Beware of Data Gaps in Home Care Research: The Streetlight Effect and Its Implications for Policy Making on Long-Term Services and Supports

PubMed Central

Newquist, Deborah D.; DeLiema, Marguerite; Wilber, Kathleen H.

2016-01-01

Policy initiatives increasingly seek greater use of home- and community-based services for older persons and those with chronic care needs, yet large gaps persist in our knowledge of home care, an indispensable component of long-term services and supports. Unrecognized data gaps, including the scope of home care provided by private hire and nonmedical providers, can distort knowledge and poorly inform long-term services and supports policy. The purpose of this article is to examine these gaps by describing the universe of formal home care services and provider types in relationship to major national sources. Findings reveal four distinct home care sectors and that the majority of formal home care is provided in the sectors that are understudied. We discuss the policy implications of data gaps and conclude with recommendations on where to expand and refine home care research. PMID:26062611

Improving detection and quality of assessment of child abuse and partner abuse is achievable with a formal organisational change approach.

PubMed

Wills, Russell; Ritchie, Miranda; Wilson, Mollie

2008-03-01

To improve detection and quality of assessment of child and partner abuse within a health service. A formal organisational change approach was used to implement the New Zealand Family Violence Intervention Guidelines in a mid-sized regional health service. The approach includes obtaining senior management support, community collaboration, developing resources to support practice, research, evaluation and training. Formal pre-post evaluations were conducted of the training. Barriers and enablers of practice change were assessed through 85 interviews with 60 staff. More than 6000 clinical records were audited to assess rates of questioning for partner abuse. Identifications of partner abuse and referrals made were counted through the Family Violence Accessory File. Referrals to the Department of Child, Youth and Family Services (CYFS) were recorded routinely by the CYFS. Audits assessed quality of assessment of child and partner abuse, when identified. More than 700 staff were trained in dual assessment for child and partner abuse. Evaluations demonstrate improved confidence following training, though staff still need support. Barriers and enablers to asking about partner abuse were identified. Referrals from the health service to the CYFS increased from 10 per quarter to 70 per quarter. Identification of partner abuse increased from 30 to 80 per 6-month period. Routine questioning rates for partner abuse vary between services. Achieving and sustaining improved rates of identification and quality of assessment of child and partner abuse is possible with a formal organisational change approach.

A model of well-being for children with neurodevelopmental disorders: Parental perceptions of functioning, services, and support.

PubMed

Ritzema, A M; Lach, L M; Nicholas, D; Sladeczek, I E

2018-03-01

Both child function and supports and services have been found to impact the well-being of parents of children with neurodevelopmental disorders (NDD). The relationship between function and services and the well-being of children with NDD is less well-understood and is important to clarify in order to effect program and service change. The current project assessed whether child function as well as the adequacy of formal supports and services provided to children and their families were predictive of child well-being. Well-being was assessed using a measure of quality of life developed for use with children with NDD. Data from 234 parents were analysed using structural equation modelling. Each predictor was found to load significantly on the overall outcome variable of well-being. Parent concerns about child function were significantly related to child well-being; parents who reported more concerns about their children's functioning reported lower levels of child well-being. Unmet needs for formal supports and services were also significantly related to child well-being; parents who reported that more of their children's and family's service needs were unmet reported lower child well-being. An indirect relationship was also found between child function and child well-being. When parents reported that their formal support needs were adequately met, their children's functional difficulties had a lower impact on parent perceptions of their children's overall well-being. Taken together, the results of the current study enrich our understanding of well-being for children with NDD. Discussion focuses on the service implications for children with NDD and their families. © 2017 John Wiley & Sons Ltd.

A proposed ecosystem services classification system to support green accounting

EPA Science Inventory

There are a multitude of actual or envisioned, complete or incomplete, ecosystem service classification systems being proposed to support Green Accounting. Green Accounting is generally thought to be the formal accounting attempt to factor environmental production into National ...

Consumer experience of formal crisis-response services and preferred methods of crisis intervention.

PubMed

Boscarato, Kara; Lee, Stuart; Kroschel, Jon; Hollander, Yitzchak; Brennan, Alice; Warren, Narelle

2014-08-01

The manner in which people with mental illness are supported in a crisis is crucial to their recovery. The current study explored mental health consumers' experiences with formal crisis services (i.e. police and crisis assessment and treatment (CAT) teams), preferred crisis supports, and opinions of four collaborative interagency response models. Eleven consumers completed one-on-one, semistructured interviews. The results revealed that the perceived quality of previous formal crisis interventions varied greatly. Most participants preferred family members or friends to intervene. However, where a formal response was required, general practitioners and mental health case managers were preferred; no participant wanted a police response, and only one indicated a preference for CAT team assistance. Most participants welcomed collaborative crisis interventions. Of four collaborative interagency response models currently being trialled internationally, participants most strongly supported the Ride-Along Model, which enables a police officer and a mental health clinician to jointly respond to distressed consumers in the community. The findings highlight the potential for an interagency response model to deliver a crisis response aligned with consumers' preferences. © 2014 Australian College of Mental Health Nurses Inc.

Beware of Data Gaps in Home Care Research: The Streetlight Effect and Its Implications for Policy Making on Long-Term Services and Supports.

PubMed

Newquist, Deborah D; DeLiema, Marguerite; Wilber, Kathleen H

2015-10-01

Policy initiatives increasingly seek greater use of home- and community-based services for older persons and those with chronic care needs, yet large gaps persist in our knowledge of home care, an indispensable component of long-term services and supports. Unrecognized data gaps, including the scope of home care provided by private hire and nonmedical providers, can distort knowledge and poorly inform long-term services and supports policy. The purpose of this article is to examine these gaps by describing the universe of formal home care services and provider types in relationship to major national sources. Findings reveal four distinct home care sectors and that the majority of formal home care is provided in the sectors that are understudied. We discuss the policy implications of data gaps and conclude with recommendations on where to expand and refine home care research. © The Author(s) 2015.

Walking the Line: Navigating Market and Gift Economies of Care in a Consumer-Directed Home-Based Care Program for Older Adults

PubMed Central

Torres, Jacqueline M; Kietzman, Kathryn G; Wallace, Steven P

2015-01-01

Context Paid caregivers of low-income older adults navigate their role at what Hochschild calls the “market frontier”: the fuzzy line between the “world of the market,” in which services are exchanged for monetary compensation, and the “world of the gift,” in which caregiving is uncompensated and motivated by emotional attachment. We examine how political and economic forces, including the reduction of long-term services and supports, shape the practice of “walking the line” among caregivers of older adults. Methods We used data from a longitudinal qualitative study with related and nonrelated caregivers (n = 33) paid through California’s In-Home Supportive Services (IHSS) program and consumers of IHSS care (n = 49). We analyzed the semistructured interviews (n = 330), completed between 2010 and 2014, using a constructivist grounded theory approach. Findings Related and nonrelated caregivers are often expected to “gift” hours of care above and beyond what is compensated by formal services. Cuts in formal services and lapses in pay push caregivers to further “walk the line” between market and gift economies of care. Both related and nonrelated caregivers who choose to stay on and provide more care without pay often face adverse economic and health consequences. Some, including related caregivers, opt out of caregiving altogether. While some consumers expect that caregivers would be willing to “walk the line” in order to meet their needs, most expressed sympathy for them and tried to alter their schedules or go without care in order to limit the caregivers’ burden. Conclusions Given economic and health constraints, caregivers cannot always compensate for cuts in formal supports by providing uncompensated time and resources. Similarly, low-income older adults are not competitive in the caregiving marketplace and, given the inadequacy of compensated hours, often depend on unpaid care. Policies that restrict formal long-term services and supports thus leave the needs of both caregivers and consumers unmet. PMID:26626984

Walking the Line: Navigating Market and Gift Economies of Care in a Consumer-Directed Home-Based Care Program for Older Adults.

PubMed

Torres, Jacqueline M; Kietzman, Kathryn G; Wallace, Steven P

2015-12-01

Paid caregivers of low-income older adults navigate their role at what Hochschild calls the "market frontier": the fuzzy line between the "world of the market," in which services are exchanged for monetary compensation, and the "world of the gift," in which caregiving is uncompensated and motivated by emotional attachment. We examine how political and economic forces, including the reduction of long-term services and supports, shape the practice of "walking the line" among caregivers of older adults. We used data from a longitudinal qualitative study with related and nonrelated caregivers (n = 33) paid through California's In-Home Supportive Services (IHSS) program and consumers of IHSS care (n = 49). We analyzed the semistructured interviews (n = 330), completed between 2010 and 2014, using a constructivist grounded theory approach. Related and nonrelated caregivers are often expected to "gift" hours of care above and beyond what is compensated by formal services. Cuts in formal services and lapses in pay push caregivers to further "walk the line" between market and gift economies of care. Both related and nonrelated caregivers who choose to stay on and provide more care without pay often face adverse economic and health consequences. Some, including related caregivers, opt out of caregiving altogether. While some consumers expect that caregivers would be willing to "walk the line" in order to meet their needs, most expressed sympathy for them and tried to alter their schedules or go without care in order to limit the caregivers' burden. Given economic and health constraints, caregivers cannot always compensate for cuts in formal supports by providing uncompensated time and resources. Similarly, low-income older adults are not competitive in the caregiving marketplace and, given the inadequacy of compensated hours, often depend on unpaid care. Policies that restrict formal long-term services and supports thus leave the needs of both caregivers and consumers unmet. © 2015 Milbank Memorial Fund.

One Stop Student Services: A Student Perspective

ERIC Educational Resources Information Center

Johannes, Cheryl Leslie

2012-01-01

Colleges and Universities have a myriad of choices in how to organize enrollment services delivery. Formalizing collaborative services to create stronger more comprehensive linkages and cross-functional service delivery in a student-centric, relationship-oriented manner is important for meeting the expectations of today's students. In support of…

Associations Between Home Death and the Use and Type of Care at Home.

PubMed

McEwen, Rebecca; Asada, Yukiko; Burge, Frederick; Lawson, Beverley

2018-01-01

Despite wishes for and benefits of home deaths, a discrepancy between preferred and actual location of death persists. Provision of home care may be an effective policy response to support home deaths. Using the population-based mortality follow-back study conducted in Nova Scotia, we investigated the associations between home death and formal care at home and between home death and the type of formal care at home. We found (1) the use of formal care at home at the end of life was associated with home death and (2) the use of formal home support services at home was associated with home death among those whose symptoms were well managed.

Alzheimer's Disease in Rural Areas: Can Informal Helpers Meet the Needs?

ERIC Educational Resources Information Center

Wolk, James; And Others

1987-01-01

Examines issues and problems confronting 20 caregivers of victims of Alzheimer's disease in rural southwest Missouri and the formal and informal services they received. Suggests that coordination of formal/informal supports must be improved. Describes characteristics and incidence of Alzheimer's disease and implications for rural areas with high…

Linking communities to formal health care providers through village health teams in rural Uganda: lessons from linking social capital.

PubMed

Musinguzi, Laban Kashaija; Turinawe, Emmanueil Benon; Rwemisisi, Jude T; de Vries, Daniel H; Mafigiri, David K; Muhangi, Denis; de Groot, Marije; Katamba, Achilles; Pool, Robert

2017-01-11

Community-based programmes, particularly community health workers (CHWs), have been portrayed as a cost-effective alternative to the shortage of health workers in low-income countries. Usually, literature emphasises how easily CHWs link and connect communities to formal health care services. There is little evidence in Uganda to support or dispute such claims. Drawing from linking social capital framework, this paper examines the claim that village health teams (VHTs), as an example of CHWs, link and connect communities with formal health care services. Data were collected through ethnographic fieldwork undertaken as part of a larger research program in Luwero District, Uganda, between 2012 and 2014. The main methods of data collection were participant observation in events organised by VHTs. In addition, a total of 91 in-depth interviews and 42 focus group discussions (FGD) were conducted with adult community members as part of the larger project. After preliminary analysis of the data, we conducted an additional six in-depth interviews and three FGD with VHTs and four FGD with community members on the role of VHTs. Key informant interviews were conducted with local government staff, health workers, local leaders, and NGO staff with health programs in Luwero. Thematic analysis was used during data analysis. The ability of VHTs to link communities with formal health care was affected by the stakeholders' perception of their roles. Community members perceive VHTs as working for and under instructions of "others", which makes them powerless in the formal health care system. One of the challenges associated with VHTs' linking roles is support from the government and formal health care providers. Formal health care providers perceived VHTs as interested in special recognition for their services yet they are not "experts". For some health workers, the introduction of VHTs is seen as a ploy by the government to control people and hide its inability to provide health services. Having received training and initial support from an NGO, VHTs suffered transition failure from NGO to the formal public health care structure. As a result, VHTs are entangled in power relations that affect their role of linking community members with formal health care services. We also found that factors such as lack of money for treatment, poor transport networks, the attitudes of health workers and the existence of multiple health care systems, all factors that hinder access to formal health care, cannot be addressed by the VHTs. As linking social capital framework shows, for VHTs to effectively act as links between the community and formal health care and harness the resources that exist in institutions beyond the community, it is important to take into account the power relationships embedded in vertical relationships and forge a partnership between public health providers and the communities they serve. This will ensure strengthened partnerships and the improved capacity of local people to leverage resources embedded in vertical power networks.

Rural Australian Women's Legal Help Seeking for Intimate Partner Violence: Women Intimate Partner Violence Victim Survivors' Perceptions of Criminal Justice Support Services

ERIC Educational Resources Information Center

Ragusa, Angela T.

2013-01-01

Intimate partner violence (IPV) is a widespread, ongoing, and complex global social problem, whose victims continue to be largely women. Women often prefer to rely on friends and family for IPV help, yet when informal support is unavailable they remain hesitant to contact formal services, particularly legal support for many reasons. This study…

The Social Integration of Supported Employees: A Qualitative Study.

ERIC Educational Resources Information Center

Hagner, David C.

This study utilized qualitative methods to examine the social interactions that occur within supported employment settings between workers with disabilities and nondisabled co-workers. The study also examined the job supports at work settings, to understand the relationship between formal, job coach support services and natural job supports. Seven…

The Support System of the Hispanic Elderly and the Use of Formal Social Services.

ERIC Educational Resources Information Center

Starrett, Richard A.; And Others

The study examined the role played by informal (i.e., family, kin, neighbors, friends) and quasiformal (i.e., church-sponsored) support systems in predicting, enhancing, or inhibiting use of social services by Hispanic elderly. Thirty-seven variables and data selected from a 1979-1980 15-state survey of 1,805 noninstitutionalized Hispanic…

Developing a Common Metadata Model for Competencies Description

ERIC Educational Resources Information Center

Sampson, Demetrios; Karampiperis, Pythagoras; Fytros, Demetrios

2007-01-01

Competence-based approaches are frequently adopted as the key paradigm in both formal or non-formal education and training. To support the provision of competence-based learning services, it is necessary to be able to maintain a record of an individual's competences in a persistent and standard way. In this paper, we investigate potential issues…

Improving the interface between informal carers and formal health and social services: a qualitative study.

PubMed

McPherson, K M; Kayes, N K; Moloczij, N; Cummins, C

2014-03-01

Reports about the impact of caring vary widely, but a consistent finding is that the role is influenced (for better or worse) by how formal services respond to, and work with informal carers and of course the cared for person. We aimed to explore the connection between informal and formal cares and identify how a positive connection or interface might be developed and maintained. We undertook a qualitative descriptive study with focus groups and individual interviews with informal carers, formal care service providers and representatives from carer advocacy groups. Content analysis was used to identify key factors impacting on the interface between informal and formal carers and propose specific recommendations for service development. Community setting including urban and rural areas of New Zealand. Seventy participants (the majority informal carers) took part in 13 focus groups and 22 individual interviews. Four key themes were derived: Quality of care for the care recipient; Knowledge exchange (valuing carer perspectives); One size does not fit all (creating flexible services); and A constant struggle (reducing the burden services add). An optimum interface to address these key areas was proposed. In addition to ensuring quality care for the care recipient, specific structures and processes to support a more positive interface appear warranted if informal carers and services are to work well together. An approach recognising the caring context and carer expertise may decrease the additional burden services contribute, and reduce conflicting information and resultant confusion and/or frustration many carers experience. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Influence of Community-Based Services on the Burden of Spouses Caring for Their Partners with Dementia

ERIC Educational Resources Information Center

Sussman, Tamara; Regehr, Cheryl

2009-01-01

Despite the vast literature on caregiver stress, few studies have explored how community services affect the stress process for spousal caregivers. The current study explores the differential effects of emotional and tangible support provided by family and friends and by formal services, and caregivers' perceptions of community services on spousal…

Meeting unmet needs of families of persons with mental illness: evaluation of a family peer support helpline.

PubMed

Shor, Ron; Birnbaum, Menachem

2012-08-01

Family members of persons with mental illness experience multiple stressors stemming from the burdens of caring for the ill family member. A potential source of help for this population is a family peer support helpline. Knowledge, however, is lacking about the types of help offered in such a service and its benefit for this population. In a study conducted in Israel, 800 calls made by family members of persons with mental illness to a family peer support helpline were analyzed utilizing an instrument developed for the family peers' evaluation of the calls. In addition, researchers conducted 77 follow-up interviews with callers who agreed to be interviewed. The findings indicate the importance of the life experience, flexibility and anonymity of the family peers in providing types of help that are complementary to the help provided by formal services. The most frequent categories of support provided were emotional support, information and advice. This help could assist family members of persons with mental illness with their care-giving role, as well as provide them with an alternative source of help if they experience difficulties with professionals. It could also serve as a catalyst in encouraging them to establish and maintain contact with the formal mental health services. Recognizing and supporting the contribution of a family peer support helpline would encourage its development within the range of services available for this population.

Subsidies to target specialist outreach services into more remote locations: a national cross-sectional study.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

2017-07-01

Objective Targeting rural outreach services to areas of highest relative need is challenging because of the higher costs it imposes on health workers to travel longer distances. This paper studied whether subsidies have the potential to support the provision of specialist outreach services into more remote locations. Methods National data about subsidies for medical specialist outreach providers as part of the Wave 7 Medicine in Australia: Balancing Employment and Life (MABEL) Survey in 2014. Results Nearly half received subsidies: 19% (n=110) from a formal policy, namely the Australian Government Rural Health Outreach Fund (RHOF), and 27% (n=154) from other sources. Subsidised specialists travelled for longer and visited more remote locations relative to the non-subsidised group. In addition, compared with non-subsidised specialists, RHOF-subsidised specialists worked in priority areas and provided equally regular services they intended to continue, despite visiting more remote locations. Conclusion This suggests the RHOF, although limited to one in five specialist outreach providers, is important to increase targeted and stable outreach services in areas of highest relative need. Other subsidies also play a role in facilitating remote service distribution, but may need to be more structured to promote regular, sustained outreach practice. What is known about this topic? There are no studies describing subsidies for specialist doctors to undertake rural outreach work and whether subsidies, including formal and structured subsidies via the Australian Government RHOF, support targeted outreach services compared with no financial support. What does this paper add? Using national data from Australia, we describe subsidisation among specialist outreach providers and show that specialists subsidised via the RHOF or another source are more likely to provide remote outreach services. What are the implications for practitioners? Subsidised specialist outreach providers are more likely to provide remote outreach services. The RHOF, as a formally structured comprehensive subsidy, further targets the provision of priority services into such locations on a regular, ongoing basis.

NGO Provision of Basic Education: Alternative or Complementary Service Delivery to Support Access to the Excluded?

ERIC Educational Resources Information Center

Rose, Pauline

2009-01-01

This paper focuses on approaches by non-government organisations (NGOs) to reach primary school-aged children excluded from access to the conventional state education system. It highlights recent shifts in international literature and agency priorities from the portrayal of NGO provision as a (non-formal) "alternative" to (formal) state…

Participation and interest in support services among family caregivers of older adults with cancer.

PubMed

Dionne-Odom, J Nicholas; Applebaum, Allison J; Ornstein, Katherine A; Azuero, Andres; Warren, Paula P; Taylor, Richard A; Rocque, Gabrielle B; Kvale, Elizabeth A; Demark-Wahnefried, Wendy; Pisu, Maria; Partridge, Edward E; Martin, Michelle Y; Bakitas, Marie A

2018-03-01

The purpose of this study was to describe distressed and underprepared family caregiver's use of and interest in formal support services (eg, professional counseling, education, organizational assistance). Cross-sectional mail survey conducted in communities of 8 cancer centers in Tennessee, Alabama, and Florida (response rate: 42%). Family caregivers of Medicare beneficiaries with pancreatic, lung, brain, ovarian, head and neck, hematologic, and stage IV cancers reported support service use and completed validated measures of depression, anxiety, burden, preparedness, and health. Caregivers (n = 294) were on average age 65 years and mostly female (73%), White (91%), and care recipients' spouse/partner (60%); patients averaged 75 years were majority male (54%) with lung cancer (39%). Thirty-two percent of caregivers reported accessing services while 28% were "mostly" or "extremely" interested. Thirty-five percent of caregivers with high depressive symptoms (n = 122), 33% with high anxiety symptoms (n = 100), and 25% of those in the lowest quartile of preparedness (n = 77) accessed services. Thirty-eight percent of those with high depressive symptoms, 47% with high anxiety symptoms, and 36% in the lowest quartile of preparedness were "mostly" or "extremely" interested in receiving services. Being interested in support services was significantly associated with being a minority, shorter durations of caregiving, and with higher stress burden. A large proportion of family caregivers, including those experiencing depression and anxiety symptoms and who were underprepared, are not using formal support services but have a strong interest in services. Strategies to increase service use may include targeting distressed caregivers early in their caregiving experience. Copyright © 2017 John Wiley & Sons, Ltd.

Implementing Elementary School Next Generation Science Standards

NASA Astrophysics Data System (ADS)

Kennedy, Katheryn B.

Implementation of the Next Generation Science Standards requires developing elementary teacher content and pedagogical content knowledge of science and engineering concepts. Teacher preparation for this undertaking appears inadequate with little known about how in-service Mid-Atlantic urban elementary science teachers approach this task. The purpose of this basic qualitative interview study was to explore the research questions related to perceived learning needs of 8 elementary science teachers and 5 of their administrators serving as instructional leaders. Strategies needed for professional growth to support learning and barriers that hamper it at both building and district levels were included. These questions were considered through the lens of Schon's reflective learning and Weick's sensemaking theories. Analysis with provisional and open coding strategies identified informal and formal supports and barriers to teachers' learning. Results indicated that informal supports, primarily internet usage, emerged as most valuable to the teachers' learning. Formal structures, including professional learning communities and grade level meetings, arose as both supportive and restrictive at the building and district levels. Existing formal supports emerged as the least useful because of the dominance of other priorities competing for time and resources. Addressing weaknesses within formal supports through more effective planning in professional development can promote positive change. Improvement to professional development approaches using the internet and increased hands on activities can be integrated into formal supports. Explicit attention to these strategies can strengthen teacher effectiveness bringing positive social change.

When Satisfaction Is Not Directly Related to the Support Services Received: Understanding Parents' Varied Experiences with Specialised Services for Children with Developmental Disabilities

ERIC Educational Resources Information Center

Robert, Marie; Leblanc, Line; Boyer, Thierry

2015-01-01

Parents of children with developmental disabilities (autism or intellectual disabilities) are more susceptible to stress and have a greater burden of adversity than other parents. Their well-being and satisfaction greatly depend on the system's response of finding them formal support and the help they need. This study proposes an interpretive…

The association between cognitive impairment and community service use patterns in older people living in Australia.

PubMed

Vecchio, Nerina; Fitzgerald, Janna A; Radford, Katrina; Fisher, Ron

2016-05-01

Family plays a vital role in supporting individuals with dementia to reside in the community, thus delaying institutionalisation. Existing research indicates that the burden of care-giving is particularly high for those caring for a person with dementia. Yet, little is known about the uptake of community services by people with a diagnosis of dementia. Therefore, this study aims to better understand the relationship between cognitive impairment and the receipt of community care services. In order to examine the relationship, secondary data collected across Queensland, Australia, from 59,352 home-care clients aged 65 and over during 2007-2008 are analysed. This cross-sectional study uses regression analyses to estimate the relationship between cognitive impairment and service mix, while controlling for socio-demographic characteristics. The dependent variables include formal services, informal care and total home-care service hours during a 12-month period. The findings of this study demonstrate that cognitive impairment is associated with accessing more hours of respite and day centre care but fewer hours of other formal care services. Additionally, the likelihood of support from an informal caregiver increases when a client becomes cognitively impaired. Therefore, this study demonstrates that there is an increased need for respite programmes to support informal caregivers in the future, as the population of people living with dementia increases. These findings support the need for investigations of new and innovative respite models in the future. © 2015 John Wiley & Sons Ltd.

Geographic patterns of at-risk species: A technical document supporting the USDA Forest Service Interim Update of the 2000 RPA Assessment

Treesearch

Curtis H. Flather; Michael S. Knowles; Jason McNees

2008-01-01

This technical document supports the Forest Service's requirement to assess the status of renewable natural resources as mandated by the Forest and Rangeland Renewable Resources Planning Act of 1974. It updates past reports on the trends and geographic patterns of species formally listed as threatened or endangered under the Endangered Species Act of 1973. We...

EMDS users guide (version 2.0): knowledge-based decision support for ecological assessment.

Treesearch

Keith M. Reynolds

1999-01-01

The USDA Forest Service Pacific Northwest Research Station in Corvallis, Oregon, has developed the ecosystem management decision support (EMDS) system. The system integrates the logical formalism of knowledge-based reasoning into a geographic information system (GIS) environment to provide decision support for ecological landscape assessment and evaluation. The...

Burnout in Human Service Organizations: Prevention and Remediation.

ERIC Educational Resources Information Center

McFadden, Hope; Moracco, John

1980-01-01

Burnout in human service organizations can be caused by funding problems, overwork, the nature of clients, and ineffective management. A social-professional support group should be a formal part of the organizational structure to provide opportunities for evaluation and feedback, as well as individual help to professionals. (JAC)

Help Seeking Among Victims of Crime: A Review of the Empirical Literature

PubMed Central

McCart, Michael R.; Smith, Daniel W.; Sawyer, Genelle K.

2013-01-01

This paper reviews the literature on help-seeking behavior among adult victims of crime. Specifically, the paper summarizes prevalence rates for formal and informal help seeking and reviews predictors of and barriers to service use following victimization. Research suggests that only a small fraction of crime victims seek help from formal support networks; however, many seek support from informal sources. Several variables are associated with increased likelihood of formal help seeking, although the manner in which these variables affect reporting behavior is not clear. From this review, it is concluded that much remains to be learned regarding patterns of help seeking among victims of crime. Gaps in the literature and directions for future research are discussed. PMID:20336674

A Formalization of HIPAA for a Medical Messaging System

NASA Astrophysics Data System (ADS)

Lam, Peifung E.; Mitchell, John C.; Sundaram, Sharada

The complexity of regulations in healthcare, financial services, and other industries makes it difficult for enterprises to design and deploy effective compliance systems. We believe that in some applications, it may be practical to support compliance by using formalized portions of applicable laws to regulate business processes that use information systems. In order to explore this possibility, we use a stratified fragment of Prolog with limited use of negation to formalize a portion of the US Health Insurance Portability and Accountability Act (HIPAA). As part of our study, we also explore the deployment of our formalization in a prototype hospital Web portal messaging system.

Return to learn: Transitioning to school and through ascending levels of academic support for students following a concussion.

PubMed

McAvoy, Karen; Eagan-Johnson, Brenda; Halstead, Mark

2018-01-01

The purpose of this article is to familiarize healthcare providers and parents with educational language, laws, and processes as they relate to a comprehensive ascending level of academic supports as it pertains to promoting a smooth and supported transition to school following a concussion. Returning to learn (RTL) following a concussion is of parallel importance to returning to sport (RTS). A successful RTL is a critical part of concussion management. Many RTL articles advise healthcare providers and parents to request formalized educational supports, also known as Tier 2 or Tier 3 services, for children with concussion as they return to school. Premature requests for formal (Tier 2 or 3) educational services, rather than allowing for immediate informal educational supports (known as Tier 1), can actually delay academic supports and have the potential to cause adversarial relationships between parents and schools. Additionally, this practice contradicts current research demonstrating the need for fast, flexible, temporary academic supports within the first month post-injury. Allowing school districts to direct the application of existing ascending levels of educational support for students with concussion as they return to school can promote robust and positive outcomes.

Environmental Awareness and Support Networks of the Hispanic Elderly.

ERIC Educational Resources Information Center

Starrett, Richard A.; And Others

Data obtained from interviews with 1,804 non-institutionalized Hispanic individuals age 55 and over were analyzed in an attempt to understand how formal and informal social support systems and awareness of available social services (environmental awareness) affect the ability of elderly Hispanics to remain independent within their communities. The…

Access to and use of health services among undocumented Mexican immigrants in a US urban area.

PubMed

Nandi, Arijit; Galea, Sandro; Lopez, Gerald; Nandi, Vijay; Strongarone, Stacey; Ompad, Danielle C

2008-11-01

We assessed access to and use of health services among Mexican-born undocumented immigrants living in New York City in 2004. We used venue-based sampling to recruit participants from locations where undocumented immigrants were likely to congregate. Participants were 18 years or older, born in Mexico, and current residents of New York City. The main outcome measures were health insurance coverage, access to a regular health care provider, and emergency department care. In multivariable models, living in a residence with fewer other adults, linguistic acculturation, higher levels of formal income, higher levels of social support, and poor health were associated with health insurance coverage. Female gender, fewer children, arrival before 1997, higher levels of formal income, health insurance coverage, greater social support, and not reporting discrimination were associated with access to a regular health care provider. Higher levels of education, higher levels of formal income, and poor health were associated with emergency department care. Absent large-scale political solutions to the challenges of undocumented immigrants, policies that address factors shown to limit access to care may improve health among this growing population.

Impact of Potential Accreditation and Certification in Family Medicine Maternity Care.

PubMed

Eden, Aimee R; Peterson, Lars E

2017-01-01

Advanced maternity care training in family medicine is highly variable at both the residency and fellowship levels. Declining numbers of family physicians providing maternity care services may exacerbate disparities in access to maternal and child care, especially in rural and other underserved communities. Accreditation of maternity care fellowships and board certification may be one potential avenue to address this trend. This study sought to understand the perceptions and beliefs of key family medicine stakeholders in advanced maternity care regarding the formalization of maternity care training through fellowship accreditation and the creation of a certificate of added qualification (CAQ). In 2014 and 2015, the authors conducted semi-structured interviews with 51 key stakeholders in family medicine maternity care. Transcribed interviews were coded using an iterative process to identify themes and patterns until saturation was reached. Participants generally supported both maternity care fellowship accreditation and a CAQ and recognized multiple advantages such as legitimization of training. Many had concerns about potential negative unintended consequences such as a loss of curricular flexibility; however, most felt that these could be mediated. Only a few did not support one or both aspects of formalization. Most participants interviewed support formalizing maternity care fellowship training in family medicine through accreditation and a subsequent CAQ, if implemented with attention to minimizing the potential negative consequences. Such formalization would recognize the advanced skill and training of family physicians practicing advanced maternity care and could address some access issues to essential maternity care services for rural and other underserved populations.

Decision-making experiences of family members of older adults with moderate dementia towards community and residential care home services: a grounded theory study protocol.

PubMed

Le Low, Lisa Pau; Lam, Lai Wah; Fan, Kim Pong

2017-06-05

Caring and supporting older people with dementia have become a major public health priority. Recent reports have also revealed a diminishing number of family carers to provide dementia care in the future. Carers who are engaged in the caring role are known to bear significant psychological, practical and economic challenges as the disease advances over time. Seemingly, evidence indicates that the burden of care can be relieved by formal services. This study aims to explore decision-making experiences of family members of older adults with moderate dementia towards the use of community support (CS) and residential care home (RCH) services. A large multi-site constructivist grounded theory in a range of non-government organizations and a private aged home will frame this Hong Kong study. Purposive sampling will begin the recruitment of family members, followed by theoretical sampling. It is estimated that more than 100 family members using CS and RCH services will participate in an interview. The process of successive constant comparative analysis will be undertaken. The final product, a theory, will generate an integrated and comprehensive conceptual understanding which will explain the processes associated with decision-making of family members for dementia sufferers. Deeper understanding of issues including, but not exclusive to, service needs, expectations and hopes among family carers for improving service support to serve dementia sufferers in CS and RCH services will also be revealed. Importantly, this study seeks to illustrate the practical and strategic aspects of the theory and how it may be useful to transfer its applicability to various service settings to better support those who deliver formal and informal care to the dementia population.

A service evaluation of self-referral to military mental health teams

PubMed Central

Kennedy, I.; Jones, N.; Sharpley, J.; Greenberg, N.

2016-01-01

Background The UK military runs a comprehensive mental health service ordinarily accessed via primary care referrals. Aims To evaluate the feasibility of self-referral to mental health services within a military environment. Methods Three pilot sites were identified; one from each service (Royal Navy, Army, Air Force). Socio-demographic information included age, rank, service and career duration. Clinical data included prior contact with general practitioner (GP), provisional diagnosis and assessment outcome. Results Of the 57 self-referrals, 69% (n = 39) had not previously accessed primary care for their current difficulties. After their mental health assessment, 47 (82%) were found to have a formal mental health problem and 41 (72%) were offered a further mental health clinician appointment. The data compared favourably with a large military mental health department that reported 87% of primary care referrals had a formal mental health condition. Conclusions The majority of self-referrals had formal mental health conditions for which they had not previously sought help from primary care; most were offered further clinical input. This supports the view that self-referral may be a useful option to encourage military personnel to seek professional care over and above the usual route of accessing care through their GP. PMID:27121634

Using an Action Learning Set (ALS) to Support the Nurse and Allied Health Professional Consultant Role

ERIC Educational Resources Information Center

Richardson, Janet; Ainsworth, Roberta; Allison, Rhoda; Billyard, Jo; Corley, Reine; Viner, Jane

2008-01-01

Advanced clinical practice roles are now an integral feature of many healthcare services and have been adopted in a diversity of areas. However, mentoring of these roles is not well documented in the literature and formal mechanisms of support are limited. An action learning set (ALS) was developed to provide support for consultants currently in…

Service guidelines based on Resource Utilization Groups Version III for Home Care provide decision-making support for case managers.

PubMed

Collister, Barbara; Stein, Glenda; Katz, Deborah; DeBruyn, Joan; Andrusiw, Linda; Cloutier, Sheila

2012-01-01

Increasing costs and budget reductions combined with increasing demand from our growing, aging population support the need to ensure that the scarce resources allocated to home care clients match client needs. This article details how Integrated Home Care for the Calgary Zone of Alberta Health Services considered ethical and economic principles and used data from the Resident Assessment Instrument for Home Care (RAI-HC) and case mix indices from the Resource Utilization Groups Version III for Home Care (RUG-III/HC) to formulate service guidelines. These explicit service guidelines formalize and support individual resource allocation decisions made by case managers and provide a consistent and transparent method of allocating limited resources.

Utilisation of Healthcare and Associated Services in Huntington’s disease: a data mining study

PubMed Central

Busse, Monica; Al-Madfai, Dr. Hasan; Kenkre, Joyce; Landwehrmeyer, G. Bernhard; Bentivoglio, AnnaRita; Rosser, Anne

2011-01-01

Background: People with Huntington’s disease (HD) often require tailored healthcare and support packages that develop as the disease progresses. The Client Service Receipt Inventory (CSRI) gathers retrospective information on service utilization. This study investigated the use of formal services and informal care as measured by the CSRI and explored associations between informal care, disease severity and functional ability as measured by the Unified Huntington’s Disease Rating Scale Total Motor Score (UHDRS-TMS) and functional scales. Methods: All monitored longitudinal data from annual clinical assessments of UHDRS-TMS and functional assessments and CSRI collected under the auspices of the European Huntington’s Disease Network (EHDN) REGISTRY study between the years 2004 and 2009 were utilised in the analyses. Disease severity was reflected by UHDRS-TMS. Functional ability was measured using the UHDRS functional scales. CSRI data were analysed according to percentage use of individual formal services and total estimated hours per week of informal care. Regression analyses were conducted to identify any associations between disease severity, functional ability and hours of informal care. Results: 451 HD patients (212 female; 239 male) completed one visit; 105 patients (54 females; 51 males) completed two visits and 47 patients (20 females; 27 males) completed three visits in total over the 5 year period. The mean time between visits was 1.2 years. At visit one, 74% of the participants reported being in receipt of at least one formal hospital-based service in the previous six months, and 89% reported receipt of formal primary and community care services. In contrast, at the third visit, 62% of people had used hospital based services and 94% formal community based services in the previous six months. Fifty % of individuals required some form of informal care in the home at visit 1; this increased to 68% at visits 2 and 3. The mean (SD) estimated weekly total informal care hours at visits 1, 2 and 3 were 32.8 (49.4); 21.6 (53.6) and 21.3 (62.4) respectively. Only the scores on the Functional Assessment Scale (FAS) accounted for the variance in the weekly total informal care hours at each visit. Conclusions: Although it must be acknowledged that service use is supply driven, most HD patients across Europe surveyed as part of this study were in receipt of formal primary and community care services and to a lesser extent formal hospital based services. There was however a large reliance on informal care in the home. The FAS appear to have predictive value on informal care requirements and may have utility in facilitating pro-active service provision and in particular when managing carer burden in this population. PMID:21304753

Social Negotiations in a Wiki Environment: A Case Study with Pre-Service Teachers

ERIC Educational Resources Information Center

Vratulis, Vetta; Dobson, Teresa M.

2008-01-01

Understanding of the nature of social negotiations in social software spaces used in support of formal, face-to-face education remains limited. In this paper, we consider how a community of learners working collaboratively in a wiki environment established social hierarchies and negotiated power. Described is a study with 36 pre-service teachers…

Influencing Self-Reported Health among Rural Low-Income Women through Health Care and Social Service Utilization: A Structural Equation Model

ERIC Educational Resources Information Center

Bice-Wigington, Tiffany; Huddleston-Casas, Catherine

2012-01-01

Using structural equation modeling, this study examined the mesosystemic processes among rural low-income women, and how these processes subsequently influenced self-reported health. Acknowledging the behavioral processes inherent in utilization of health care and formal social support services, this study moved beyond a behavioral focus by…

Predictors of Help-Seeking Intentions in Operation Enduring Freedom and Operation Iraqi Freedom Veterans and Service Members.

