium Cooling System (CLHCS) planned for the NorthStar accelerator-based 99Mo production facility. The current analysis incorporates a conceptual helium recovery system, beam diagnostics, and prototype control system into the reliability analysis. The results from the 1000 hr blower test are addressed.

  4. Hardware and software reliability estimation using simulations

    NASA Technical Reports Server (NTRS)

    Swern, Frederic L.

    1994-01-01

    The simulation technique is used to explore the validation of both hardware and software. It was concluded that simulation is a viable means for validating both hardware and software and associating a reliability number with each. This is useful in determining the overall probability of system failure of an embedded processor unit, and improving both the code and the hardware where necessary to meet reliability requirements. The methodologies were proved using some simple programs, and simple hardware models.

  5. Developing Confidence Limits For Reliability Of Software

    NASA Technical Reports Server (NTRS)

    Hayhurst, Kelly J.

    1991-01-01

    Technique developed for estimating reliability of software by use of Moranda geometric de-eutrophication model. Pivotal method enables straightforward construction of exact bounds with associated degree of statistical confidence about reliability of software. Confidence limits thus derived provide precise means of assessing quality of software. Limits take into account number of bugs found while testing and effects of sampling variation associated with random order of discovering bugs.

  6. Thin-film reliability and engineering overview

    NASA Technical Reports Server (NTRS)

    Ross, R. G., Jr.

    1984-01-01

    The reliability and engineering technology base required for thin film solar energy conversions modules is discussed. The emphasis is on the integration of amorphous silicon cells into power modules. The effort is being coordinated with SERI's thin film cell research activities as part of DOE's Amorphous Silicon Program. Program concentration is on temperature humidity reliability research, glass breaking strength research, point defect system analysis, hot spot heating assessment, and electrical measurements technology.

  7. Reliability of composite vessels and proof testing.

    NASA Technical Reports Server (NTRS)

    Yang, J.-N.; Knoell, A. C.

    1972-01-01

    The reliability of anisotropic structures is formulated with the aid of the yield and fracture criteria, on the basis of recent studies of composite rocket motor cases in a state of plane stress. The vessel reliability is estimated in terms of the safety factor, thus permitting a rational interpretation of the design safety factor in terms of the vessel relability. The formulation is consistent with the finite element approach, and is being coded into a computer program for practical design evaluation.

  8. Nuclear industry embraces reliability-centered maintenance

    SciTech Connect

    Worledge, D.H. )

    1993-07-01

    This article discusses a common sense approach to maintenance that increases the reliability of power plants at a reasonable cost. The topic of the article include the debut of reliability centered maintenance (RCM) in the airline industry, early utility experience is reviewed, the rational behind RCM, implementing RCM, cost and benefits of the program, outage rate falls, the EPRI RCM user's group, and cost trends of one-time RCM costs.

  9. Gearbox Reliability Collaborative (GRC) Description and Loading

    SciTech Connect

    Oyague, F.

    2011-11-01

    This document describes simulated turbine load cases in accordance to the IEC 61400-1 Ed.3 standard, which is representative of the typical wind turbine design process. The information presented herein is intended to provide a broad understanding of the gearbox reliability collaborative 750kW drivetrain and turbine configuration. In addition, fatigue and ultimate strength drivetrain loads resulting from simulations are presented. This information provides the bases for the analytical work of the gearbox reliability collaborative effort.

  10. System Reliability for LED-Based Products

    SciTech Connect

    Davis, J Lynn; Mills, Karmann; Lamvik, Michael; Yaga, Robert; Shepherd, Sarah D; Bittle, James; Baldasaro, Nick; Solano, Eric; Bobashev, Georgiy; Johnson, Cortina; Evans, Amy

    2014-04-07

    Results from accelerated life tests (ALT) on mass-produced commercially available 6” downlights are reported along with results from commercial LEDs. The luminaires capture many of the design features found in modern luminaires. In general, a systems perspective is required to understand the reliability of these devices since LED failure is rare. In contrast, components such as drivers, lenses, and reflector are more likely to impact luminaire reliability than LEDs.

  11. Reliability evaluation methodology for NASA applications

    NASA Technical Reports Server (NTRS)

    Taneja, Vidya S.