PubMed

Porcari, Carole; Koch, Ellen I; Rauch, Sheila A M; Hoodin, Flora; Ellison, Grant; McSweeney, Lauren

2017-05-01

Despite significant numbers of Afghanistan and Iraqi veterans and service members who report symptoms of posttraumatic stress disorder, depression, anxiety, and substance abuse, the majority do not seek help for these problems. A better understanding of the help-seeking process might aid providers and administrators in outreach and provision of services for those who need them. Past research has shown several variables that influence an individual's help-seeking behavior: demographic variables, the nature and severity of a mental health problem, and psychological variables. The three goals of the study were to determine which variables predicted help-seeking intentions from various sources for a psychological problem, identify barriers to help seeking, and identify sources of help sought in the past year. All Operation Enduring Freedom and Operation Iraqi Freedom veterans and service members registered with a Midwestern VA Healthcare System between 2001 and 2007 received a letter requesting participation in an Internet-based survey. Participants completed nine questionnaires regarding their current physical and psychological health, social support, self-efficacy, public and self-stigma, and barriers to seeking help for a psychological problem. In addition, patterns of help seeking from informal (i.e., partner/spouse, family, friends) and formal (i.e., physician, psychiatrist, or psychologist, either from Veterans Affairs [VA] or the private sector) sources of help were examined. Results from the linear regression model including all formal and informal sources of help indicated a significant model fit with attitudes toward psychotherapy, social support, and current mental health status as significant coefficients. Of note, attitudes toward psychotherapy were a significant coefficient in all help-seeking models; stigma was a significant coefficient with formal and VA sources, and social support was found to be a significant predictor with informal sources. Documentation of a mental health problem on one's record was found to be a significant barrier to help seeking and participants indicated they would most likely seek help in the next year from their partner/spouse, family, or friends versus formal VA or non-VA sources. This is one of the first studies to examine attitudes toward psychotherapy as contributing to help-seeking intentions of veterans and service members and results provide strong support for inclusion of this variable in future studies in addition to social support and stigma. Limitations of the study are discussed as well as suggestions for future research. It is our hope that findings from this study may inform administrators and providers regarding assessment, outreach, and program development for our country's veterans and service members. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Battered wives--measures by the social and medical services.

PubMed Central

Bergman, B.; Brismar, B.

1990-01-01

The social files and medical records of 98 acutely battered wives who attended a surgical emergency department were studied. Although all women had been hospitalized during the decade preceding the present incident, wife battering was documented in the records in only 18%. The majority of the women (73%) were also known to the social services, but battering was documented in less than half of the cases in the social service files. The measures taken by the social services to help the battered women consisted mainly of economic support and psychotherapy. The cooperation between the medical and social services and the police in cases of wife battering was very limited or non-existent. It is concluded that support given to battered women by the formal sources of aid is insufficient. The documentation of the cases is poor, there is a lack of practical measures and the cooperation between the authorities is limited. This study indicates that the social and medical services underestimate the importance of informal help sources like women's groups or shelters which often are the most valued resources by the battered women themselves. With improved cooperation between authorities and between formal and informal sources of aid the battered wives could be helped more effectively. PMID:2349163

Peer Advocacy in a Personalized Landscape: The Role of Peer Support in a Context of Individualized Support and Austerity

ERIC Educational Resources Information Center

Power, Andrew; Bartlett, Ruth; Hall, Edward

2016-01-01

Whilst personalization offers the promise of more choice and control and wider participation in the community, the reality in the United Kingdom has been hampered by local council cuts and a decline in formal services. This has left many people with intellectual disabilities feeling dislocated from collective forms of support (Needham, 2015). What…

Violence-related coping, help-seeking and health care-based intervention preferences among perinatal women in Mumbai, India.

PubMed

Decker, Michele R; Nair, Saritha; Saggurti, Niranjan; Sabri, Bushra; Jethva, Meghna; Raj, Anita; Donta, Balaiah; Silverman, Jay G

2013-06-01

Domestic violence is a significant public health issue. India is uniquely affected with an estimated 1 in 3 women facing abuse at the hands of a partner. The current mixed-methods study describes violence-related coping and help-seeking, and preferences for health care-based intervention, among perinatal women residing in low-income communities in Mumbai, India. In-depth interviews were conducted with women who had recently given birth and self-reported recent violence from husbands (n = 32), followed by survey data collection (n = 1,038) from mothers seeking immunization for their infants ages 6 months or younger at 3 large urban health centers in Mumbai, India. Participants described fears and other barriers to abuse disclosure, and there was a low level of awareness of formal support services related to violence. Qualitative and quantitative findings indicated that formal help-seeking is uncommon and that informal help sources are most frequently sought. Quantitative results revealed that, while few (<5%) women had been screened for violence in the health care setting, most (67%) would be willing to disclose abuse if asked. When presented with a list of possible clinic-based violence support interventions, participants endorsed crisis counseling and safety planning as most helpful (90.9%). Findings provide direction for violence-related intervention services for perinatal women. A multipronged approach that includes strengthening the informal support system, for example, neighbors and family members, as well as facilitating access to formal services building on the health care system, warrants exploration in this context.

Assessing missed opportunities for the prevention of mother-to-child HIV transmission in an Eastern Cape local service area.

PubMed

Rispel, L C; Peltzer, K; Phaswana-Mafuya, N; Metcalf, C A; Treger, L

2009-03-01

Prevention of new HIV infections is a critical imperative for South Africa; the prevention of mother-to-child transmission (PMTCT) is one of the most efficacious HIV prevention interventions. Assessment of a PMTCT programme to determine missed opportunities. The Kouga local service area (LSA), bordering Nelson Mandela Bay Municipality (Port Elizabeth) in the Eastern Cape. An assessment was conducted in 2007 before implementing technical support for strengthening the PMTCT programme, including: interviews with 20 PMTCT managers, 4 maternity staff and 27 other health workers on service provision, management, infrastructure, human resources and the health information system; 296 antenatal clinic users on their service perceptions; 70 HIV-positive women on HIV knowledge, infant feeding, coping, support and service perceptions; 8 representatives from community organisations and 101 traditional health practitioners (THPs). Observations were conducted during site visits to health facilities, and the District Health Information System (DHIS) data were reviewed. Staff had high levels of awareness of HIV policies and most had received some relevant training. Nevirapine uptake varied by clinic, with an average of 56%. There were many missed opportunities for PMTCT, with 67% of pregnant women tested for HIV and only 43% of antenatal care attendees tested during a previous pregnancy. Only 6% of HIV-positive women reported support group participation. Reducing missed opportunities for PMTCT requires strengthening of the formal health sector, intersectoral liaison, and greater community support. Priority areas that require strengthening in the formal health sector include HIV counselling and testing; family planning and nutrition counselling; infant follow-up; human resources; and monitoring and evaluation.

Strategic planning for clinical services: the University of Texas M.D. Anderson Hospital and Tumor Institute.

PubMed

Anderson, R W

1986-09-01

A formal, hospitalwide strategic-planning process provides structure for the pharmacy's plans for implementing clinical services. The state-supported clinical cancer and research center began a formal strategic-planning process in 1981. The institution's planning report, prepared every two years and covering three two-year periods, drives the institution's budget through the state's biennial budget process. The report focuses on each department's responsibilities, areas of service, and relationship to the mission of the institution. Through the long-range planning process, upper-level administrators learned that pharmacy was eager not only to provide high-volume drug distribution services but also to assume direct patient-care and research responsibilities. This prompted an organizational change for pharmacy from a hospital department to a clinical division. The division of pharmacy now consists of three professional departments (patient care, pharmacy research, and pharmacy academic programs) and an administrative support service area. Services offered by each of the three departments are discussed, along with specific initiatives planned for the years 1987-1993. Within the next few years, all managers will come from the ranks of clinical practitioners; nonpharmacists will oversee financial and human resource functions. The division encourages existing pharmacy staff members to enhance their clinical skills through staff development programs. Strategic planning serves the dual purposes of structuring plans for implementing clinical pharmacy services and communicating pharmacy's goals within the institution.

Investigating Education and Support Needs of Families Who Have Children with Intellectual Disabilities

ERIC Educational Resources Information Center

Cavkaytar, Atilla; Ceyhan, Esra; Adiguzel, Oktay Cem; Uysal, Hakan; Garan, Omer

2012-01-01

The purpose of the study was to define families' of children with intellectual disabilities, needs on education and support services. Descriptive survey model was used in the study. Data was collected via semi-structured interviews. The study was conducted in 9 Training Application Schools (Egitim Uygulama Okulu) that were formal special education…

Services and supports for young children with Down syndrome: parent and provider perspectives.

PubMed

Marshall, J; Tanner, J P; Kozyr, Y A; Kirby, R S

2015-05-01

As individuals with Down syndrome are living longer and more socially connected lives, early access to supports and services for their parents will ensure an optimal start and improved outcomes. The family's journey begins at the child's diagnosis, and cumulative experiences throughout infancy and childhood set the tone for a lifetime of decisions made by the family regarding services, supports and activities. This study utilized focus groups and interviews with seven nurses, five therapists, 25 service co-ordinators, and 10 English- and three Spanish-speaking parents to better understand family experiences and perceptions on accessing Down syndrome-related perinatal, infant and childhood services and supports. Parents and providers reflected on key early life issues for children with Down syndrome and their families in five areas: prenatal diagnosis; perinatal care; medical and developmental services; care co-ordination and services; and social and community support. Systems of care are not consistently prepared to provide appropriate family-centred services to individuals with Down syndrome and their families. Individuals with disabilities require formal and informal supports from birth to achieve and maintain a high quality of life. © 2014 John Wiley & Sons Ltd.

Help-seeking amongst women survivors of domestic violence: a qualitative study of pathways towards formal and informal support.

PubMed

Evans, Maggie A; Feder, Gene S

2016-02-01

Informal and formal support for women experiencing domestic violence and abuse (DVA) can improve safety and health outcomes. There has been little qualitative work on the role of both pathways to support and women's experiences of disclosing their experience of DVA in different contexts. This qualitative study used repeat interviews with women survivors of DVA to explore their pathways to support and their experiences of barriers and facilitators to disclosure and help-seeking. Thirty-one women seeking help from specialist DVA agencies in the UK were interviewed twice over 5 months. Women recounted long journeys of ambivalence, often only disclosing abuse after leaving the perpetrator. Access to specialist support rarely came via general practitioners, despite high levels of consulting for anxious and depressed feelings, and was more often facilitated by police or housing agencies following a crisis such as assault. Informal disclosure only led to specialist help if the family member or friend themselves had experience or knowledge of DVA. Women experiencing DVA need earlier access to specialized DVA services. Many women needed an 'enabler' to facilitate access, but once this contact was made, disclosure to other professionals or to family and friends was legitimized in the eyes of the women. Safely accessible publicity about DVA services and an appropriate response from social and health-care professionals should be promoted, including support for women disclosing DVA to take action on the information they receive about services. © 2014 John Wiley & Sons Ltd.

Factors Affecting Mental Health Service Utilization Among California Public College and University Students.

PubMed

Sontag-Padilla, Lisa; Woodbridge, Michelle W; Mendelsohn, Joshua; D'Amico, Elizabeth J; Osilla, Karen Chan; Jaycox, Lisa H; Eberhart, Nicole K; Burnam, Audrey M; Stein, Bradley D

2016-08-01

Unmet need for mental health treatment among college students is a significant public health issue. Despite having access to campus mental health providers and insurance to cover services, many college students do not receive necessary services. This study examined factors influencing college students' use of mental health services. Online survey data for 33,943 students and 14,018 staff and faculty at 39 college campuses in California were analyzed by using logistic regressions examining the association between students' use of mental health services and student characteristics, campus environment, and the presence of a formal network of campus mental health clinics. Nineteen percent of students reported current serious psychological distress in the past 30 days, and 11% reported significant mental health-related academic impairment in the past year. Twenty percent reported using mental health services while at their current college, 10% by using campus services and 10% off-campus services. Students on campuses with a formal network of mental health clinics were more likely than students at community colleges to receive mental health services (odds ratio [OR] range=1.68-1.69), particularly campus services (OR=3.47-5.72). Students on campuses that are supportive of mental health issues were more likely to receive mental health services (OR=1.22), particularly on campus (OR=1.65). Students with active (versus low) coping skills were consistently more likely to use mental health services. Establishing more campus mental health clinics, fostering supportive campus environments, and increasing students' coping skills may reduce unmet need for mental health services among college students.

The role of community-based and philanthropic organizations in meeting cancer patient and caregiver needs.

PubMed

Shelby, Rebecca A; Taylor, Kathryn L; Kerner, Jon F; Coleman, Ellen; Blum, Diane

2002-01-01

We examined information from community-based and philanthropic organizations to document the cancer-related services that are currently available, establish which services are still needed, and determine who utilizes these formal support networks. In Phase I, 32 of 41 eligible organizations participated in a survey conducted from December 1999 to March 2000. The most common mission focus among participating organizations was information/referral-centered. The most common services provided were referrals to information resources and provision of cancer-related information. Only two of the organizations in Phase I provided client demographic information and both indicated that client populations were predominantly white, female, and over age 40. Phase II of the study involved analyzing patient data from Cancer Care, Inc., a national service organizations for cancer patients. Between 1983 and 1997, there were 2,714 prostate cancer patients and 9,451 breast cancer patients included in the Cancer Care database. Their most commonly reported problems were related to personal adjustment to illness, financial, home care, and transportation needs. There were significant differences in problems reported depending upon age and disease status. In addition, the results of this study support the idea that those at highest risk for developing and dying of cancer are the least likely to utilize formal support networks. Further, a gap in service provision for assistance with practical needs (e.g., transportation, home care, child care, psychosocial support) was identified. Due to the increasing use of outpatient care for cancer patients, a greater demand for practical assistance can be expected in the future. The availability of practical services will need to be increased in order to effectively meet cancer patient needs.

Indicators and protocols for monitoring impacts of formal and informal trails in protected areas

USGS Publications Warehouse

Marion, Jeffrey L.; Leung, Yu-Fai

2011-01-01

Trails are a common recreation infrastructure in protected areas and their conditions affect the quality of natural resources and visitor experiences. Various trail impact indicators and assessment protocols have been developed in support of monitoring programs, which are often used for management decision-making or as part of visitor capacity management frameworks. This paper reviews common indicators and assessment protocols for three types of trails, surfaced formal trails, unsurfaced formal trails, and informal (visitor-created) trails. Monitoring methods and selected data from three U.S. National Park Service units are presented to illustrate some common trail impact indicators and assessment options.

Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families

DTIC Science & Technology

2013-01-01

a need for a more formal flow of information from the military to the civilian community about troop deployments and reintegration. In the five...Interviewees also offered a mixed assessment of how information about available supports and services is communicated to service members and their...and military parents. This team serves as a conduit of information between the community and the installation, addresses questions with changes of

How important are human immunodeficiency virus (HIV) clinical markers to the long-term formal employment among people living with HIV in developing countries? A study in South Africa.

PubMed

Odek, W O; Glendinning, A; Charalambous, S

2014-01-01

To examine the relationship of Human Immunodeficiency Virus (HIV) clinical markers and socio-demographic characteristics with long-term formal employment among people living with HIV (PLHIV). 554 adults, 55% females, on HIV treatment for at least two years at two public hospitals in Johannesburg, South Africa. A retrospective cohort design, tracing changes in study participants' formal employment status since the first HIV-positive diagnosis. Data collection included historical medical records review and interviewer-administered questionnaires. 44% of all study participants (39% and 49% among males and females, respectively) were formally employed at the time of the study, primarily in low-skilled jobs in the private sector. The majority (83%) of males and 60% of females remained in formal employment since being diagnosed as HIV-positive. Female gender, education to grade 12 or higher, a smaller household size and being married were significantly associated with current formal employment. Formal employment was unrelated to HIV treatment indicators (CD4 count, viral load and duration since diagnosis). Of those in formal employment, 68 (28%) were aware of HIV policies at their workplaces, which was also positively associated with the duration in their current employment. PLHIV in developing country contexts can enter into and maintain formal employment, especially when treatment and workplace support are available. Thus, employer organisations should implement effective workplace HIV policies to enhance employment experiences of their workforce living with HIV. Care and support services for people on HIV treatment should also address their career development needs.

The Influence of Formal and Informal Formative Pre-Service Experiences on Teacher Self-Efficacy

ERIC Educational Resources Information Center

Tuchman, Elie; Isaacs, Jenny

2011-01-01

Formal pre-service training has been shown to be effective in building teacher self-efficacy beliefs. However, the impact of other, less formal, "teacher-like" pre-service experiences on the formation of efficacy beliefs has not previously been investigated. This study examines the associations between both formal and informal formative…

A service evaluation of self-referral to military mental health teams.

PubMed

Kennedy, I; Whybrow, D; Jones, N; Sharpley, J; Greenberg, N

2016-07-01

The UK military runs a comprehensive mental health service ordinarily accessed via primary care referrals. To evaluate the feasibility of self-referral to mental health services within a military environment. Three pilot sites were identified; one from each service (Royal Navy, Army, Air Force). Socio-demographic information included age, rank, service and career duration. Clinical data included prior contact with general practitioner (GP), provisional diagnosis and assessment outcome. Of the 57 self-referrals, 69% (n = 39) had not previously accessed primary care for their current difficulties. After their mental health assessment, 47 (82%) were found to have a formal mental health problem and 41 (72%) were offered a further mental health clinician appointment. The data compared favourably with a large military mental health department that reported 87% of primary care referrals had a formal mental health condition. The majority of self-referrals had formal mental health conditions for which they had not previously sought help from primary care; most were offered further clinical input. This supports the view that self-referral may be a useful option to encourage military personnel to seek professional care over and above the usual route of accessing care through their GP. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Achieving universal health care coverage: Current debates in Ghana on covering those outside the formal sector

PubMed Central

2012-01-01

Background Globally, extending financial protection and equitable access to health services to those outside the formal sector employment is a major challenge for achieving universal coverage. While some favour contributory schemes, others have embraced tax-funded health service cover for those outside the formal sector. This paper critically examines the issue of how to cover those outside the formal sector through the lens of stakeholder views on the proposed one-time premium payment (OTPP) policy in Ghana. Discussion Ghana in 2004 implemented a National Health Insurance Scheme, based on a contributory model where service benefits are restricted to those who contribute (with some groups exempted from contributing), as the policy direction for moving towards universal coverage. In 2008, the OTPP system was proposed as an alternative way of ensuring coverage for those outside formal sector employment. There are divergent stakeholder views with regard to the meaning of the one-time premium and how it will be financed and sustained. Our stakeholder interviews indicate that the underlying issue being debated is whether the current contributory NHIS model for those outside the formal employment sector should be maintained or whether services for this group should be tax funded. However, the advantages and disadvantages of these alternatives are not being explored in an explicit or systematic way and are obscured by the considerable confusion about the likely design of the OTPP policy. We attempt to contribute to the broader debate about how best to fund coverage for those outside the formal sector by unpacking some of these issues and pointing to the empirical evidence needed to shed even further light on appropriate funding mechanisms for universal health systems. Summary The Ghanaian debate on OTPP is related to one of the most important challenges facing low- and middle-income countries seeking to achieve a universal health care system. It is critical that there is more extensive debate on the advantages and disadvantages of alternative funding mechanisms, supported by a solid evidence base, and with the policy objective of universal coverage providing the guiding light. PMID:23102454

Manpower Planning for New Weapon Systems

DTIC Science & Technology

1978-12-01

Logistics) take the following actions : 1. Institute formal, post-DSARC management reviews of integrated logistic support implementation to verify...that actions are being taken to minimize manpower and other support resource requirements. 2. Urge the Army, Navy and Marine Corps to press on with...examines how manpower planning actually is done by the military services, and recommends actions by the Assistant Secretary of Defense (Manpower Reserve

Supporting People with an Intellectual Disability and Mental Health Problems: A Scoping Review of What They Say about Service Provision

ERIC Educational Resources Information Center

Venville, Annie; Sawyer, Anne-Maree; Long, Maureen; Edwards, Niki; Hair, Sara

2015-01-01

This article reports on the findings of a scoping review of peer-reviewed research that investigates the formal support experiences of adults with an intellectual disability and mental health problems. Seven databases and 21 sources of grey literature were searched and 17 articles were retained for review, demonstrating the dearth of literature in…

Supporting research readiness in social enterprise health services.

PubMed

Wright, Nat M J; Hearty, Philippa; Harris, Linda; Burnell, Andrew; Pender, Sue; Oxnard, Chris; Charlesworth, George

2017-09-13

Health-based social enterprises are spun out of the NHS, yet continue to provide NHS-funded services. With the spin-out, however, formal processes for research governance were lost. Patients have a right to take part in research, regardless of where they access healthcare. This paper discusses the barriers to social enterprises undertaking applied health research and makes recommendations to address the need for equivalence of governance processes with NHS trusts.

Apollo experience report the command and service module milestone review process

NASA Technical Reports Server (NTRS)

Brendle, H. L.; York, J. A.

1974-01-01

The sequence of the command and service module milestone review process is given, and the Customer Acceptance Readiness Review and Flight Readiness Review plans are presented. Contents of the System Summary Acceptance Documents for the two formal spacecraft reviews are detailed, and supplemental data required for presentation to the review boards are listed. Typical forms, correspondence, supporting documentation, and minutes of a board meeting are included.

Clinical staff perceptions of palliative care-related quality of care, service access, education and training needs and delivery confidence in an acute hospital setting.

PubMed

Frey, Rosemary; Gott, Merryn; Raphael, Deborah; O'Callaghan, Anne; Robinson, Jackie; Boyd, Michal; Laking, George; Manson, Leigh; Snow, Barry

2014-12-01

Central to appropriate palliative care management in hospital settings is ensuring an adequately trained workforce. In order to achieve optimum palliative care delivery, it is first necessary to create a baseline understanding of the level of palliative care education and support needs among all clinical staff (not just palliative care specialists) within the acute hospital setting. The objectives of the study were to explore clinical staff: perceptions concerning the quality of palliative care delivery and support service accessibility, previous experience and education in palliative care delivery, perceptions of their own need for formal palliative care education, confidence in palliative care delivery and the impact of formal palliative care training on perceived confidence. A purposive sample of clinical staff members (598) in a 710-bed hospital were surveyed regarding their experiences of palliative care delivery and their education needs. On average, the clinical staff rated the quality of care provided to people who die in the hospital as 'good' (x̄=4.17, SD=0.91). Respondents also reported that 19.3% of their time was spent caring for end-of-life patients. However, only 19% of the 598 respondents reported having received formal palliative care training. In contrast, 73.7% answered that they would like formal training. Perceived confidence in palliative care delivery was significantly greater for those clinical staff with formal palliative care training. Formal training in palliative care increases clinical staff perceptions of confidence, which evidence suggests impacts on the quality of palliative care provided to patients. The results of the study should be used to shape the design and delivery of palliative care education programmes within the acute hospital setting to successfully meet the needs of all clinical staff. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Building Psychological Health: The Services’ Perspectives on Resilience

DTIC Science & Technology

2011-01-24

program; medical supported • Doctrine signed Dec 2010 • Training: > 200,000 trained to date • 8 courses on Navy eLearning • Formal curriculum delivered...Address future concerns and build psychological resiliency 10 Reserve Resilience Initiatives 2011 MHS Conference NSW Resilience Enterprise  Resilience

Stress Process Model for Individuals with Dementia

ERIC Educational Resources Information Center

Judge, Katherine S.; Menne, Heather L.; Whitlatch, Carol J.

2010-01-01

Purpose: Individuals with dementia (IWDs) face particular challenges in managing and coping with their illness. The experience of dementia may be affected by the etiology, stage, and severity of symptoms, preexisting and related chronic conditions, and available informal and formal supportive services. Although several studies have examined…

Bringing eCare platforms to the market.

PubMed

Vannieuwenborg, Frederic; Van der Auwermeulen, Thomas; Van Ooteghem, Jan; Jacobs, An; Verbugge, Sofie; Colle, Didier

2017-09-01

Due to changes in the demographic situation of most Western European countries, interest in Information and Communication Technologies (ICT)-supported care services is growing fast. eCare services that foster better care information exchange, social involvement, lifestyle monitoring services, etc., offered via ICT platforms, integrated in the homes of the elderly are believed to be cost-effective. Additionally, they could lead to an increased quality of life of both care receiver and (in)formal caregiver. Currently, adoption and integration of these eCare platforms (eCPs) is slowed down by several barriers such as unclear added value, a lack of regulations, or lack of sustainable financial models. In this work, the added value of eCPs is identified for the several involved key actors such as the care receiver, the (in)formal care providers, and the home care organizations. In a second step, several go-to-market strategies are formulated. Because the gap between the current way of providing home care and providing home care supported by a fully integrated eCP seems too big to bridge in one effort, a migration path is provided for stepwise integration and adoption of eCPs in the current way of home care provisioning.

Service composition towards increasing end-user accessibility.

PubMed

Kaklanis, Nikolaos; Votis, Konstantinos; Tzovaras, Dimitrios

2015-01-01

This paper presents the Cloud4all Service Synthesizer Tool, a framework that enables efficient orchestration of accessibility services, as well as their combination into complex forms, providing more advanced functionalities towards increasing the accessibility of end-users with various types of functional limitations. The supported services are described formally within an ontology, enabling, thus, semantic service composition. The proposed service composition approach is based on semantic matching between services specifications on the one hand and user needs/preferences and current context of use on the other hand. The use of automatic composition of accessibility services can significantly enhance end-users' accessibility, especially in cases where assistive solutions are not available in their device.

Formal design specification of a Processor Interface Unit

NASA Technical Reports Server (NTRS)

Fura, David A.; Windley, Phillip J.; Cohen, Gerald C.

1992-01-01

This report describes work to formally specify the requirements and design of a processor interface unit (PIU), a single-chip subsystem providing memory-interface bus-interface, and additional support services for a commercial microprocessor within a fault-tolerant computer system. This system, the Fault-Tolerant Embedded Processor (FTEP), is targeted towards applications in avionics and space requiring extremely high levels of mission reliability, extended maintenance-free operation, or both. The need for high-quality design assurance in such applications is an undisputed fact, given the disastrous consequences that even a single design flaw can produce. Thus, the further development and application of formal methods to fault-tolerant systems is of critical importance as these systems see increasing use in modern society.

The impact of living arrangements and deinstitutionalisation in the health status of persons with intellectual disability in Europe

PubMed Central

Martínez-Leal, R.; Salvador-Carulla, L.; Linehan, C.; Walsh, P.; Weber, G.; Van Hove, G.; Määttä, T.; Azema, B.; Haveman, M.; Buono, S.; Germanavicius, A.; van Schrojenstein Lantman-de Valk, H.; Tossebro, J.; Carmen-Câra, A.; Moravec Berger, D.; Perry, J.; Kerr, M.

2011-01-01

Background Despite progress in the process of deinstitutionalisation, very little is known about the health conditions of people with intellectual disability (PWID) who live in large institutions and PWID living in small residential services, family homes or independent living within the community. Furthermore, there are no international comparison studies at European level of the health status and health risk factors of PWID living in fully staffed residential services with formal support and care compared with those living in unstaffed family homes or independent houses with no formal support. Methods A total of 1269 persons with ID and/or their proxy respondents were recruited and face-to-face interviewed in 14 EU countries with the P15, a multinational assessment battery for collecting data on health indicators relevant to PWID. Participants were grouped according to their living arrangements, availability of formal support and stage of deinstitutionalisation. Results Obesity and sedentary lifestyle along with a number of illnesses such as epilepsy, mental disorders, allergies or constipation were highly prevalent among PWID. A significantly higher presence of myocardial infarctions, chronic bronchitis, osteoporosis and gastric or duodenal ulcers was found among participants in countries considered to be at the early stage of deinstitutionalisation. Regardless of deinstitutionalisation stage, important deficits in variables related to such medical health promotion measures as vaccinations, cancer screenings and medical checks were found in family homes and independent living arrangements. Age, number of people living in the same home or number of places in residential services, presence of affective symptoms and obesity require further attention as they seem to be related to an increase in the number of illnesses suffered by PWID. Discussion Particular illnesses were found to be highly prevalent in PWID. There were important differences between different living arrangements depending on the level of formal support available and the stage of deinstitutionalisation. PWID are in need of tailored primary health programs that guarantee their access to quality health and health promotion and the preventative health actions of vaccination programs, systematic health checks, specific screenings and nutritional controls. Extensive national health surveys and epidemiological studies of PWID in the EC member states are urgently needed in order to reduce increased morbidity rates among this population. PMID:21726319

Program Review/Evaluation Policy and Procedures.

ERIC Educational Resources Information Center

Colorado Northwestern Community Coll., Rangely.

At Colorado Northwestern Community College (CNCC), all educational programs, as well as student services and support functions, are formally reviewed/evaluated in depth at least once every five years. This nine-part outline, providing a step-by-step description of the program review process at CNCC, includes the following sections: (1) the value…

In-Service Support Plan for Electromagnetic Environment Effects.

DTIC Science & Technology

1978-05-05

assure highly motivated and trained Fleet personnel are placed in positions to initiate formal EME deficiency reports. The human factors and technological...Assistant I )eputy C hief of Naval Material AD P Automiated Data Processing ALRE-I1 Air-LUmnhed G uided Weapons System Perform-rance Re- port APL

Improving pathways into mental health care for black and ethnic minority groups: a systematic review of the grey literature.

PubMed

Moffat, Joanne; Sass, Bernd; McKenzie, Kwame; Bhui, Kamaldeep

2009-01-01

Black and ethnic minorities show different pathways to care services and different routes out of care. These often involve non-statutory sector services. In order to improve access to services, and to develop appropriate and effective interventions, many innovations are described but the knowledge about how to improve pathways to recovery has not been synthesized. Much of this work is not formally published. Hence, this paper addresses this oversight and undertakes a review of the grey literature. The key components of effective pathway interventions include specialist services for ethnic minority groups, collaboration between sectors, facilitating referral routes between services, outreach and facilitating access into care, and supporting access to rehabilitation and moving out of care. Services that support collaboration, referral between services, and improve access seem effective, but warrant further evaluation. Innovative services must ensure that their evaluation frameworks meet minimum quality standards if the knowledge gained from the service is to be generalized, and if it is to inform policy.

Barriers to formal emergency obstetric care services' utilization.

PubMed

Essendi, Hildah; Mills, Samuel; Fotso, Jean-Christophe

2011-06-01

Access to appropriate health care including skilled birth attendance at delivery and timely referrals to emergency obstetric care services can greatly reduce maternal deaths and disabilities, yet women in sub-Saharan Africa continue to face limited access to skilled delivery services. This study relies on qualitative data collected from residents of two slums in Nairobi, Kenya in 2006 to investigate views surrounding barriers to the uptake of formal obstetric services. Data indicate that slum dwellers prefer formal to informal obstetric services. However, their efforts to utilize formal emergency obstetric care services are constrained by various factors including ineffective health decision making at the family level, inadequate transport facilities to formal care facilities and insecurity at night, high cost of health services, and inhospitable formal service providers and poorly equipped health facilities in the slums. As a result, a majority of slum dwellers opt for delivery services offered by traditional birth attendants (TBAs) who lack essential skills and equipment, thereby increasing the risk of death and disability. Based on these findings, we maintain that urban poor women face barriers to access of formal obstetric services at family, community, and health facility levels, and efforts to reduce maternal morbidity and mortality among the urban poor must tackle the barriers, which operate at these different levels to hinder women's access to formal obstetric care services. We recommend continuous community education on symptoms of complications related to pregnancy and timely referral. A focus on training of health personnel on "public relations" could also restore confidence in the health-care system with this populace. Further, we recommend improving the health facilities in the slums, improving the services provided by TBAs through capacity building as well as involving TBAs in referral processes to make access to services timely. Measures can also be put in place to enhance security in the slums at night.

Professionalization and retention outcomes of a university-service mentoring program partnership.

PubMed

Latham, Christine L; Ringl, Karen; Hogan, Mikel

2011-01-01

With the use of a university-service partnership to introduce mentoring and shared governance, the aim of this study was to evaluate the effect of these interventions on nurse perceptions of the supportive culture of the workplace environment, professional skill development, decisional involvement, and retention and vacancy rates. A nonequivalent pretest-posttest, noncontrol group design was used with mentors of newly hired mentees to evaluate their workplace perspectives following mentor classes, ongoing mentor support, and a formal mentor-management workforce governance board. A convenience sample of 89 RNs from two acute care facilities attended mentoring and professionalization classes and worked with 109 mentees over 1-3 years. Mentors reported improved teamwork and the ability to deal with conflict but wanted more administrative oversight of the quality and scope of practice of support staff and additional interdepartmental collaboration. One hospital's vacancy rate decreased by 80%, and the other facility's retention rate improved by 21%. The data suggest that a mentor program with comprehensive education and mentor-management alliances through formal workforce environment governance enhances professionalization of frontline nurses and helps sustain a positive, constructive workplace environment. Mentoring classes on communication and cultural sensitivity skills and other leadership concepts, followed by mentor support and mentor-administrative forums, have positive implications for sustained improvement of a supportive culture as perceived by hospital-based RNs and new nurse graduates. Copyright © 2011 Elsevier Inc. All rights reserved.

Access to timely formal dementia care in Europe: protocol of the Actifcare (ACcess to Timely Formal Care) study.

PubMed

Kerpershoek, Liselot; de Vugt, Marjolein; Wolfs, Claire; Jelley, Hannah; Orrell, Martin; Woods, Bob; Stephan, Astrid; Bieber, Anja; Meyer, Gabriele; Engedal, Knut; Selbaek, Geir; Handels, Ron; Wimo, Anders; Hopper, Louise; Irving, Kate; Marques, Maria; Gonçalves-Pereira, Manuel; Portolani, Elisa; Zanetti, Orazio; Verhey, Frans

2016-08-23

Previous findings indicate that people with dementia and their informal carers experience difficulties accessing and using formal care services due to a mismatch between needs and service use. This mismatch causes overall dissatisfaction and is a waste of the scarce financial care resources. This article presents the background and methods of the Actifcare (ACcess to Timely Formal Care) project. This is a European study aiming at best-practice development in finding timely access to formal care for community-dwelling people with dementia and their informal carers. There are five main objectives: 1) Explore predisposing and enabling factors associated with the use of formal care, 2) Explore the association between the use of formal care, needs and quality of life and 3) Compare these across European countries, 4) Understand the costs and consequences of formal care services utilization in people with unmet needs, 5) Determine the major costs and quality of life drivers and their relationship with formal care services across European countries. In a longitudinal cohort study conducted in eight European countries approximately 450 people with dementia and informal carers will be assessed three times in 1 year (baseline, 6 and 12 months). In this year we will closely monitor the process of finding access to formal care. Data on service use, quality of life and needs will be collected. The results of Actifcare are expected to reveal best-practices in organizing formal care. Knowledge about enabling and predisposing factors regarding access to care services, as well as its costs and consequences, can advance the state of the art in health systems research into pathways to dementia care, in order to benefit people with dementia and their informal carers.

Validation of Resource Utilization Groups version III for Home Care (RUG-III/HC): evidence from a Canadian home care jurisdiction.

PubMed

Poss, Jeffrey W; Hirdes, John P; Fries, Brant E; McKillop, Ian; Chase, Mary

2008-04-01

The case-mix system Resource Utilization Groups version III for Home Care (RUG-III/HC) was derived using a modest data sample from Michigan, but to date no comprehensive large scale validation has been done. This work examines the performance of the RUG-III/HC classification using a large sample from Ontario, Canada. Cost episodes over a 13-week period were aggregated from individual level client billing records and matched to assessment information collected using the Resident Assessment Instrument for Home Care, from which classification rules for RUG-III/HC are drawn. The dependent variable, service cost, was constructed using formal services plus informal care valued at approximately one-half that of a replacement worker. An analytic dataset of 29,921 episodes showed a skewed distribution with over 56% of cases falling into the lowest hierarchical level, reduced physical functions. Case-mix index values for formal and informal cost showed very close similarities to those found in the Michigan derivation. Explained variance for a function of combined formal and informal cost was 37.3% (20.5% for formal cost alone), with personal support services as well as informal care showing the strongest fit to the RUG-III/HC classification. RUG-III/HC validates well compared with the Michigan derivation work. Potential enhancements to the present classification should consider the large numbers of undifferentiated cases in the reduced physical function group, and the low explained variance for professional disciplines.

Assessing the perceived level of institutional support for the second victim after a patient safety event.

PubMed

Joesten, Leroy; Cipparrone, Nancy; Okuno-Jones, Susan; DuBose, Edwin R

2015-06-01

The objective of this study was to establish a baseline of perceived availability of institutional support services or interventions and experiences following an adverse patient safety event (PSE) in a 650-bed children and adult community teaching hospital. Investigators queried associates about their experiences after a PSE, what institutional support services or interventions they perceived to be available, and how helpful used services were. The investigators used an online modified version of a PSE survey developed by several health related organizations in Boston. One hundred twenty evaluable surveys were analyzed. Sixty-eight percent of respondents were nurses, 99% of whom were female. Only 10% to 30% of respondents reported that various support services or interventions were actively offered, and 30% to 60% indicated that they were not available. Respondents reported having experienced several distressing symptoms after a PSE, most notably, troubling memories (56%) and worry about lawsuits (37%). Less than 32% "agreed" or "strongly agreed" that they could report concerns without fear of retribution or punitive action. More respondents experienced support from clinical colleagues (64%) than from their manager or department chair (38%). These results validate a need by associates for emotional support after a PSE and that associates' perception of available formal institutional support services or interventions is low.

Professionalisation of a breast-feeding peer support service: issues and experiences of peer supporters.

PubMed

Aiken, Annette; Thomson, Gill

2013-12-01

to describe the issues faced by breast-feeding peer supporters as their roles altered from a voluntary to a professionalised role with targets, accountability and more formalised interface with health professionals. a descriptive qualitative study utilising group and individual semi-structured interviews, with thematic network analysis. 19 breast-feeding peer supporters were consulted from one peer support service located in the UK. thematic network analysis of the peer supporter data generated a global theme of 'Professionalising Breast-feeding Peer Support'. The three underpinning organising themes (and their associated basic themes): 'visibility and communication', 'guardianship of knowledge' and 'roles and boundaries' revealed the early and transitional tensions and anxieties that peer supporters faced when their role altered from a voluntary position to a formal model of service delivery, particularly within the clinical environment. professionalisation of peer support can lead to benefits in terms of providing a standardised and comprehensive service with increased capacity for service provision. However, the transitional difficulties faced by the peer supporters as they moved from a voluntary into a professionalised role included a lack of identity; restricted time to care for new mothers; pressures and anxieties of meeting targets and accountability of case recording and the hostility and gatekeeping practices experienced amongst some of the health professionals. Flexible systems incorporating service-user involvement and needs-led strategies may help to overcome these issues. Copyright © 2013 Elsevier Ltd. All rights reserved.

Competences, education and support for new roles in cancer genetics services: outcomes from the cancer genetics pilot projects.

PubMed

Bennett, Catherine; Burton, Hilary; Farndon, Peter

2007-01-01

In 2004 the Department of Health in collaboration with Macmillan Cancer Support set up service development projects to pilot the integration of genetics in mainstream medicine in the area of cancer genetics.In developing these services, new roles and responsibilities were devised that required supporting programmes of education and training. The NHS National Genetics Education and Development Centre has worked with the projects to draw together their experience in these aspects. New roles include the Cancer Family Nurse Specialist, in which a nurse working in a cancer setting was trained to identify and manage genetic or family history concerns, and the Genetic Risk Assessment Practitioner--a small team of practitioners working within a secondary care setting to deliver a standardised risk assessment pathway. Existing roles were also adapted for a different setting, in particular the use of genetic counsellors working in a community ethnic minority setting. These practitioners undertook a range of clinical activities that can be mapped directly to the 'UK National Workforce Competences for Genetics in Clinical Practice for Non-genetics Healthcare Staff' framework developed by Skills for Health and the NHS National Genetics Education and Development Centre (2007; draft competence framework). The main differences between the various roles were in the ordering of genetic tests and the provision of advice on invasive preventive options such as mastectomy. Those involved in service development also needed to develop competences in project management, business skills, audit and evaluation, working with users, general management (personnel, multi-agency work and marketing), educational supervision, IT, public and professional outreach, and research. Important resources to support the development of new roles and competences included pathways and guidelines, a formal statement of competences, a recognised syllabus, appropriate and timely courses, the availability of a mentor, supervision and opportunities to discuss cases, a formal assessment of learning and continuing support from specialist genetics services. This represents a current resource gap that will be of concern to cancer networks and a challenge to providers of educational resources and regional genetics services.

Implementation of evidence-based supported employment in regional Australia.

PubMed

Morris, Adrienne; Waghorn, Geoffrey; Robson, Emma; Moore, Lyndell; Edwards, Emma

2014-06-01

To implement the Individual Placement and Support (IPS) approach at 4 locations in regional New South Wales, Australia. Outcomes attained were compared with a national non-IPS program and with international trials of IPS within and outside the United States. Four IPS programs were established through formal partnerships between mental health services and disability employment services. Ninety-five mental health service clients commenced employment assistance and were tracked for a minimum of 12 months. Two sites achieved good fidelity to IPS principles, and 2 sites achieved fair fidelity. IPS clients had 3.5 times greater odds of attaining 13 weeks' employment than those receiving assistance in the national network of disability employment services. Implementing IPS is challenging in the Australian service delivery context. Factors other than program fidelity appear to contribute to excellent employment outcomes. Further research is needed to identify these factors.

An ORCID based synchronization framework for a national CRIS ecosystem.

PubMed

Mendes Moreira, João; Cunha, Alcino; Macedo, Nuno

2015-01-01

PTCRIS (Portuguese Current Research Information System) is a program aiming at the creation and sustained development of a national integrated information ecosystem, to support research management according to the best international standards and practices. This paper reports on the experience of designing and prototyping a synchronization framework for PTCRIS based on ORCID (Open Researcher and Contributor ID). This framework embraces the "input once, re-use often" principle, and will enable a substantial reduction of the research output management burden by allowing automatic information exchange between the various national systems. The design of the framework followed best practices in rigorous software engineering, namely well-established principles in the research field of consistency management, and relied on formal analysis techniques and tools for its validation and verification. The notion of consistency between the services was formally specified and discussed with the stakeholders before the technical aspects on how to preserve said consistency were explored. Formal specification languages and automated verification tools were used to analyze the specifications and generate usage scenarios, useful for validation with the stakeholder and essential to certificate compliant services.

Vocational Rehabilitation and the Dilemma of Race in Rural Communities: Sociopolitical Realities and Myths from the Past.

ERIC Educational Resources Information Center

Wilson, Keith B.; Edwards, Dothel W., Jr.; Alston, Reginald J.; Harley, Debra A.; Doughty, Jhan D.

2001-01-01

Examines social factors that influence outcomes and access to vocational rehabilitation (VR) services for rural people of color with disabilities. Discusses attitudes toward disabilities, racial attitudes, formal and informal support systems in rural areas, religious influences, informal communication systems, access to health care and employment…

Korean Elderly in America: Acculturation and Changes in Life Style.

ERIC Educational Resources Information Center

Koh, Yang K.; Bell, William G.

As the numbers of Korean immigrants, particularly Korean elders continues to increase, their adjustment problems and service needs are beginning to receive attention in communities with a large influx of Asian immigrants. To examine Korean elders' use of filial and formal support systems in dealing with their problems, 151 older Koreans living in…

Steelhead of the south-central/southern California coast: Population characterization for recovery planning

USGS Publications Warehouse

Boughton, David A.; Adams, P.B.; Anderson, E.; Fusaro, Craig; Keller, E.; Kelley, Elsie; Lentsch, Leo; Nielsen, J. L.; Perry, Katie; Regan, Helen; Swift, C.; Watson, Fred

2006-01-01

This report by the National Marine Fisheries Service applies a formal evaluation framework to the problem of delineating Oncorhynchus mykiss populations in the South-Central/Southern California Coast recovery domain, in support of recovery planning under the Endangered Species Act.

Creative Movement as a Stress-Reduction Intervention for Caregivers

ERIC Educational Resources Information Center

Vetter, Rheba E.; Myllykangas, Susan A.; Donorfio, Laura K. M.; Foose, Alice K.

2011-01-01

A caregiver is one who provides formal or informal services to a person with physical disabilities or a long-term illness. The day-to-day responsibilities place inordinate amounts of stress on caregivers. Thus, caregivers need mental and physical support. Creative movement enables dancers to express anxieties through movement and to experience an…

A Student Environment Model: A Measure of Institutional Effectiveness. AIR 1998 Annual Forum Paper.

ERIC Educational Resources Information Center

Morris-Baldwin, Darline

This study traces the development of a student environment model (SEM) at Texas State Technical College (Waco) that is used to assess students' perceptions of their college environment outside the formal classroom, provides baseline data for comparative analyses, establishes goals for student support services, measures program and process…

Tutorials in the Polytechnic University of the Philippines (PUP) Open University System

ERIC Educational Resources Information Center

Castolo, Carmencita L.

2016-01-01

Tutorial is one of the student support services often provided by open and distance teaching institutions. These are regularly scheduled meetings between a tutor and his/here students which may include individual consultation sessions, either face-to-face or through telephone; a more formal "lecture format;" optimal participation in…

Formal Service Practitioners' Views of Family Caregivers' Responsibilities and Difficulties

ERIC Educational Resources Information Center

Guberman, Nancy; Lavoie, Jean-Pierre; Pepin, Jacinthe; Lauzon, Sylvie; Montejo, Maria-Elisa

2006-01-01

This article identifies home care practitioners' perceptions of the responsibilities, difficulties, and needs for support of caregivers. It is based on a study undertaken in Quebec with 55 practitioners and 10 administrators from 10 CLSCs located in rural, urban, and metropolitan areas. The study had a qualitative, multiple-case design and used…

Commentary: The failure of social inclusion: an alternative approach through community development.

PubMed

Mandiberg, James M

2012-01-01

Mental health services have not resulted in broad-based inclusion of people with psychiatric disabilities. Rather, many maintain their community lives only through the support of formal mental health services, which is financially unsustainable given current fiscal realities. Fundamental assumptions about sources of support for everyday life need to be reassessed. The economic and social development of the mental health recovery community provides an alternative approach to helping people maintain successful community lives and shifts some of the supports from mental health providers to business infrastructure within the mental health recovery identity community. Some projects that have utilized this approach, such as business incubators and work integration social enterprises, are described, and community development that builds on concepts of recovery is discussed.

EPA Facility Registry Service (FRS): ICIS

EPA Pesticide Factsheets

This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link to the Integrated Compliance Information System (ICIS). When complete, ICIS will provide a database that will contain integrated enforcement and compliance information across most of EPA's programs. The vision for ICIS is to replace EPA's independent databases that contain enforcement data with a single repository for that information. Currently, ICIS contains all Federal Administrative and Judicial enforcement actions and a subset of the Permit Compliance System (PCS), which supports the National Pollutant Discharge Elimination System (NPDES). ICIS exchanges non-sensitive enforcement/compliance activities, non-sensitive formal enforcement actions and NPDES information with FRS. This web feature service contains the enforcement/compliance activities and formal enforcement action related facilities; the NPDES facilities are contained in the PCS_NPDES web feature service. FRS identifies and geospatially locates facilities, sites or places subject to environmental regulations or of environmental interest. Using vigorous verification and data management procedures, FRS integrates facility data from EPA's national program systems, other federal agencies, and State and tribal master facility records and provides EPA with a centrally managed, single source of comprehensive and authoritative information on f

Developing and utilising a new funding model for home-care services in New Zealand.

PubMed

Parsons, Matthew; Rouse, Paul; Sajtos, Laszlo; Harrison, Julie; Parsons, John; Gestro, Lisa

2018-05-01

Worldwide increases in the numbers of older people alongside an accompanying international policy incentive to support ageing-in-place have focussed the importance of home-care services as an alternative to institutionalisation. Despite this, funding models that facilitate a responsive, flexible approach are lacking. Casemix provides one solution, but the transition from the well-established hospital system to community has been problematic. This research seeks to develop a Casemix funding solution for home-care services through meaningful client profile groups and supporting pathways. Unique assessments from 3,135 older people were collected from two health board regions in 2012. Of these, 1,009 arose from older people with non-complex needs using the interRAI-Contact Assessment (CA) and 2,126 from the interRAI-Home-Care (HC) from older people with complex needs. Home-care service hours were collected for 3 months following each assessment and the mean weekly hours were calculated. Data were analysed using a decision tree analysis, whereby mean hours of weekly home-care was the dependent variable with responses from the assessment tools, the independent variables. A total of three main groups were developed from the interRAI-CA, each one further classified into "stable" or "flexible." The classification explained 16% of formal home-care service hour variability. Analysis of the interRAI-HC generated 33 clusters, organised through eight disability "sub" groups and five "lead" groups. The groupings explained 24% of formal home-care services hour variance. Adopting a Casemix system within home-care services can facilitate a more appropriate response to the changing needs of older people. © 2017 John Wiley & Sons Ltd.

Building capacity in social service agencies to employ peer providers.

PubMed

Gates, Lauren B; Mandiberg, James M; Akabas, Sheila H

2010-01-01

While there is evidence that peer providers are valuable to service delivery teams, the agencies where they work face difficulties in fulfilling the potential of including peers on staff effectively. The purpose of this article is to report findings of a pilot test of a workplace strategy that promoted inclusion of peer providers at social service agencies by building organizational capacity to support people with mental health conditions in peer provider roles. The strategy included training, goal setting and ongoing consultation. Seventy-one peer, non-peer and supervisory staff participated from 6 agencies over a one year period. Goal attainment scaling and data from in-depth interviews about perceptions of differences in the ways in which staff are supported, administered prior to and after the consultation period, were used to assess strategy impact. Most frequently staff set goals to respond to role conflict or a lack of support. Staff that met or exceeded their goals utilized the formal structure of consultation to improve communication among themselves, had leadership that sanctioned changes and felt that their participation was of value to the organization and contributed to their individual development. Strategy participation promoted inclusion by initiating changes to policies and practices that devalued the peer provider role, increased skill sets, and formalized lines of communication for sharing information and understanding related to peer providers. Findings demonstrate that a strategy of training, goal setting and consultation can positively affect perceptions of inclusion, and promote implementation of practices associated with inclusive workplaces.

Towards Formal Implementation of PUS Standard

NASA Astrophysics Data System (ADS)

Ilić, D.

2009-05-01

As an effort to promote the reuse of on-board and ground systems ESA developed a standard for packet telemetry and telecommand - PUS. It defines a set of standard service models with the corresponding structures of the associated telemetry and telecommand packets. Various missions then can choose to implement those standard PUS services that best conform to their specific requirements. In this paper we propose a formal development (based on the Event-B method) of reusable service patterns, which can be instantiated for concrete application. Our formal models allow us to formally express and verify specific service properties including various telecommand and telemetry packet structure validation.

Changing access to mental health care and social support when people living with HIV/AIDS become service providers.

PubMed

Li, Alan Tai-Wai; Wales, Joshua; Wong, Josephine Pui-Hing; Owino, Maureen; Perreault, Yvette; Miao, Andrew; Maseko, Precious; Guiang, Charlie

2015-01-01

As people living with HIV/AIDS (PHAs) achieve more stable health, many have taken on active peer support and professional roles within AIDS service organizations. Although the increased engagement has been associated with many improved health outcomes, emerging program and research evidence have identified new challenges associated with such transition. This paper reports on the results of a qualitative interpretive study that explored the effect of this role transition on PHA service providers' access to mental health support and self care. A total of 27 PHA service providers of diverse ethno-racial backgrounds took part in the study. Results show that while role transition often improves access to financial and health-care benefits, it also leads to new stress from workload demands, emotional triggers from client's narratives, feeling of burnout from over-immersion in HIV at both personal and professional levels, and diminished self care. Barriers to seeking support included: concerns regarding confidentiality; self-imposed and enacted stigma associated with accessing mental health services; and boundary issues resulting from changes in relationships with peers and other service providers. Evolving support mechanisms included: new formal and informal peer support networks amongst colleagues or other PHA service providers to address both personal and professional challenges, and having access to professional support offered through the workplace. The findings suggest the need for increased organizational recognition of HIV support work as a form of emotional labor that places complex demands on PHA service providers. Increased access to employer-provided mental health services, supportive workplace policies, and adequate job-specific training will contribute to reduced work-related stress. Community level strategies that support expansion of social networks amongst PHA service providers would reduce isolation. Systemic policies to increase access to insurance benefits and enhance sector-wide job preparedness and post-employment support will sustain long-term and meaningful involvement of PHAs in service provision.

Peer advocacy in a personalized landscape: The role of peer support in a context of individualized support and austerity.

PubMed

Power, Andrew; Bartlett, Ruth; Hall, Edward

2016-06-01

Whilst personalization offers the promise of more choice and control and wider participation in the community, the reality in the United Kingdom has been hampered by local council cuts and a decline in formal services. This has left many people with intellectual disabilities feeling dislocated from collective forms of support (Needham, 2015). What fills this gap and does peer advocacy have a role to play? Drawing on a co-researched study undertaken with and by persons with intellectual disabilities, we examined what role peer advocacy can play in a context of reduced day services, austerity and individualized support. The findings reveal that peer advocacy can help people reconnect in the face of declining services, problem-solve issues and informally learn knowledge and skills needed to participate in the community. We argue that peer advocacy thus offers a vital role in enabling people to take up many of the opportunities afforded by personalization. © The Author(s) 2016.

Costs of care for dementia patients in community setting: an analysis for mild and moderate disease stage.

PubMed

Schwarzkopf, Larissa; Menn, Petra; Kunz, Simone; Holle, Rolf; Lauterberg, Jörg; Marx, Peter; Mehlig, Hilmar; Wunder, Sonja; Leidl, Reiner; Donath, Carolin; Graessel, Elmar

2011-01-01

Rising life expectancy is associated with higher prevalence rates of dementia disorders. When disease progresses the patients' call on formal health care services and on social support grows which imposes increasing costs of care. The aim of this study was to investigate the costs for patients with mild and moderate dementia in community setting in Germany. We assessed total costs of care and individual cost components for 383 community-living dementia patients alongside a cluster-randomized trial from societal and health insurance perspective. Utilization of formal health care services was based on insurance claims data and time dedicated to informal care was assessed within caregiver interviews. We estimated costs using a two-part regression model adjusting for age, gender and cluster-effects. Costs of care equal €47,747 (Euros) from societal perspective which is almost the 4.7-fold of health insurance expenditures. Valued informal care covers 80.2% of societal costs and increases disproportionally when disease progresses. In moderate dementia the corresponding amount exceeds the one in mild dementia by 69.9%, whereas costs for formal health care services differ by 14.3%. Due to valued informal care, costs of care for community-living patients with moderate dementia are significantly higher than for patients with mild dementia. Informal care is a non-cash item saving expenditures for professional care. To relieve social security system and family caregivers as well as to allow dementia patients to stay at home as long as possible, concepts fostering community-based dementia care and support to family caregivers need to be further developed. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Enhancing formal educational and in-service training programs in rural Rwanda: a partnership among the public sector, a nongovernmental organization, and academia.

PubMed

Cancedda, Corrado; Farmer, Paul E; Kyamanywa, Patrick; Riviello, Robert; Rhatigan, Joseph; Wagner, Claire M; Ngabo, Fidele; Anatole, Manzi; Drobac, Peter C; Mpunga, Tharcisse; Nutt, Cameron T; Kakoma, Jean Baptiste; Mukherjee, Joia; Cortas, Chadi; Condo, Jeanine; Ntaganda, Fabien; Bukhman, Gene; Binagwaho, Agnes

2014-08-01

Global disparities in the distribution, specialization, diversity, and competency of the health workforce are striking. Countries with fewer health professionals have poorer health outcomes compared with countries that have more. Despite major gains in health indicators, Rwanda still suffers from a severe shortage of health professionals.This article describes a partnership launched in 2005 by Rwanda's Ministry of Health with the U.S. nongovernmental organization Partners In Health and with Harvard Medical School and Brigham and Women's Hospital. The partnership has expanded to include the Faculty of Medicine and the School of Public Health at the National University of Rwanda and other Harvard-affiliated academic medical centers. The partnership prioritizes local ownership and-with the ultimate goals of strengthening health service delivery and achieving health equity for poor and underserved populations-it has helped establish new or strengthen existing formal educational programs (conferring advanced degrees) and in-service training programs (fostering continuing professional development) targeting the local health workforce. Harvard Medical School and Brigham and Women's Hospital have also benefited from the partnership, expanding the opportunities for training and research in global health available to their faculty and trainees.The partnership has enabled Rwandan health professionals at partnership-supported district hospitals to acquire new competencies and deliver better health services to rural and underserved populations by leveraging resources, expertise, and growing interest in global health within the participating U.S. academic institutions. Best practices implemented during the partnership's first nine years can inform similar formal educational and in-service training programs in other low-income countries.

Bottom-up approaches to strengthening child protection systems: Placing children, families, and communities at the center.

PubMed

Wessells, Michael G

2015-05-01

Efforts to strengthen national child protection systems have frequently taken a top-down approach of imposing formal, government-managed services. Such expert-driven approaches are often characterized by low use of formal services and the misalignment of the nonformal and formal aspects of the child protection system. This article examines an alternative approach of community-driven, bottom-up work that enables nonformal-formal collaboration and alignment, greater use of formal services, internally driven social change, and high levels of community ownership. The dominant approach of reliance on expert-driven Child Welfare Committees produces low levels of community ownership. Using an approach developed and tested in rural Sierra Leone, community-driven action, including collaboration and linkages with the formal system, promoted the use of formal services and achieved increased ownership, effectiveness, and sustainability of the system. The field needs less reliance on expert-driven approaches and much wider use of slower, community-driven, bottom-up approaches to child protection. Copyright © 2015 The Author. Published by Elsevier Ltd.. All rights reserved.

Vignettes: diverse library staff offering diverse bioinformatics services*

PubMed Central

Osterbur, David L.; Alpi, Kristine; Canevari, Catharine; Corley, Pamela M.; Devare, Medha; Gaedeke, Nicola; Jacobs, Donna K.; Kirlew, Peter; Ohles, Janet A.; Vaughan, K.T.L.; Wang, Lili; Wu, Yongchun; Geer, Renata C.

2006-01-01

Objectives: The paper gives examples of the bioinformatics services provided in a variety of different libraries by librarians with a broad range of educational background and training. Methods: Two investigators sent an email inquiry to attendees of the “National Center for Biotechnology Information's (NCBI) Introduction to Molecular Biology Information Resources” or “NCBI Advanced Workshop for Bioinformatics Information Specialists (NAWBIS)” courses. The thirty-five-item questionnaire addressed areas such as educational background, library setting, types and numbers of users served, and bioinformatics training and support services provided. Answers were compiled into program vignettes. Discussion: The bioinformatics support services addressed in the paper are based in libraries with academic and clinical settings. Services have been established through different means: in collaboration with biology faculty as part of formal courses, through teaching workshops in the library, through one-on-one consultations, and by other methods. Librarians with backgrounds from art history to doctoral degrees in genetics have worked to establish these programs. Conclusion: Successful bioinformatics support programs can be established in libraries in a variety of different settings and by staff with a variety of different backgrounds and approaches. PMID:16888664

Do informal caregivers for elderly in the community use support measures? A qualitative study in five European countries.

PubMed

Willemse, Evi; Anthierens, Sibyl; Farfan-Portet, Maria Isabel; Schmitz, Olivier; Macq, Jean; Bastiaens, Hilde; Dilles, Tinne; Remmen, Roy

2016-07-16

Informal caregivers are essential figures for maintaining frail elderly at home. Providing informal care can affect the informal caregivers' physical and psychological health and labour market participation capabilities. They need support to prevent caregiver burden. A variety of existing support measures can help the caregiver care for the elderly at home, but with some limitations. The objective of this review was to explore the experiences of informal caregivers caring for elderly in the community with the use of supportive policy measures in Belgium and compare these to the experiences in other European countries. An empirical qualitative case study research was conducted in five European countries (Belgium, The Netherlands, Luxembourg, France and Germany). Semi-structured interviews were conducted with informal caregivers and their dependent elderly. Interview data from the different cases were analysed. In particular data from Belgium was compared to data from the cases abroad. Formal services (e.g. home care) were reported to have the largest impact on allowing the caregiver to care for the dependent elderly at home. One of the key issues in Belgium is the lack of timely access to reliable information about formal and informal services in order to proactively support the informal caregiver. Compared to the other countries, informal caregivers in Belgium expressed more difficulties in accessing support measures and navigating through the health system. In the other countries information seemed to be given more timely when home care was provided via care packages. To support the informal caregiver, who is the key person to support the frail elderly, fragmentation of information regarding supportive policy measures is an important issue of concern.

Bolstering Resilience through Teacher-Student Interaction: Lessons for School Psychologists

ERIC Educational Resources Information Center

Liebenberg, Linda; Theron, Linda; Sanders, Jackie; Munford, Robyn; van Rensburg, Angelique; Rothmann, Sebastian; Ungar, Michael

2016-01-01

Schools are often the only formal service provider for young people living in socio-economically marginalized communities, uniquely positioning school staff to support positive psychosocial outcomes of youth living in adverse contexts. Using data from 2,387 school-going young people [Canada (N = 1,068), New Zealand (N = 591), and South Africa (N =…

Family Care of People with Intellectual Disability in Rural China: A Magnified Responsibility

ERIC Educational Resources Information Center

Pan, Lu; Ye, Jingzhong

2015-01-01

Background: Welfare for the disabled is becoming an important issue in China and care for people with intellectual disability is challenging because of the inadequacies in formal support and the social service system. Material and Method: Based on ethnographic research in two villages in North China, this paper analyses the dilemmas of family care…

From Special Tasks to Extensive Roles: The Changing Face of Special Needs Teachers in Finnish Vocational Further Education

ERIC Educational Resources Information Center

Pirttimaa, Raija; Hirvonen, Maija

2016-01-01

Following the development of inclusive education in vocational education and training (VET), the discussion about the prevention of marginalisation and dropouts has increased. At the same time, the formal education system has strengthened the position of support services, such as special educational needs (SEN) teachers, social workers and…

Failure in Success; An Assessment of Agricultural Extension in the United States.

ERIC Educational Resources Information Center

Carlson, Robert A.

The United States formalized its cooperative national support program for agricultural extension in 1941. The hope was to increase agricultural production and to help maintain a rural way of life in the United States. The Cooperative Extension Service was unable to strike a balance between these two goals, emphasizing increased production to such…

Implementation of Integrated Service Networks under the Quebec Mental Health Reform: Facilitators and Barriers associated with Different Territorial Profiles.

PubMed

Fleury, Marie-Josée; Grenier, Guy; Vallée, Catherine; Aubé, Denise; Farand, Lambert

2017-03-10

This study evaluates implementation of the Quebec Mental Health Reform (2005-2015), which promoted the development of integrated service networks, in 11 local service networks organized into four territorial groups according to socio-demographic characteristics and mental health services offered. Data were collected from documents concerning networks; structured questionnaires completed by 90 managers and by 16 respondent-psychiatrists; and semi-structured interviews with 102 network stakeholders. Factors associated with implementation and integration were organized according to: 1) reform characteristics; 2) implementation context; 3) organizational characteristics; and 4) integration strategies. While local networks were in a process of development and expansion, none were fully integrated at the time of the study. Facilitators and barriers to implementation and integration were primarily associated with organizational characteristics. Integration was best achieved in larger networks including a general hospital with a psychiatric department, followed by networks with a psychiatric hospital. Formalized integration strategies such as service agreements, liaison officers, and joint training reduced some barriers to implementation in networks experiencing less favourable conditions. Strategies for the implementation of healthcare reform and integrated service networks should include sustained support and training in best-practices, adequate performance indicators and resources, formalized integration strategies to improve network coordination and suitable initiatives to promote staff retention.

Public responses to intimate partner violence: comparing preferences of Chinese and American college students.

PubMed

Wu, Yuning; Button, Deeanna M; Smolter, Nicole; Poteyeva, Margarita

2013-01-01

Based on data collected from college students in Beijing and Hong Kong (China) and in Newark and Detroit (United States), this study assesses and explains citizen preferences of 2 major formalized responses to intimate partner violence (IPV)--law enforcement and social services intervention--in a cross-cultural context. Results show that Chinese respondents have lower support for law enforcement responses. Regional variation is only observed within China with students from Hong Kong supporting both law enforcement and social services responses more than their Beijing counterparts. Results also show that social attitudinal variables--including male dominance ideology, perceptions of IPV causation, support for the criminalization of IPV, and tolerance of IPV--influence public preferences of responses to IPV more than do demographic and experiential variables.

Formal plan for self-disclosure enhances supported employment outcomes among young people with severe mental illness.

PubMed

McGahey, Ellie; Waghorn, Geoffrey; Lloyd, Chris; Morrissey, Shirley; Williams, Philip Lee

2016-04-01

Young people with mental illness experience high levels of unemployment, which can be related to stigma and discrimination. This may result from poor choices in disclosing personal information, such as their mental illness diagnosis, in the workplace. The aim of this study was to investigate the predictive validity of a formal plan to manage personal information (PMPI) during the early stages of supported employment. The focal question was: does the use of a brief structured PMPI lead to more employment outcomes for young people with a mental illness? A sample of 40 young unemployed mental health service users (mean age 23.9 years), who were also attending employment services on the Gold Coast, was asked about their disclosure preferences. If they preferred not to disclose at all, they did not complete a plan for managing personal information. If they preferred to disclose some personal information, they were provided with assistance to complete a PMPI. Baseline information was gathered from two equal groups of 20 individuals. Employment status was ascertained at a 6-week follow-up interview. Those who completed a plan to manage their personal information had 4.9 times greater odds of employment at 6 weeks than those who preferred not to disclose any personal information. A formal PMPI has promising predictive validity with respect to job seekers not opposed to pragmatic forms of self-disclosure. Further research is needed to examine other properties of this decision-making tool. © 2014 Wiley Publishing Asia Pty Ltd.

39 CFR 3001.72 - Filing of formal requests.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Requests for Changes in the Nature of Postal Services § 3001.72 Filing of formal requests. Whenever the... in the nature of postal services subject to this subpart, the Postal Service shall file with the... Postal Service proposes to make effective the change in the nature of postal services involved. Within 5...

Peer counselling for doctors in Norway: A qualitative study of the relationship between support and surveillance.

PubMed

Isaksson Rø, Karin; Veggeland, Frode; Aasland, Olaf G

2016-08-01

Peer support can entail collegial responsibility for counselling and support as well as reactions to academic or ethical failure. These considerations can be complementary, but also conflicting. This article focuses on how the peer support programme in Norway addresses these considerations. Focus group interviews held with Norwegian peer counsellors from August 2011 to June 2012 were analysed by a stepwise deductive-inductive method. Based on organisational theory, two "ideal types" of counsellors were identified from the data, and these were then used to reanalyse the text. We found that the organisational framework is associated with the peer counsellors' role conception and thereby the relationship between the counsellor and the help-seeking doctor. The relationship between informal frameworks like collegiality, confidence and discretion, and more formalized incentive-driven frameworks, appear to influence the accessibility to peer support, the mandate to provide relevant help and the understanding of what peer support represents. The study showed the need for a continuous awareness of a balance between the informal and the more formalized elements in the framework for peer support. This is of importance for how the service can contribute to better health among doctors and to secure quality and safety in the treatment of patients. The analysis can also be used to demonstrate the consequences of how the peer support program is designed - such as the degree of formalisation and the balance between "hard" and "soft" ways to regulate the interaction between peer counsellors and doctors - for the ability to achieve the stated objectives of the service. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Peer support for parents of disabled children part 2: how organizational and process factors influenced shared experience in a one-to-one service, a qualitative study.

PubMed

Shilling, V; Bailey, S; Logan, S; Morris, C

2015-07-01

Parents of disabled children often seek support from their peers. The shared experience between parents appears to be a crucial mediating factor. Understanding how a sense of shared experience is fostered can help to design and evaluate services that seek to provide peer support. We carried out a qualitative study involving semi-structured interviews and focus groups. Participants were 12 parents and 23 befrienders who had contact with the Face2Face one-to-one befriending service in Devon and Cornwall during a 12-month period, and 10 professionals from health, social care and education. Formal structures and processes in place such as training and ongoing supervision and support were highly valued as was the highly personalized, confidential, flexible, one-to-one at-home nature of the service. Crucial to establishing rapport was putting the right people together and ensuring a good match between befrienders and parents. Clearly, the befriending parent has to be emotionally prepared to provide help. However, if the parent being offered support was not ready to accept help at the time it was offered or the type of support was not right for them, they are less likely to engage with the service. Organizational and process factors as well as characteristics of the parents offering and receiving support contribute to the sense of shared experience in one-to-one peer support. These factors interact to influence whether peer support is effective and should be explicitly considered when designing and evaluating services. © 2015 John Wiley & Sons Ltd.

Utilization of mobile phones for accessing menstrual regulation services among low-income women in Bangladesh: a qualitative analysis.

PubMed

Messinger, Chelsea Jordan; Mahmud, Ilias; Kanan, Sushama; Jahangir, Yamin Tauseef; Sarker, Malabika; Rashid, Sabina Faiz

2017-01-14

As many as one-third of all pregnancies in Bangladesh are unplanned, with nearly one-half of these pregnancies ending in either menstrual regulation (MR) or illegal clandestine abortion. Although MR is provided free of charge, or at a nominal cost, through the public sector and various non-profits organizations, many women face barriers in accessing safe, affordable MR and post-MR care. Mobile health (mHealth) services present a promising platform for increasing access to MR among low-income women at risk for clandestine abortion. We sought to investigate the knowledge, attitudes and practices regarding mHealth of both MR clients and formal and informal sexual and reproductive healthcare providers in urban and rural low-income settlements in Bangladesh. A total of 58 interviews were conducted with MR clients, formal MR providers, and informal MR providers in four low-income settlements in the Dhaka and Sylhet districts of Bangladesh. Interview data was coded and qualitatively analysed for themes using standard qualitative research practices. Our findings suggest that low-income MR clients in Bangladesh have an inadequate understanding of how to use their mobile phones to obtain health service information or counselling related to MR, and correspondingly low levels of formal or informal mHealth service utilization. Few were aware of any formal mHealth services in place in their communities, despite the fact that providers stated that hotlines were available. Overall, MR clients expressed positive opinions of mHealth services as a means of improving women's access to affordable and timely MR. Formal and informal MR providers believed that mobile phones had benefits with respect to information dissemination and making appointments, but emphasized the necessity of in-person consultations for effective sexual and reproductive healthcare. We report low utilization yet high acceptability of mHealth services among low-income MR clients in Bangladesh. Expanding formal and informal mHealth services targeted towards MR - and increasing publicity of these services in low-income communities - may help increase timely access to accurate MR information and formal providers among women at risk for clandestine abortion. While expanding formal and informal mHealth services for SRHR in Bangladesh may be useful in disseminating information about MR and connecting women with formal providers, in-person visits remain necessary for adequate treatment.

Predictors of personal recovery for persons with psychiatric disabilities: An examination of the Unity Model of Recovery.

PubMed

Song, Li-Yu

2017-04-01

This study examined a comprehensive set of potential correlates of recovery based on the Unity Model of Recovery. Thirty-two community psychiatric rehabilitation centers in Taiwan agreed to participate in this study. A sample of 592 participants were administered the questionnaires. Five groups of independent variables were included in the model: socio-demographic variables, illness variables, resilience, informal support, and formal support. The results of regression analysis provided support for the validity of the Unity Model of Recovery. The independent variables explained 53.5% of the variance in recovery for the full sample, and 55.5% for the subsample of the consumers who have been ever employed. The significance of the three cornerstones (resilience, family support, and symptoms) for recovery was confirmed. Other critical support variables, including the extent of rehabilitation service use, professional relationship, and professional support were also found to be significant factors. Among all the significant correlates, resilience, family support, and extent of rehabilitation service use ranked in the top three. The findings could shed light on paths to recovery. Implications for psychiatric services were discussed and suggested. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Development and Implementation of an Inpatient Otolaryngology Consultation Service at an Academic Medical Center.

PubMed

Huddle, Matthew G; London, Nyall R; Stewart, C Matthew

2018-02-01

To design and implement a formal otolaryngology inpatient consultation service that improves satisfaction of consulting services, increases educational opportunities, improves the quality of patient care, and ensures sustainability after implementation. This was a retrospective cohort study in a large academic medical center encompassing all inpatient otolaryngology service consultations from July 2005 to June 2014. Staged interventions included adding fellow coverage (July 2007 onward), intermittent hospitalist coverage (July 2010 onward), and a physician assistant (October 2011 onward). Billing data were collected for incidences of new patient and subsequent consultation charges. The 2-year preimplementation period (July 2005-June 2007) was compared with the postimplementation periods, divided into 2-year blocks (July 2007-June 2013). Outcome measures of patient encounters and work relative value units were compared between pre- and postimplementation blocks. Total encounters increased from 321 preimplementation to 1211, 1347, and 1073 in postimplementation groups ( P < 0.001). Total work relative value units increased from 515 preimplementation to 2090, 1934, and 1273 in postimplementation groups ( P < 0.001). A formal inpatient consultation service was designed with supervisory oversight by non-Accreditation Council for Graduate Medical Education fellows and then expanded to include intermittent hospitalist management, followed by the addition of a dedicated physician assistant. These additions have led to the formation of a sustainable consultation service that supports the mission of high-quality care and service to consulting teams.

Prescription for Learning? Meeting the Development Needs of the Pharmacy Profession.

ERIC Educational Resources Information Center

Wilson, Valerie; Schlapp, Ursula; Davidson, Julia

2003-01-01

A survey (n=947) of pharmacists and instructors was compared with 1999 results. Over 90% of both high and low users of formal continuing education also engaged in informal learning. Low users received the most employer support for training. Differences among high, medium, and low users and nonuers suggest a need for diverse formats and services,…

Canine-Assisted Reading Programs for Children with Special Educational Needs: Rationale and Recommendations for the Use of Dogs in Assisting Learning

ERIC Educational Resources Information Center

Fung, Suk-chun

2017-01-01

A canine-assisted reading program, a form of animal-assisted intervention (AAI), is a goal-oriented program that incorporates trained animals--particularly canines--in formal human services. In recent decades, the positive effects of human-animal interaction in supporting the social, psychological, and physiological needs of humans have been…

The visual management system of the Forest Service, USDA

Treesearch

Warren R. Bacon

1979-01-01

The National Forest Landscape Management Program began, as a formal program, at a Servicewide meeting in St. Louis in 1969 in response to growing agency and public concern for the visual resource. It is now an accepted part of National Forest management and is supported by a large and growing foundation of handbooks, research papers, and audio/visual programs. This...

Intergenerational Exchanges in Mexico: Types and Intensity of Support.

PubMed

Gomes, Cristina

2007-07-01

This article analyses exchanges of support between the elderly and adult generations and by gender, based on data from the United Nations household survey in Mexico City (SABE, 2000), and the National Study of Ageing and Health (ENASEM, 2001). Results indicate that in Mexico both generations - elderly parents and adult children - provide support, such as money, services, care or gifts for grandchildren, according to gender roles and the generation's resources. Men provide monetary support and reproduce their role as family providers, but this role depends on having an income from work and, in later years, a pension, a more common situation among men than among women. Women develop their female domestic role as caregivers. They do not have a formal income, but receive informal economic support and offer services and care to their relatives, reproducing their invisible and unpaid work during their life course. Both types of support are widely exchanged between elderly parents and adult children and children-in-law.

The redefinition of the familialist home care model in France: the complex formalization of care through cash payment.

PubMed

Le Bihan, Blanche

2012-05-01

This article investigates the impact of policy measures on the organisation of home-based care for older people in France, by examining the balance between formal and informal care and the redefinition of the initial familialist model. It focuses on the specific cash for care scheme (the Allocation personnalisée d'autonomie - Personalised allowance for autonomy) which is at the core of the French home-based care policy. The author argues that in a redefined context of 'welfare mix', the French public strategy for supporting home-based care in France is articulated around two major objectives, which can appear contradictory. It aims to formalise a professional care sector, with respect to the employment policy while allowing the development of new forms of informal care, which cannot be considered to be formal employment. The data collection is two-fold. Firstly, a detailed analysis was made of different policy documents and public reports, together with a systematic review of existing studies. Secondly, statistical analysis on home-based care resources were collected, which was not easy, as home-care services for older people in France are part of a larger sector of activity, 'personal services' (services à la personne). The article exposes three main findings. First, it highlights the complexity of the formalisation process related to the introduction of the French care allowance and demonstrates that formalisation, which facilitates the recognition of care as work, does not necessarily mean professionalisation. Second, it outlines the diversity of the resources available: heterogeneous professional care, semi-formal forms of care work with the possibility to employ a relative and informal family care. Finally, the analysis outlines the importance of the regulation of cash payments on the reshaping of formal and informal care and comments on its impact on the redefinition of informal caring activities. © 2012 Blackwell Publishing Ltd.

A Conceptual Design for a Reliable Optical Bus (ROBUS)

NASA Technical Reports Server (NTRS)

Miner, Paul S.; Malekpour, Mahyar; Torres, Wilfredo

2002-01-01

The Scalable Processor-Independent Design for Electromagnetic Resilience (SPIDER) is a new family of fault-tolerant architectures under development at NASA Langley Research Center (LaRC). The SPIDER is a general-purpose computational platform suitable for use in ultra-reliable embedded control applications. The design scales from a small configuration supporting a single aircraft function to a large distributed configuration capable of supporting several functions simultaneously. SPIDER consists of a collection of simplex processing elements communicating via a Reliable Optical Bus (ROBUS). The ROBUS is an ultra-reliable, time-division multiple access broadcast bus with strictly enforced write access (no babbling idiots) providing basic fault-tolerant services using formally verified fault-tolerance protocols including Interactive Consistency (Byzantine Agreement), Internal Clock Synchronization, and Distributed Diagnosis. The conceptual design of the ROBUS is presented in this paper including requirements, topology, protocols, and the block-level design. Verification activities, including the use of formal methods, are also discussed.

Making work fit care: reconciliation strategies used by working mothers of adults with intellectual disabilities.