    1992-01-01

    Liquid rocket engine technology has been characterized by the development of complex systems containing large number of subsystems, components, and parts. The trend to even larger and more complex system is continuing. The liquid rocket engineers have been focusing mainly on performance driven designs to increase payload delivery of a launch vehicle for a given mission. In otherwords, although the failure of a single inexpensive part or component may cause the failure of the system, reliability in general has not been considered as one of the system parameters like cost or performance. Up till now, quantification of reliability has not been a consideration during system design and development in the liquid rocket industry. Engineers and managers have long been aware of the fact that the reliability of the system increases during development, but no serious attempts have been made to quantify reliability. As a result, a method to quantify reliability during design and development is needed. This includes application of probabilistic models which utilize both engineering analysis and test data. Classical methods require the use of operating data for reliability demonstration. In contrast, the method described in this paper is based on similarity, analysis, and testing combined with Bayesian statistical analysis.

  12. A Bayesian approach to reliability and confidence

    NASA Technical Reports Server (NTRS)

    Barnes, Ron

    1989-01-01

    The historical evolution of NASA's interest in quantitative measures of reliability assessment is outlined. The introduction of some quantitative methodologies into the Vehicle Reliability Branch of the Safety, Reliability and Quality Assurance (SR and QA) Division at Johnson Space Center (JSC) was noted along with the development of the Extended Orbiter Duration--Weakest Link study which will utilize quantitative tools for a Bayesian statistical analysis. Extending the earlier work of NASA sponsor, Richard Heydorn, researchers were able to produce a consistent Bayesian estimate for the reliability of a component and hence by a simple extension for a system of components in some cases where the rate of failure is not constant but varies over time. Mechanical systems in general have this property since the reliability usually decreases markedly as the parts degrade over time. While they have been able to reduce the Bayesian estimator to a simple closed form for a large class of such systems, the form for the most general case needs to be attacked by the computer. Once a table is generated for this form, researchers will have a numerical form for the general solution. With this, the corresponding probability statements about the reliability of a system can be made in the most general setting. Note that the utilization of uniform Bayesian priors represents a worst case scenario in the sense that as researchers incorporate more expert opinion into the model, they will be able to improve the strength of the probability calculations.

  13. Reliability improvement of distribution systems using SSVR.

    PubMed

    Hosseini, Mehdi; Shayanfar, Heidar Ali; Fotuhi-Firuzabad, Mahmoud

    2009-01-01

    This paper presents a reliability assessment algorithm for distribution systems using a Static Series Voltage Regulator (SSVR). Furthermore, this algorithm considers the effects of Distributed Generation (DG) units, alternative sources, system reconfiguration, load shedding and load adding on distribution system reliability indices. In this algorithm, load points are classified into 8 types and separated restoration times are considered for each class. Comparative studies are conducted to investigate the impacts of DG and alternative source unavailability on the distribution system reliability. For reliability assessment, the customer-oriented reliability indices such as SAIFI, SAIDI, CAIDI ASUI and also load- and energy-oriented indices such as ENS and AENS are evaluated. The effectiveness of the proposed algorithm is examined on the two standard distribution systems consisting of 33 and 69 nodes. The best location of the SSVR in distribution systems is determined based on different reliability indices, separately. Results show that the proposed algorithm is efficient for large-scale radial distribution systems and can accommodate the effects of fault isolation and load restoration. PMID:19006802

  14. Multi-Disciplinary System Reliability Analysis

    NASA Technical Reports Server (NTRS)

    Mahadevan, Sankaran; Han, Song

    1997-01-01

    The objective of this study is to develop a new methodology for estimating the reliability of engineering systems that encompass multiple disciplines. The methodology is formulated in the context of the NESSUS probabilistic structural analysis code developed under the leadership of NASA Lewis Research Center. The NESSUS code has been successfully applied to the reliability estimation of a variety of structural engineering systems. This study examines whether the features of NESSUS could be used to investigate the reliability of systems in other disciplines such as heat transfer, fluid mechanics, electrical circuits etc., without considerable programming effort specific to each discipline. In this study, the mechanical equivalence between system behavior models in different disciplines are investigated to achieve this objective. A new methodology is presented for the analysis of heat transfer, fluid flow, and electrical circuit problems using the structural analysis routines within NESSUS, by utilizing the equivalence between the computational quantities in different disciplines. This technique is integrated with the fast probability integration and system reliability techniques within the NESSUS code, to successfully compute the system reliability of multi-disciplinary systems. Traditional as well as progressive failure analysis methods for system reliability estimation are demonstrated, through a numerical example of a heat exchanger system involving failure modes in structural, heat transfer and fluid flow disciplines.

  15. Test-retest reliability of cognitive EEG

    NASA Technical Reports Server (NTRS)

    McEvoy, L. K.; Smith, M. E.; Gevins, A.