PubMed

Chou, Yueh-Ching; Fu, Li-yeh; Chang, Heng-Hao

2013-03-01

This study explored the experiences of working mothers with an adult child with intellectual disabilities to understand how they reconcile paid work and care responsibilities. Fifteen working mothers in Taiwan with an adult child with intellectual disabilities were interviewed, and an interpretative phenomenological approach was adopted for data collection and analysis. All included mothers prioritized their caregiving role over paid work. The strategies used by these mothers to make paid work fit with caregiving included having strong social networks and informal support for their care work, use of formal services, personal religious beliefs and positive attitudes towards care, as well as having flexible working hours due to self-employment, good relations with employers, working positions and work locations. Formal systems, which include both welfare and labour policies, need to be responsive to and involved in supporting these working mothers, especially those who lack good personal networks. © 2012 Blackwell Publishing Ltd.

The influence of formal and informal policies and practices on health care innovation implementation: A mixed-methods analysis.

PubMed

DiMartino, Lisa D; Birken, Sarah A; Hanson, Laura C; Trogdon, Justin G; Clary, Alecia S; Weinberger, Morris; Reeder-Hayes, Katherine; Weiner, Bryan J

The implementation science literature has contributed important insights regarding the influence of formal policies and practices on health care innovation implementation, whereas informal implementation policies and practices have garnered little attention. The broader literature suggests that informal implementation policies and practices could also influence innovation use. We used the Organizational Theory of Innovation Implementation to further understand the role of formal and informal implementation policies and practices as determinants of implementation effectiveness. We examined their role within the context of initiatives to increase palliative care consultation in inpatient oncology. We used a case study design in two organizational settings within one academic medical center: medical and gynecologic oncology. We completed semistructured interviews with medical (n = 12) and gynecologic (n = 10) oncology clinicians using questions based on organizational theory. Quantitative data assessed implementation effectiveness, defined as aggregated palliative care consult rates within oncology services from 2010 to 2016. Four palliative care clinicians were interviewed to gain additional implementation context insights. Medical oncology employed multiple formal policies and practices including training and clinician prompting to support palliative care consultation and a top-down approach, yet most clinicians were unaware of the policies and practices, contributing to a weak implementation climate. In contrast, gynecologic oncology employed one formal policy (written guideline of criteria for initiating a consult) but also relied on informal policies and practices, such as spontaneous feedback and communication; they adopted a bottom-up approach, contributing to broader clinician awareness and strong implementation climate. Both services exhibited variable, increasing consult rates over time. Informal policies and practices may compensate or substitute for formal policies and practices under certain conditions (e.g., smaller health care organizations). Further research is needed to investigate the role of formal and informal policies and practices in shaping a strong and sustainable implementation climate and subsequent effective innovation implementation.

Responses to and Resources for Intimate Partner Violence: Qualitative Findings from Women, Men, and Service Providers in Rural Kenya

PubMed Central

Odero, Merab; Hatcher, Abigail M; Bryant, Chenoia; Onono, Maricianah; Romito, Patrizia; Bukusi, Elizabeth A.; Turan, Janet M.

2014-01-01

Intimate partner violence (IPV) is reported by one in five women globally, but the prevalence is much higher in East Africa. Though some formal and informal resources do exist for women experiencing IPV, data suggest that disclosure, help seeking, and subsequent utilization of these resources are often hindered by socio-cultural, economic, and institutional factors. This paper explores actions taken by victims, available support services, and barriers to utilization of available IPV resources by pregnant women in rural Nyanza, Kenya. Qualitative data were collected through 9 focus group discussions and 20 in-depth interviews with pregnant women, partners or male relatives of pregnant women, and service providers. Data were managed in NVivo 8 using a descriptive analytical approach that harnessed thematic content coding and in-depth grounded analysis. We found that while formal resources for IPV were scarce, women utilized many informal resources (family, pastors, local leaders) as well as the health facility. In rare occasions, women escalated their response to formal services (police, judiciary). The community was sometimes responsive to women experiencing IPV, but often viewed it as a “normal” part of local culture. Further barriers to women accessing services included logistical challenges and providers who were under-trained or uncommitted to responding to IPV appropriately. Moreover, the very sanctions meant to address violence (such as fines or jail) were often inhibiting for women who depended on their partners for financial resources. The results suggest that future IPV interventions should address community views around IPV and build upon locally available resources – including the health clinic - to address violence among women of child-bearing age. PMID:24255067

Responses to and resources for intimate partner violence: qualitative findings from women, men, and service providers in rural Kenya.

PubMed

Odero, Merab; Hatcher, Abigail M; Bryant, Chenoia; Onono, Maricianah; Romito, Patrizia; Bukusi, Elizabeth A; Turan, Janet M

2014-03-01

Intimate partner violence (IPV) is reported by one in three women globally, but the prevalence is much higher in East Africa. Though some formal and informal resources do exist for women experiencing IPV, data suggest that disclosure, help seeking, and subsequent utilization of these resources are often hindered by sociocultural, economic, and institutional factors. This article explores actions taken by victims, available support services, and barriers to the utilization of available IPV resources by pregnant women in rural Nyanza, Kenya. Qualitative data were collected through nine focus group discussions and 20 in-depth interviews with pregnant women, partners or male relatives of pregnant women, and service providers. Data were managed in NVivo 8 using a descriptive analytical approach that harnessed thematic content coding and in-depth grounded analysis. We found that while formal resources for IPV were scarce, women utilized many informal resources (family, pastors, local leaders) as well as the health facility. In rare occasions, women escalated their response to formal services (police, judiciary). The community was sometimes responsive to women experiencing IPV but often viewed it as a "normal" part of local culture. Further barriers to women accessing services included logistical challenges and providers who were undertrained or uncommitted to responding to IPV appropriately. Moreover, the very sanctions meant to address violence (such as fines or jail) were often inhibiting for women who depended on their partners for financial resources. The results suggest that future IPV interventions should address community views around IPV and build upon locally available resources-including the health clinic-to address violence among women of childbearing age.

External Service Providers to the National Security Technology Incubator: Formalization of Relationships

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

None

2008-04-30

This report documents the formalization of relationships with external service providers in the development of the National Security Technology Incubator (NSTI). The technology incubator is being developed as part of the National Security Preparedness Project (NSPP), funded by a Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant. This report summarizes the process in developing and formalizing relationships with those service providers and includes a sample letter of cooperation executed with each provider.

Linking case management and community development.

PubMed

Austin, Carol D; McClelland, Robert W; Gursansky, Di

2006-01-01

Case management, in various forms, is now institutionalized as a core part of policy and programs designed to deliver home- and community-based services to older adults. The case management role, in theory, requires attention to both client and system goals, although in practice the system goals that have received most attention have been gatekeeping and resource allocation. While case managers have been admonished to find and develop resources in the community, this has primarily taken the form of including informal services in individual client care plans. What has been missing is focused attention to the potential of the community as a nurturing environment with the capacity to support older adults and their caregivers. Sustainable care for older adults cannot be achieved by formal service and family support alone. This article proposes the creation of linkages between case managers, who build the service arrangements for older people, and community developers, who are responsible for building community capacity and social capital. It is argued that this linkage is essential for establishing the foundations of a caring community with the capacity to support older people.

Social Involvement in Religious Institutions and God-Mediated Control Beliefs: A Longitudinal Investigation.

PubMed

Krause, Neal M

2007-12-07

This study examines the relationships among race, education, formal as well as informal involvement in the church, and God-mediated control. Formal involvement in the church was assessed by the frequency of attendance at worship services, Bible study groups, and prayer groups. Informal involvement was measured with an index of spiritual support provided by fellow church members. Data from a nationwide longitudinal survey of older people suggest that both formal and informal church involvement tend to sustain feelings of God-mediated control over time. The findings further reveal that compared to older whites, older African Americans are more likely to have stronger feelings of God-mediated control at the baseline survey and older blacks are more likely to sustain their sense of God-mediated control over time. In contrast, the data suggest that education is not significantly related to feelings of God-mediated control.

From generic pathways to ICT-supported horizontally integrated care: the SmartCare approach and convergence with future Internet assembly.

PubMed

Urošević, Vladimir; Mitić, Marko

2014-01-01

Successful service integration in policy and practice requires both technology innovation and service process innovation being pursued and implemented at the same time. The SmartCare project (partially EC-funded under CIP ICT PSP Program) aims to achieve this through development, piloting and evaluation of ICT-based services, horizontally integrating health and social care in ten pilot regions, including Kraljevo region in Serbia. The project has identified and adopted two generic highest-level common thematic pathways in joint consolidation phase - integrated support for long-term care and integrated support after hospital discharge. A common set of standard functional specifications for an open ICT platform enabling the delivery of integrated care is being defined, around the challenges of data sharing, coordination and communication in these two formalized pathways. Implementation and system integration on technology and architecture level are to be based on open standards, multivendor interoperability, and leveraging on the current evolving open specification technology foundations developed in relevant projects across the European Research Area.

Information persistence services designed to support home care.

PubMed

Rocha, Nelson Pacheco; Queirós, Alexandra; Augusto, Filipe; Rodríguez, Yosvany Llerena; Cardoso, Carlos; Grade, José Miguel; Quintas, João

2015-03-10

Due to the challenges faced by health and social care systems, in particular those related to actual demographic trends, home care emerges as a potentially cost-effective solution to answer the needs of citizens, and to allow the reallocation of resources to alternatives to hospitalization or institutionalization. Home care services require cooperation between different actors, including health and social caregivers, care receivers, and their informal caregivers (eg, relatives or friends), across time, space, and organizational boundaries. Therefore, it is foreseeable that eHealth services can contribute to their improvement. The aim of this study is to evaluate information persistence services based on the Reference Information Model (RIM) of the Health Level Seven (HL7) version 3 to support formal caregivers, both health and social care providers, and informal caregivers in the context of home care services. A pilot study was set up involving two Portuguese institutions that provide home care services for the elderly. Defining of information requirements was performed according to a comprehensive process. This included a review of the literature, observations of work activities, interviews with caregivers, care receivers and their relatives, analysis of paper documentation related to care receivers' histories, health conditions and care plans, and brainstorming groups involving specialized professionals. Following this, information objects were implemented and validated. The methodological approach, as well as the information persistence services, proved to be robust and adequate to specify, implement, and validate different types of information objects related to home care services for the elderly. This study also reinforces the application of the RIM of the HL7 version 3 beyond the strict scope of health care, allowing the persistence of not only health care information, but also information related to social assistance activities. This study contributes to the ongoing efforts related to the development of eHealth applications to improve the cooperation among formal health care and social caregivers, as well as care receivers and their informal caregivers.

Information Persistence Services Designed to Support Home Care

PubMed Central

Queirós, Alexandra; Augusto, Filipe; Rodríguez, Yosvany Llerena; Cardoso, Carlos; Grade, José Miguel; Quintas, João

2015-01-01

Background Due to the challenges faced by health and social care systems, in particular those related to actual demographic trends, home care emerges as a potentially cost-effective solution to answer the needs of citizens, and to allow the reallocation of resources to alternatives to hospitalization or institutionalization. Objective Home care services require cooperation between different actors, including health and social caregivers, care receivers, and their informal caregivers (eg, relatives or friends), across time, space, and organizational boundaries. Therefore, it is foreseeable that eHealth services can contribute to their improvement. The aim of this study is to evaluate information persistence services based on the Reference Information Model (RIM) of the Health Level Seven (HL7) version 3 to support formal caregivers, both health and social care providers, and informal caregivers in the context of home care services. Methods A pilot study was set up involving two Portuguese institutions that provide home care services for the elderly. Defining of information requirements was performed according to a comprehensive process. This included a review of the literature, observations of work activities, interviews with caregivers, care receivers and their relatives, analysis of paper documentation related to care receivers’ histories, health conditions and care plans, and brainstorming groups involving specialized professionals. Following this, information objects were implemented and validated. Results The methodological approach, as well as the information persistence services, proved to be robust and adequate to specify, implement, and validate different types of information objects related to home care services for the elderly. This study also reinforces the application of the RIM of the HL7 version 3 beyond the strict scope of health care, allowing the persistence of not only health care information, but also information related to social assistance activities. Conclusions This study contributes to the ongoing efforts related to the development of eHealth applications to improve the cooperation among formal health care and social caregivers, as well as care receivers and their informal caregivers. PMID:25757462

Assistance received by employed caregivers and their care recipients: who helps care recipients when caregivers work full time?

PubMed

Scharlach, Andrew E; Gustavson, Kristen; Dal Santo, Teresa S

2007-12-01

This study examined the association among caregiver labor force participation, employees' caregiving activities, and the amount and quality of care received by care recipients. Telephone interviews were conducted with 478 adults who were employed full time and 705 nonemployed adults who provided care to a family member or friend aged 50 or older, identified through random sampling of California households. We assessed care recipient impairment and service problems; the amounts and types of assistance received from caregivers, family and friends, and paid providers; and caregiver utilization of support services. Care recipients of caregivers employed full time were less likely to receive large amounts of care from their caregivers, more likely to receive personal care from paid care providers, more likely to use community services, and more likely to experience service problems than were care recipients of nonemployed caregivers. Employed caregivers were more likely to use caregiver support services than were nonemployed caregivers. Accommodation to caregiver full-time employment involves selective supplementation by caregivers and their care recipients, reflecting increased reliance on formal support services as well as increased vulnerability to service problems and unmet care recipient needs. These findings suggest the need for greater attention to the well-being of disabled elders whose caregivers are employed full time.

Towards the formal specification of the requirements and design of a processor interface unit

NASA Technical Reports Server (NTRS)

Fura, David A.; Windley, Phillip J.; Cohen, Gerald C.

1993-01-01

Work to formally specify the requirements and design of a Processor Interface Unit (PIU), a single-chip subsystem providing memory interface, bus interface, and additional support services for a commercial microprocessor within a fault-tolerant computer system, is described. This system, the Fault-Tolerant Embedded Processor (FTEP), is targeted towards applications in avionics and space requiring extremely high levels of mission reliability, extended maintenance free operation, or both. The approaches that were developed for modeling the PIU requirements and for composition of the PIU subcomponents at high levels of abstraction are described. These approaches were used to specify and verify a nontrivial subset of the PIU behavior. The PIU specification in Higher Order Logic (HOL) is documented in a companion NASA contractor report entitled 'Towards the Formal Specification of the Requirements and Design of a Processor Interfacs Unit - HOL Listings.' The subsequent verification approach and HOL listings are documented in NASA contractor report entitled 'Towards the Formal Verification of the Requirements and Design of a Processor Interface Unit' and NASA contractor report entitled 'Towards the Formal Verification of the Requirements and Design of a Processor Interface Unit - HOL Listings.'

Formal and informal maternal health care: comparing the service provision of health facilities and village health volunteers in East Sepik Province.

PubMed

O'Keefe, Daniel; Davis, Jessica; Yakuna, Glenda; Van Gemert, Caroline; Morgan, Chris

2011-01-01

Maternal health across Papua New Guinea (PNG) is of extreme public health concern. In response, the National Department of Health explicitly prioritized improving maternal, neonatal and child health services, envisaging increased collaboration between the formal health system and community-based initiatives as one method for achieving this. This study examined the patterns of formal and non-formal service utilization during pregnancy and childbirth in one province. We analysed the activity database of the East Sepik Women and Children's Health Project's Village Health Volunteer (VHV) program, an informal health service in East Sepik Province of PNG, estimating VHV activity and coverage for two maternal health care services (first antenatal care visit and VHV-attended deliveries) and comparing these to the volume and estimated coverage of these services delivered by the formal health system in East Sepik over the years 2007 to 2010. We found a significant increase in women's utilization of VHVs for first antenatal care and for an attended delivery. Reported coverage of these services delivered by the formal health service declined or at best remained static over the same time period. Our data cannot illuminate the causes of an apparent and highly concerning decline in health facility usage for assisted delivery, nor the reasons for increased usage of VHVs. The factors contributing to these trends in service provision require urgent study, to improve our understanding of the drivers of utilization of critical maternal health services. Our study demonstrates that VHVs deliver a substantial proportion of maternal health services in East Sepik. This finding alone highlights the importance of considering this cadre when planning health service improvements and suggests that a national VHV policy that builds on the work of the National Health Plan in defining the most appropriate role for VHVs in maternal health care is long overdue.

UTM UAS Service Supplier Specification

NASA Technical Reports Server (NTRS)

Rios, Joseph Lucio

2017-01-01

Within the Unmanned Aircraft Systems (UAS) Traffic Management (UTM) system, the UAS Service Supplier (USS) is a key component. The USS serves several functions. At a high level, those include the following: Bridging communication between UAS Operators and Flight Information Management System (FIMS) Supporting planning of UAS operations Assisting strategic deconfliction of the UTM airspace Providing information support to UAS Operators during operations Helping UAS Operators meet their formal requirements This document provides the minimum set of requirements for a USS. In order to be recognized as a USS within UTM, successful demonstration of satisfying the requirements described herein will be a prerequisite. To ensure various desired qualities (security, fairness, availability, efficiency, maintainability, etc.), this specification relies on references to existing public specifications whenever possible.

The challenges of reshaping disease specific and care oriented community based services towards comprehensive goals: a situation appraisal in the Western Cape Province, South Africa.

PubMed

Schneider, Helen; Schaay, Nikki; Dudley, Lilian; Goliath, Charlyn; Qukula, Tobeka

2015-09-30

Similar to other countries in the region, South Africa is currently reorienting a loosely structured and highly diverse community care system that evolved around HIV and TB, into a formalized, comprehensive and integrated primary health care outreach programme, based on community health workers (CHWs). While the difficulties of establishing national CHW programmes are well described, the reshaping of disease specific and care oriented community services, based outside the formal health system, poses particular challenges. This paper is an in-depth case study of the challenges of implementing reforms to community based services (CBS) in one province of South Africa. A multi-method situation appraisal of CBS in the Western Cape Province was conducted over eight months in close collaboration with provincial stakeholders. The appraisal mapped the roles and service delivery, human resource, financing and governance arrangements of an extensive non-governmental organisation (NGO) contracted and CHW based service delivery infrastructure that emerged over 15-20 years in this province. It also gathered the perspectives of a wide range of actors - including communities, users, NGOs, PHC providers and managers - on the current state and future visions of CBS. While there was wide support for new approaches to CBS, there are a number of challenges to achieving this. Although largely government funded, the community based delivery platform remains marginal to the formal public primary health care (PHC) and district health systems. CHW roles evolved from a system of home based care and are limited in scope. There is a high turnover of cadres, and support systems (supervision, monitoring, financing, training), coordination between CHWs, NGOs and PHC facilities, and sub-district capacity for planning and management of CBS are all poorly developed. Reorienting community based services that have their origins in care responses to HIV and TB presents an inter-related set of resource mobilisation, system design and governance challenges. These include not only formalising community based teams themselves, but also the forging of new roles, relationships and mind-sets within the primary health care system, and creating greater capacity for contracting and engaging a plural set of actors - government, NGO and community - at district and sub-district level.

Expectations of support among White British and Asian-Indian older people in Britain: the interdependence of formal and informal spheres.

PubMed

Sin, Chih Hoong

2006-05-01

Abstract The discourse surrounding community care characterises informal support being superior to and preferred over formal sources of support, with this distinction buttressed by policy changes. There is a lack of understanding of the interdependence of both spheres of support. This article argues that an individual's experience and expectation of one type of support is often made in relation to his or her understanding, expectation and experience of other sources of support. There is also an urgent need to understand how these associations operate in a cross-cultural context as it is naïve to assume that normative expectations will remain constant when the relationship between family, state and other sources of support are unstable. This article reports on findings emerging from part of a Growing Older study funded by the Economic and Social Research Council of Great Britain to explore the relationship between quality of life and the social networks and support of older people from different ethnic groups. Research involved the use of a questionnaire comprising closed- and open-ended questions. In addition, in-depth qualitative interviews covering the existence and nature of social networks and support, as well as perceptions and expectations of these, were also conducted. This article reports on data relating to a sample comprising seven White British men, 10 White British women, 12 Asian-Indian men, and nine Asian-Indian women aged 55 and over derived from the Family Resources Survey. Findings reveal that the high level of expectation for family support amongst Asian-Indian respondents coexists with a high level of expectation for state support and an acknowledgement that the ideal of family support may not always materialise. Amongst White British respondents, the high level of expectation for state support exists regardless of whether the respondent has satisfactory informal social networks. This expectation is commonly expressed in terms of rights and entitlement by White British respondents but not by Asian-Indians. Associated with this, Asian-Indian respondents display a consistently lower level of awareness and usage of a range of health and social care services. Regardless of the extent of current and past usage of services, however, respondents from both groups overwhelmingly indicate an expectation for the continued provision of such services as they would like to be able to use one or more of these at some stage.

An academic practice's transition to the business of medicine in the community. A case study.

PubMed

Griffin, S L; Schryver, D L

2000-01-01

This case study highlights the problems confronting a clinical practice corporation affiliated with a major medical school, and the business realizations it made in the acquisition of a community-based clinic. Launching a financially viable enterprise requires careful planning, determination of formal goals and expectations, an appropriate mix of physicians and services, a specific marketing campaign and community support.

Intergenerational Exchanges in Mexico

PubMed Central

Gomes, Cristina

2017-01-01

This article analyses exchanges of support between the elderly and adult generations and by gender, based on data from the United Nations household survey in Mexico City (SABE, 2000), and the National Study of Ageing and Health (ENASEM, 2001). Results indicate that in Mexico both generations – elderly parents and adult children – provide support, such as money, services, care or gifts for grandchildren, according to gender roles and the generation’s resources. Men provide monetary support and reproduce their role as family providers, but this role depends on having an income from work and, in later years, a pension, a more common situation among men than among women. Women develop their female domestic role as caregivers. They do not have a formal income, but receive informal economic support and offer services and care to their relatives, reproducing their invisible and unpaid work during their life course. Both types of support are widely exchanged between elderly parents and adult children and children-in-law. PMID:29375143

Psychosocial Interventions in Reducing Cannabis Use in Early Phase Psychosis: A Canadian Survey of Treatments Offered.

PubMed

Aydin, Cristina; Tibbo, Philip G; Ursuliak, Zenovia

2016-06-01

Cannabis use in people with early phase psychosis (EPP) can have a significant impact on long-term outcomes. The purpose of this investigation was to describe current cannabis use treatment practices in English-speaking early intervention services (EISs) in Canada and determine if their services are informed by available evidence. Thirty-five Canadian English-speaking EISs for psychosis were approached to complete a survey through email, facsimile, or online in order to collect information regarding their current cannabis use treatment practices. Data were acquired from 27 of the 35 (78%) programs approached. Only 12% of EISs offered formal services that targeted cannabis use, whereas the majority (63%) of EISs offered informal services for all substance use, not specifically cannabis. In programs with informal services, individual patient psychoeducation (86%) was slightly more common than individual motivational interviewing (MI) (76%) followed by group patient psychoeducation (52%) and information handouts (52%). Thirty-seven percent of EISs offered formal services for substance use, and compared to programs with informal services, more MI, cognitive-behavioural therapy, and family services were offered, with individual treatment modalities more common than groups. No EISs used contingency management, even though it has some preliminary evidence in chronic populations. Evidence-based service implementation barriers included appropriate training and administrative support. While most English-speaking Canadian EIS programs offer individual MI and psychoeducation, which is in line with the available literature, there is room for improvement in cannabis treatment services based on current evidence for both people with EPP and their families. © The Author(s) 2016.

Rural and remote dementia care challenges and needs: perspectives of formal and informal care providers residing in Saskatchewan, Canada.

PubMed

Dal Bello-Haas, Vanina P M; Cammer, Allison; Morgan, Debra; Stewart, Norma; Kosteniuk, Julie

2014-01-01

Rural and remote settings pose particular healthcare and service delivery challenges. Providing appropriate care and support for individuals with dementia and their families living in these communities is especially difficult, and can only be accomplished when the needs of care providers and the context and complexity of care provision are understood. This paper describes formal and informal caregivers' perceptions of the challenges and needs in providing care and support for individuals with dementia living in rural and remote areas of Saskatchewan, Canada. A mixed-methods exploratory approach was used to examine caregivers' needs. This research was a component of a broader process evaluation designed to inform the initial and ongoing development of a community-based participatory research program in rural dementia care, which included the development of the Rural and Remote Memory Clinic (RRMC). Four approaches were used for data collection and analyses: (1) thematic analysis of consultation meetings with rural healthcare providers: documented discussions from consultation meetings that occurred in 2003-2004 with rural physicians and healthcare providers regarding plans for a new RRMC were analysed thematically; (2) telephone and mail questionnaires: consultation meeting participants completed a subsequent telephone or mail questionnaire (2003-2004) that was analysed descriptively; (3) thematic analysis of referral letters to the Rural and Remote Memory Clinic: physician referral letters over a five-year period (2003-2008) were analysed descriptively and thematically; and (4) examination of family caregiver satisfaction: four specific baseline questionnaire questions completed by family caregivers (2007-2010) were analysed descriptively and thematically. Both physician and non-physician healthcare providers identified increased facilities and care programs as needs. Physicians were much more likely than other providers to report available support services for patients and families as adequate. Non-physician providers identified improved services, better coordination of services, travel and travel burden related needs, and staff training and education needs as priorities. Physician needs, as determined via referral letters, included confirmation of diagnosis or treatment, request for further management suggestions, patient or family request, and consultation regarding difficult cases. One-third of informal caregivers expressed not being satisfied with the care received prior to the Rural and Remote Memory Clinic assessment visit, and identified lack of diagnosis and long wait times for services as key issues. Delivering services and providing care and support for individuals with dementia living in rural and remote communities are especially challenging. The need for increased extent of services was a commonality among formal and informal caregivers. Primary care physicians may seek confirmation of their diagnosis or may need assistance when dealing with difficult aspects of care, as identified by referral letters. Differences between the needs identified via referral letters and questionnaire responses of physicians may be a reflection of the rural or remote context of care provision. Informal caregiver needs were more aligned with non-physician healthcare providers with respect to the need for improved access to additional healthcare professionals and services. The findings have implications for regional policy development that addresses human and other resource shortages.

Structure of the Social Support Network of Patients with Severe and Persistent Psychiatric Disorders in Follow-Ups to Primary Health Care.

PubMed

de Souza, Jacqueline; de Almeida, Letícia Yamawaka; Moll, Marciana Fernandes; Silva, Lucas Duarte; Ventura, Carla Aparecida Arena

2016-02-01

The objective of this study is to analyze the characteristics of social support networks of patients with psychiatric disorders at follow-up to primary care. This is a cross-sectional qualitative research study. Forty-five interviews were held with patients and their supporters. The results showed small and dense networks, with a strong emphasis on the bonds with formal supporters and a scant network of informal supporters. It is recommended to develop strategies to improve social support networks and use this as an outcome indicator related to social integration of these patients and to the quality of services involved with outpatient healthcare. Copyright © 2015 Elsevier Inc. All rights reserved.

ICU staffing: identification and survey of staff involved in providing technical support services to Australian and New Zealand intensive care units.

PubMed

Carter, B G; Kiraly, N; Hochmann, M; Stephens, R; Osborne, A

2007-04-01

We conducted a survey of all (200) Australian and New Zealand intensive care units to determine the presence and nature of staff employed in a technical support role. Specifically, we attempted to identify staff who are formally employed in a role where they are directly responsible for the equipment used in intensive care. Of 130 returned surveys, 80 units (62%) reported not having any personnel in this role. In these units technical tasks were most commonly performed by registered nurses (79%) but were also performed by a variety of other personnel. Fifty units (38%), consisting of approximately 105 individuals providing a total of 84.3 EFTs and most commonly in public (84%) or metropolitan (70%) hospitals or level 3 (64%) intensive care units, did have one or more staff acting in a formal technical support role. The most common groups filling the technical support role were nurses (42%), technicians (24%), biomedical engineers (10%) and technologists (6%). The most common duties performed were equipment troubleshooting (92%), training (80%), equipment evaluation (80%), ordering supplies (77%), consumable evaluation (75%), equipment cleaning (73%), delivery of supplies (70%), handling product recalls (65%), equipment maintenance (65%) and sitting on hospital committees (52%). This is the first attempt to identify and understand the technical support role in Australian and New Zealand intensive care units. Numerous issues remain and future work will hopefully add to our findings, with the possibility of formal recognition of the role, training and/or accreditation and its extension into other hospital departments.

Discrimination and Mental Health–Related Service Use in a National Study of Asian Americans

PubMed Central

Chen, Juan; Gee, Gilbert C.; Fabian, Cathryn G.; Takeuchi, David T.

2010-01-01

Objectives. We examined the association between perceived discrimination and use of mental health services among a national sample of Asian Americans. Methods. Our data came from the National Latino and Asian American Study, the first national survey of Asian Americans. Our sample included 600 Chinese, 508 Filipinos, 520 Vietnamese, and 467 other Asians (n=2095). We used logistic regression to examine the association between discrimination and formal and informal service use and the interactive effect of discrimination and English language proficiency. Results. Perceived discrimination was associated with more use of informal services, but not with less use of formal services. Additionally, higher levels of perceived discrimination combined with lower English proficiency were associated with more use of informal services. Conclusions. The effect of perceived discrimination and language proficiency on service use indicates a need for more bilingual services and more collaborations between formal service systems and community resources. PMID:20299649

Spatial dynamics of ecosystem service flows: a comprehensive approach to quantifying actual services

USGS Publications Warehouse

Bagstad, Kenneth J.; Johnson, Gary W.; Voigt, Brian; Villa, Ferdinando

2013-01-01

Recent ecosystem services research has highlighted the importance of spatial connectivity between ecosystems and their beneficiaries. Despite this need, a systematic approach to ecosystem service flow quantification has not yet emerged. In this article, we present such an approach, which we formalize as a class of agent-based models termed “Service Path Attribution Networks” (SPANs). These models, developed as part of the Artificial Intelligence for Ecosystem Services (ARIES) project, expand on ecosystem services classification terminology introduced by other authors. Conceptual elements needed to support flow modeling include a service's rivalness, its flow routing type (e.g., through hydrologic or transportation networks, lines of sight, or other approaches), and whether the benefit is supplied by an ecosystem's provision of a beneficial flow to people or by absorption of a detrimental flow before it reaches them. We describe our implementation of the SPAN framework for five ecosystem services and discuss how to generalize the approach to additional services. SPAN model outputs include maps of ecosystem service provision, use, depletion, and flows under theoretical, possible, actual, inaccessible, and blocked conditions. We highlight how these different ecosystem service flow maps could be used to support various types of decision making for conservation and resource management planning.

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

PubMed

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

2015-10-01

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

"I Must Be Silent Because of Residency": Barriers to Escaping Domestic Violence in the Context of Insecure Immigration Status in England and Sweden.

PubMed

Voolma, Halliki

2018-02-01

This article draws on qualitative research examining domestic violence against women with insecure immigration status in England and Sweden. Empirical data were collected through in-depth semistructured interviews with 31 survivors from 14 non-European Union (EU) countries, and 57 professional stakeholders including 19 support service providers. This article reveals a multilayered process of actualizing women's right to live free from violence, with survivors required to be formally eligible for services according to their immigration status, having to prove their eligibility, overcome informal barriers including the fear of deportation, and gain access to accurate information about their rights and services.

Use of healthcare services by injured people in Khartoum State, Sudan.

PubMed

El Tayeb, Sally; Abdalla, Safa; Van den Bergh, Graziella; Heuch, Ivar

2015-05-01

Trauma care is an important factor in preventing death and reducing disability. Injured persons in low- and middle-income countries are expected to use the formal healthcare system in increasing numbers. The objective of this paper is to examine use of healthcare services after injury in Khartoum State, Sudan. A community-based survey using a stratified two-stage cluster sampling technique in Khartoum State was performed. Information on healthcare utilisation was taken from injured people. A logistic regression analysis was used to explore factors affecting the probability of using formal healthcare services. During the 12 months preceding the survey a total of 441 cases of non-fatal injuries occurred, with 260 patients accessing formal healthcare. About a quarter of the injured persons were admitted to hospital. Injured people with primary education were less likely to use formal healthcare compared to those with no education. Formal health services were most used by males and in cases of road traffic injuries. The lowest socio-economic strata were least likely to use formal healthcare. Public health measures and social security should be strengthened by identifying other real barriers that prevent low socio-economic groups from making use of formal healthcare facilities. Integration and collaboration with traditional orthopaedic practitioners are important aspects that need further attention. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Development of a case-mix funding system for adults with combined vision and hearing loss.

PubMed

Guthrie, Dawn M; Poss, Jeffrey W

2013-04-15

Adults with vision and hearing loss, or dual sensory loss (DSL), present with a wide range of needs and abilities. This creates many challenges when attempting to set the most appropriate and equitable funding levels. Case-mix (CM) funding models represent one method for understanding client characteristics that correlate with resource intensity. A CM model was developed based on a derivation sample (n = 182) and tested with a replication sample (n = 135) of adults aged 18+ with known DSL who were living in the community. All items within the CM model came from a standardized, multidimensional assessment, the interRAI Community Health Assessment and the Deafblind Supplement. The main outcome was a summary of formal and informal service costs which included intervenor and interpreter support, in-home nursing, personal support and rehabilitation services. Informal costs were estimated based on a wage rate of half that for a professional service provider ($10/hour). Decision-tree analysis was used to create groups with homogeneous resource utilization. The resulting CM model had 9 terminal nodes. The CM index (CMI) showed a 35-fold range for total costs. In both the derivation and replication sample, 4 groups (out of a total of 18 or 22.2%) had a coefficient of variation value that exceeded the overall level of variation. Explained variance in the derivation sample was 67.7% for total costs versus 28.2% in the replication sample. A strong correlation was observed between the CMI values in the two samples (r = 0.82; p = 0.006). The derived CM funding model for adults with DSL differentiates resource intensity across 9 main groups and in both datasets there is evidence that these CM groups appropriately identify clients based on need for formal and informal support.

Disclosure of physical, emotional and sexual child abuse, help-seeking and access to abuse response services in two South African Provinces.

PubMed

Meinck, Franziska; Cluver, Lucie; Loening-Voysey, Heidi; Bray, Rachel; Doubt, Jenny; Casale, Marisa; Sherr, Lorraine

2017-03-01

Physical, emotional and sexual child abuse are major problems in South Africa. This study investigates whether children know about post-abuse services, if they disclose and seek services, and what the outcomes of help-seeking behaviour are. It examines factors associated with request and receipt of services. Confidential self-report questionnaires were completed by adolescents aged 10-17 (n = 3515) in South Africa. Prevalence of frequent (>weekly) physical abuse was 7.4%, frequent emotional abuse 12.4%, and lifetime contact sexual abuse 9.0%. 98.6% could name one suitable confidante or formal service for abuse disclosure, but only 20.0% of abuse victims disclosed. Of those, 72% received help. Most common confidantes were caregivers and teachers. Of all abuse victims, 85.6% did not receive help due to non-disclosure or inactivity of services, and 14.4% received help: 4.9% from formal health or social services and 7.1% through community vigilante action. Emotional abuse, sexual abuse and female gender were associated with higher odds of help-seeking. While children in South Africa showed high knowledge of available services, access to and receipt of formal services among abused children was low. Notably fewer children received help from formal services than through community vigilante action. Urgent action is needed to improve service access for child abuse victims.

The Outcome of Constructive Alignment between Open Educational Services and Learners' Needs, Employability and Capabilities Development: Heutagogy and Transformative Migration among Underprivileged Learners in Rwanda

ERIC Educational Resources Information Center

Nkuyubwatsi, Bernard

2016-01-01

While teachers play an important role in education and supporting learning, many learners in under-resourced settings are not privileged to have access to teachers. Some of these underprivileged learners deal with the issue by engaging in self-determined and self-directed learning. Their efforts sometimes pay off with access to formal higher…

The Children's Workforce: A Data Scoping Study. A Report for the Department of Children, School and Family (DCSF). CEE Special Report

ERIC Educational Resources Information Center

Machin, Stephen; McNally, Sandra; Ou, Dongshu

2010-01-01

There has been much policy interest on the theme of children's services in recent years. For example, the 1998 National Child Strategy explicitly aims to ensure good quality, affordable childcare for children aged 0 to 14 in every neighbourhood, including both formal childcare and support for informal arrangements. The sector has a changed a lot…

The effectiveness of Teratology Information Services (TIS).

PubMed

Hancock, Rebecca L; Koren, Gideon; Einarson, Adrienne; Ungar, Wendy J

2007-02-01

Women and their health care providers have few reliable sources of information regarding the safety of exposures in pregnancy and lactation. Evidence-based information on these topics is provided by Teratology Information Services (TIS). Access to TIS, however, is limited in many regions, and many services have difficulty maintaining ongoing funding. The objective of this review is to highlight published reports of the effectiveness of TIS in improving maternal and neonatal health. A search of the Pub Med and Econ Lit databases was performed with no date restriction, using the search terms teratology, information, counseling, pregnancy, effectiveness, birth defects. Information disseminated from TIS has been shown to prevent congenital malformations, unnecessary pregnancy terminations, and occupational risks. TIS support optimal nutritional supplementation in pregnancy and optimal drug therapy in pregnancy and breast-feeding. In addition, they correct misperceptions of risk and facilitate knowledge transfer and translation. TIS have the potential to provide health care cost savings. TIS are vital services in supporting optimal maternal and neonatal health. A formal economic evaluation of TIS is required in order to inform resource allocation decision-making and continued funding of these services.

Ethics support for GPs: what should it look like?

PubMed

Clark-Grill, Monika

2016-03-01

INTRODUCTION Ethics support services for hospital clinicians have become increasingly common globally but not as yet in New Zealand. However, an initiative to change this is gathering momentum. Its slogan 'Clinical ethics is everyone's business' indicates that the aim is to encompass all of health care, not just the hospital sector. General Practitioners (GPs) deal with ethical issues on a daily basis. These issues are often quite different from ethical issues in hospitals. To make future ethics support relevant for primary care, local GPs were interviewed to find out how they might envisage ethics support services that could be useful to them. METHODS A focus group interview with six GPs and semi-structured individual interviews with three GPs were conducted. Questions included how they made decisions on ethical issues at present, what they perceived as obstacles to ethical reflection and decision-making, and what support might be helpful. FINDINGS Three areas of ethics support were considered potentially useful: Formal ethics education during GP training, access to an ethicist for assistance with analysing an ethical issue, and professional guidance with structured ethics conversations in peer groups. CONCLUSION The complex nature of general practice requires GPs to be well educated and supported for handling ethical issues. The findings from this study could serve as input to the development of ethics support services. KEYWORDS General practice; primary care; ethics; support; education.

Understanding How to Support Family Caregivers of Seniors with Complex Needs.