    2000-01-01

    OBJECTIVE: Task-related EEG is sensitive to changes in cognitive state produced by increased task difficulty and by transient impairment. If task-related EEG has high test-retest reliability, it could be used as part of a clinical test to assess changes in cognitive function. The aim of this study was to determine the reliability of the EEG recorded during the performance of a working memory (WM) task and a psychomotor vigilance task (PVT). METHODS: EEG was recorded while subjects rested quietly and while they performed the tasks. Within session (test-retest interval of approximately 1 h) and between session (test-retest interval of approximately 7 days) reliability was calculated for four EEG components: frontal midline theta at Fz, posterior theta at Pz, and slow and fast alpha at Pz. RESULTS: Task-related EEG was highly reliable within and between sessions (r0.9 for all components in WM task, and r0.8 for all components in the PVT). Resting EEG also showed high reliability, although the magnitude of the correlation was somewhat smaller than that of the task-related EEG (r0.7 for all 4 components). CONCLUSIONS: These results suggest that under appropriate conditions, task-related EEG has sufficient retest reliability for use in assessing clinical changes in cognitive status.

  16. Bioharness™ Multivariable Monitoring Device: Part. II: Reliability

    PubMed Central

    Johnstone, James A.; Ford, Paul A.; Hughes, Gerwyn; Watson, Tim; Garrett, Andrew T.

    2012-01-01

    The Bioharness™ monitoring system may provide physiological information on human performance but the reliability of this data is fundamental for confidence in the equipment being used. The objective of this study was to assess the reliability of each of the 5 Bioharness™ variables using a treadmill based protocol. 10 healthy males participated. A between and within subject design to assess the reliability of Heart rate (HR), Breathing Frequency (BF), Accelerometry (ACC) and Infra-red skin temperature (ST) was completed via a repeated, discontinuous, incremental treadmill protocol. Posture (P) was assessed by a tilt table, moved through 160°. Between subject data reported low Coefficient of Variation (CV) and strong correlations(r) for ACC and P (CV< 7.6; r = 0.99, p < 0.01). In contrast, HR and BF (CV~19.4; r~0.70, p < 0.01) and ST (CV 3.7; r = 0.61, p < 0.01), present more variable data. Intra and inter device data presented strong relationships (r > 0.89, p < 0.01) and low CV (<10.1) for HR, ACC, P and ST. BF produced weaker relationships (r < 0.72) and higher CV (<17.4). In comparison to the other variables BF variable consistently presents less reliability. Global results suggest that the Bioharness™ is a reliable multivariable monitoring device during laboratory testing within the limits presented. Key pointsHeart rate and breathing frequency data increased in variance at higher velocities (i.e. ≥ 10 km.h-1)In comparison to the between subject testing, the intra and inter reliability presented good reliability in data suggesting placement or position of device relative to performer could be important for data collectionUnderstanding a devices variability in measurement is important before it can be used within an exercise testing or monitoring setting PMID:24149347

  17. Reliability analysis of an ultra-reliable fault tolerant control system

    NASA Technical Reports Server (NTRS)

    Curry, R. E.; Vandervelde, W. E.; Frey, P. R.

    1984-01-01

    This report analyzes the reliability of NASA's Ultra-reliable Fault Tolerant Control System (UFTCS) architecture as it is currently envisioned for helicopter control. The analysis is extended to air transport and spacecraft control using the same computational and voter modules applied within the UFTCS architecture. The system reliability is calculated for several points in the helicopter, air transport, and space flight missions when there are initially 4, 5, and 6 operating channels. Sensitivity analyses are used to explore the effects of sensor failure rates and different system configurations at the 10 hour point of the helicopter mission. These analyses show that the primary limitation to system reliability is the number of flux windings on each flux summer (4 are assumed for the baseline case). Tables of system reliability at the 10 hour point are provided to allow designers to choose a configuration to meet specified reliability goals.

  18. Design for reliability: NASA reliability preferred practices for design and test

    NASA Technical Reports Server (NTRS)

    Lalli, Vincent R.

    1994-01-01

    This tutorial summarizes reliability experience from both NASA and industry and reflects engineering practices that support current and future civil space programs. These practices were collected from various NASA field centers and were reviewed by a committee of senior technical representatives from the participating centers (members are listed at the end). The material for this tutorial was taken from the publication issued by the NASA Reliability and Maintainability Steering Committee (NASA Reliability Preferred Practices for Design and Test. NASA TM-4322, 1991). Reliability must be an integral part of the systems engineering process. Although both disciplines must be weighed equally with other technical and programmatic demands, the application of sound reliability principles will be the key to the effectiveness and affordability of America's space program. Our space programs have shown that reliability efforts must focus on the design characteristics that affect the frequency of failure. Herein, we emphasize that these identified design characteristics must be controlled by applying conservative engineering principles.