PubMed

Charles, Lesley; Brémault-Phillips, Suzette; Parmar, Jasneet; Johnson, Melissa; Sacrey, Lori-Ann

2017-06-01

The purpose of this study was to describe the experiences and challenges of supporting family caregivers of seniors with complex needs and to outline support strategies and research priorities aimed at supporting them. A CIHR-funded, two-day conference entitled "Supporting Family Caregivers of Seniors: Improving Care and Caregiver Outcomes" was held. An integrated knowledge translation approach guided this planning conference. Day 1 included presentations of research evidence, followed by participant engagement Qualitative data was collected regarding facilitators, barriers/gaps, and recommendations for the provision of caregiver supports. Day 2 focused on determination of research priorities. Identified facilitators to the provision of caregiver support included accessibility of health-care and community-based resources, availability of well-intended health-care providers, and recognition of caregivers by the system. Barriers/gaps related to challenges with communication, access to information, knowledge of what is needed, system navigation, access to financial resources, and current policies. Recommendations regarding caregiver services and research revolved around assisting caregivers to self-identify and seek support, formalizing caregiver supports, centralizing resources, making system navigation available, and preparing the next generation for caregiving. A better understanding of the needs of family caregivers and ways to support them is critical to seniors' health services redesign.

Privatization of solid waste collection services: Lessons from Gaborone

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

Bolaane, Benjamin, E-mail: bolaaneb@mopipi.ub.bw; Isaac, Emmanuel, E-mail: eisaac300@gmail.com

Highlights: • We compared efficiency and effectiveness of waste collection by the public and private sector. • Public sector performs better than private sector in some areas and vice versa. • Outsourcing waste collection in developing countries is hindered by limited capacity on contractual issues. • Outsourcing collection in developing countries is hampered by inadequate waste information. • There is need to build capacity in the public sector of developing countries to support outsourcing. - Abstract: Formal privatization of solid waste collection activities has often been flagged as a suitable intervention for some of the challenges of solid waste managementmore » experienced by developing countries. Proponents of outsourcing collection to the private sector argue that in contrast to the public sector, it is more effective and efficient in delivering services. This essay is a comparative case study of efficiency and effectiveness attributes between the public and the formal private sector, in relation to the collection of commercial waste in Gaborone. The paper is based on analysis of secondary data and key informant interviews. It was found that while, the private sector performed comparatively well in most of the chosen indicators of efficiency and effectiveness, the public sector also had areas where it had a competitive advantage. For instance, the private sector used the collection crew more efficiently, while the public sector was found to have a more reliable workforce. The study recommends that, while formal private sector participation in waste collection has some positive effects in terms of quality of service rendered, in most developing countries, it has to be enhanced by building sufficient capacity within the public sector on information about services contracted out and evaluation of performance criteria within the contracting process.« less

Towards Using Reo for Compliance-Aware Business Process Modeling

NASA Astrophysics Data System (ADS)

Arbab, Farhad; Kokash, Natallia; Meng, Sun

Business process modeling and implementation of process supporting infrastructures are two challenging tasks that are not fully aligned. On the one hand, languages such as Business Process Modeling Notation (BPMN) exist to capture business processes at the level of domain analysis. On the other hand, programming paradigms and technologies such as Service-Oriented Computing (SOC) and web services have emerged to simplify the development of distributed web systems that underly business processes. BPMN is the most recognized language for specifying process workflows at the early design steps. However, it is rather declarative and may lead to the executable models which are incomplete or semantically erroneous. Therefore, an approach for expressing and analyzing BPMN models in a formal setting is required. In this paper we describe how BPMN diagrams can be represented by means of a semantically precise channel-based coordination language called Reo which admits formal analysis using model checking and bisimulation techniques. Moreover, since additional requirements may come from various regulatory/legislative documents, we discuss the opportunities offered by Reo and its mathematical abstractions for expressing process-related constraints such as Quality of Service (QoS) or time-aware conditions on process states.

Estimating Capacity Requirements for Mental Health Services After a Disaster Has Occurred: A Call for New Data

PubMed Central

Siegel, Carole E.; Laska, Eugene; Meisner, Morris

2004-01-01

Objectives. We sought to estimate the extended mental health service capacity requirements of persons affected by the September 11, 2001, terrorist attacks. Methods. We developed a formula to estimate the extended mental health service capacity requirements following disaster situations and assessed availability of the information required by the formula. Results. Sparse data exist on current services and supports used by people with mental health problems outside of the formal mental health specialty sector. There also are few systematically collected data on mental health sequelae of disasters. Conclusions. We recommend research-based surveys to understand service usage in non–mental health settings and suggest that federal guidelines be established to promote uniform data collection of a core set of items in studies carried out after disasters. PMID:15054009

A Formal Specification and Verification Method for the Prevention of Denial of Service in Ada Services

DTIC Science & Technology

1988-03-01

Mechanism; Computer Security. 16. PRICE CODE 17. SECURITY CLASSIFICATION IS. SECURITY CLASSIFICATION 19. SECURITY CLASSIFICATION 20. UMrrATION OF ABSTRACT...denial of service. This paper assumes that the reader is a computer science or engineering professional working in the area of formal specification and...recovery from such events as deadlocks and crashes can be accounted for in the computation of the waiting time for each service in the service hierarchy

Evaluating the effectiveness of different approaches to home support for people in later stage dementia: a protocol for an observational study.

PubMed

Chester, Helen; Clarkson, Paul; Hughes, Jane; Russell, Ian; Beresford, Joan; Davies, Linda; Jolley, David; Peconi, Julie; Poland, Fiona; Roberts, Chris; Sutcliffe, Caroline; Challis, David

2017-07-01

Dementia is a major health problem with a growing number of people affected by the condition, both directly and indirectly through caring for someone with dementia. Many live at home but little is known about the range and intensity of the support they receive. Previous studies have mainly reported on discrete services within a single geographical area. This paper presents a protocol for study of different services across several sites in England. The aim is to explore the presence, effects, and cost-effectiveness of approaches to home support for people in later stage dementia and their carers. This is a prospective observational study employing mixed methods. At least 300 participants (people with dementia and their carers) from geographical areas with demonstrably different ranges of services available for people with dementia will be selected. Within each area, participants will be recruited from a range of services. Participants will be interviewed on two occasions and data will be collected on their characteristics and circumstances, quality of life, carer health and burden, and informal and formal support for the person with dementia. The structured interviews will also collect qualitative data to explore the perceptions of older people and carers. This national study will explore the components of appropriate and effective home support for people with late stage dementia and their carers. It aims to inform commissioners and service providers across health and social care.

From Policy to Practice: Implementation of Treatment for Substance Misuse in Québec Primary Healthcare Clinics

PubMed Central

Maynard, Serge; Campbell, Emily; Boodhoo, Katie; Gauthier, Gail; Xenocostas, Spyridoula; Charney, Dara A.

2015-01-01

Background and Objectives: In 2007, the Québec Ministry of Health issued a policy document that specifically mandated the development of addiction treatment services including screening, brief interventions and referral (SBIR) to be delivered by primary healthcare clinics throughout Québec. The current study examined the level of implementation of SBIR one year following the end of the mandate (2007–2012). Approach: Semi-structured interviews were conducted with 45 participants from 21 primary health and social service centres throughout the province. Qualitative analysis was used to evaluate the level of success each centre had in implementing SBIR and to identify organizational measures that contributed to successful implementation. Results: The results show that Québec primary health and social service centres had limited success in their efforts to integrate SBIR into their services. A comparative analysis of the centres, categorized according to their level of implementation, revealed the presence of significant organizational- and staff-level factors, including the creation of formal action plans that were conducive to the successful implementation of SBIR in primary care. Conclusion: The findings highlight the importance of offering support and guidance, as well as a menu of specific practices that are likely to assist primary health and social services centres to implement SBIR. At the organizational level, the adoption of local action plans and formal service trajectories offers a framework that allows for horizontal and vertical integration of new practices. PMID:26742118

From Policy to Practice: Implementation of Treatment for Substance Misuse in Québec Primary Healthcare Clinics.

PubMed

Maynard, Serge; Campbell, Emily; Boodhoo, Katie; Gauthier, Gail; Xenocostas, Spyridoula; Charney, Dara A; Gill, Kathryn

2015-11-01

In 2007, the Québec Ministry of Health issued a policy document that specifically mandated the development of addiction treatment services including screening, brief interventions and referral (SBIR) to be delivered by primary healthcare clinics throughout Québec. The current study examined the level of implementation of SBIR one year following the end of the mandate (2007-2012). Semi-structured interviews were conducted with 45 participants from 21 primary health and social service centres throughout the province. Qualitative analysis was used to evaluate the level of success each centre had in implementing SBIR and to identify organizational measures that contributed to successful implementation. The results show that Québec primary health and social service centres had limited success in their efforts to integrate SBIR into their services. A comparative analysis of the centres, categorized according to their level of implementation, revealed the presence of significant organizational- and staff-level factors, including the creation of formal action plans that were conducive to the successful implementation of SBIR in primary care. The findings highlight the importance of offering support and guidance, as well as a menu of specific practices that are likely to assist primary health and social services centres to implement SBIR. At the organizational level, the adoption of local action plans and formal service trajectories offers a framework that allows for horizontal and vertical integration of new practices. Copyright © 2015 Longwoods Publishing.

The organizational social context of mental health medicaid waiver programs with family support services: implications for research and practice.

PubMed

Glisson, Charles; Williams, Nathaniel J; Green, Philip; Hemmelgarn, Anthony; Hoagwood, Kimberly

2014-01-01

Peer family support specialists (FSS) are parents with practical experience in navigating children's mental health care systems who provide support, advocacy, and guidance to the families of children who need mental health services. Their experience and training differ from those of formally trained mental health clinicians, creating potential conflicts in priorities and values between FSS and clinicians. We hypothesized that these differences could negatively affect the organizational cultures and climates of mental health clinics that employ both FSS and mental health clinicians, and lower the job satisfaction and organizational commitment of FSS. The Organizational Social Context measure was administered on site to 209 FSS and clinicians in 21 mental health programs in New York State. The study compared the organizational-level culture and climate profiles of mental health clinics that employ both FSS and formally trained clinicians to national norms for child mental health clinics, assessed individual-level job satisfaction and organizational commitment as a function of job (FSS vs. clinician) and other individual-level and organizational-level characteristics, and tested whether FSS and clinicians job attitudes were differentially associated with organizational culture and climate. The programs organizational culture and climate profiles were not significantly different from national norms. Individual-level job satisfaction and organizational commitment were unrelated to position (FSS vs. clinician) or other individual-level and organizational-level characteristics except for culture and climate. Both FSS' and clinicians' individual-level work attitudes were associated similarly with organizational culture and climate.

Negotiating safety and sexual risk reduction with clients in unsanctioned safer indoor sex work environments: a qualitative study.

PubMed

Krüsi, Andrea; Chettiar, Jill; Ridgway, Amelia; Abbott, Janice; Strathdee, Steffanie A; Shannon, Kate

2012-06-01

We examined how unique, low-barrier, supportive housing programs for women who are functioning as unsanctioned indoor sex work environments in a Canadian urban setting influence risk negotiation with clients in sex work transactions. We conducted 39 semistructured qualitative interviews and 6 focus groups with women who live in low-barrier, supportive housing for marginalized sex workers with substance use issues. All interviews were transcribed verbatim and thematically analyzed. Women's accounts indicated that unsanctioned indoor sex work environments promoted increased control over negotiating sex work transactions, including the capacity to refuse unwanted services, negotiate condom use, and avoid violent perpetrators. Despite the lack of formal legal and policy support for indoor sex work venues in Canada, the environmental-structural supports afforded by these unsanctioned indoor sex work environments, including surveillance cameras and support from staff or police in removing violent clients, were linked to improved police relationships and facilitated the institution of informal peer-safety mechanisms. This study has drawn attention to the potential role of safer indoor sex work environments as venues for public health and violence prevention interventions and has indicated the critical importance of removing the sociolegal barriers preventing the formal implementation of such programs.

Negotiating Safety and Sexual Risk Reduction With Clients in Unsanctioned Safer Indoor Sex Work Environments: A Qualitative Study

PubMed Central

Krüsi, Andrea; Chettiar, Jill; Ridgway, Amelia; Abbott, Janice; Strathdee, Steffanie A.

2012-01-01

Objectives. We examined how unique, low-barrier, supportive housing programs for women who are functioning as unsanctioned indoor sex work environments in a Canadian urban setting influence risk negotiation with clients in sex work transactions. Methods. We conducted 39 semistructured qualitative interviews and 6 focus groups with women who live in low-barrier, supportive housing for marginalized sex workers with substance use issues. All interviews were transcribed verbatim and thematically analyzed. Results. Women’s accounts indicated that unsanctioned indoor sex work environments promoted increased control over negotiating sex work transactions, including the capacity to refuse unwanted services, negotiate condom use, and avoid violent perpetrators. Despite the lack of formal legal and policy support for indoor sex work venues in Canada, the environmental-structural supports afforded by these unsanctioned indoor sex work environments, including surveillance cameras and support from staff or police in removing violent clients, were linked to improved police relationships and facilitated the institution of informal peer-safety mechanisms. Conclusions. This study has drawn attention to the potential role of safer indoor sex work environments as venues for public health and violence prevention interventions and has indicated the critical importance of removing the sociolegal barriers preventing the formal implementation of such programs. PMID:22571708

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

PubMed

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

2007-01-01

Food insecurity in older adults is influenced by financial constraints, functional disability, and isolation. Twenty-eight social- and community-service providers participated in four focus groups to report (a) perceptions and experiences with food insecurity in their older clients, (b) beliefs about their potential role(s) in promoting food security, and (c) opinions about constraints that influenced these roles. A constant comparison analysis identified key themes. The formal caregivers reported six roles for improving food security: (a) monitoring, (b) coordination, and (c) promoting services, (d) education, (e) advocacy, and (f) providing a social environment. The final theme summarizes these roles as "the need for personalization of service". Social and community service providers are involved in roles that can promote the health of older adults by addressing their food insecurity. Social service providers need to be acknowledged and supported in this health promotion role.

Ontology-aided Data Fusion (Invited)

NASA Astrophysics Data System (ADS)

Raskin, R.

2009-12-01

An ontology provides semantic descriptions that are analogous to those in a dictionary, but are readable by both computers and humans. A data or service is semantically annotated when it is formally associated with elements of an ontology. The ESIP Federation Semantic Web Cluster has developed a set of ontologies to describe datatypes and data services that can be used to support automated data fusion. The service ontology includes descriptors of the service function, its inputs/outputs, and its invocation method. The datatype descriptors resemble typical metadata fields (data format, data model, data structure, originator, etc.) augmented with descriptions of the meaning of the data. These ontologies, in combination with the SWEET science ontology, enable a registered data fusion service to be chained together and implemented that is scientifically meaningful based on machine understanding of the associated data and services. This presentation describes initial results and experiences in automated data fusion.

The Study on Collaborative Manufacturing Platform Based on Agent

NASA Astrophysics Data System (ADS)

Zhang, Xiao-yan; Qu, Zheng-geng

To fulfill the trends of knowledge-intensive in collaborative manufacturing development, we have described multi agent architecture supporting knowledge-based platform of collaborative manufacturing development platform. In virtue of wrapper service and communication capacity agents provided, the proposed architecture facilitates organization and collaboration of multi-disciplinary individuals and tools. By effectively supporting the formal representation, capture, retrieval and reuse of manufacturing knowledge, the generalized knowledge repository based on ontology library enable engineers to meaningfully exchange information and pass knowledge across boundaries. Intelligent agent technology increases traditional KBE systems efficiency and interoperability and provides comprehensive design environments for engineers.

California four cities program, 1971 - 1973. [aerospace-to-urban technology application

NASA Technical Reports Server (NTRS)

Macomber, H. L.; Wilson, J. H.

1974-01-01

A pilot project in aerospace-to-urban technology application is reported. Companies assigned senior engineering professionals to serve as Science and Technology Advisors to participating city governments. Technical support was provided by the companies and JPL. The cities, Anaheim, Fresno, Pasadena, and San Hose, California, provided the working environment and general service support. Each city/company team developed and carried out one or more technical or management pilot projects together with a number of less formalized technology efforts and studies. An account and evaluation is provided of the initial two-year phase of the program.

2005 Defense Economics Conference: Perspectives on the Military Medical Mission

DTIC Science & Technology

2005-09-22

organized, formal level to take certain areas like congestive heart failure, diabetes, asthma, obesity —areas where we see a lot of expenditure of...Australia and overseas, including a tour of Malaysia . Air Vice Marshal Austin was made a member of the Order of Australia in 1997 for services to...provided aviation medicine support to the Australian Defence Force within Australia and overseas, including a tour of Malaysia . Air Vice Marshal

Using a Formal Approach for Reverse Engineering and Design Recovery to Support Software Reuse

NASA Technical Reports Server (NTRS)

Gannod, Gerald C.

2002-01-01

This document describes 3rd year accomplishments and summarizes overall project accomplishments. Included as attachments are all published papers from year three. Note that the budget for this project was discontinued after year two, but that a residual budget from year two allowed minimal continuance into year three. Accomplishments include initial investigations into log-file based reverse engineering, service-based software reuse, and a source to XML generator.

A Comparative Study of Pre-Service Education for Preschool Teachers in China and the United States

ERIC Educational Resources Information Center

Gong, Xin; Wang, Pengcheng

2017-01-01

This study provides a comparative analysis of the pre-service education system for preschool educators in China and the United States. Based on collected data and materials (literature, policy documents, and statistical data), we compare two areas of pre-service training: (1) the formal system; (2) the informal system. In the formal system, most…

Instinctive analytics for coalition operations (Conference Presentation)

NASA Astrophysics Data System (ADS)

de Mel, Geeth R.; La Porta, Thomas; Pham, Tien; Pearson, Gavin

2017-05-01

The success of future military coalition operations—be they combat or humanitarian—will increasingly depend on a system's ability to share data and processing services (e.g. aggregation, summarization, fusion), and automatically compose services in support of complex tasks at the network edge. We call such an infrastructure instinctive—i.e., an infrastructure that reacts instinctively to address the analytics task at hand. However, developing such an infrastructure is made complex for the coalition environment due to its dynamism both in terms of user requirements and service availability. In order to address the above challenge, in this paper, we highlight our research vision and sketch some initial solutions into the problem domain. Specifically, we propose means to (1) automatically infer formal task requirements from mission specifications; (2) discover data, services, and their features automatically to satisfy the identified requirements; (3) create and augment shared domain models automatically; (4) efficiently offload services to the network edge and across coalition boundaries adhering to their computational properties and costs; and (5) optimally allocate and adjust services while respecting the constraints of operating environment and service fit. We envision that the research will result in a framework which enables self-description, discover, and assemble capabilities to both data and services in support of coalition mission goals.

The emergence of non-governmental support groups in migration.

PubMed

Liem, N H

1989-01-01

The Philippine labor export policy, though always stated as a temporary policy, has been implemented for over a decade. From the beginning it has had 2 main features: 1) a strong presence of the government in the process of sending overseas contract workers, especially through the Philippine Overseas Employment Administration (POEA), and 2) the increasing involvement of the private sector, notably the recruitment industry, in the implementation and, to a certain extent, in the policy formulation of labor export policy. Another feature is the change in the structure of overseas contract workers over the years from a male-dominated to an increasingly female-characterized temporary migration. During the past few years, increasing attention has been focused on the actual and potential role in the process of development of non-governmental support groups, commonly known as Non-Governmental Organizations (NGOs). This paper focuses on the NGOs which have a direct link, and to a limited extent those with an indirect link, with the issue of migrant workers. The paper attempts to 1) come up with a typology of these NGOs based on certain classification criteria, 2) elaborate on their main patterns of support services, 3) pinpoint some of their weaknesses as an organization and in delivering services, and 4) draw a picture of future prospects. NGOs came about mainly because of the social aspect of migration. Most of the NGOs were formally organized in the early 1980s, except those serving the sea-based workers and the Philippine Nurses Association. A limited number of NGOs in migration are exclusively servicing migrant workers; the others have broader target groups, such as women's groups and trade unions. Services provided to the migrant workers include, especially in the early stages of the organization, mainly advocacy and non-economic activities related to the pre-departure of the migrant workers. Many activities are related to the pre-departure stage. Few NGOs are extending their services on the job sites; reintegration activities, though recognized and already started, are still inadequate. Loose coordination exists among the NGOs. There is an absence of networking and a lack of formal participation in decision-making on issues related to migrant workers.

41 CFR 105-68.835 - Are debarment proceedings formal?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are debarment proceedings formal? 105-68.835 Section 105-68.835 Public Contracts and Property Management Federal Property Management Regulations System (Continued) GENERAL SERVICES ADMINISTRATION Regional Offices-General Services...

41 CFR 105-68.740 - Are suspension proceedings formal?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are suspension proceedings formal? 105-68.740 Section 105-68.740 Public Contracts and Property Management Federal Property Management Regulations System (Continued) GENERAL SERVICES ADMINISTRATION Regional Offices-General Services...

“Who Believes Most in Me and in My Recovery”: The Importance of Families for Persons With Serious Mental Illness Living in Structured Community Housing

PubMed Central

PIAT, MYRA; SABETTI, JUDITH; FLEURY, MARIE-JOSÉÉ; BOYER, RICHARD; LESAGE, ALAIN

2016-01-01

In this article, the authors report on qualitative findings on the role of family in supporting recovery for mental health consumers living in structured, community housing in a large Canadian city. Despite living separately from families and relying heavily on formal services, residents identified their families more often than mental health professionals, friends, and residential caregivers as those who most believe in them and their recovery. Families supported recovery by providing affection and belonging, offering emotional and instrumental support, and by staying actively involved with residents. Families are a vital, untapped resource for social workers in promoting independent living. PMID:21360400

The link between past informal payments and willingness of the Hungarian population to pay formal fees for health care services: results from a contingent valuation study.

PubMed

Baji, Petra; Pavlova, Milena; Gulácsi, László; Farkas, Miklós; Groot, Wim

2014-11-01

We examine the willingness of health care consumers to pay formal fees for health care use and how this willingness to pay is associated with past informal payments. We use data from a survey carried out in Hungary in 2010 among a representative sample of 1,037 respondents. The contingent valuation method is used to elicit the willingness to pay official charges for health care services covered by the social health insurance if certain quality attributes (regarding the health care facility, access to the services and health care personnel) are guaranteed. A bivariate probit model is applied to examine the relationship between willingness to pay and past informal payments. We find that 66% of the respondents are willing to pay formal fees for specialist examinations and 56% are willing to pay for planned hospitalizations if these services are provided with certain quality and access attributes. The act of making past informal payments for health care services is positively associated with the willingness to pay formal charges. The probability that a respondent is willing to pay official charges for health care services is 22% points higher for specialist examinations and 45% points higher for hospitalization if the respondent paid informally during the last 12 months. The introduction of formal fees should be accompanied by adequate service provision to assure acceptance of the fees. Furthermore, our results suggest that the problem of informal patient payments may remain even after the implementation of user fees.

Involving service users in trials: developing a standard operating procedure

PubMed Central

2013-01-01

Background Many funding bodies require researchers to actively involve service users in research to improve relevance, accountability and quality. Current guidance to researchers mainly discusses general principles. Formal guidance about how to involve service users operationally in the conduct of trials is lacking. We aimed to develop a standard operating procedure (SOP) to support researchers to involve service users in trials and rigorous studies. Methods Researchers with experience of involving service users and service users who were contributing to trials collaborated with the West Wales Organisation for Rigorous Trials in Health, a registered clinical trials unit, to develop the SOP. Drafts were prepared in a Task and Finish Group, reviewed by all co-authors and amendments made. Results We articulated core principles, which defined equality of service users with all other research team members and collaborative processes underpinning the SOP, plus guidance on how to achieve these. We developed a framework for involving service users in research that defined minimum levels of collaboration plus additional consultation and decision-making opportunities. We recommended service users be involved throughout the life of a trial, including planning and development, data collection, analysis and dissemination, and listed tasks for collaboration. We listed people responsible for involving service users in studies and promoting an inclusive culture. We advocate actively involving service users as early as possible in the research process, with a minimum of two on all formal trial groups and committees. We propose that researchers protect at least 1% of their total research budget as a minimum resource to involve service users and allow enough time to facilitate active involvement. Conclusions This SOP provides guidance to researchers to involve service users successfully in developing and conducting clinical trials and creating a culture of actively involving service users in research at all stages. The UK Clinical Research Collaboration should encourage clinical trials units actively to involve service users and research funders should provide sufficient funds and time for this in research grants. PMID:23866730

Space Applications in Support of Future Urban Development in Armenia

NASA Astrophysics Data System (ADS)

Alhaddad, Bahaaeddin; Reppucci, Antonio; Moreno, Laura

2016-08-01

The fast growing of some cities has produced important changes in the urban sectors not always following sustainability criteria. As results, most urban growth falls outside formal planning controls and many cities suffer poor urban services management, traffic, and congestion, loss of green areas, poor air quality, and noise. The main advantages of satellite-based EO products are to support the decision-making process, and the development and operation of smart services. Satellite-based urban morphology analysis can help to identify the transformation of the urban development and evolution. The pilot presented here is a demonstration in the framework of the collaboration between ESA and ADB, called EOTAP "Earth Observation for a Transforming Asia Pacific". Aim of the pilot is to exploit satellite Earth observation data for sustainable growth and help preparing a series of city development and investment plans.

Informal and Formal Social Support and Caregiver Burden: The AGES Caregiver Survey

PubMed Central

Shiba, Koichiro; Kondo, Naoki; Kondo, Katsunori

2016-01-01

Background We examined the associations of informal (eg, family members and friends) and formal (eg, physician and visiting nurses) social support with caregiver’s burden in long-term care and the relationship between the number of available sources of social support and caregiver burden. Methods We conducted a mail-in survey in 2003 and used data of 2998 main caregivers of frail older adults in Aichi, Japan. We used a validated scale to assess caregiver burden. Results Multiple linear regression demonstrated that, after controlling for caregivers’ sociodemographic and other characteristics, informal social support was significantly associated with lower caregiver burden (β = −1.59, P < 0.0001), while formal support was not (β = −0.30, P = 0.39). Evaluating the associations by specific sources of social support, informal social supports from the caregiver’s family living together (β = −0.71, P < 0.0001) and from relatives (β = −0.61, P = 0.001) were associated with lower caregiver burden, whereas formal social support was associated with lower caregiver burden only if it was from family physicians (β = −0.56, P = 0.001). Compared to caregivers without informal support, those who had one support (β = −1.62, P < 0.0001) and two or more supports (β = −1.55, P < 0.0001) had significantly lower burden. This association was not observed for formal support. Conclusions Social support from intimate social relationships may positively affect caregivers’ psychological wellbeing independent of the receipt of formal social support, resulting in less burden. PMID:27180934

Care Experiences of Adults With a Dual Diagnosis and Their Family Caregivers

PubMed Central

Nicholas, David B.; Calhoun, Avery; McLaughlin, Anne Marie; Shankar, Janki; Kreitzer, Linda; Uzande, Masimba

2017-01-01

Individuals diagnosed with developmental disability and mental illness (a “dual diagnosis”) contend with multiple challenges and system-related barriers. Using an interpretive description approach, separate qualitative interviews were conducted with adults with a dual diagnosis (n = 7) and their caregiving parents (n = 8) to examine care-related experiences. Results indicate that individuals with a dual diagnosis and their families experience misunderstanding and stigma. Families provide informal complex care amid insufficient and uncoordinated services but are often excluded from formal care planning. A lack of available funding and services further impedes care. While negative care experiences are reported as prevalent, participants also describe instances of beneficial care. Overall, findings indicate a lack of sufficiently targeted resources, leaving families to absorb system-related care gaps. Recommendations include person- and family-centered care, navigation support, and capacity building. Prevention and emergency and crisis care services, along with housing, vocation, and other supports, are needed. Practice and research development regarding life span needs are recommended. PMID:28804747

Use of mental health services by nursing home residents after hurricanes.

PubMed

Brown, Lisa M; Hyer, Kathryn; Schinka, John A; Mando, Ahed; Frazier, Darvis; Polivka-West, Lumarie

2010-01-01

A growing body of research supports the value of mental health intervention to treat people affected by disasters. This study used a mixed-methods approach to evaluate pre- and posthurricane mental health service use in Florida nursing homes. A questionnaire was administered to 258 directors of nursing, administrators, and owners of nursing homes, representing two-thirds of Florida's counties, to identify residents' mental health needs and service use. In four subsequent focus group meetings with 22 nursing home administrators, underlying factors influencing residents' use of services were evaluated. Although most nursing homes provided some type of mental health care during normal operations, disaster-related mental health services were not routinely provided to residents. Receiving facilities were more likely than evacuating facilities to provide treatment to evacuated residents. Nursing home staff should be trained to deliver disaster-related mental health intervention and in procedures for making referrals for follow-up evaluation and formal intervention.

Analysis of changes in the association of income and the utilization of curative health services in Mexico between 2000 and 2006

PubMed Central

2011-01-01

Background A common characteristic of health systems in most developing countries is unequal access to health services. As a result, members of the poorest population groups often do not receive formal attention for health services, because they cannot afford it. In 2001 in Mexico, to address income-related differences in the use of health services, the government launched a major healthcare reform, which includes a health insurance program called Seguro Popular, aimed at improving healthcare access among poor, uninsured residents. This paper analyzes the before and after changes in the demand for curative ambulatory health services focusing on the association of income-related characteristics and the utilization of formal healthcare providers vs. no healthcare service utilization. Methods By using two nationally representative health surveys (ENSA-2000 and ENSANUT-2006), we modeled an individual's decision when experiencing an illness to use services provided by the (1) Ministry of Health (MoH), (2) social security, (3) private entities, or (4) to not use formal services (no healthcare service utilization). Results Poorer individuals were more likely in 2006 than in 2000 to respond to an illness by using formal healthcare providers. Trends in provider selection differed, however. The probability of using public services from the MoH increased among the poorest population, while the findings indicated an increase in utilization of private health services among members of low- and middle-income groups. No significant change was seen among formal workers -covered by social security services-, regardless of socioeconomic status. Conclusions Overall, for 2006 the Mexican population appears less differentiated in using healthcare across economic groups than in 2000. This may be related, in part, to the implementation of Seguro Popular, which seems to be stimulating healthcare demand among the poorest and previously uninsured segment of the population. Still, public health authorities need to address the remaining income-related healthcare utilization differences, the differences in quality between public and private health services, and the general perception that MoH facilities offer inferior services. PMID:21978183

Analysis of changes in the association of income and the utilization of curative health services in Mexico between 2000 and 2006.

PubMed

Danese-Dlsantos, Laura G; Sosa-Rubí, Sandra G; Valencia-Mendoza, Atanacio

2011-10-07

A common characteristic of health systems in most developing countries is unequal access to health services. As a result, members of the poorest population groups often do not receive formal attention for health services, because they cannot afford it. In 2001 in Mexico, to address income-related differences in the use of health services, the government launched a major healthcare reform, which includes a health insurance program called Seguro Popular, aimed at improving healthcare access among poor, uninsured residents. This paper analyzes the before and after changes in the demand for curative ambulatory health services focusing on the association of income-related characteristics and the utilization of formal healthcare providers vs. no healthcare service utilization. By using two nationally representative health surveys (ENSA-2000 and ENSANUT-2006), we modeled an individual's decision when experiencing an illness to use services provided by the (1) Ministry of Health (MoH), (2) social security, (3) private entities, or (4) to not use formal services (no healthcare service utilization). Poorer individuals were more likely in 2006 than in 2000 to respond to an illness by using formal healthcare providers. Trends in provider selection differed, however. The probability of using public services from the MoH increased among the poorest population, while the findings indicated an increase in utilization of private health services among members of low- and middle-income groups. No significant change was seen among formal workers -covered by social security services-, regardless of socioeconomic status. Overall, for 2006 the Mexican population appears less differentiated in using healthcare across economic groups than in 2000. This may be related, in part, to the implementation of Seguro Popular, which seems to be stimulating healthcare demand among the poorest and previously uninsured segment of the population. Still, public health authorities need to address the remaining income-related healthcare utilization differences, the differences in quality between public and private health services, and the general perception that MoH facilities offer inferior services.

5 CFR 2638.304 - Form of requests for formal advisory opinions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Form of requests for formal advisory opinions. 2638.304 Section 2638.304 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS... Service § 2638.304 Form of requests for formal advisory opinions. (a) A request for a formal advisory...

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

Co-production in practice: how people with assisted living needs can help design and evolve technologies and services.

PubMed

Wherton, Joseph; Sugarhood, Paul; Procter, Rob; Hinder, Sue; Greenhalgh, Trisha

2015-05-26

The low uptake of telecare and telehealth services by older people may be explained by the limited involvement of users in the design. If the ambition of 'care closer to home' is to be realised, then industry, health and social care providers must evolve ways to work with older people to co-produce useful and useable solutions. We conducted 10 co-design workshops with users of telehealth and telecare, their carers, service providers and technology suppliers. Using vignettes developed from in-depth ethnographic case studies, we explored participants' perspectives on the design features of technologies and services to enable and facilitate the co-production of new care solutions. Workshop discussions were audio recorded, transcribed and analysed thematically. Analysis revealed four main themes. First, there is a need to raise awareness and provide information to potential users of assisted living technologies (ALTs). Second, technologies must be highly customisable and adaptable to accommodate the multiple and changing needs of different users. Third, the service must align closely with the individual's wider social support network. Finally, the service must support a high degree of information sharing and coordination. The case vignettes within inclusive and democratic co-design workshops provided a powerful means for ALT users and their carers to contribute, along with other stakeholders, to technology and service design. The workshops identified a need to focus attention on supporting the social processes that facilitate the collective efforts of formal and informal care networks in ALT delivery and use.

Understanding How to Support Family Caregivers of Seniors with Complex Needs

PubMed Central

Charles, Lesley; Brémault-Phillips, Suzette; Parmar, Jasneet; Johnson, Melissa; Sacrey, Lori-Ann

2017-01-01

Purpose of the Study The purpose of this study was to describe the experiences and challenges of supporting family caregivers of seniors with complex needs and to outline support strategies and research priorities aimed at supporting them. Design and Methods A CIHR-funded, two-day conference entitled “Supporting Family Caregivers of Seniors: Improving Care and Caregiver Outcomes” was held. An integrated knowledge translation approach guided this planning conference. Day 1 included presentations of research evidence, followed by participant engagement Qualitative data was collected regarding facilitators, barriers/gaps, and recommendations for the provision of caregiver supports. Day 2 focused on determination of research priorities. Results Identified facilitators to the provision of caregiver support included accessibility of health-care and community-based resources, availability of well-intended health-care providers, and recognition of caregivers by the system. Barriers/gaps related to challenges with communication, access to information, knowledge of what is needed, system navigation, access to financial resources, and current policies. Recommendations regarding caregiver services and research revolved around assisting caregivers to self-identify and seek support, formalizing caregiver supports, centralizing resources, making system navigation available, and preparing the next generation for caregiving. Implication A better understanding of the needs of family caregivers and ways to support them is critical to seniors’ health services redesign. PMID:28690707

The Day-to-Day Co-Production of Ageing in Place.

PubMed

Procter, Rob; Greenhalgh, Trisha; Wherton, Joe; Sugarhood, Paul; Rouncefield, Mark; Hinder, Sue

We report findings from a study that set out to explore the experience of older people living with assisted living technologies and care services. We find that successful 'ageing in place' is socially and collaboratively accomplished - 'co-produced' - day-to-day by the efforts of older people, and their formal and informal networks of carers (e.g. family, friends, neighbours). First, we reveal how 'bricolage' allows care recipients and family members to customise assisted living technologies to individual needs. We argue that making customisation easier through better design must be part of making assisted living technologies 'work'. Second, we draw attention to the importance of formal and informal carers establishing and maintaining mutual awareness of the older person's circumstances day-to-day so they can act in a concerted and coordinated way when problems arise. Unfortunately, neither the design of most current assisted living technologies, nor the ways care services are typically configured, acknowledges these realities of ageing in place. We conclude that rather than more 'advanced' technologies, the success of ageing in place programmes will depend on effortful alignments in the technical, organisational and social configuration of support.

Congressional Submission RDT&E Descriptive Summaries, FY 1994

DTIC Science & Technology

1993-04-01

U) Extremely High Frequency (EHF) lower cost, communication technologies ( ASTEC ) will be developed to support the ASD/C 3 1 MILSATCOM modernization...restructured and formalized into the ASTEC , CAMEO and IMPACT Programs. F. (U) PROGRAM DOCUMENTATION: * (U) U.S. Air Force/DARPA MOA dated 1988 * (U) U.S...Army/DARPA MOA dated 1990 * (U) SDIO/DARPA MOA dated 1990 * (U) DARPA/U.S. Air Force TAOS MOA dated 1992 * (U) DARPA/Joint Services ASTEC MOA (in

Technical Review of Water-Resources Investigations of the Tule Desert, Lincoln County, Southern Nevada

USGS Publications Warehouse

Berger, David L.; Halford, Keith J.; Belcher, Wayne R.; Lico, Michael S.

2008-01-01

The Nevada State Engineer in Ruling No. 5181 required Lincoln County and Vidler Water Company, Inc., to provide results from additional water-resources studies of Tule Desert in southern Nevada to support water-rights application 64692. As outlined by the ruling, the additional studies were to include the determination of the amount of ground water available from the Tule Desert basin, ground-water recharge to the Tule Desert, and the direction of ground-water flow. Results of these additional studies were published in five reports prepared for Lincoln County and Vidler Water Company, Inc. The National Park Service formally requested that the U.S. Geological Survey provide technical reviews of these five reports. The Nevada State Engineer in Ruling No. 5181 required Lincoln County and Vidler Water Company, Inc., to provide results from additional water-resources studies of Tule Desert in southern Nevada to support water-rights application 64692. As outlined by the ruling, the additional studies were to include the determination of the amount of ground water available from the Tule Desert basin, ground-water recharge to the Tule Desert, and the direction of ground-water flow. Results of these additional studies were published in five reports prepared for Lincoln County and Vidler Water Company, Inc. The National Park Service formally requested that the U.S. Geological Survey provide technical reviews of these five reports.

Use-Inspired Data Information Services for NOAA's National Centers for Environmental Information

NASA Astrophysics Data System (ADS)

Owen, T.

2015-12-01

Leveraging environmental data and information to make specific, informed decisions is critical to the Nation's economy, environment, and public safety. The ability to successfully transform past and recent data into environmental intelligence is predicated on the articulation of use-inspired, actionable requirements for product and service development. With the formation of the National Centers for Environmental Information (NCEI), there is a unique opportunity to revolutionize the delivery of information services in support of customer requirements. Such delivery cuts across the disciplines of meteorology, geophysics, and oceanography, as well as regions and sectors for the United States. At NCEI, information services are based on a two-way dialogue that (i) raises awareness of environmental data products and services and (ii) captures user needs for product and services sustainment and development. To this end, NCEI information services has developed a formal process for collecting user needs and translating them into requirements. This process reflects economically-prevalent and regionally-focused sectors based on Census Bureau classifications.

Refocusing and Evolving Subseasonal-to-Seasonal Services in NOAA's National Weather Service

NASA Astrophysics Data System (ADS)

Timofeyeva-Livezey, M. M.; Horsfall, F. M. C.; Silva, V.; Mangan, M. R.; Meyers, J. C.; Zdrojewski, J.