  19. Commingled Samples: A Neglected Source of Bias in Reliability Analysis

    ERIC Educational Resources Information Center

    Waller, Niels G.

    2008-01-01

    Reliability is a property of test scores from individuals who have been sampled from a well-defined population. Reliability indices, such as coefficient and related formulas for internal consistency reliability (KR-20, Hoyt's reliability), yield lower bound reliability estimates when (a) subjects have been sampled from a single population and when…

  20. Continuous Reliability Enhancement for Wind (CREW) database :

    SciTech Connect

    Hines, Valerie Ann-Peters; Ogilvie, Alistair B.; Bond, Cody R.

    2013-09-01

    To benchmark the current U.S. wind turbine fleet reliability performance and identify the major contributors to component-level failures and other downtime events, the Department of Energy funded the development of the Continuous Reliability Enhancement for Wind (CREW) database by Sandia National Laboratories. This report is the third annual Wind Plant Reliability Benchmark, to publically report on CREW findings for the wind industry. The CREW database uses both high resolution Supervisory Control and Data Acquisition (SCADA) data from operating plants and Strategic Power Systems ORAPWindª (Operational Reliability Analysis Program for Wind) data, which consist of downtime and reserve event records and daily summaries of various time categories for each turbine. Together, these data are used as inputs into CREWs reliability modeling. The results presented here include: the primary CREW Benchmark statistics (operational availability, utilization, capacity factor, mean time between events, and mean downtime); time accounting from an availability perspective; time accounting in terms of the combination of wind speed and generation levels; power curve analysis; and top system and component contributors to unavailability.

  1. Reliability of Radioisotope Stirling Convertor Linear Alternator

    NASA Technical Reports Server (NTRS)

    Shah, Ashwin; Korovaichuk, Igor; Geng, Steven M.; Schreiber, Jeffrey G.

    2006-01-01

    Onboard radioisotope power systems being developed and planned for NASA s deep-space missions would require reliable design lifetimes of up to 14 years. Critical components and materials of Stirling convertors have been undergoing extensive testing and evaluation in support of a reliable performance for the specified life span. Of significant importance to the successful development of the Stirling convertor is the design of a lightweight and highly efficient linear alternator. Alternator performance could vary due to small deviations in the permanent magnet properties, operating temperature, and component geometries. Durability prediction and reliability of the alternator may be affected by these deviations from nominal design conditions. Therefore, it is important to evaluate the effect of these uncertainties in predicting the reliability of the linear alternator performance. This paper presents a study in which a reliability-based methodology is used to assess alternator performance. The response surface characterizing the induced open-circuit voltage performance is constructed using 3-D finite element magnetic analysis. Fast probability integration method is used to determine the probability of the desired performance and its sensitivity to the alternator design parameters.

  2. On the reliability of seasonal climate forecasts.

    PubMed

    Weisheimer, A; Palmer, T N

    2014-07-01

    Seasonal climate forecasts are being used increasingly across a range of application sectors. A recent UK governmental report asked: how good are seasonal forecasts on a scale of 1-5 (where 5 is very good), and how good can we expect them to be in 30 years time? Seasonal forecasts are made from ensembles of integrations of numerical models of climate. We argue that 'goodness' should be assessed first and foremost in terms of the probabilistic reliability of these ensemble-based forecasts; reliable inputs are essential for any forecast-based decision-making. We propose that a '5' should be reserved for systems that are not only reliable overall, but where, in particular, small ensemble spread is a reliable indicator of low ensemble forecast error. We study the reliability of regional temperature and precipitation forecasts of the current operational seasonal forecast system of the European Centre for Medium-Range Weather Forecasts, universally regarded as one of the world-leading operational institutes producing seasonal climate forecasts. A wide range of 'goodness' rankings, depending on region and variable (with summer forecasts of rainfall over Northern Europe performing exceptionally poorly) is found. Finally, we discuss the prospects of reaching '5' across all regions and variables in 30 years time.