2017-12-01

NOAA's National Weather Service (NWS) recently completed a reorganization to better support its goal to build a Weather-Ready Nation. As part of the reorganization, NWS streamlined its 11 national service programs, including climate services, to provide a more structured approach to supporting service delivery needs. As the American public increasingly requests information at sub-seasonal and seasonal time scales for decision making, the NWS Climate Services Program is striving to meet those needs by accelerating transition of research to operations, improving delivery of products and services, and enhancing partnerships to facilitate provision of seamless weather, water, and climate products and services at regional and local scales. Additionally, NWS forecasters are requesting more tools to be able to put severe weather and water events into a climate context to provide more effective impact-based decision support services (IDSS). This paper will describe the activities to more effectively integrate climate services into the NWS suite of environmental information, the roles of the NWS offices supporting or delivering sub-seasonal and seasonal information to the US public, and engaging NWS core and deep-core partners in provision of information on climatological risks and preparedness as a part of IDSS. We will discuss the process by which we collect user requests and/or needs and the NWS process that allows us to move these requests and needs through a formal requirements validation process and thus place the requirement on a path to identify a potential solution for implementation. The validation of a NWS climate-related requirement is also key to identify research, development, and transition mission delivery needs that are supported through the Office of Oceanic and Atmospheric Research (OAR) Climate Program Office (CPO). In addition, we will present the outcomes of key actions of the first ever NWS National Climate Services Meeting (NCSM) that was held in May 2016 with the participation of more than 250 NWS climate services staff and key partners from across the country. The key actions include understanding core and deep-core partners, advancing training for NWS staff focused on IDSS, and better organization of service delivery at regional and local levels.

Long-term care planning and preparation among persons with multiple sclerosis.

PubMed

Putnam, Michelle; Tang, Fengyan

2008-01-01

Individuals with multiple sclerosis (MS) primarily rely on informal supports such as family members and assistive technology to meet their daily needs. As they age, formal supports may become important to compliment these supports and sustain community-based living. No previous research exists exploring plans and preparations of persons with MS for future independent living and long-term care needs. We analyzed data from a random sample survey (N = 580) to assess knowledge and perceptions of future service needs using ANOVA, chi-square, correlations, and MANOVA procedures. Results indicate that overall, most respondents are not well informed and have not planned or prepared for future care needs. Persons reporting severe MS were more likely to plan and prepare. Key "entry points" for making preparations include receiving specific education and planning information, discussions with family and professional service providers, and increased age, education, and income. We recommend greater infusion of long-term care planning into these existing entry points and creation of new entry points including healthcare provides and insurers.

Implementing nurse prescribing: a case study in diabetes.

PubMed

Stenner, Karen; Carey, Nicola; Courtenay, Molly

2010-03-01

This paper is a report of a study exploring the views of nurses and team members on the implementation of nurse prescribing in diabetes services. Nurse prescribing is adopted as a means of improving service efficiency, particularly where demand outstretches resources. Although factors that support nurse prescribing have been identified, it is not known how these function within specific contexts. This is important as its uptake and use varies according to mode of prescribing and area of practice. A case study was undertaken in nine practice settings across England where nurses prescribed medicines for patients with diabetes. Thematic analysis was conducted on qualitative data from 31 semi-structured interviews undertaken between 2007 and 2008. Participants were qualified nurse prescribers, administrative staff, physicians and non-nurse prescribers. Nurses prescribed more often following the expansion of nurse independent prescribing rights in 2006. Initial implementation problems had been resolved and few current problems were reported. As nurses' roles were well-established, no major alterations to service provision were required to implement nurse prescribing. Access to formal and informal resources for support and training were available. Participants were accepting and supportive of this initiative to improve the efficiency of diabetes services. The main factors that promoted implementation of nurse prescribing in this setting were the ability to prescribe independently, acceptance of the prescribing role, good working relationships between doctors and nurses, and sound organizational and interpersonal support. The history of established nursing roles in diabetes care, and increasing service demand, meant that these diabetes services were primed to assimilate nurse prescribing.

Formalized landscape models for surveying and modelling tasks

NASA Astrophysics Data System (ADS)

Löwner, Marc-Oliver

2010-05-01

We present a formalization of main geomorphic landscape models, mainly the concept of slopes, to clarify the needs and potentials of surveying technologies and modelling approaches. Using the Unified Modelling Language (UML) it is implemented as a exchangeable Geography Markup Language (GML3) -based application schema and therefore supports shared measurement campaigns. Today, knowledge in Geomorphology is given synoptically in textbooks in a more or less lyrical way. This knowledge is hard to implement for the use of modelling algorithms or data storage and sharing questions. On the other hand physical based numerical modelling and high resolution surveying technologies enable us to investigate case scenarios within small scales. Bringing together such approaches and organizing our data in an appropriate way will need the formalization of the concepts and knowledge that is archived in the science of geomorphology. The main problem of comparing research results in geomorphology but is that the objects under investigation are composed of 3-dimensional geometries that change in time due to processes of material fluxes, e. g. soil erosion or mass movements. They have internal properties, e. g. soil texture or bulk density, that determine the effectiveness of these processes but are under change as well. The presented application schema is available on the Internet and therefore a first step to enable researchers to share information using an OGC's Web feature service. In this vein comparing modelling results of landscape evolution with results of other scientist's observations is possible. Compared to prevalent data concepts the model presented makes it possible to store information about landforms, their geometry and the characteristics in more detail. It allows to represent the 3D-geometry, the set of material properties and the genesis of a landform by associating processes to a geoobject. Thus, time slices of a geomorphic system can be represented as well as scenarios of landscape modelling. Commercial GI-software is not adapted to the needs of the science of geomorphology. Therefore the development of an application model i. e. a formal description of semantics is imperative to partake in technologies like Web Feature Services supporting interoperable data transfer.

The UK Haemophilia Doctors Organisation triennial audit of UK Comprehensive Care Haemophilia Centres.

PubMed

Wilde, J T

2012-07-01

Under the auspices of the United Kingdom Haemophilia Doctors Organisation (UKHCDO) the UK Comprehensive Care Haemophilia Centres (CCCs) have undergone a three yearly formal audit assessment since 1993. This report describes the evolution of the audit process and details the findings of the most recent audit round, the sixth since inception. The audit reports from the 2009 audit round were reviewed by the audit organizing group and a structured analysis of the data was compiled. CCCs in the UK offer a high standard of comprehensive care services. The main areas of concern were the state of the premises (seven centres), lack of dental services (seven centres), physiotherapy (seven centres) and social work support (11 centres). Major concerns were identified at eight centres requiring a formal letter from the chairman of UKHCDO to the chief executive of the host trust. Since inception of the triennial audit process centre report recommendations have resulted in major improvements in the services available at UK CCCs. The audit process is considered to be a highly effective means of improving the quality of care for patients with bleeding disorders and can be used as a model for the introduction of a similar process in other countries. © 2012 Blackwell Publishing Ltd.

Formal strategy in public hospitals.

PubMed

Denis, J; Langley, A; Lozeau, D

1991-02-01

This paper suggests that the difficulties associated with the application of formal strategic planning in public professional service organizations may have been underestimated in much of the literature. A survey of written strategic plans produced by Canadian hospitals showed that these plans were often heavily oriented towards expansion, ambiguous and rather loosely integrated, leading to questions concerning their realism and utility as a basis for strategic decisions. This phenomenon seems symptomatic of the complex (and often highly political) decision making environment faced by hospital administrators (and by managers of other professional service organizations such as universities and social service agencies). It is concluded that the benefits of formal planning may be different and less tangible for these organizations than for private business.

18 CFR 2.1 - Initial notice; service; and information copies of formal documents.

Code of Federal Regulations, 2011 CFR

2011-04-01

...] (iii) Hydroelectric, Federal Power Act. (A) Applications for preliminary permits pursuant to section 4... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Initial notice; service; and information copies of formal documents. 2.1 Section 2.1 Conservation of Power and Water Resources...

Developing a change model for peer worker interventions in mental health services: a qualitative research study.

PubMed

Gillard, S; Gibson, S L; Holley, J; Lucock, M

2015-10-01

A range of peer worker roles are being introduced into mental health services internationally. There is some evidence that attests to the benefits of peer workers for the people they support but formal trial evidence in inconclusive, in part because the change model underpinning peer support-based interventions is underdeveloped. Complex intervention evaluation guidance suggests that understandings of how an intervention is associated with change in outcomes should be modelled, theoretically and empirically, before the intervention can be robustly evaluated. This paper aims to model the change mechanisms underlying peer worker interventions. In a qualitative, comparative case study of ten peer worker initiatives in statutory and voluntary sector mental health services in England in-depth interviews were carried out with 71 peer workers, service users, staff and managers, exploring their experiences of peer working. Using a Grounded Theory approach we identified core processes within the peer worker role that were productive of change for service users supported by peer workers. Key change mechanisms were: (i) building trusting relationships based on shared lived experience; (ii) role-modelling individual recovery and living well with mental health problems; (iii) engaging service users with mental health services and the community. Mechanisms could be further explained by theoretical literature on role-modelling and relationship in mental health services. We were able to model process and downstream outcomes potentially associated with peer worker interventions. An empirically and theoretically grounded change model can be articulated that usefully informs the development, evaluation and planning of peer worker interventions.

Who Helps the Helpers? Social Support for Rape Crisis Advocates.

PubMed

Houston-Kolnik, Jaclyn D; Odahl-Ruan, Charlynn A; Greeson, Megan R

2017-08-01

Secondary exposure to trauma may have negative effects on rape victim advocates' well-being. Self-care can help to mitigate these negative effects on advocates' well-being, and prior research suggests that social support is an especially important aspect of advocates' self-care. However, there is a lack of research on how rape crisis advocates access and receive social support in relationship to their advocacy work. Therefore, semistructured qualitative interviews were conducted with 15 rape crisis advocates who volunteered for a rape crisis center in Chicago to understand how they accessed social support from informal and formal support providers, and when they did receive support, what was helpful versus unhelpful. Data were analyzed using thematic content analysis. Results revealed that many advocates were able to seek out and receive positive instrumental and emotional social support that nurtured them and their work. However, advocates also experienced a variety of barriers to obtaining positive support from informal support providers, including fear of burdening providers and a reluctance or lack of preparedness of their support providers to speak about the issue. Advocates emphasized the need for rape crisis centers to provide resources for their informal social support systems in order to encourage helpful responses. In addition, advocates praised the rape crisis center for its built-in formal support structures, but also encouraged the organization to seek broader representation of persons from minority backgrounds among their advocates and mentors. Implications and future directions for research and rape crisis centers are also discussed. The present study highlights the importance of social support systems for advocates and potential barriers that may be addressed to reduce service provider burnout and vicarious trauma.

Breastfeeding education and support services offered to pediatric residents in the US.

PubMed

Osband, Yardaena B; Altman, Robin L; Patrick, Patricia A; Edwards, Karen S

2011-01-01

The American Academy of Pediatrics (AAP) encourages pediatricians to support the practice of breastfeeding and residency educators to develop formal curricula in breastfeeding education. Few studies, however, describe breastfeeding education or support services currently provided to pediatric residents in the United States. The goals of this study were to investigate breastfeeding training offered during 3-year pediatric residency programs and to describe residency programs' policies and services for residents who breastfeed. We conducted a cross-sectional study using a Web-based survey of pediatric program directors regarding breastfeeding education and support services for residents. Seventy percent of program directors (132 of 189) completed the survey, with 77.3% of respondents (n = 102) estimating the amount of breastfeeding education offered to their pediatric residents. Residents are provided with a median total of 9.0 hours of breastfeeding training over 3 years, primarily in continuity clinic and in lectures and rounds with attendings. At the programs' primary teaching hospitals, breastfeeding residents are provided breastfeeding rooms (67.0%), breast pumps (75.3%), and breast milk storage facilities (87.6%). Only 10 programs reported having an official policy to accommodate breastfeeding residents. Pediatric residents receive approximately 3 hours of breastfeeding training per year. In addition, there is less than universal implementation by residency programs of AAP recommendations for supporting breastfeeding in the workplace. Pediatric residency programs should find ways to improve and assess the quality of breastfeeding education and workplace support to better role model this advocacy standard. Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Portfolio careers for medical graduates: implications for postgraduate training and workforce planning.

PubMed

Eyre, Harris A; Mitchell, Rob D; Milford, Will; Vaswani, Nitin; Moylan, Steven

2014-06-01

Portfolio careers in medicine can be defined as significant involvement in one or more portfolios of activity beyond a practitioner's primary clinical role, either concurrently or in sequence. Portfolio occupations may include medical education, research, administration, legal medicine, the arts, engineering, business and consulting, leadership, politics and entrepreneurship. Despite significant interest among junior doctors, portfolios are poorly integrated with prevocational and speciality training programs in Australia. The present paper seeks to explore this issue. More formal systems for portfolio careers in Australia have the potential to increase job satisfaction, flexibility and retention, as well as diversify trainee skill sets. Although there are numerous benefits from involvement in portfolio careers, there are also risks to the trainee, employing health service and workforce modelling. Formalising pathways to portfolio careers relies on assessing stakeholder interest, enhancing flexibility in training programs, developing support programs, mentorship and coaching schemes and improving support structures in health services.

The Informal Economy: Recent Trends, Future Directions.

PubMed

Chen, Martha Alter

2016-08-01

Informal employment represents more than half of nonagricultural employment in most developing regions, contributes to the overall economy, and provides pathways to reduction of poverty and inequality. Support to the informal economy should include the expansion of occupational health and safety to include informal workers, based on an analysis of their work places and work risks. The paper presents main schools of thought and argues for a holistic understanding of the different segments of the informal work force and for policies and interventions tailored to the needs and constraints of these different segments. The paper recommends a policy approach which seeks to extend social protection, including occupational health and safety services, to informal workers, and to increase the productivity of informal enterprises and informal workers through an enabling environment and support services. The paper calls for a new paradigm of a hybrid economy which would value and integrate the informal economy alongside the formal economies. © The Author(s) 2016.

The stories of older parents of adult sons and daughters with autism: a balancing act.

PubMed

Hines, Monique; Balandin, Susan; Togher, Leanne

2014-03-01

Researchers acknowledge the importance of understanding how families of children with autism cope. Yet, little is known about the experiences of older parents of adults with autism. In-depth interviews were conducted with 16 older parents of adults with autism. Narrative analysis was used to gain insights into their lived experiences. Participants' narratives reflected the notion that much of their experience was a delicate balancing act as they attempted to manage their offspring's symptoms of autism whilst achieving a degree of fulfilment in their own lives. Parents did not believe that formal services had adequately supported their ability to provide care whilst meeting other needs within the family context. The findings have implications for services that attempt to support older parents' abilities to provide care, including the need for tailored intervention strategies that match each family's unique needs. © 2013 John Wiley & Sons Ltd.

Impact of provider level, training and gender on the utilization of palliative care and hospice in neuro-oncology: a North-American survey.

PubMed

Walbert, Tobias; Glantz, Michael; Schultz, Lonni; Puduvalli, Vinay K

2016-01-01

Specialized palliative care (PC) services have emerged to address symptoms and provide end-of-life management for patients with brain tumors. The utilization patterns of PC in neuro-oncology are unknown. A 22-question survey was distributed to participants of the society for neuro-oncology annual meeting 2012 (n = 4487). Nonparametric methods including Wilcoxon two-sample and Kruskal-Wallis tests were used to assess differences in responses. 239 (5.3 %) evaluable responses were received; 79 % of respondents were physicians, and 17 % were nurses or midlevel providers. Forty-seven percent were medical or neuro-oncologists, 31 % neurosurgeons and 11 % radiation oncologists. Forty percent had no formal training in PC, 57 % had some formal training and 3 % completed a PC fellowship. Seventy-nine percent practiced in an academic setting. Of the respondents, 57 % referred patients to PC when symptoms required treatment and 18 % at end of life. Only 51 % of all providers felt comfortable dealing with end-of-life issues and symptoms, while 33 % did not. Fifty-one percent preferred a service named "Supportive Care" rather than "Palliative Care" (MDs > midlevel providers, p < 0.001), and 32 % felt that patient expectations for ongoing therapy hindered their ability to make PC referrals. Female gender, formal training in neuro-oncology and PC, and medical versus surgical neuro-oncology training were significantly associated with hospice referral, comfort in dealing with end-of-life issues, and ease of access to PC services. Provider level, specialty, gender, training in PC and neuro-oncology have significant impact on the utilization of PC and hospice in neuro-oncology.

Utilisation of formal and informal care and services at home among persons with dementia: a cross-sectional study.

PubMed

Bökberg, Christina; Ahlström, Gerd; Karlsson, Staffan

2017-09-04

The progression of dementia disease implies increasing needs for both informal and formal care and services but also risk of institutionalisation. To better adjust care and services in the phase preceding institutionalisation it is important to find out whether utilisation of formal and informal care and services is determined by increased needs and by who meets the needs. The aim was to compare persons with dementia (65+) with different levels of cognitive impairment, regarding utilisation of formal and informal care and service at home. The participants consisted of 177 persons with dementia ≥65 years old and at risk of nursing home admission, divided into groups according to their cognitive function. Structured interviews were conducted based on questionnaires about type and amount of formal and informal care utilised, as well as questions regarding cognitive impairment, dependency in activities of daily living (ADLs) and neuropsychiatric symptoms. To analyse the data, descriptive and comparative statistics were used. The findings revealed that the group with severe dementia used significantly more help with ADLs and supervision in terms of time (number of hours and days) provided by the informal caregiver, compared with the group with moderate dementia. Utilisation of formal care and services was highest in the group with the most severe cognitive impairments (Standardized Mini-Mental State Examination score of <9). The group with severe dementia were more dependent in ADLs and had more neuropsychiatric symptoms (hallucinations and motor disturbances). They were younger and more often cohabitated with the informal caregiver, compared with the group with moderate dementia. This study shows that in the phase preceding institutionalisation the ADL and supervision needs due to progression of dementia appear to tend to be met first and foremost by the informal caregivers. © 2017 Nordic College of Caring Science.

Engaging Scientists in NASA Education and Public Outreach: K - 12 Formal Education

NASA Astrophysics Data System (ADS)

Bartolone, Lindsay; Smith, D. A.; Eisenhamer, B.; Lawton, B. L.; Universe Professional Development Collaborative, Multiwavelength; NASA Data Collaborative, Use of; SEPOF K-12 Formal Education Working Group; E/PO Community, SMD

2014-01-01

The NASA Science Education and Public Outreach Forums support the NASA Science Mission Directorate (SMD) and its education and public outreach (E/PO) community through a coordinated effort to enhance the coherence and efficiency of SMD-funded E/PO programs. The Forums foster collaboration between scientists with content expertise and educators with pedagogy expertise. We present opportunities for the astronomy community to participate in collaborations supporting the NASA SMD efforts in the K - 12 Formal Education community. Members of the K - 12 Formal Education community include classroom educators, homeschool educators, students, and curriculum developers. The Forums’ efforts for the K - 12 Formal Education community include a literature review, appraisal of educators’ needs, coordination of audience-based NASA resources and opportunities, professional development, and support with the Next Generation Science Standards. Learn how to join in our collaborative efforts to support the K - 12 Formal Education community based upon mutual needs and interests.

ICT services for active ageing and independent living: identification and assessment.

PubMed

Christophorou, Christophoros; Kleanthous, Styliani; Georgiadis, Dimosthenis; Cereghetti, Donato M; Andreou, Panayiotis; Wings, Cindy; Christodoulou, Eleni; Samaras, George

2016-09-01

Based on the demographic changes and the rapid increase of older population in Europe, major challenges are expected to rise, both in the economy as well as the society, whether the dominant care model for supporting elderly in living independently at home continues to rely on informal and formal caregivers' assistance. To respond to the above challenges, assistive technologies are called to develop Information and Communication Technology (ICT) services for supporting seniors to remain active and independent, for as long as possible, in their chosen home environment. The work described in this Letter is based on the Miraculous-Life project and it emphasises the identification and assessment of a set of services that an ICT system for Ageing Well should support, in an actual end-users setting. The outcome of this work may inform fellow researchers and other projects in the area of Ageing Well in: (i) understanding which ICT services can be the most valuable for end-users' Quality of Life, (ii) prioritising the development of related ICT services and (iii) facilitating better recourse allocation in order to reduce any risks associated to implementation failures of these services within their respective projects. A final trial phase is planned, aiming to validate the Miraculous Life prototype longitudinally in a naturalistic environment with a larger sample size. During this trial, it will be investigated if perceived usefulness, satisfaction and motivation could be predicted by sociodemographic variables and personality.

The Willingness of Military Members to Seek Help: The Role of Social Involvement and Social Responsibility.

PubMed

Bowen, Gary L; Jensen, Todd M; Martin, James A; Mancini, Jay A

2016-03-01

Anchored in the social organization theory of action and change, we use data from a large sample of active-duty Air Force members to examine the direct and indirect influence of social involvement and social responsibility on willingness to seek help in times of need via trust in formal systems and informal supports. Group comparisons are conducted between junior male, junior female, senior male, and senior female service members. The key mediational path in the model for all groups is the connection between social involvement and willingness to seek help via trust in formal systems. These results can inform both unit- and community-level interventions intended to increase the likelihood that active-duty AF members will seek help in times of need. © Society for Community Research and Action 2016.

Sources and directions of social support and life satisfaction among solitary Chinese older adults in Hong Kong: the mediating role of sense of loneliness.

PubMed

Bai, Xue; Yang, Shuyan; Knapp, Martin

2018-01-01

Based on survey data collected from 151 community-dwelling solitary Chinese older adults in Hong Kong, the present study used path analysis to examine the mediating role of sense of loneliness in the relationship between different sources and directions of social support and life satisfaction. The results showed that sense of loneliness mediated the effects of support from families, friends, and support for others on life satisfaction. In addition, a formal source of social support was not associated with life satisfaction among solitary older adults, although those with a more secure financial status had greater overall life satisfaction. These findings highlight the importance of enhancing awareness among social and health care service providers about the negative effects of insufficient social support on older adults' sense of loneliness and life satisfaction. Family and friendship networks should be expanded for solitary older adults.

Sources and directions of social support and life satisfaction among solitary Chinese older adults in Hong Kong: the mediating role of sense of loneliness

PubMed Central

Bai, Xue; Yang, Shuyan; Knapp, Martin

2018-01-01

Based on survey data collected from 151 community-dwelling solitary Chinese older adults in Hong Kong, the present study used path analysis to examine the mediating role of sense of loneliness in the relationship between different sources and directions of social support and life satisfaction. The results showed that sense of loneliness mediated the effects of support from families, friends, and support for others on life satisfaction. In addition, a formal source of social support was not associated with life satisfaction among solitary older adults, although those with a more secure financial status had greater overall life satisfaction. These findings highlight the importance of enhancing awareness among social and health care service providers about the negative effects of insufficient social support on older adults’ sense of loneliness and life satisfaction. Family and friendship networks should be expanded for solitary older adults. PMID:29379277

Defense Manpower Commission Staff Studies and Supporting Papers. Volume 3. Military Recruitment and Accessions and Future of the All Volunteer Force

DTIC Science & Technology

1976-05-01

active duty end additional Reserve recruiters were assigned to large ustropeliten areas. * The relationship of AF Reserve recruiting functions io...headquarters. There Also is a marked contrast between the Services in the comand relationship between recruiting and the initial training of recruits...the Deputy Chief of Staff, Personnel. Thus, the only formal command relationship between the two waste st the Office of the Chief of Staff. The sm

47 CFR 7.16 - Informal or formal complaints.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Informal or formal complaints. 7.16 Section 7.16 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO VOICEMAIL AND INTERACTIVE MENU SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Enforcement § 7.16 Informal or formal...

47 CFR 7.16 - Informal or formal complaints.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Informal or formal complaints. 7.16 Section 7.16 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO VOICEMAIL AND INTERACTIVE MENU SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Enforcement § 7.16 Informal or formal...

47 CFR 7.16 - Informal or formal complaints.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Informal or formal complaints. 7.16 Section 7.16 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO VOICEMAIL AND INTERACTIVE MENU SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Enforcement § 7.16 Informal or formal...

47 CFR 7.16 - Informal or formal complaints.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false Informal or formal complaints. 7.16 Section 7.16 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO VOICEMAIL AND INTERACTIVE MENU SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Enforcement § 7.16 Informal or formal...

47 CFR 7.16 - Informal or formal complaints.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false Informal or formal complaints. 7.16 Section 7.16 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO VOICEMAIL AND INTERACTIVE MENU SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Enforcement § 7.16 Informal or formal...

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. Copyright © 2015 John Wiley & Sons, Ltd.

Development of a case-mix funding system for adults with combined vision and hearing loss

PubMed Central

2013-01-01

Background Adults with vision and hearing loss, or dual sensory loss (DSL), present with a wide range of needs and abilities. This creates many challenges when attempting to set the most appropriate and equitable funding levels. Case-mix (CM) funding models represent one method for understanding client characteristics that correlate with resource intensity. Methods A CM model was developed based on a derivation sample (n = 182) and tested with a replication sample (n = 135) of adults aged 18+ with known DSL who were living in the community. All items within the CM model came from a standardized, multidimensional assessment, the interRAI Community Health Assessment and the Deafblind Supplement. The main outcome was a summary of formal and informal service costs which included intervenor and interpreter support, in-home nursing, personal support and rehabilitation services. Informal costs were estimated based on a wage rate of half that for a professional service provider ($10/hour). Decision-tree analysis was used to create groups with homogeneous resource utilization. Results The resulting CM model had 9 terminal nodes. The CM index (CMI) showed a 35-fold range for total costs. In both the derivation and replication sample, 4 groups (out of a total of 18 or 22.2%) had a coefficient of variation value that exceeded the overall level of variation. Explained variance in the derivation sample was 67.7% for total costs versus 28.2% in the replication sample. A strong correlation was observed between the CMI values in the two samples (r = 0.82; p = 0.006). Conclusions The derived CM funding model for adults with DSL differentiates resource intensity across 9 main groups and in both datasets there is evidence that these CM groups appropriately identify clients based on need for formal and informal support. PMID:23587314

Selecting services for a service robot: evaluating the problematic activities threatening the independence of elderly persons.

PubMed

Bedaf, Sandra; Gelderblom, Gert Jan; de Witte, Luc; Syrdal, Dag; Lehmann, Hagen; Amirabdollahian, Farshid; Dautenhahn, Kerstin; Hewson, David

2013-06-01

Sustaining independent living for the elderly is desirable both for the individual as well as for societies as a whole. Substantial care interventions are provided to citizens supporting their independent living. Currently, such interventions are primarily based on human care provision, but due to demographic changes the demand for such support is continuously increasing. Assistive Robotics has the potential to answer this growing demand. The notions research towards service robots that support the independence of elderly people has been given increased attention. The challenge is to develop robots that are able to adequately support with those activities that pose the greatest problems for elderly people seeking to remain independent. In order to develop the capabilities of the Care-O-bot 3 in the ACCOMPANY project, problematic activities that may threaten continued independent living of elderly people were studied. Focus groups were conducted in the Netherlands, UK, and France and included three separate user groups: (1) elderly (N=41), (2) formal caregivers (N=40), and (3) informal caregivers (N=32). This resulted in a top 3 of problematic activity domains that received the highest priority: (1) Mobility, (2) Self-care, and (3) Social isolation. The findings inform the further development of the Care-O-bot. In the ACCOMPANY project the Care-O-bot 3 will be developed further to enable it to support independently living older persons in one of these domains.

Design and Use of a Joint Order Vocabulary Knowledge Representation Tier in a Multi-tier CPOE Architecture

PubMed Central

Rucker, Donald W.; Steele, Andrew W.; Douglas, Ivor S.; Couderc, Carmela A.; Hardel, Gary G.

2006-01-01

Two major barriers to adoption of computerized physician order entry (CPOE) systems are the initial physician effort to learn the system and ongoing time costs to use the system. These barriers stem from the CPOE system’s need to reformulate physician orders into services that can be electronically communicated to ancillary clinical systems such as pharmacy, nursing, lab or radiology as well as to billing systems. Typical CPOE systems use significant custom user interface programming to match the terms used by physicians to order services as well as the aggregation of those orders into order sets with the underlying orderable services. We describe the design and implementation of a commercial CPOE system that has a formal separate intermediate mapping layer to match physician screen vocabulary and ordering behaviors to underlying services, both individually and in groups, supported by powerful search tools. PMID:17238425

Gender and ergonomics: a case study on the 'non-formal' work of women nurses.

PubMed

Salerno, Silvana; Livigni, Lucilla; Magrini, Andrea; Talamanca, Irene Figà

2012-01-01

Women's work activities are often characterised by 'non-formal actions' (such as giving support). Gender differences in ergonomics may be due to this peculiarity. We applied the method of organisational congruencies (MOC) to ascertain the 'non-formal' work portion of nurses employed in three hospital units (haematology, emergency room and general medicine) during the three work shifts in a major University Hospital in Rome, Italy. We recorded a total of 802 technical actions performed by nine nurses in 72 h of work. Twenty-six percent of the actions in direct patient's care were communicative actions (mainly giving psychological support) while providing physical care. These 'double actions' are often not considered to be a formal part of the job by hospital management. In our case study, the 'non-formal' work of nurses (psychological support) is mainly represented by double actions while taking physical care of the patients. The dual task paradigm in gender oriented research is discussed in terms of its implications in prevention in occupational health. The main purpose of the study was to assess all the formal and non-formal activities of women in the nursing work setting. Offering psychological support to patients is often not considered to be a formal part of the job. Our case study found that nurses receive no explicit guidelines on this activity and no time is assigned to perform it. In measuring the burden of providing psychological support to patients, we found that this is often done while nurses are performing tasks of physical care for the patients (double actions). The article discusses the significance of non-formal psychological work load of women nurses through double actions from the ergonomic point view.

Post-Acute Home Care and Hospital Readmission of Elderly Patients with Congestive Heart Failure

ERIC Educational Resources Information Center

Li, Hong; Morrow-Howell, Nancy; Proctor, Enola K.

2004-01-01

After inpatient hospitalization, many elderly patients with congestive heart failure (CHF) are discharged home and receive post-acute home care from informal (family) caregivers and formal service providers. Hospital readmission rates are high among elderly patients with CHF, and it is thought that use of informal and formal services may reduce…

Influences of Formal Learning, Personal Learning Orientation, and Supportive Learning Environment on Informal Learning

ERIC Educational Resources Information Center

Choi, Woojae; Jacobs, Ronald L.

2011-01-01

While workplace learning includes formal and informal learning, the relationship between the two has been overlooked, because they have been viewed as separate entities. This study investigated the effects of formal learning, personal learning orientation, and supportive learning environment on informal learning among 203 middle managers in Korean…

Well-Being and Support Systems of Taiwanese Mothers of Young Children with Developmental Disabilities

ERIC Educational Resources Information Center

Ho, Tzu-Hua

2013-01-01

This study investigated the influences of children's adaptive skills, problem behaviors, and parent support systems (informal support and formal professional support) on maternal well-being (health and stress) in Taiwanese mothers of young children with developmental disabilities. The study examined the moderating effects of formal support and…

Intimate partner violence victims' acceptance and refusal of on-site counseling in emergency departments: Predictors of help-seeking behavior explored through a 5-year medical chart review.

PubMed

Choi, Anna Wai-Man; Wong, Janet Yuen-Ha; Lo, Ruby Tsz-Fung; Chan, Pik-Ying; Wong, John Kit-Shing; Lau, Chu-Leung; Kam, Chak-Wah

2018-03-01

Healthcare services constitute the first formal support that many intimate partner violence (IPV) victims receive and a link to formal welfare and psychological support. The help-seeking behavior for psychosocial support, e.g., Accident and Emergency Departments (AED) onsite counseling, is key to developing effective support for IPV victims. This study aimed to strengthen the health-welfare support link to aid IPV prevention in AEDs by investigating the acceptance and refusal of on-site counseling by IPV victims. A retrospective cohort study retrieved and reviewed all records of IPV victims presenting at the AEDs of two Hong Kong hospitals between 2010 and 2014. A total of 157 male and 823 female IPV victims were identified, 295 of whom refused on-site counseling. Bivariate and multivariate analyses were performed to examine the association between help-seeking and demographic and violent injury-related factors. The odds of help-seeking via on-site counseling were significantly lower for victims with mental illness (aOR=0.49; 95% CI=0.27, 0.88). After controlling for all demographic characteristics, mental illness, and drug abuse information, sex remained an independent predictor of help-seeking (aOR=2.62; 95% CI=1.45, 4.74); victims who had experienced >2 abuse incidents were more likely to seek help than those who had experienced ≤2 abuse incidents (aOR=1.90; 95% CI=1.11, 3.26). The factors associated with help-seeking from on-site services by IPV victims reflect the need for multidisciplinary collaborative work aimed at IPV prevention. Healthcare professionals require training on how to promote help-seeking behavior targeted specifically for male and female IPV victims according to their needs and preferences. Copyright © 2018 Elsevier Inc. All rights reserved.

14 CFR 302.404 - Formal complaints.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Formal complaints. 302.404 Section 302.404 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) PROCEDURAL... business or the ends of justice. (e) Service. A formal complaint, and any amendments thereto, shall be...

One system's journey in creating a disclosure and apology program.

PubMed

Peto, Randolph R; Tenerowicz, Lynn M; Benjamin, Evan M; Morsi, Deborah S; Burger, Pamela K

2009-10-01

Patients experience adverse events more frequently than the public appreciates. A number of health systems have led the movement toward open, prompt, and compassionate disclosure of adverse events. In 2006 Baystate Health (BH) formed a disclosure advisory committee to design and implement an enhanced program to support prompt and skillful disclosure of adverse events. The proposed model for a disclosure and apology program resembled a consultation service, similar to a hospital ethics consultation service. BH hired an outside trainer to teach coaches/facilitators. Emotional support services were formalized and expanded not only for patients and families but also clinicians. THE EXPERIENCE SO FAR: Implementation of a formal disclosure and apology program has placed internal pressure on the organization to more promptly determine causality of adverse events and to respond to patient/family requests for information and/or assistance. Root causes and degree of system culpability are often not clear early after an event and sometimes are debated among the clinical team and the trained coaches/facilitators and risk managers. After a medical error, patients and families expect the organization to make changes to the system to prevent other patients from being harmed by the same mistake. To minimize the chance that patients and families feel that their suffering has been "in vain," health care systems will need to put systems in place to deliver on the promise to reduce the risk of future harm. Some of the challenges in sustaining such a program include the ability to promptly investigate, to accurately determine liability, to communicate empathetically even if unable to meet all patient/family expectations, and to ensure establishment of a just culture.

The Relative Contribution of Formal and Informal Organizational Work-Family Support

ERIC Educational Resources Information Center

Behson, Scott J.

2005-01-01

Recent work-family research has proposed that informal means of organizational work-family support (e.g., managerial support) are more useful than formal means of organizational work-family support (e.g., work-family benefit availability) in explaining variance in employee affective, intentional, and behavioral outcomes. However, the relative…

Accompaniment of second-trimester abortions: the model of the feminist Socorrista network of Argentina.

PubMed

Zurbriggen, Ruth; Keefe-Oates, Brianna; Gerdts, Caitlin

2018-02-01

Legal restrictions on abortion access impact the safety and timing of abortion. Women affected by these laws face barriers to safe care that often result in abortion being delayed. Second-trimester abortion affects vulnerable groups of women disproportionately and is often more difficult to access. In Argentina, where abortion is legally restricted except in cases of rape or threat to the health of the woman, the Socorristas en Red, a feminist network, offers a model of accompaniment wherein they provide information and support to women seeking second-trimester abortions. This qualitative analysis aimed to understand Socorristas' experiences supporting women who have second-trimester medication abortion outside the formal health care system. We conducted 2 focus groups with 16 Socorristas in total to understand experiences accompanying women having second-trimester medication abortion who were at 14-24 weeks' gestational age. We performed a thematic analysis of the data and present key themes in this article. The Socorristas strived to ensure that women had the power of choice in every step of their abortion. These cases required more attention and logistical, legal and medical risks than first-trimester care. The Socorristas learned how to help women manage the possibility of these risks and were comfortable providing this support. They understood their work as activism through which they aim to destigmatize abortion and advocate against patriarchal systems denying the right to abortion. Socorrista groups have shown that they can provide supportive, women-centered accompaniment during second-trimester medication abortions outside the formal health care system in a setting where abortion access is legally restricted. Second-trimester self-use of medication abortion outside of the formal health system supported by feminist activist groups could provide an alternative model for second-trimester care worldwide. More research is needed to document the safety and effectiveness of this accompaniment service-provision model. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

A STUDY OF FORMALLY ADVERTISED PROCUREMENT

DTIC Science & Technology

As a method of procuring goods and services, formally advertised procurement offers a number of advantages. These include the prevention of fraud and...two-thirds of all contracts are let in these cases. This is done by examining over 2,300 contracts let under formal advertising procedures. A measure of

47 CFR 7.22 - Formal complaints based on unsatisfied informal complaints.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Formal complaints based on unsatisfied informal complaints. 7.22 Section 7.22 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO VOICEMAIL AND INTERACTIVE MENU SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Enforcement § 7.22 Formal...

5 CFR 2638.311 - Copies of published formal advisory opinions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Copies of published formal advisory... Service § 2638.311 Copies of published formal advisory opinions. Each designated agency ethics official shall receive a copy of each published opinion. Copies will also be available to the public from the...

78 FR 35826 - Unfair Competitive Advantages; Enhancement of the Formal Complaint Process

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-14

... Postal Service to the time and expense of the discovery process. The Commission anticipates that allowing.... 1739] Unfair Competitive Advantages; Enhancement of the Formal Complaint Process AGENCY: Postal... enhance the formal complaint process in cases involving alleged violations of a law that prohibits the...

49 CFR Appendix E to Part 40 - SAP Equivalency Requirements for Certification Organizations

Code of Federal Regulations, 2011 CFR

2011-10-01

... formal education, in-service training, and professional development courses. Part of any professional counselor's development is participation in formal and non-formal education opportunities within the field... is important if the individual is to be considered a professional in the field of alcohol and drug...

39 CFR 3001.20 - Formal intervention.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Formal intervention. 3001.20 Section 3001.20... Applicability § 3001.20 Formal intervention. (a) Who may intervene. A notice of intervention will be entertained... interest of such nature that intervention is allowed by the Act, or appropriate to its administration. (b...

39 CFR 3001.20 - Formal intervention.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Formal intervention. 3001.20 Section 3001.20... Applicability § 3001.20 Formal intervention. (a) Who may intervene. A notice of intervention will be entertained... interest of such nature that intervention is allowed by the Act, or appropriate to its administration. (b...

39 CFR 3001.20 - Formal intervention.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Formal intervention. 3001.20 Section 3001.20... Applicability § 3001.20 Formal intervention. (a) Who may intervene. A notice of intervention will be entertained... interest of such nature that intervention is allowed by the Act, or appropriate to its administration. (b...