  3. Creating High Reliability in Health Care Organizations

    PubMed Central

    Pronovost, Peter J; Berenholtz, Sean M; Goeschel, Christine A; Needham, Dale M; Sexton, J Bryan; Thompson, David A; Lubomski, Lisa H; Marsteller, Jill A; Makary, Martin A; Hunt, Elizabeth

    2006-01-01

    Objective The objective of this paper was to present a comprehensive approach to help health care organizations reliably deliver effective interventions. Context Reliability in healthcare translates into using valid rate-based measures. Yet high reliability organizations have proven that the context in which care is delivered, called organizational culture, also has important influences on patient safety. Model for Improvement Our model to improve reliability, which also includes interventions to improve culture, focuses on valid rate-based measures. This model includes (1) identifying evidence-based interventions that improve the outcome, (2) selecting interventions with the most impact on outcomes and converting to behaviors, (3) developing measures to evaluate reliability, (4) measuring baseline performance, and (5) ensuring patients receive the evidence-based interventions. The comprehensive unit-based safety program (CUSP) is used to improve culture and guide organizations in learning from mistakes that are important, but cannot be measured as rates. Conclusions We present how this model was used in over 100 intensive care units in Michigan to improve culture and eliminate catheter-related blood stream infections—both were accomplished. Our model differs from existing models in that it incorporates efforts to improve a vital component for system redesign—culture, it targets 3 important groups—senior leaders, team leaders, and front line staff, and facilitates change management—engage, educate, execute, and evaluate for planned interventions. PMID:16898981

  4. Integration of NDE Reliability and Fracture Mechanics

    SciTech Connect

    Becker, F. L.; Doctor, S. R.; Heas!er, P. G.; Morris, C. J.; Pitman, S. G.; Selby, G. P.; Simonen, F. A.

    1981-03-01

    The Pacific Northwest Laboratory is conducting a four-phase program for measuring and evaluating the effectiveness and reliability of in-service inspection (lSI} performed on the primary system piping welds of commercial light water reactors (LWRs). Phase I of the program is complete. A survey was made of the state of practice for ultrasonic rsr of LWR primary system piping welds. Fracture mechanics calculations were made to establish required nondestrutive testing sensitivities. In general, it was found that fatigue flaws less than 25% of wall thickness would not grow to failure within an inspection interval of 10 years. However, in some cases failure could occur considerably faster. Statistical methods for predicting and measuring the effectiveness and reliability of lSI were developed and will be applied in the "Round Robin Inspections" of Phase II. Methods were also developed for the production of flaws typical of those found in service. Samples fabricated by these methods wilI be used in Phase II to test inspection effectiveness and reliability. Measurements were made of the influence of flaw characteristics {i.e., roughness, tightness, and orientation) on inspection reliability. These measurernents, as well as the predictions of a statistical model for inspection reliability, indicate that current reporting and recording sensitivities are inadequate.

  5. Culture Representation in Human Reliability Analysis

    SciTech Connect

    David Gertman; Julie Marble; Steven Novack

    2006-12-01

    Understanding human-system response is critical to being able to plan and predict mission success in the modern battlespace. Commonly, human reliability analysis has been used to predict failures of human performance in complex, critical systems. However, most human reliability methods fail to take culture into account. This paper takes an easily understood state of the art human reliability analysis method and extends that method to account for the influence of culture, including acceptance of new technology, upon performance. The cultural parameters used to modify the human reliability analysis were determined from two standard industry approaches to cultural assessment: Hofstede’s (1991) cultural factors and Davis’ (1989) technology acceptance model (TAM). The result is called the Culture Adjustment Method (CAM). An example is presented that (1) reviews human reliability assessment with and without cultural attributes for a Supervisory Control and Data Acquisition (SCADA) system attack, (2) demonstrates how country specific information can be used to increase the realism of HRA modeling, and (3) discusses the differences in human error probability estimates arising from cultural differences.

  6. Microbial community modeling using reliability theory.

    PubMed

    Zilles, Julie L; Rodríguez, Luis F; Bartolerio, Nicholas A; Kent, Angela D

    2016-08-01

    Linking microbial community composition with the corresponding ecosystem functions remains challenging. Because microbial communities can differ in their functional responses, this knowledge gap limits ecosystem assessment, design and management. To develop models that explicitly incorporate microbial populations and guide efforts to characterize their functional differences, we propose a novel approach derived from reliability engineering. This reliability modeling approach is illustrated here using a microbial ecology dataset from denitrifying bioreactors. Reliability modeling is well-suited for analyzing the stability of complex networks composed of many microbial populations. It could also be applied to evaluate the redundancy within a particular biochemical pathway in a microbial community. Reliability modeling allows characterization of the system's resilience and identification of failure-prone functional groups or biochemical steps, which can then be targeted for monitoring or enhancement. The reliability engineering approach provides a new perspective for unraveling the interactions between microbial community diversity, functional redundancy and ecosystem services, as well as practical tools for the design and management of engineered ecosystems.

  7. Key Reliability Drivers of Liquid Propulsion Engines and A Reliability Model for Sensitivity Analysis

    NASA Technical Reports Server (NTRS)

    Huang, Zhao-Feng; Fint, Jeffry A.; Kuck, Frederick M.

    2005-01-01

    This paper is to address the in-flight reliability of a liquid propulsion engine system for a launch vehicle. We first establish a comprehensive list of system and sub-system reliability drivers for any liquid propulsion engine system. We then build a reliability model to parametrically analyze the impact of some reliability parameters. We present sensitivity analysis results for a selected subset of the key reliability drivers using the model. Reliability drivers identified include: number of engines for the liquid propulsion stage, single engine total reliability, engine operation duration, engine thrust size, reusability, engine de-rating or up-rating, engine-out design (including engine-out switching reliability, catastrophic fraction, preventable failure fraction, unnecessary shutdown fraction), propellant specific hazards, engine start and cutoff transient hazards, engine combustion cycles, vehicle and engine interface and interaction hazards, engine health management system, engine modification, engine ground start hold down with launch commit criteria, engine altitude start (1 in. start), Multiple altitude restart (less than 1 restart), component, subsystem and system design, manufacturing/ground operation support/pre and post flight check outs and inspection, extensiveness of the development program. We present some sensitivity analysis results for the following subset of the drivers: number of engines for the propulsion stage, single engine total reliability, engine operation duration, engine de-rating or up-rating requirements, engine-out design, catastrophic fraction, preventable failure fraction, unnecessary shutdown fraction, and engine health management system implementation (basic redlines and more advanced health management systems).

  8. Reliability systems for implantable cardiac defibrillator batteries

    NASA Astrophysics Data System (ADS)

    Takeuchi, Esther S.

    The reliability of the power sources used in implantable cardiac defibrillators is critical due to the life-saving nature of the device. Achieving a high reliability power source depends on several systems functioning together. Appropriate cell design is the first step in assuring a reliable product. Qualification of critical components and of the cells using those components is done prior to their designation as implantable grade. Product consistency is assured by control of manufacturing practices and verified by sampling plans using both accelerated and real-time testing. Results to date show that lithium/silver vanadium oxide cells used for implantable cardiac defibrillators have a calculated maximum random failure rate of 0.005% per test month.

  9. Wikipedia : its reliability and social role

    NASA Astrophysics Data System (ADS)

    Kusaka, Kyuhachi

    This article discusses Japanese Wikipedia's reliability and its social role as a free, collaborative, multilingual Internet encyclopedia supported by the non-profit Wikimedia Foundation. Japanese Wikipedia's reliability is explained from several surveys. The central concern is how the nature of encyclopedia and Wikipedia affects the quality of Wikipedia's articles. Wikipedia's core content policies such as verifiability, no original research and a neutral point of view will make articles better. But incomplete or poorly written first drafts exist because Wikipedia is a work in progress. The article also argues that social role of online encyclopedia which provides knowledge for all. Knowledge-based society or/and advanced information society require public understanding of science and other expertise. Online encyclopedia attributed to a reliable, published source using an inline citation will guide anyone to specialized knowledge.

  10. A Reliability-Based Track Fusion Algorithm

    PubMed Central

    Xu, Li; Pan, Liqiang; Jin, Shuilin; Liu, Haibo; Yin, Guisheng

    2015-01-01

    The common track fusion algorithms in multi-sensor systems have some defects, such as serious imbalances between accuracy and computational cost, the same treatment of all the sensor information regardless of their quality, high fusion errors at inflection points. To address these defects, a track fusion algorithm based on the reliability (TFR) is presented in multi-sensor and multi-target environments. To improve the information quality, outliers in the local tracks are eliminated at first. Then the reliability of local tracks is calculated, and the local tracks with high reliability are chosen for the state estimation fusion. In contrast to the existing methods, TFR reduces high fusion errors at the inflection points of system tracks, and obtains a high accuracy with less computational cost. Simulation results verify the effectiveness and the superiority of the algorithm in dense sensor environments. PMID:25950174

  11. Reliability of cortical activity during natural stimulation.

    PubMed

    Hasson, Uri; Malach, Rafael; Heeger, David J

    2010-01-01

    Response reliability is complementary to more conventional measurements of response amplitudes, and can reveal phenomena that response amplitudes do not. Here we review studies that measured reliability of cortical activity within or between human subjects in response to naturalistic stimulation (e.g. free viewing of movies). Despite the seemingly uncontrolled nature of the task, some of these complex stimuli evoke highly reliable, selective and time-locked activity in many brain areas, including some regions that show little response modulation in most conventional experimental protocols. This activity provides an opportunity to address novel questions concerning natural vision, temporal scale of processing, memory and the neural basis of inter-group differences. PMID:20004608

  12. Reliability of cortical activity during natural stimulation

    PubMed Central

    Hasson, Uri; Malach, Rafael; Heeger, David J.