39 CFR 3001.20 - Formal intervention.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Formal intervention. 3001.20 Section 3001.20... Applicability § 3001.20 Formal intervention. (a) Who may intervene. A notice of intervention will be entertained... interest of such nature that intervention is allowed by the Act, or appropriate to its administration. (b...

47 CFR 7.22 - Formal complaints based on unsatisfied informal complaints.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Formal complaints based on unsatisfied informal complaints. 7.22 Section 7.22 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO VOICEMAIL AND INTERACTIVE MENU SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Enforcement § 7.22 Formal...

47 CFR 7.22 - Formal complaints based on unsatisfied informal complaints.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false Formal complaints based on unsatisfied informal complaints. 7.22 Section 7.22 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO VOICEMAIL AND INTERACTIVE MENU SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Enforcement § 7.22 Formal...

47 CFR 7.22 - Formal complaints based on unsatisfied informal complaints.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false Formal complaints based on unsatisfied informal complaints. 7.22 Section 7.22 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO VOICEMAIL AND INTERACTIVE MENU SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Enforcement § 7.22 Formal...

47 CFR 7.22 - Formal complaints based on unsatisfied informal complaints.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Formal complaints based on unsatisfied informal complaints. 7.22 Section 7.22 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO VOICEMAIL AND INTERACTIVE MENU SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Enforcement § 7.22 Formal...

How Can Data Drive Policy and Practice in Child Welfare? Making the Link in Canada.

PubMed

Fallon, Barbara; Filippelli, Joanne; Black, Tara; Trocmé, Nico; Esposito, Tonino

2017-10-14

Formal university-child welfare partnerships offer a unique opportunity to begin to fill the gaps in the child welfare knowledge base and link child welfare services to the realities of practice. With resources from a knowledge mobilization grant, a formal partnership was developed between the University of Toronto, clinicians, policy analysts, and researchers from child welfare agencies across Ontario. The key objectives of the grant included: (1) enhancing the capacity of service providers to access and analyze child welfare data to inform service and policy decisions; (2) integrating clinical expertise in service and policy decisions; and (3) developing a joint research agenda addressing high-priority knowledge gaps. This partnership was an opportunity to advance the evidence base with respect to service provision in Ontario and to create a culture of knowledge and evidence that would eventually support more complex research initiatives. Administrative data was analyzed for this partnership through the Ontario Child Abuse and Neglect Data System (OCANDS)-the first child welfare data system in Ontario to track child welfare-involved children and their families. Child welfare agencies identified recurrence as an important priority and agency-driven analyses were subsequently conducted on OCANDS generated recurrence Service Performance Indicators (SPI's). Using an urgent versus chronic investigative taxonomy for analyses, findings revealed that the majority of cases did not recur within 12 months and cases identified as chronic needs are more likely to return to the attention of child welfare authorities. One of the key outcomes of the partnership - helping agencies to understand their administrative data is described, as are considerations for next steps for future partnerships and research.

How Can Data Drive Policy and Practice in Child Welfare? Making the Link in Canada

PubMed Central

Filippelli, Joanne; Black, Tara; Trocmé, Nico; Esposito, Tonino

2017-01-01

Formal university–child welfare partnerships offer a unique opportunity to begin to fill the gaps in the child welfare knowledge base and link child welfare services to the realities of practice. With resources from a knowledge mobilization grant, a formal partnership was developed between the University of Toronto, clinicians, policy analysts, and researchers from child welfare agencies across Ontario. The key objectives of the grant included: (1) enhancing the capacity of service providers to access and analyze child welfare data to inform service and policy decisions; (2) integrating clinical expertise in service and policy decisions; and (3) developing a joint research agenda addressing high-priority knowledge gaps. This partnership was an opportunity to advance the evidence base with respect to service provision in Ontario and to create a culture of knowledge and evidence that would eventually support more complex research initiatives. Administrative data was analyzed for this partnership through the Ontario Child Abuse and Neglect Data System (OCANDS)—the first child welfare data system in Ontario to track child welfare-involved children and their families. Child welfare agencies identified recurrence as an important priority and agency-driven analyses were subsequently conducted on OCANDS generated recurrence Service Performance Indicators (SPI’s). Using an urgent versus chronic investigative taxonomy for analyses, findings revealed that the majority of cases did not recur within 12 months and cases identified as chronic needs are more likely to return to the attention of child welfare authorities. One of the key outcomes of the partnership — helping agencies to understand their administrative data is described, as are considerations for next steps for future partnerships and research. PMID:29036894

Extension of specification language for soundness and completeness of service workflow

NASA Astrophysics Data System (ADS)

Viriyasitavat, Wattana; Xu, Li Da; Bi, Zhuming; Sapsomboon, Assadaporn

2018-05-01

A Service Workflow is an aggregation of distributed services to fulfill specific functionalities. With ever increasing available services, the methodologies for the selections of the services against the given requirements become main research subjects in multiple disciplines. A few of researchers have contributed to the formal specification languages and the methods for model checking; however, existing methods have the difficulties to tackle with the complexity of workflow compositions. In this paper, we propose to formalize the specification language to reduce the complexity of the workflow composition. To this end, we extend a specification language with the consideration of formal logic, so that some effective theorems can be derived for the verification of syntax, semantics, and inference rules in the workflow composition. The logic-based approach automates compliance checking effectively. The Service Workflow Specification (SWSpec) has been extended and formulated, and the soundness, completeness, and consistency of SWSpec applications have been verified; note that a logic-based SWSpec is mandatory for the development of model checking. The application of the proposed SWSpec has been demonstrated by the examples with the addressed soundness, completeness, and consistency.

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

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

2016-01-29

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. 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. Carers were recruited from voluntary sector organisations supporting carers, stroke survivors and black and minority ethnic groups in the UK. 41 carers from 5 ethnic groups (Asian Indian, Asian Pakistani, black African, black Caribbean, white British) participated in the focus groups. 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. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

How Costly Is It to Care for Disabled Elders in a Community Setting?

ERIC Educational Resources Information Center

Harrow, Brooke S.; And Others

1995-01-01

Describes the total cost of care, including both formal and informal services calculated using a market value approach, for a cohort of disabled elderly. The total annual cost of caring was estimated at $9,600; for most elders, the cost of a complete substitution of informal care for formal services, plus living expenses, was less costly than…

18 CFR 2.1 - Initial notice; service; and information copies of formal documents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Initial notice; service; and information copies of formal documents. 2.1 Section 2.1 Conservation of Power and Water Resources... Order 463, 37 FR 28054, Dec. 20, 1972; 38 FR 3192, Feb. 2, 1973; 44 FR 34941, June 18, 1979; 45 FR 21224...

18 CFR 2.1 - Initial notice; service; and information copies of formal documents.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Initial notice; service; and information copies of formal documents. 2.1 Section 2.1 Conservation of Power and Water Resources...; 38 FR 3192, Feb. 2, 1973; 44 FR 34941, June 18, 1979; 45 FR 21224, Apr. 1, 1980; Order 541, 57 FR...

18 CFR 2.1 - Initial notice; service; and information copies of formal documents.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Initial notice; service; and information copies of formal documents. 2.1 Section 2.1 Conservation of Power and Water Resources...; 38 FR 3192, Feb. 2, 1973; 44 FR 34941, June 18, 1979; 45 FR 21224, Apr. 1, 1980; Order 541, 57 FR...

18 CFR 2.1 - Initial notice; service; and information copies of formal documents.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Initial notice; service; and information copies of formal documents. 2.1 Section 2.1 Conservation of Power and Water Resources...; 38 FR 3192, Feb. 2, 1973; 44 FR 34941, June 18, 1979; 45 FR 21224, Apr. 1, 1980; Order 541, 57 FR...

Social capital and HIV Competent Communities: The role of community groups in managing HIV/AIDS in rural Zimbabwe

PubMed Central

Campbell, Catherine; Scott, Kerry; Nhamo, Mercy; Nyamukapa, Constance; Madanhire, Claudius; Skovdal, Morten; Sherr, Lorraine; Gregson, Simon

2013-01-01

Community involvement is increasingly identified as a “critical enabler” of an effective HIV/AIDS response. We explore pathways between community participation and HIV prevention, treatment and impact mitigation in Zimbabwe, reviewing six qualitative studies in Manicaland. These find that community group membership is often (not always) associated with decreased HIV incidence, reduced stigma and improved access to some services, particularly amongst women. Participation in formal community groups (e.g., church or women's groups) and informal local networks (e.g., neighbours, families) provides opportunities for critical dialogue about HIV/AIDS, often facilitating renegotiation of harmful social norms, sharing of previously hidden personal experiences of HIV/AIDS, formulation of positive action plans and solidarity to action them. However, implementation of new plans and insights is constrained by poverty, social uncertainty and poor service delivery. Furthermore, dialogue may have negative effects, spreading false information and entrenching negative norms. The extent that formal groups and informal networks facilitate externally imposed HIV/AIDS interventions varies. They potentially provide vital practical and emotional support, facilitating service access, treatment adherence and AIDS care. However, they may sometimes play a negative role in prevention activities, challenging stereotypes about sexuality or gender. There is an urgent need for greater recognition of the role of indigenous community groups and networks, and the inclusion of “strengthening local responses” as a key element of interventions and policy. Such efforts require great sensitivity. Heavy-handed external interference in complex indigenous relationships risks undermining the localism and bottom-up initiative and activism that might be central to their effectiveness. Cautious efforts might seek to enhance the potentially beneficial effects of groups, especially for women, and limit potentially damaging ones, especially for men. Efforts should be made to facilitate contexts that enable groups to have beneficial effects, through nesting them within wider comprehensive responses, and supporting them through strong partnerships with service providers. PMID:23745625

Social capital and HIV competent communities: the role of community groups in managing HIV/AIDS in rural Zimbabwe.

PubMed

Campbell, Catherine; Scott, Kerry; Nhamo, Mercy; Nyamukapa, Constance; Madanhire, Claudius; Skovdal, Morten; Sherr, Lorraine; Gregson, Simon

2013-01-01

Community involvement is increasingly identified as a "critical enabler" of an effective HIV/AIDS response. We explore pathways between community participation and HIV prevention, treatment and impact mitigation in Zimbabwe, reviewing six qualitative studies in Manicaland. These find that community group membership is often (not always) associated with decreased HIV incidence, reduced stigma and improved access to some services, particularly amongst women. Participation in formal community groups (e.g., church or women's groups) and informal local networks (e.g., neighbours, families) provides opportunities for critical dialogue about HIV/AIDS, often facilitating renegotiation of harmful social norms, sharing of previously hidden personal experiences of HIV/AIDS, formulation of positive action plans and solidarity to action them. However, implementation of new plans and insights is constrained by poverty, social uncertainty and poor service delivery. Furthermore, dialogue may have negative effects, spreading false information and entrenching negative norms. The extent that formal groups and informal networks facilitate externally imposed HIV/AIDS interventions varies. They potentially provide vital practical and emotional support, facilitating service access, treatment adherence and AIDS care. However, they may sometimes play a negative role in prevention activities, challenging stereotypes about sexuality or gender. There is an urgent need for greater recognition of the role of indigenous community groups and networks, and the inclusion of "strengthening local responses" as a key element of interventions and policy. Such efforts require great sensitivity. Heavy-handed external interference in complex indigenous relationships risks undermining the localism and bottom-up initiative and activism that might be central to their effectiveness. Cautious efforts might seek to enhance the potentially beneficial effects of groups, especially for women, and limit potentially damaging ones, especially for men. Efforts should be made to facilitate contexts that enable groups to have beneficial effects, through nesting them within wider comprehensive responses, and supporting them through strong partnerships with service providers.

The Isis Centre: a counselling service within the National Health Service.

PubMed Central

Agulnik, P; Holroyd, P; Mandelbrote, B

1976-01-01

A new centre has been established to provide readily accessible counselling, consultation, and mental health information. People may refer themselves or are recommended to attend by general practitioners or other agencies. The counsellors have varied backgrounds in paramedical or counselling services, and they are supported by psychiatrists. Of a sample of 100 clients, four were referred to one of the team's psychiatrists and 33 visited the centre only once. The centre's staff aim to adopt a flexible approach to the client and his problems, and formal psychiatric categories have not been found useful. Provision is made for people who want to solve their problems by discussion rather than medication and those for whom the existing psychiatric services may have little time to spare. Consequently, the approach adopted by the Isis Centre, whereby many people benefit from psychotherapy yet the psychiatrist deals directly with only a few selected cases, contributes towards meeting the great need for psychiatric services and using the psychiatrist's skills more effectively. PMID:947421

Informationist programme in support of biomedical research: a programme description and preliminary findings of an evaluation

PubMed Central

Whitmore, Susan C.; Grefsheim, Suzanne F.; Rankin, Jocelyn A.

2008-01-01

Background The informationist programme at the Library of the National Institutes of Health (NIH) in Bethesda, MD, USA has grown to 14 informationists working with 40 clinical and basic science research teams. Purpose This case report, intended to contribute to the literature on informationist programmes, describes the NIH informationist programme including implementation experiences, the informationists' training programme, their job responsibilities and programme outcomes. Brief description The NIH informationist programme was designed to enhance the library's service capacity. Over time, the steps for introducing the service to new groups were formalized to ensure support by leadership, the team being served and the library. Job responsibilities also evolved from traditional library roles to a wide range of knowledge management activities. The commitment by the informationist, the team and the library to continuous learning is critical to the programme's success. Results/outcomes NIH scientists reported that informationists saved them time and contributed to teamwork with expert searching and point-of-need instruction. Process evaluation helped refine the programme. Evaluation method High-level, preliminary outcomes were identified from a survey of scientists receiving informationist services, along with key informant interviews. Process evaluation examined service implementation, informationists' training, and service components. Anecdotal evidence has also indicated a favorable response to the programme. PMID:18494648

Informationist programme in support of biomedical research: a programme description and preliminary findings of an evaluation.

PubMed

Whitmore, Susan C; Grefsheim, Suzanne F; Rankin, Jocelyn A

2008-06-01

The informationist programme at the Library of the National Institutes of Health (NIH) in Bethesda, MD, USA has grown to 14 informationists working with 40 clinical and basic science research teams. This case report, intended to contribute to the literature on informationist programmes, describes the NIH informationist programme, including implementation experiences, the informationists' training programme, their job responsibilities and programme outcomes. The NIH informationist programme was designed to enhance the library's service capacity. Over time, the steps for introducing the service to new groups were formalized to ensure support by leadership, the team being served and the library. Job responsibilities also evolved from traditional library roles to a wide range of knowledge management activities. The commitment by the informationist, the team and the library to continuous learning is critical to the programme's success. RESULTS / OUTCOMES: NIH scientists reported that informationists saved them time and contributed to teamwork with expert searching and point-of-need instruction. Process evaluation helped refine the programme. High-level, preliminary outcomes were identified from a survey of scientists receiving informationist services, along with key informant interviews. Process evaluation examined service implementation, informationists' training and service components. Anecdotal evidence has also indicated a favourable response to the programme.

The Organizational Social Context of Mental Health Medicaid Waiver Programs with Family Support Services: Implications for Research and Practice

PubMed Central

Glisson, Charles; Williams, Nathaniel J.; Green, Philip; Hemmelgarn, Anthony; Hoagwood, Kimberly

2013-01-01

Introduction Peer family support specialists (FSS) are parents with practical experience in navigating children’s mental health care systems who provide support, advocacy and guidance to the families of children who need mental health services. Their experience and training differ from those of formally trained mental health clinicians, creating potential conflicts in priorities and values between FSS and clinicians. We hypothesized that these differences could negatively affect the organizational cultures and climates of mental health clinics that employ both FSS and mental health clinicians, and lower the job satisfaction and organizational commitment of FSS. Method The Organizational Social Context (OSC) measure was administered on site to 209 FSS and clinicians in 21 mental health programs in New York State. The study compared the organizational-level culture and climate profiles of mental health clinics that employ both FSS and formally trained clinicians to national norms for child mental health clinics, assessed individual-level job satisfaction and organizational commitment as a function of job (FSS vs. clinician) and other individual-level and organizational-level characteristics, and tested whether FSS and clinicians’ job attitudes are differentially associated with organizational culture and climate. Results The programs’ organizational culture and climate profiles were not significantly different from national norms. Individual-level job satisfaction and organizational commitment were unrelated to position (FSS vs. clinician) or other individual-level and organizational-level characteristics except for culture and climate. Conclusions Organizational culture and climate are not related to the employment of FSS. Both FSS’ and clinicians’ individual-level work attitudes are associated similarly with organizational culture and climate. PMID:24065458

Conceptual Model Formalization in a Semantic Interoperability Service Framework: Transforming Relational Database Schemas to OWL.

PubMed

Bravo, Carlos; Suarez, Carlos; González, Carolina; López, Diego; Blobel, Bernd

2014-01-01

Healthcare information is distributed through multiple heterogeneous and autonomous systems. Access to, and sharing of, distributed information sources are a challenging task. To contribute to meeting this challenge, this paper presents a formal, complete and semi-automatic transformation service from Relational Databases to Web Ontology Language. The proposed service makes use of an algorithm that allows to transform several data models of different domains by deploying mainly inheritance rules. The paper emphasizes the relevance of integrating the proposed approach into an ontology-based interoperability service to achieve semantic interoperability.

A Case Study of Exploring Older Chinese Immigrants' Social Support within a Chinese Church Community in the United States.

PubMed

Liou, Chih-Ling; Shenk, Dena

2016-09-01

The number of older Chinese immigrants living in the United States is increasing steadily. They are faced with challenges to meet their needs for social support and are unlikely to turn to formal services. This case study utilizes an ecological framework to analyze social support among Chinese immigrants age 65 year and older within a Christian Chinese church community, and to explore the ways in which a Chinese church functions as the source of social support for older Chinese immigrants. Seven months of participant observation and ten face-to-face, in-depth interviews were conducted with 65+ Chinese adults who attended one Chinese church in the Southern United State and included questions concerning patterns of support and personal relationships within the church. Findings revealed that gender, living arrangements, working experiences, ability to drive, and English language skills were related to support the older Chinese immigrants sought, received, and provided. Although the Chinese church can be a viable source of supplementary support, some participants in this study felt the support they received from the church was insufficient, particularly in terms of emotional support. Therefore, suggestions are outlined that may assist Chinese churches to be more proactive in better understanding and providing services that meet the different needs and desires of older Chinese immigrants.

Healing or Hurtful: Sexual Assault Survivors' Interpretations of Social Reactions from Support Providers

ERIC Educational Resources Information Center

Ahrens, Courtney E.; Cabral, Giannina; Abeling, Samantha

2009-01-01

Sexual assault survivors often receive both positive and negative reactions to the disclosure of their assault. Although positive reactions are typically more common from informal support providers and negative reactions are typically more common from formal support providers, not all formal and informal support providers react the same way. To…

Supporting family caregivers to identify their own needs in end-of-life care: Qualitative findings from a stepped wedge cluster trial.

PubMed

Aoun, Samar; Deas, Kathleen; Toye, Chris; Ewing, Gail; Grande, Gunn; Stajduhar, Kelli

2015-06-01

The Carer Support Needs Assessment Tool encompasses the physical, psychological, social, practical, financial, and spiritual support needs that government policies in many countries emphasize should be assessed and addressed for family caregivers during end-of-life care. To describe the experience of family caregivers of terminally ill people of the Carer Support Needs Assessment Tool intervention in home-based palliative care. This study was conducted during 2012-2014 in Silver Chain Hospice Care Service in Western Australia. This article reports on one part of a three-part evaluation of a stepped wedge cluster trial. All 233 family caregivers receiving the Carer Support Needs Assessment Tool intervention provided feedback on their experiences via brief end-of-trial semi-structured telephone interviews. Data were subjected to a thematic analysis. The overwhelming majority reported finding the Carer Support Needs Assessment Tool assessment process straightforward and easy. Four key themes were identified: (1) the practicality and usefulness of the systematic assessment; (2) emotional responses to caregiver reflection; (3) validation, reassurance, and empowerment; and (4) accessing support and how this was experienced. Family caregivers appreciated the value of the Carer Support Needs Assessment Tool intervention in engaging them in conversations about their needs, priorities, and solutions. The Carer Support Needs Assessment Tool presented a simple, yet potentially effective intervention to help palliative care providers systematically assess and address family caregivers' needs. The Carer Support Needs Assessment Tool provided a formal structure to facilitate discussions with family caregivers to enable needs to be addressed. Such discussions can also inform an evidence base for the ongoing development of services for family caregivers, ensuring that new or improved services are designed to meet the explicit needs of family caregivers. © The Author(s) 2015.

The influence of ethnicity and culture on dementia caregiving: a review of empirical studies on Chinese Americans.

PubMed

Sun, Fei; Ong, Rebecca; Burnette, Denise

2012-02-01

The purpose of this article is to pinpoint the cultural and ethnic influences on dementia caregiving in Chinese American families through a systemic review and analysis of published research findings. Eighteen publications on Chinese American dementia family caregivers published in peer-reviewed journals between 1990 and early 2011 were identified. Based on a systematic database search and review process, we found that caregivers' beliefs concerning dementia and the concept of family harmony as evidenced through the practice of filial piety are permeating cultural values, which together affect attitudes toward research and help-seeking behaviors (ie, seeking information on diagnosis and using formal services). There is also evidence to suggest that these cultural beliefs impinge on key elements of the caregiving process, including caregivers' appraisal of stress, coping strategies, and informal and formal support. The study concludes with recommendations for future research and practice with the Chinese American population.

Professional Development across the Teaching Career: Teachers' Uptake of Formal and Informal Learning Opportunities

ERIC Educational Resources Information Center

Richter, Dirk; Kunter, Mareike; Klusmann, Uta; Ludtke, Oliver; Baumert, Jurgen

2011-01-01

This study examined teachers' uptake of formal and informal learning opportunities across the career cycle. Analyses were based on data from 1939 German secondary teachers in 198 schools. Results showed that formal learning opportunities (in-service training) were used most frequently by mid-career teachers, whereas informal learning opportunities…

75 FR 38129 - The Berry Company LLC, a Subsidiary of Local Insight Media Holdings, Inc., Formally Known as...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-01

... Subsidiary of Local Insight Media Holdings, Inc., Formally Known as Local Insight Yellow Pages Including On... Company LLC, a subsidiary of Local Insight Media Holdings, Inc., formally known as Local Insight Yellow... directory advertising and Internet advertising services. The company reports that workers leased from...

39 CFR 3001.20 - Formal intervention.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Formal intervention. 3001.20 Section 3001.20... Applicability § 3001.20 Formal intervention. Link to an amendment published at 79 FR 33407, June 10, 2014. (a) Who may intervene. A notice of intervention will be entertained in those cases that are noticed for a...

A review of the coroner system in England and Wales: a commentary.

PubMed

Berry, Colin; Heaton-Armstrong, Anthony

2005-01-01

The certification of deaths and their investigation is flawed and has not been subject to comprehensive revision for many decades; the current system is fragmented. Despite its historical 'stability', it is poorly understood by many who have to use it and the lack of supervisory structures within the system means that there is no leadership, accountability or quality assurance. No formal linkage to or communication with other public health services and systems exists, minimising its epidemiological value. There is a lack of clear participation rights in these processes for bereaved families. The standards for the treatment and support of the bereaved are woefully inadequate and have contributed in a major way to certain causes celebres. A report in 2003 suggested that death investigation should be a service that is consistent and professional, able to deal effectively with legal and health issues, work across the full range of concerns about public health and public safety and support, and audit the death certification process. The role of those supporting the current system must be properly established in a framework of accountability.

The ``One Archive'' for JWST

NASA Astrophysics Data System (ADS)

Greene, G.; Kyprianou, M.; Levay, K.; Sienkewicz, M.; Donaldson, T.; Dower, T.; Swam, M.; Bushouse, H.; Greenfield, P.; Kidwell, R.; Wolfe, D.; Gardner, L.; Nieto-Santisteban, M.; Swade, D.; McLean, B.; Abney, F.; Alexov, A.; Binegar, S.; Aloisi, A.; Slowinski, S.; Gousoulin, J.

2015-09-01

The next generation for the Space Telescope Science Institute data management system is gearing up to provide a suite of archive system services supporting the operation of the James Webb Space Telescope. We are now completing the initial stage of integration and testing for the preliminary ground system builds of the JWST Science Operations Center which includes multiple components of the Data Management Subsystem (DMS). The vision for astronomical science and research with the JWST archive introduces both solutions to formal mission requirements and innovation derived from our existing mission systems along with the collective shared experience of our global user community. We are building upon the success of the Hubble Space Telescope archive systems, standards developed by the International Virtual Observatory Alliance, and collaborations with our archive data center partners. In proceeding forward, the “one archive” architectural model presented here is designed to balance the objectives for this new and exciting mission. The STScI JWST archive will deliver high quality calibrated science data products, support multi-mission data discovery and analysis, and provide an infrastructure which supports bridges to highly valued community tools and services.

An emergency department-based mental health nurse practitioner outpatient service: part 2, staff evaluation.

PubMed

Wand, Timothy; White, Kathryn; Patching, Joanna; Dixon, Judith; Green, Timothy

2011-12-01

The nurse practitioner role incorporates enhancing access to health-care services, particularly for populations that are underserved. This entails working collaboratively with colleagues across multidisciplinary teams and emphasizing a nursing model of practice within the nurse practitioner role. In Australia, the added value associated with establishing mental health nurse practitioner (MHNP) positions based in the emergency department (ED) is emerging. This paper presents qualitative findings from a study using a mixed-method design to evaluate an ED-based MHNP outpatient service in Sydney, Australia. One component of the evaluation involved semistructured interviews conducted with a random selection of study participants and a stratified sample of ED staff. This is the second of a two-part paper that presents an analysis of the qualitative data derived from the staff interviews (n = 20). Emergency staff were very supportive of the outpatient service, and perceived that it enhanced overall service provision and improved outcomes for patients. Moreover, staff expressed interest in receiving more formal feedback on the outcomes of the service. Staff also felt that service provision would be enhanced through additional mental health liaison nurses working in the department, especially after hours. An ED-based MHNP outpatient service expedites access to follow up to individuals with a broad range of problems, and supports ED staff in the provision of safe, effective, and more holistic care. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

Who serves the urban poor? A geospatial and descriptive analysis of health services in slum settlements in Dhaka, Bangladesh

PubMed Central

Adams, Alayne M; Islam, Rubana; Ahmed, Tanvir

2015-01-01

In Bangladesh, the health risks of unplanned urbanization are disproportionately shouldered by the urban poor. At the same time, affordable formal primary care services are scarce, and what exists is almost exclusively provided by non-government organizations (NGOs) working on a project basis. So where do the poor go for health care? A health facility mapping of six urban slum settlements in Dhaka was undertaken to explore the configuration of healthcare services proximate to where the poor reside. Three methods were employed: (1) Social mapping and listing of all Health Service Delivery Points (HSDPs); (2) Creation of a geospatial map including Global Positioning System (GPS) co-ordinates of all HSPDs in the six study areas and (3) Implementation of a facility survey of all HSDPs within six study areas. Descriptive statistics are used to examine the number, type and concentration of service provider types, as well as indicators of their accessibility in terms of location and hours of service. A total of 1041 HSDPs were mapped, of which 80% are privately operated and the rest by NGOs and the public sector. Phamacies and non-formal or traditional doctors make up 75% of the private sector while consultation chambers account for 20%. Most NGO and Urban Primary Health Care Project (UPHCP) static clinics are open 5–6 days/week, but close by 4–5 pm in the afternoon. Evening services are almost exclusively offered by private HSDPs; however, only 37% of private sector health staff possess some kind of formal medical qualification. This spatial analysis of health service supply in poor urban settlements emphasizes the importance of taking the informal private sector into account in efforts to increase effective coverage of quality services. Features of informal private sector service provision that have facilitated market penetration may be relevant in designing formal services that better meet the needs of the urban poor. PMID:25759453

A survey of nurse staffing levels in interventional radiology units throughout the UK.

PubMed

Christie, A; Robertson, I

2016-07-01

To supplement previous surveys analysing provision of interventional radiology (IR), in-hours (IH) and out-of-hours (OOH), by specifically surveying the level of nursing support provided. A web-based questionnaire was distributed to all British Society of Interventional Radiology (BSIR) members. This addressed several aspects of radiology nursing support for IR procedures, both IH and OOH. Sixty percent of respondents indicated that they have a formal OOH service. Of these, all have a dedicated nursing rota, with the vast majority operating with one nurse. IH, 77% of respondents always have a scrubbed nurse assistant, but this reduces to 40% OOH. IH, 4% never have a scrubbed radiology nurse assistant, which rises to 25% OOH. IH, 75% of respondents always have a radiology nurse dedicated to patient monitoring, but this reduces to 20% OOH. IH, 3% never have a radiology nurse dedicated to patient monitoring, which rises to 42% OOH. A significant disparity exists in the level of IR nursing support between IH and OOH. The majority of sites provide a single nurse with ad hoc additional support. This is potentially putting patients at increased risk. Radiology nurses are integral to the safe and sustainable provision of IR OOH services and a greater focus is required to ensure adequate and safe staffing levels for 24/7 IR services. Copyright © 2016. Published by Elsevier Ltd.

Effects of respite care training on respite provider knowledge and confidence, and outcomes for family caregivers receiving respite services.

PubMed

Ackerman, Lynn; Sheaffer, Lois

2018-01-01

Respite services are vital in supporting informal caregivers in need of a break from their caregiving duties. A respite training program aimed at developing respite provider competence and improving caregiver well-being was evaluated. Trainees experienced significant growth in their perceived respite knowledge and confidence to deliver respite from pretraining to posttraining. An objective core competency assessment confirmed posttraining knowledge in 10 core areas of respite. Family caregivers provided more favorable ratings on various measures of their well-being while receiving respite from a trained provider compared to before respite began and if respite were to end. Findings suggest that formal training prepares providers to deliver quality respite resulting in improved caregiver outcomes.

A service-oriented architecture for integrating the modeling and formal verification of genetic regulatory networks

PubMed Central

2009-01-01

Background The study of biological networks has led to the development of increasingly large and detailed models. Computer tools are essential for the simulation of the dynamical behavior of the networks from the model. However, as the size of the models grows, it becomes infeasible to manually verify the predictions against experimental data or identify interesting features in a large number of simulation traces. Formal verification based on temporal logic and model checking provides promising methods to automate and scale the analysis of the models. However, a framework that tightly integrates modeling and simulation tools with model checkers is currently missing, on both the conceptual and the implementational level. Results We have developed a generic and modular web service, based on a service-oriented architecture, for integrating the modeling and formal verification of genetic regulatory networks. The architecture has been implemented in the context of the qualitative modeling and simulation tool GNA and the model checkers NUSMV and CADP. GNA has been extended with a verification module for the specification and checking of biological properties. The verification module also allows the display and visual inspection of the verification results. Conclusions The practical use of the proposed web service is illustrated by means of a scenario involving the analysis of a qualitative model of the carbon starvation response in E. coli. The service-oriented architecture allows modelers to define the model and proceed with the specification and formal verification of the biological properties by means of a unified graphical user interface. This guarantees a transparent access to formal verification technology for modelers of genetic regulatory networks. PMID:20042075

The results from a two-year case study of an information and communication technology support system for family caregivers.

PubMed

Lundberg, Stefan

2014-07-01

The aim was to better understand how information and communication technology (ICT) can provide support to elderly family caregivers caring for significant others suffering from dementia or stroke. Ten households equipped with an ICT system, with a family caregiver and a spouse diagnosed with dementia or stroke, were followed and observed in a two-year case study. The family caregivers had regular meetings in groups organised by the municipal care of the elderly. Data from observations, semi-structured interviews, user data from the ICT system and data about the support provided by the municipality has been used to validate the findings. The family caregivers socialised with users in the group as long as the users were stayed in the group. Meetings in the group were an important opportunity for exchanging experiences and to easing one"s mind. The ICT system did not reduce the municipality"s level of services to the participating families. The information built into the system has to be constantly updated to be of interest. An ICT support must be provided in a context of personal meetings and with a formal caregiver backing. This will empower informal or family caregivers. Such support must give the user the possibility to communicate and get access to the Internet. Benefits were obtained when informal caregivers met with a group of people with whom they share the same kind of experiences and were supported by a formal caregiver. Informal caregivers need more attention and recognition. ICT systems can help but must be current and maintain the users interest.

Applications of Formal Methods to Specification and Safety of Avionics Software

NASA Technical Reports Server (NTRS)

Hoover, D. N.; Guaspari, David; Humenn, Polar

1996-01-01

This report treats several topics in applications of formal methods to avionics software development. Most of these topics concern decision tables, an orderly, easy-to-understand format for formally specifying complex choices among alternative courses of action. The topics relating to decision tables include: generalizations fo decision tables that are more concise and support the use of decision tables in a refinement-based formal software development process; a formalism for systems of decision tables with behaviors; an exposition of Parnas tables for users of decision tables; and test coverage criteria and decision tables. We outline features of a revised version of ORA's decision table tool, Tablewise, which will support many of the new ideas described in this report. We also survey formal safety analysis of specifications and software.

Exploring the context in which different close-to-community sexual and reproductive health service providers operate in Bangladesh: a qualitative study.

PubMed

Mahmud, Ilias; Chowdhury, Sadia; Siddiqi, Bulbul Ashraf; Theobald, Sally; Ormel, Hermen; Biswas, Salauddin; Jahangir, Yamin Tauseef; Sarker, Malabika; Rashid, Sabina Faiz

2015-09-01

A range of formal and informal close-to-community (CTC) health service providers operate in an increasingly urbanized Bangladesh. Informal CTC health service providers play a key role in Bangladesh's pluralistic health system, yet the reasons for their popularity and their interactions with formal providers and the community are poorly understood. This paper aims to understand the factors shaping poor urban and rural women's choice of service provider for their sexual and reproductive health (SRH)-related problems and the interrelationships between these providers and communities. Building this evidence base is important, as the number and range of CTC providers continue to expand in both urban slums and rural communities in Bangladesh. This has implications for policy and future programme interventions addressing the poor women's SRH needs. Data was generated through 24 in-depth interviews with menstrual regulation clients, 12 focus group discussions with married men and women in communities and 24 semi-structured interviews with formal and informal CTC SRH service providers. Data was collected between July and September 2013 from three urban slums and one rural site in Dhaka and Sylhet, Bangladesh. Atlas.ti software was used to manage data analysis and coding, and a thematic analysis was undertaken. Poor women living in urban slums and rural areas visit a diverse range of CTC providers for SRH-related problems. Key factors influencing their choice of provider include the following: availability, accessibility, expenses and perceived quality of care, the latter being shaped by notions of trust, respect and familiarity. Informal providers are usually the first point of contact even for those clients who subsequently access SRH services from formal providers. Despite existing informal interactions between both types of providers and a shared understanding that this can be beneficial for clients, there is no effective link or partnership between these providers for referral, coordination and communication regarding SRH services. Training informal CTC providers and developing strategies to enable better links and coordination between this community-embedded cadre and the formal health sector has the potential to reduce service cost and improve availability of quality SRH (and other) care at the community level.

End-of-life care: an agenda for policy improvement.

PubMed

Shugarman, Lisa R; Lorenz, Karl; Lynn, Joanne

2005-02-01

Current arrangements for health care in the United States do not adequately address the needs of a growing population that has serious, eventually fatal chronic illness. New programs and policies are necessary to encourage coordination of care; better match services to the needs of patients; better provide education and incentives; and better support formal and informal caregivers. Models of end-of-life care, such as MediCaring, are described along with a research and policy agenda that focuses on modifying the health care system and building on new innovations.

42 CFR 411.380 - When CMS issues a formal advisory opinion.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false When CMS issues a formal advisory opinion. 411.380... Relationships Between Physicians and Entities Furnishing Designated Health Services § 411.380 When CMS issues a formal advisory opinion. (a) CMS considers an advisory opinion to be issued once it has received payment...

Home Enteral Nutrition therapy: Difficulties, satisfactions and support needs of caregivers assisting older patients.

PubMed

Jukic P, Nikolina; Gagliardi, Cristina; Fagnani, Donata; Venturini, Claudia; Orlandoni, Paolo

2017-08-01

The purpose of this study was to comprehend and describe the views, experiences and adaptations of caregivers who assist older patients treated with Home Enteral Nutrition. The objective was to gather empirical evidence to improve the delivery of Home Enteral Nutrition for old patients taking into account the caregivers' support needs. A qualitative methodology with focus groups as data collection method was used to collect the testimonies of 30 informal and formal caregivers of older patients treated with Home Enteral Nutrition by the Clinical Nutrition Service of INRCA (Ancona) during 2014. Quantitative methodology was used to collect socio-demographic data. Partially modified Silver's "Home Enteral Nutrition Caregiver Task Checklist" was used to identify training needs. The constant comparison method was used to code and categorize data and to develop themes of focus groups. Simple descriptive statistics were used to summarize questionnaires. Five main themes were identified from focus groups: acceptance of the therapy, skill acquisition process, need for psychological and practical support at home from healthcare professionals, lifestyle adaptation, affirmation of life and family. All caregivers testified the initial fear and refusal to manage the nutrition pump and the therapy. They expressed the need to be trained gradually, starting during a patient's hospitalization, and continuing in the community. With reference to their overall QoL, it emerged that informal caregivers suffered mostly from the reduction of their free time while formal caregivers suffered social isolation and psychological burden. For both groups the monthly home visit was the most important element of the HEN service. Informal caregivers highlighted the importance of having their loved ones at home. Unsatisfied training needs were identified by the modified Silver's "Home Enteral Nutrition Caregiver Task Checklist". This qualitative study underlined the challenges and adaptations of caregivers who assist older patients treated with Home Enteral Nutrition, which should be considered when defining clinical protocols and supporting caregivers. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

A Formal Semantics for the WS-BPEL Recovery Framework

NASA Astrophysics Data System (ADS)

Dragoni, Nicola; Mazzara, Manuel

While current studies on Web services composition are mostly focused - from the technical viewpoint - on standards and protocols, this work investigates the adoption of formal methods for dependable composition. The Web Services Business Process Execution Language (WS-BPEL) - an OASIS standard widely adopted both in academic and industrial environments - is considered as a touchstone for concrete composition languages and an analysis of its ambiguous Recovery Framework specification is offered. In order to show the use of formal methods, a precise and unambiguous description of its (simplified) mechanisms is provided by means of a conservative extension of the π-calculus. This has to be intended as a well known case study providing methodological arguments for the adoption of formal methods in software specification. The aspect of verification is not the main topic of the paper but some hints are given.

Perceived Case Management Needs and Service Preferences of Frequent Emergency Department Users: Lessons Learned in a Large Urban Centre.