    2009-01-01

    Response reliability is complementary to more conventional measurements of response amplitudes, and can reveal phenomena that response amplitudes do not. Here we review studies that measured reliability of cortical activity within or between human subjects in response to naturalistic stimulation (e.g., free viewing of movies). Despite the seemingly uncontrolled nature of the task, some of these complex stimuli evoke highly reliable, selective, and time-locked activity in many brain areas, including some brain regions that often do not show much response modulation with conventional experimental protocols. This activity provides an opportunity to address novel questions concerning natural vision, temporal scale of processing, memory, and the neural basis of inter-group differences. PMID:20004608

  13. A reliability-based track fusion algorithm.

    PubMed

    Xu, Li; Pan, Liqiang; Jin, Shuilin; Liu, Haibo; Yin, Guisheng

    2015-01-01

    The common track fusion algorithms in multi-sensor systems have some defects, such as serious imbalances between accuracy and computational cost, the same treatment of all the sensor information regardless of their quality, high fusion errors at inflection points. To address these defects, a track fusion algorithm based on the reliability (TFR) is presented in multi-sensor and multi-target environments. To improve the information quality, outliers in the local tracks are eliminated at first. Then the reliability of local tracks is calculated, and the local tracks with high reliability are chosen for the state estimation fusion. In contrast to the existing methods, TFR reduces high fusion errors at the inflection points of system tracks, and obtains a high accuracy with less computational cost. Simulation results verify the effectiveness and the superiority of the algorithm in dense sensor environments.

  14. How reliable are human phylogenetic hypotheses?

    PubMed Central

    Collard, Mark; Wood, Bernard

    2000-01-01

    Cladistic analysis of cranial and dental evidence has been widely used to generate phylogenetic hypotheses about humans and their fossil relatives. However, the reliability of these hypotheses has never been subjected to external validation. To rectify this, we applied identical methods to equivalent evidence from two groups of extant higher primates for whom reliable molecular phylogenies are available, the hominoids and papionins. We found that the phylogenetic hypotheses based on the craniodental data were incompatible with the molecular phylogenies for the groups. Given the robustness of the molecular phylogenies, these results indicate that little confidence can be placed in phylogenies generated solely from higher primate craniodental evidence. The corollary of this is that existing phylogenetic hypotheses about human evolution are unlikely to be reliable. Accordingly, new approaches are required to address the problem of hominin phylogeny. PMID:10781112

  15. Design of the hybrid automated reliability predictor

    NASA Technical Reports Server (NTRS)

    Geist, R.; Trivedi, K.; Dugan, J. B.; Smotherman, M.

    1983-01-01

    The design of the Hybrid Automated Reliability Predictor (HARP), now under development at Duke University, is presented. The HARP approach to reliability prediction is characterized by a decomposition of the overall model into fault-occurrence and fault-handling sub-models. The fault-occurrence model is a non-homogeneous Markov chain which is solved analytically, while the fault-handling model is a Petri Net which is simulated. HARP provides automated analysis of sensitivity to uncertainties in the input parameters and in the initial state specifications. It then produces a predicted reliability band as a function of mission time, as well as estimates of the improvement (narrowing of the band) to be gained by a specified amount of reduction in uncertainty.

  16. [Interrater reliability of the Braden scale].

    PubMed

    Kottner, Jan; Tannen, Antje; Dassen, Theo

    2008-04-01

    Pressure ulcer risk assessment scales can assist nurses in determining the individual pressure ulcer risk. Although the Braden scale is widely used throughout Germany, its psychometric properties are yet unknown. The aim of the study was to determine the interrater reliability of the Braden scale and to compare the results with those of published data. A literature review was conducted. 20 studies measuring the interrater reliability of the Braden scale were evaluated. Only three of those studies investigated the interrater reliability of single items. The Pearson product-moment correlation coefficient (0.80 to 1.00) was calculated in most studies for an evaluation of the Braden scale as a whole. However, the use of correlation coefficients is inappropriate for measuring the interrater reliability of the Braden scale. Measures of the intraclass correlation coefficient varied from 0.83 to 0.99. The investigation of the interrater reliability of the Braden scale's German version was conducted in a German nursing home in 2006. Nurses independently rated 18 and 32 residents twice. Nurses achieved the highest agreement when rating the items "friction and shear" and "activity" (overall proportion of agreement = 0.67 to 0.84, Cohen's Kappa = 0.57 to 0.73). The lowest agreement was achieved when the item "nutrition" (overall proportion of agreement = 0.47 to 0.51, Cohen's Kappa = 0.28 to 0.30) was rated. For 66% of the rated residents the difference in the obtained Braden scores was equal or less than one point. Intraclass correlation coefficients were 0.91 (95% confidence interval 0.82 to 0.96) and 0.88 (95% confidence interval 0.61 to 0.96). This indicates that the interrater reliability of the Braden scale was high in the examined setting.

  17. MEASUREMENT: ACCOUNTING FOR RELIABILITY IN PERFORMANCE ESTIMATES.

    PubMed

    Waterman, Brian; Sutter, Robert; Burroughs, Thomas; Dunagan, W Claiborne

    2014-01-01

    When evaluating physician performance measures, physician leaders are faced with the quandary of determining whether departures from expected physician performance measurements represent a true signal or random error. This uncertainty impedes the physician leader's ability and confidence to take appropriate performance improvement actions based on physician performance measurements. Incorporating reliability adjustment into physician performance measurement is a valuable way of reducing the impact of random error in the measurements, such as those caused by small sample sizes. Consequently, the physician executive has more confidence that the results represent true performance and is positioned to make better physician performance improvement decisions. Applying reliability adjustment to physician-level performance data is relatively new. As others have noted previously, it's important to keep in mind that reliability adjustment adds significant complexity to the production, interpretation and utilization of results. Furthermore, the methods explored in this case study only scratch the surface of the range of available Bayesian methods that can be used for reliability adjustment; further study is needed to test and compare these methods in practice and to examine important extensions for handling specialty-specific concerns (e.g., average case volumes, which have been shown to be important in cardiac surgery outcomes). Moreover, it's important to note that the provider group average as a basis for shrinkage is one of several possible choices that could be employed in practice and deserves further exploration in future research. With these caveats, our results demonstrate that incorporating reliability adjustment into physician performance measurements is feasible and can notably reduce the incidence of "real" signals relative to what one would expect to see using more traditional approaches. A physician leader who is interested in catalyzing performance improvement

  18. Experiments in fault tolerant software reliability

    NASA Technical Reports Server (NTRS)

    Mcallister, David F.; Tai, K. C.; Vouk, Mladen A.

    1987-01-01

    The reliability of voting was evaluated in a fault-tolerant software system for small output spaces. The effectiveness of the back-to-back testing process was investigated. Version 3.0 of the RSDIMU-ATS, a semi-automated test bed for certification testing of RSDIMU software, was prepared and distributed. Software reliability estimation methods based on non-random sampling are being studied. The investigation of existing fault-tolerance models was continued and formulation of new models was initiated.

  19. Issues in providing a reliable multicast facility

    NASA Technical Reports Server (NTRS)

    Dempsey, Bert J.; Strayer, W. Timothy; Weaver, Alfred C.

    1990-01-01

    Issues involved in point-to-multipoint communication are presented and the literature for proposed solutions and approaches surveyed. Particular attention is focused on the ideas and implementations that align with the requirements of the environment of interest. The attributes of multicast receiver groups that might lead to useful classifications, what the functionality of a management scheme should be, and how the group management module can be implemented are examined. The services that multicasting facilities can offer are presented, followed by mechanisms within the communications protocol that implements these services. The metrics of interest when evaluating a reliable multicast facility are identified and applied to four transport layer protocols that incorporate reliable multicast.

  20. A general software reliability process simulation technique

    NASA Technical Reports Server (NTRS)

    Tausworthe, Robert C.

    1991-01-01

    The structure and rationale of the generalized software reliability process, together with the design and implementation of a computer program that simulates this process are described. Given assumed parameters of a particular project, the users of this program are able to generate simulated status timelines of work products, numbers of injected anomalies, and the progress of testing, fault isolation, repair, validation, and retest. Such timelines are useful in comparison with actual timeline data, for validating the project input parameters, and for providing data for researchers in reliability prediction modeling.