PubMed

Kahan, Deborah; Poremski, Daniel; Wise-Harris, Deborah; Pauly, Daniel; Leszcz, Molyn; Wasylenki, Donald; Stergiopoulos, Vicky

2016-01-01

This study aimed to explore the service needs and preferences of frequent emergency department users with mental health and addictions concerns who participated in a brief intensive case management intervention. We conducted semi-structured individual interviews with 20 frequent emergency department users with mental health and addictions challenges, 13 service providers involved in the delivery of a brief case management intervention, and a focus group with intervention case managers. Thematic analysis was used to explore perceived service user profiles, service needs and preferences of care. Service users experienced complex health and social needs and social isolation, while exhibiting resilience and the desire to contribute. They described multiple instances of stigmatization in interactions with healthcare professionals. Components of the brief intensive case management intervention perceived to be helpful included system navigation, advocacy, intermediation, and practical needs assistance. Frequent service users valued relational responsiveness, a non-judgmental stance, and a recovery orientation in case managers. Interventions for frequent service users in mental health may be enhanced by focusing on the engagement of formal and informal social supports, practical needs assistance, system navigation, advocacy and intermediation, and attention to the recovery goals of service users.

Towards Compensation Correctness in Interactive Systems

NASA Astrophysics Data System (ADS)

Vaz, Cátia; Ferreira, Carla

One fundamental idea of service-oriented computing is that applications should be developed by composing already available services. Due to the long running nature of service interactions, a main challenge in service composition is ensuring correctness of failure recovery. In this paper, we use a process calculus suitable for modelling long running transactions with a recovery mechanism based on compensations. Within this setting, we discuss and formally state correctness criteria for compensable processes compositions, assuming that each process is correct with respect to failure recovery. Under our theory, we formally interpret self-healing compositions, that can detect and recover from failures, as correct compositions of compensable processes.

Pricing health care services: applications to the health maintenance organization.

PubMed

Sweeney, R E; Franklin, S P

1986-01-01

This article illustrates how management in one type of service industry, the health maintenance organization (HMO), have attempted to formalize pricing. This effort is complicated by both the intangibility of the service delivered and the relatively greater influence in service industries of non-cost price factors such as accessibility, psychology, and delays. The presentation describes a simple computerized approach that allows the marketing manager to formally estimate the effect of incremental changes in rates on the firm's projected patterns of enrollment growth and net revenues. The changes in turn reflect underlying variations in the mix of pricing influences including psychological and other factors. Enrollment projections are crucial to the firm's financial planning and staffing. In the past, most HMO enrollment and revenue projections of this kind were notoriously unreliable. The approach described here makes it possible for HMOs to fine-tune their pricing policies. It also provides a formal and easily understood mechanism by which management can evaluate and reach consensus on alternative scenarios for enrollment growth, staff recruitment and capacity expansion.

Guiding Principles for Data Architecture to Support the Pathways Community HUB Model

PubMed Central

Zeigler, Bernard P.; Redding, Sarah; Leath, Brenda A.; Carter, Ernest L.; Russell, Cynthia

2016-01-01

Introduction: The Pathways Community HUB Model provides a unique strategy to effectively supplement health care services with social services needed to overcome barriers for those most at risk of poor health outcomes. Pathways are standardized measurement tools used to define and track health and social issues from identification through to a measurable completion point. The HUB use Pathways to coordinate agencies and service providers in the community to eliminate the inefficiencies and duplication that exist among them. Pathways Community HUB Model and Formalization: Experience with the Model has brought out the need for better information technology solutions to support implementation of the Pathways themselves through decision-support tools for care coordinators and other users to track activities and outcomes, and to facilitate reporting. Here we provide a basis for discussing recommendations for such a data infrastructure by developing a conceptual model that formalizes the Pathway concept underlying current implementations. Requirements for Data Architecture to Support the Pathways Community HUB Model: The main contribution is a set of core recommendations as a framework for developing and implementing a data architecture to support implementation of the Pathways Community HUB Model. The objective is to present a tool for communities interested in adopting the Model to learn from and to adapt in their own development and implementation efforts. Problems with Quality of Data Extracted from the CHAP Database: Experience with the Community Health Access Project (CHAP) data base system (the core implementation of the Model) has identified several issues and remedies that have been developed to address these issues. Based on analysis of issues and remedies, we present several key features for a data architecture meeting the just mentioned recommendations. Implementation of Features: Presentation of features is followed by a practical guide to their implementation allowing an organization to consider either tailoring off-the-shelf generic systems to meet the requirements or offerings that are specialized for community-based care coordination. Discussion: Looking to future extensions, we discuss the utility and prospects for an ontology to include care coordination in the Unified Medical Language System (UMLS) of the National Library of Medicine and other existing medical and nursing taxonomies. Conclusions and Recommendations: Pathways structures are an important principle, not only for organizing the care coordination activities, but also for structuring the data stored in electronic form in the conduct of such care. We showed how the proposed architecture encourages design of effective decision support systems for coordinated care and suggested how interested organizations can set about acquiring such systems. Although the presentation focuses on the Pathways Community HUB Model, the principles for data architecture are stated in generic form and are applicable to any health information system for improving care coordination services and population health. PMID:26870743

Towards Effective In-Service Teacher Development in the United Arab Emirates: Getting Teachers to Be in Charge of Their Own Professional Growth

ERIC Educational Resources Information Center

Alwan, Fatma Hamad

2000-01-01

Progress in education depends very much on keeping up with the various trends that emerge around the world. In-service teacher training (INSET) is a formal means through which teachers are constantly updated with the new findings in the field. There are also self-directed development activities that complement formal training. The need for this…

At the intersection of culture: Ethnically diverse dementia caregivers' service use.

PubMed

Richardson, Virginia E; Fields, Noelle; Won, Seojin; Bradley, Evie; Gibson, Allison; Rivera, Gretchen; Holmes, Sarah D

2017-01-01

This study used an ethnocultural approach to explore how cultural factors influenced ethnically diverse dementia caregivers' experiences and use of services. A modified thematic analysis of in-depth interviews with 15 caregivers, ranging in age from 50 to 75 years, including spouses, daughters, sons, cousins, and a friend, from three minority groups-African American, Hispanic, and South Korean caregivers-was conducted by a team of multi-lingual researchers. Caregiver stress was pervasive across all subgroups. Several themes emerged that were qualitatively different across groups, including knowledge about dementia, language barriers, religion and spirituality, and cultural differences in attitudes about caring and formal services. A two-pronged intervention model that includes a generic intervention to reduce caregiver stress along with a culturally targeted intervention tailored to a family's language, food preferences, religious practices, gender norms, and other values was recommended to more successfully reach and support these caregivers.

Clinical, information and business process modeling to promote development of safe and flexible software.

PubMed

Liaw, Siaw-Teng; Deveny, Elizabeth; Morrison, Iain; Lewis, Bryn

2006-09-01

Using a factorial vignette survey and modeling methodology, we developed clinical and information models - incorporating evidence base, key concepts, relevant terms, decision-making and workflow needed to practice safely and effectively - to guide the development of an integrated rule-based knowledge module to support prescribing decisions in asthma. We identified workflows, decision-making factors, factor use, and clinician information requirements. The Unified Modeling Language (UML) and public domain software and knowledge engineering tools (e.g. Protégé) were used, with the Australian GP Data Model as the starting point for expressing information needs. A Web Services service-oriented architecture approach was adopted within which to express functional needs, and clinical processes and workflows were expressed in the Business Process Execution Language (BPEL). This formal analysis and modeling methodology to define and capture the process and logic of prescribing best practice in a reference implementation is fundamental to tackling deficiencies in prescribing decision support software.

The perspectives of older Greek-Australians toward changes in the nature of family support: implications for family care policies.

PubMed

Walker, Ruth; Newman, Lareen; Tsianikas, Michael; Panagiotopoulos, Georgia; Hurley, Catherine

2013-01-01

Internationally, public policies encourage "aging in place," and the majority of older Australians requiring care in the community receive informal care, supplemented by publicly subsidized formal services. The effect of contemporary social changes on informal care in aging migrant communities is poorly understood. This articles explores the perceptions of older Greek-Australians toward changes in the nature of family support. Bicultural and bilingual researchers carried out in-depth interviews (n = 27) and five focus groups (n = 63 total participants) with older Greek-Australians in modern Greek. While "cultures of care" remain among Greek-Australian families, the means for a family to assist have shifted, and these compromises are met with considerable powerlessness among older Greek-Australians. Implications for policy include the need to better involve older migrants and their families in decisions about their care needs, potentially involving consumer-directed care models. Service providers may also need to adopt the use of new technologies to communicate with increasingly time-pressured family members.

Sustaining the future of HIV counselling to reach 90-90-90: a regional country analysis.

PubMed

Bemelmans, Marielle; Baert, Saar; Negussie, Eyerusalem; Bygrave, Helen; Biot, Marc; Jamet, Christine; Ellman, Tom; Banda, Amanda; van den Akker, Thomas; Ford, Nathan

2016-01-01

Counselling services are recommended by the World Health Organization and have been partially adopted by national HIV guidelines. In settings with a high HIV burden, patient education and counselling is often performed by lay workers, mainly supported with international funding. There are few examples where ministries of health have been able to absorb lay counsellors into their health systems or otherwise sustain their work. We document the role of lay cadres involved in HIV testing and counselling and adherence support and discuss approaches to sustainability. We focused on a purposive sample of eight sub-Saharan African countries where Médecins Sans Frontières supports HIV programmes: Guinea, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Zambia and Zimbabwe. We reviewed both published and grey literature, including national policies and donor proposals, and interviewed key informants, including relevant government staff, donors and non-governmental organizations. Lay counsellors play a critical role in scaling up HIV services and addressing gaps in the HIV testing and treatment cascade by providing HIV testing and counselling and adherence support at both the facility and community levels. Countries have taken various steps in recognizing lay counsellors, including harmonizing training, job descriptions and support structures. However, formal integration of this cadre into national health systems is limited, as lay counsellors are usually not included in national strategies or budgeting. The current trend of reduced donor support for lay counsellors, combined with lack of national prioritization, threatens the sustainability of this cadre and thereby quality HIV service delivery.

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

PubMed

Czaja, Sara J

2016-01-01

The aging of the population, especially the increase in the "oldest old," is a remarkable achievement that presents both opportunities and challenges for policymakers, researchers, and society. Although many older adults enjoy relatively good health into their later years, many have one or more chronic conditions or diseases and need help with disease management activities or activities important to independent living. Technology is playing an increasingly important role in the health care arena and is becoming ubiquitous in health management activities. There are a variety of technology applications that can be used to enhance the mobility and quality of life of people who have limitations and help to foster the ability of those with chronic conditions to remain at home. Technology applications can also provide a central role in providing support to family caregivers in terms of enhancing access to information and community resources and connections to formal and informal support services. Monitoring technologies may also allow caregivers to check on the status or activities of their loved one while they are at work or at a distant location. Furthermore, telemedicine applications can aid the ability of care providers to monitor patients and deliver health services. The objective of this article is to highlight the potential role that technology can play in the provision of long-term support for older adults and their families. Challenges and barriers that currently limit the full potential of technology to be realized for these populations will also be discussed. Finally the role of psychological science toward maximizing the potential of technology applications in enhancing long term care and support services will be highlighted. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Perspectives of basic wheelchair users on improving their access to wheelchair services in Kenya and Philippines: a qualitative study.

PubMed

Williams, Emma; Hurwitz, Elizabeth; Obaga, Immaculate; Onguti, Brenda; Rivera, Adovich; Sy, Tyrone Reden L; Kirby, R Lee; Noon, Jamie; Tanuku, Deepti; Gichangi, Anthony; Bazant, Eva

2017-08-17

The United Nations has called for countries to improve access to mobility devices when needed. The World Health Organization has published guidelines on the provision of manual wheelchairs in less-resourced settings. Yet little is known about the extent to which appropriate wheelchairs are available and provided according to international guidelines. This study's purpose was to describe wheelchair users' experiences receiving services and acquiring wheelchair skills in urban and peri-urban areas of Kenya and the Philippines. Local researchers in Nairobi and Manila interviewed 48 adult basic wheelchair users, with even distribution of those who had and had not received wheelchair services along with their wheelchair. Recordings were transcribed in the local language and translated into English. The study team coded transcripts for predetermined and emergent themes, using Atlas-ti software. A qualitative content analysis approach was taken with the WHO service delivery process as an organizing framework. Wheelchair users frequently described past experiences with ill-fitting wheelchairs and little formal training to use wheelchairs effectively. Through exposure to multiple wheelchairs and self-advocacy, they learned to select wheelchairs suitable for their needs. Maintenance and repair services were often in short supply. Participants attributed shorter duration of wheelchair use to lack of repair. Peer support networks emerged as an important source of knowledge, resources and emotional support. Most participants acknowledged that they received wheelchairs that would have been difficult or impossible for them to pay for, and despite challenges, they were grateful to have some means of mobility. Four themes emerged as critical for understanding the implementation of wheelchair services: barriers in the physical environment, the need for having multiple chairs to improve access, perceived social stigma, and the importance of peer support. Interventions are needed to provide wheelchairs services efficiently, at scale, in an environment facilitating physical access and peer support, and reduced social stigma. Not applicable since this was a descriptive study.

Factors influencing choice of veterinary service provider by pastoralist in Kenya.

PubMed

Onono, Joshua Orungo; Wieland, Barbara; Rushton, Jonathan

2013-08-01

This study analyzed the determinants for choice of animal health providers in a semiarid pastoral area with an aim of identifying specific attributes that could be targeted for intervention to enhance pastoralist access to quality veterinary services. The data were collected through administration of semi-structured questionnaires to 350 randomly selected household heads in different locations in Narok County of Kenya. Most of these respondents had no formal education (66.9%), and most households were headed by men (88.9%). The men were in control of sales (84.2%), purchases (83.7%), and treatment of sick cattle (70.3%), while women were responsible for milking (83.8%). Animal health services were delivered by drug stockists (87.76%) and government veterinarians (12.24%). The time spent while seeking animal health services and transport cost were specific attributes with impact on the probability of choice for service providers. Although distance covered to the preferred service provider was a significant attribute, it was inversely related to the probability of choice. The other factors including herd sizes, age and sex of household head, cost incurred per visit, level of education of household head, and the number of visits did not have significant impact on choices. These findings support commercialization of veterinary services in marginalized areas where the delivery of essential animal health services such as disease control programs are often viewed as a public good. In order to enhance delivery of veterinary services in these areas, it is proposed that public and private means are investigated to support qualified veterinarians and to strengthen the activities of untrained personnel operating drug outlets.

The Influence of Low-Barrier and Voluntary Service Policies on Survivor Empowerment in a Domestic Violence Housing Organization.

PubMed

Nnawulezi, Nkiru; Godsay, Surbhi; Sullivan, Cris M; Marcus, Suzanne; Hacskaylo, Margaret

2018-01-18

The purpose of community-based domestic violence crisis housing programs (e.g., shelters) is to provide a safe setting that promotes empowerment for survivors of intimate partner violence. For staff to reach this aim, the program must have formal structures and processes in place to support such efforts. This study explored how low-barrier and voluntary service policies influenced staff practices and survivor empowerment. Low-barrier policies require that programs remove barriers that prevent survivors, particularly those who have mental health concerns and/or addictions, from being able to access services. A voluntary service policy states that survivors have the right to choose which services, if any, they would like to engage in during their stay at the program. Survivors' ability to stay at the housing program is not contingent on their participation in program services. This exploratory-sequential (QUAL→ quan) mixed-method study examined how low-barrier and voluntary service policies influenced staff behavior and how these behaviors then related to survivor empowerment. Qualitative results revealed that low-barrier and voluntary service were guided by cultural values of justice and access, encouraged survivor-centered practices among staff, and were believed to promote survivor autonomy. Quantitative results suggested that when survivors perceived they had a choice to engage in program services or meet with an advocate, their empowerment increased. This study has implications for domestic violence organizational practice and provides evidence about the contextual factors that support individual empowerment. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Ecosystem services: From theory to implementation

PubMed Central

Daily, Gretchen C.; Matson, Pamela A.

2008-01-01

Around the world, leaders are increasingly recognizing ecosystems as natural capital assets that supply life-support services of tremendous value. The challenge is to turn this recognition into incentives and institutions that will guide wise investments in natural capital, on a large scale. Advances are required on three key fronts, each featured here: the science of ecosystem production functions and service mapping; the design of appropriate finance, policy, and governance systems; and the art of implementing these in diverse biophysical and social contexts. Scientific understanding of ecosystem production functions is improving rapidly but remains a limiting factor in incorporating natural capital into decisions, via systems of national accounting and other mechanisms. Novel institutional structures are being established for a broad array of services and places, creating a need and opportunity for systematic assessment of their scope and limitations. Finally, it is clear that formal sharing of experience, and defining of priorities for future work, could greatly accelerate the rate of innovation and uptake of new approaches. PMID:18621697

Measures of Success for Earth System Science Education: The DLESE Evaluation Services and the Evaluation Toolkit Collection

NASA Astrophysics Data System (ADS)

McCaffrey, M. S.; Buhr, S. M.; Lynds, S.

2005-12-01

Increased agency emphasis upon the integration of research and education coupled with the ability to provide students with access to digital background materials, learning activities and primary data sources has begun to revolutionize Earth science education in formal and informal settings. The DLESE Evaluation Services team and the related Evaluation Toolkit collection (http://www.dlese.org/cms/evalservices/ ) provides services and tools for education project leads and educators. Through the Evaluation Toolkit, educators may access high-quality digital materials to assess students' cognitive gains, examples of alternative assessments, and case studies and exemplars of authentic research. The DLESE Evaluation Services team provides support for those who are developing evaluation plans on an as-requested basis. In addition, the Toolkit provides authoritative peer reviewed articlesabout evaluation research techniques and strategies of particular importance to geoscience education. This paper will provide an overview of the DLESE Evaluation Toolkit and discuss challenges and best practices for assessing student learning and evaluating Earth system sciences education in a digital world.

Nursing and health-care assistant experience of supervision in a medium secure psychiatric service for women: implications for service development.

PubMed

Long, C G; Harding, S; Payne, K; Collins, L

2014-03-01

In secure psychiatric services where the potential for 'burnout' by nurses is high, clinical supervision is viewed as a key to reflective practice to support staff in stressful working environments. Barriers to the uptake of clinical supervision in such service settings are personal and organizational. The study was prompted by the need to evaluate the effectiveness of supervision for registered nurses and health-care assistants (HCAs) and a desire to use survey findings to improve the quality and uptake of supervision. The study examined the perceived benefits, the best practice elements and the practical aspects of clinical supervision including how to improve practice. An approximate uptake of clinical supervision by 50% of staff confirmed previous findings; that HCAs were significantly less likely to engage in supervision and less likely to perceive benefit from it. Initiatives to address the training and managerial obstacles to the provision of formal supervision are described. © 2013 John Wiley & Sons Ltd.

Academic-Service Partnerships in Nursing: An Integrative Review

PubMed Central

Beal, Judy A.

2012-01-01

This integrative review summarizes currently available evidence on academic-service partnerships in the profession of nursing. More than 300 articles, published primarily in refereed journals, were accessed. Articles (110) were included in this review as they presented detailed and substantive information about any aspect of a nursing academic-service partnership. The majority were anecdotal in nature. Topics clustered around the following categories: pre-requisites for successful partnerships, benefits of partnerships, types of partnerships, and workforce development with its themes of academic-practice progression and educational re-design. Many examples of partnerships between academic and service settings were thoroughly described and best practices suggested, most often, however, without formal evaluation of outcomes. Nursing leaders in both settings have a long tradition of partnering with very little replicable evidence to support their efforts. It is critical that future initiatives evaluate the effectiveness of these partnerships, not only to ensure quality of patient outcomes but also to maximize efforts at building capacity for tomorrow's workforce. PMID:22548160

Ecosystem services: from theory to implementation.

PubMed

Daily, Gretchen C; Matson, Pamela A

2008-07-15

Around the world, leaders are increasingly recognizing ecosystems as natural capital assets that supply life-support services of tremendous value. The challenge is to turn this recognition into incentives and institutions that will guide wise investments in natural capital, on a large scale. Advances are required on three key fronts, each featured here: the science of ecosystem production functions and service mapping; the design of appropriate finance, policy, and governance systems; and the art of implementing these in diverse biophysical and social contexts. Scientific understanding of ecosystem production functions is improving rapidly but remains a limiting factor in incorporating natural capital into decisions, via systems of national accounting and other mechanisms. Novel institutional structures are being established for a broad array of services and places, creating a need and opportunity for systematic assessment of their scope and limitations. Finally, it is clear that formal sharing of experience, and defining of priorities for future work, could greatly accelerate the rate of innovation and uptake of new approaches.

Hydra Revisited: Substituting Formal for Self- and Informal In-Home Care among Older Adults with Disabilities

ERIC Educational Resources Information Center

Penning, Margaret J.

2002-01-01

Purpose: In response to concerns among policymakers and others that increases in the availability of publicly funded formal services will lead to reductions in self- and informal care, this study examines the relationship between the extent of formal in-home care received and levels of self- and informal care. Design and Methods: Two-stage least…

Formalizing structured file services for the data storage and retrieval subsystem of the data management system for Spacestation Freedom

NASA Technical Reports Server (NTRS)

Jamsek, Damir A.

1993-01-01

A brief example of the use of formal methods techniques in the specification of a software system is presented. The report is part of a larger effort targeted at defining a formal methods pilot project for NASA. One possible application domain that may be used to demonstrate the effective use of formal methods techniques within the NASA environment is presented. It is not intended to provide a tutorial on either formal methods techniques or the application being addressed. It should, however, provide an indication that the application being considered is suitable for a formal methods by showing how such a task may be started. The particular system being addressed is the Structured File Services (SFS), which is a part of the Data Storage and Retrieval Subsystem (DSAR), which in turn is part of the Data Management System (DMS) onboard Spacestation Freedom. This is a software system that is currently under development for NASA. An informal mathematical development is presented. Section 3 contains the same development using Penelope (23), an Ada specification and verification system. The complete text of the English version Software Requirements Specification (SRS) is reproduced in Appendix A.

Older people and falls: health status, quality of life, lifestyle, care networks, prevention and views on service use following a recent fall.

PubMed

Roe, Brenda; Howell, Fiona; Riniotis, Konstantinos; Beech, Roger; Crome, Peter; Ong, Bie Nio

2009-08-01

This study has investigated older people's experiences of a recent fall, its impact on their health, lifestyle, quality of life, care networks, prevention and their views on service use. Falls are common in older people and prevalence increases with age. Falls prevention is a major policy and service initiative. An exploratory, qualitative design involving two time points. A convenience sample of 27 older people from two primary care trusts who had a recent fall. Taped semi structured qualitative interviews were conducted and repeated at follow up to detect change over time and repeat falls. Data were collected on their experience of falls, health, activities of living, lifestyle, quality of life, use of services, prevention of falls, informal care and social networks. Content analysis of transcribed interviews identified key themes. The majority of people fell indoors (n = 23), were repeat fallers (n = 22) with more than half alone when they fell (n = 15). For five people it was their first ever fall. Participants in primary care trust 1 had a higher mean age than those in primary care trust 2 and had more injurious falls (n = 12, mean age 87 years vs. n = 15, mean age 81 years). The majority of non-injurious falls went unreported to formal services. Falls can result in a decline in health status, ability to undertake activities of living, lifestyle and quality of life. Local informal care and support networks are as important as formal care for older people at risk of falls or who have fallen. Access to falls prevention programmes and services is limited for people living in more rural communities. Falls prevention initiatives and services should work with local communities, agencies and informal carers to ensure equitable access and provision of information, resources and care to meet the needs of older people at risk or who have fallen.

Structured social relationships: a review of volunteer home visiting programs for parents of young children.

PubMed

Byrne, Fiona; Grace, Rebekah; Tredoux, Jaimie; Kemp, Lynn

2016-06-01

Objective The aims of the present paper were to: (1) review the research literature that contributes to an understanding of the role of volunteer home visiting programs in supporting the health and well being of families with young children; and (2) propose a conceptual model outlining service pathways for families in need of additional support. Methods An integrative literature review method was used, with a mix of electronic and manual search methods for the period January 1980-January 2014. Forty-five studies were identified that met the inclusion criteria for review and were coded according to themes developed a priori. Results There is little formal research that has examined the effectiveness of volunteer home visiting programs for supporting family health and well being. The available research suggests that volunteer home visiting programs provide socioemotional support through structured social relationships; however, there is limited empirical evidence to explicate the factors that contribute to these outcomes. Conclusion In recognition of the importance of peer support for new parents, the not-for-profit sector has been involved in providing volunteer home visiting services to families for decades. However, the body of research to support this work is characterised by methodological limitations, and rigorous evidence is limited. What is clear anecdotally and qualitatively from the existing research is that parents who are in need of additional support value engagement with a community volunteer. These structured social relationships appear to fulfil a service need within the community, helping build bridges to support social networks, and thus complementing professional services and relationships. Overall, structured social relationships in the form of volunteer home visiting programs appear to provide an important pathway to support family health and well being. Findings from the existing research are mixed and often characterised by methodological limitations, pointing to a need for further rigorous research. What is known about the topic? Volunteer family support programs have been an important part of the service landscape for vulnerable families, both nationally and internationally, for many years. Anecdotal reports suggest that this is a valued form of support that increases a sense of community connectedness and breaks down barriers for families in accessing other community support services. What does this paper add? This paper proposes a model identifying broad service pathways impacting on family health and well being that takes into account the importance of structured social relationships and social connectedness. What are the implications for practitioners? The proposed model may encourage discussion by practitioners and organisations interested in models of support for families who are socially isolated and/or in need of assistance to access and engage with services within the community.

Better and more efficient care through ICT-enabled integration of social care and healthcare services: experiences from two European projects

PubMed Central

Müller, Sonja; Meyer, Ingo; Kubitschke, Lutz; Delaney, Sarah

2012-01-01

Unsynchronised social and health care service delivery leads to inefficiencies, duplication of resources and reduced levels of quality of care. Older people are particularly affected by this situation. They often need both types of services, such as support with daily living activities and chronic disease management. ICT has the potential to support integrated service delivery to achieve high quality independent living and wellbeing for older people across Europe and elsewhere. Against this background, the presentation will demonstrate experiences and results derived from the development and piloting of ICT-supported integrated care services in eight sites across Europe, namely Dublin, Hull, Milton Keynes, Malaga, Veldhoven, Geldrop, Eindhoven and Bielefeld. Through innovative usage of ICT, current ‘silos’ in service delivery are broken up to allow for cooperation across relevant care sectors and participation of family members. The integrated services are to support the effective management of chronic diseases, and to address issues which affect independence, such as reduced agility, vision or hearing, in order to significantly improve the quality of life for older people and their carers. A dedicated programme of service process innovation complemented by adaptation of technology is being pursued in order to develop an integrated digital support infrastructure and related services: using appropriate existing technology to provide as many older people as possible with digital access to support services they needaugmenting and opening sectoral care platforms to enable coordinated cross-sector support deliveryadopting a clearly demand-driven inclusive approach and avoiding a technology ‘push’. Wider deployment of the services is supported by a dedicated programme of socio-economic service evaluation. The evaluation framework utilises a multi-method and multi-perspective approach, involving end users, family carers, service provider staff and key informants at corporate level. Triangulation is used to cross-reference data from different sources in order to maximize the reliability and robustness of conclusions drawn from the evaluation. Based on an overall framework taking into account themes such as integration, user outcomes, staff impact, organisational impact, technology, implementation and overall satisfaction, the specifics of each site are taken into account in operationally applying the overall framework in each case. The designs to be employed at each site have been developed to be as robust as possible, taking into account the constraints of the realities of the interventions. The evaluation is accompanied by a business case modelling approach that builds largely on a cost-benefit analysis covering the service development and implementation activities as well as the pilots and modelling the further deployment of services in each of the pilot sites. The presentation builds upon experiences gained within the framework of two European projects, CommonWell and INDEPENDENT. They are both co-funded under the EU’s Competitiveness and Innovation Framework Programme (CIP) focus on better joining-up of formal social/healthcare services and strengthening participation of the so-called ‘third sector’.

Reasons and remedies for under-representation of women in medical leadership roles: a qualitative study from Australia.

PubMed

Bismark, Marie; Morris, Jennifer; Thomas, Laura; Loh, Erwin; Phelps, Grant; Dickinson, Helen

2015-11-16

To elicit medical leaders' views on reasons and remedies for the under-representation of women in medical leadership roles. Qualitative study using semistructured interviews with medical practitioners who work in medical leadership roles. Interviews were transcribed verbatim and transcripts were analysed using thematic analysis. Public hospitals, private healthcare providers, professional colleges and associations and government organisations in Australia. 30 medical practitioners who hold formal medical leadership roles. Despite dramatic increases in the entry of women into medicine in Australia, there remains a gross under-representation of women in formal, high-level medical leadership positions. The male-dominated nature of medical leadership in Australia was widely recognised by interviewees. A small number of interviewees viewed gender disparities in leadership roles as a 'natural' result of women's childrearing responsibilities. However, most interviewees believed that preventable gender-related barriers were impeding women's ability to achieve and thrive in medical leadership roles. Interviewees identified a range of potential barriers across three broad domains-perceptions of capability, capacity and credibility. As a counter to these, interviewees pointed to a range of benefits of women adopting these roles, and proposed a range of interventions that would support more women entering formal medical leadership roles. While women make up more than half of medical graduates in Australia today, significant barriers restrict their entry into formal medical leadership roles. These constraints have internalised, interpersonal and structural elements that can be addressed through a range of strategies for advancing the role of women in medical leadership. These findings have implications for individual medical practitioners and health services, as well as professional colleges and associations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Factors influencing research productivity among health sciences librarians.

PubMed Central

Fenske, R E; Dalrymple, P W

1992-01-01

Secondary analysis was performed of data collected in 1989 from a random sample of members of the Medical Library Association. Results show that about half the sample had at least one publication; academic health sciences librarians were much more likely than hospital librarians to have published. Almost half the sample had taken formal courses in research, but only a small percentage had taken continuing education (CE) courses in research. Institutional support services for research were most available in academic settings. The combination of institutional support, CE training, and research courses explained 31.1% of the variation in research productivity among academic librarians; these factors were less important in hospitals and other institutional settings. The authors suggest that health sciences librarians working outside academia should seek support for research from sources outside the employing institution. PMID:1422506

Emotional climate of a pre-service science teacher education class in Bhutan

NASA Astrophysics Data System (ADS)

Rinchen, Sonam; Ritchie, Stephen M.; Bellocchi, Alberto

2016-09-01

This study explored pre-service secondary science teachers' perceptions of classroom emotional climate in the context of the Bhutanese macro-social policy of Gross National Happiness. Drawing upon sociological perspectives of human emotions and using Interaction Ritual Theory this study investigated how pre-service science teachers may be supported in their professional development. It was a multi-method study involving video and audio recordings of teaching episodes supported by interviews and the researcher's diary. Students also registered their perceptions of the emotional climate of their classroom at 3-minute intervals using audience response technology. In this way, emotional events were identified for video analysis. The findings of this study highlighted that the activities pre-service teachers engaged in matter to them. Positive emotional climate was identified in activities involving students' presentations using video clips and models, coteaching, and interactive whole class discussions. Decreases in emotional climate were identified during formal lectures and when unprepared presenters led presentations. Emotions such as frustration and disappointment characterized classes with negative emotional climate. The enabling conditions to sustain a positive emotional climate are identified. Implications for sustaining macro-social policy about Gross National Happiness are considered in light of the climate that develops in science teacher education classes.

Clinical handover practices in maternity services in Ireland: A qualitative descriptive study.

PubMed

Fealy, Gerard; Munroe, Deirdre; Riordan, Fiona; Croke, Eilish; Conroy, Celine; McNamara, Martin; Shannon, Michael

2016-08-01

the objective was to examine and describe clinical handover practices in Irish maternity services. the study design incorporated interviews and focus group discussions with a purposive sample of healthcare practitioners working in Irish maternity services. five maternity hospitals and fourteen co-located maternity units. midwives, obstetricians and other healthcare professionals, specifically physiotherapists and radiologists, midwifery students and health care assistants working in maternity services. the study participants provided nuanced and differentiated accounts of clinical handover practices, which indicated a general absence of formal policy and training on clinical handover and the practice of midwifery and medical teams holding separate clinical handovers based on their separate, respective needs for transferring information and clinical responsibility. Participants spoke of barriers to effective clinical handover, including unsuitable environments, lack of dedicated time and fatigue during duty shift clinical handover, lack of supportive information technology (IT) infrastructure, and resistance of some staff to the adoption of new technologies to support clinical handover. whether internal and external to clinical handover events, the barriers to effective clinical handover represent threats to patient safety and quality of care, since effective clinical handover is essential to the provision of safe quality care. clear and effective communication between collaborating professionals within maternity teams is essential. Copyright © 2016 Elsevier Ltd. All rights reserved.

School personnel experiences in notifying parents about their child’s risk for suicide: lessons learned

PubMed Central

Nadeem, Erum; Santiago, Catherine DeCarlo; Kataoka, Sheryl H.; Chang, Vickie Y.; Stein, Bradley D.

2015-01-01

BACKGROUND Schools across the nation are increasingly implementing suicide prevention programs that involve training school staff and connecting students and their families to appropriate services. However, little is known about how parents are engaged in such efforts. METHODS This qualitative study examined school staff perspectives on parent involvement in the implementation of a district-wide suicide prevention program by analyzing focus group and interview data gathered on the program implementation processes. Participants included middle school teachers, administrators, and other school personnel. RESULTS Study results revealed that in the immediate wake of a crisis or concern about suicide, school staff routinely contacted parents. However, substantial barriers prevent some students from receiving needed follow-up care (eg, lack of consistent follow-up, financial strain, parental stress, availability of appropriate services). Despite these challenges, school staff identified strategies that could better support parents before, during, and after the crisis. In particular, school-based services increased the success of mental health referrals. CONCLUSIONS Our study suggests that systematic post-crisis follow-up procedures are needed to improve the likelihood that students and families receive ongoing support. In particular, school-based services and home visits, training and outreach for parents, and formal training for school mental health staff on parent engagement may be beneficial in this context. PMID:26645415

School Personnel Experiences in Notifying Parents About Their Child's Risk for Suicide: Lessons Learned.

PubMed

Nadeem, Erum; Santiago, Catherine DeCarlo; Kataoka, Sheryl H; Chang, Vickie Y; Stein, Bradley D

2016-01-01

Schools across the nation are increasingly implementing suicide prevention programs that involve training school staff and connecting students and their families to appropriate services. However, little is known about how parents are engaged in such efforts. This qualitative study examined school staff perspectives on parent involvement in the implementation of a district-wide suicide prevention program by analyzing focus group and interview data gathered on the program implementation processes. Participants included middle school teachers, administrators, and other school personnel. Study results revealed that in the immediate wake of a crisis or concern about suicide, school staff routinely contacted parents. However, substantial barriers prevent some students from receiving needed follow-up care (eg, lack of consistent follow-up, financial strain, parental stress, availability of appropriate services). Despite these challenges, school staff identified strategies that could better support parents before, during, and after the crisis. In particular, school-based services increased the success of mental health referrals. Our study suggests that systematic postcrisis follow-up procedures are needed to improve the likelihood that students and families receive ongoing support. In particular, school-based services and home visits, training and outreach for parents, and formal training for school mental health staff on parent engagement may be beneficial in this context. © 2015, American School Health Association.

Psychological Well-Being Among Women Who Experienced Intimate Partner Violence and Received Civil Legal Services.

PubMed

Renner, Lynette M; Hartley, Carolyn Copps

2018-05-01

Intimate partner violence (IPV) victimization is often associated with negative mental health outcomes; yet, little is known about the psychological well-being of women who experience IPV and receive civil legal services. Civil legal services are not specifically designed to focus on women's mental health needs but Sullivan's Social and Emotional Well-Being Framework helps to explain why women receiving this type of formal assistance may demonstrate positive changes in psychological well-being. Using a panel study design and data from 85 women who experienced IPV and sought civil legal services, we examined women's psychological well-being over a one-year period of time. Approximately two thirds of the women received assistance from Iowa Legal Aid (ILA) for a civil protective order ( n = 56) and the rest were represented in a family law matter. We used measures of mental health (depression, posttraumatic stress disorder [PTSD]) and well-being (social support, resilience, goal directed thinking, empowerment). Our hypotheses that women would experience a decrease in mental health symptoms and an increase in well-being were partially supported. Women reported a decrease in depressive and PTSD symptoms over one year but there were no changes in their goal-oriented thinking or resilience. Implications for practice and future research are included.

Global Outreach: Formal and Non-Formal Education.

ERIC Educational Resources Information Center

Smith, Mary Oakes; Bradsher, Monica

"Global outreach" refers to the international delivery of education, health, public information, commercial, and other services using appropriate communications technology. International organizations are partnering in various ways with developing-country governments, private companies, local communities, and non-governmental…

Efficient and Scalable Cross-Matching of (Very) Large Catalogs

NASA Astrophysics Data System (ADS)

Pineau, F.-X.; Boch, T.; Derriere, S.

2011-07-01

Whether it be for building multi-wavelength datasets from independent surveys, studying changes in objects luminosities, or detecting moving objects (stellar proper motions, asteroids), cross-catalog matching is a technique widely used in astronomy. The need for efficient, reliable and scalable cross-catalog matching is becoming even more pressing with forthcoming projects which will produce huge catalogs in which astronomers will dig for rare objects, perform statistical analysis and classification, or real-time transients detection. We have developed a formalism and the corresponding technical framework to address the challenge of fast cross-catalog matching. Our formalism supports more than simple nearest-neighbor search, and handles elliptical positional errors. Scalability is improved by partitioning the sky using the HEALPix scheme, and processing independently each sky cell. The use of multi-threaded two-dimensional kd-trees adapted to managing equatorial coordinates enables efficient neighbor search. The whole process can run on a single computer, but could also use clusters of machines to cross-match future very large surveys such as GAIA or LSST in reasonable times. We already achieve performances where the 2MASS (˜470M sources) and SDSS DR7 (˜350M sources) can be matched on a single machine in less than 10 minutes. We aim at providing astronomers with a catalog cross-matching service, available on-line and leveraging on the catalogs present in the VizieR database. This service will allow users both to access pre-computed cross-matches across some very large catalogs, and to run customized cross-matching operations. It will also support VO protocols for synchronous or asynchronous queries.

Psychosocial changes following transition to an aged care home: qualitative findings from Iran.

PubMed

Zamanzadeh, Vahid; Rahmani, Azad; Pakpour, Vahid; Chenoweth, Lynnette Lorraine; Mohammadi, Eesa

2017-06-01

The study explored the psychosocial effects of transitioning from home to an aged care home for older Iranian people. Moving from one's own home to a communal aged care home is challenging for older people and may give rise to numerous psychosocial responses. The extent and intensity of such changes have rarely been explored in Middle Eastern countries. Data were collected through purposive sampling by in-depth semi-structured interviews with 20 participants (17 people living in aged care homes and three formal caregivers). All the interviews were recorded and typed, and conventional qualitative content analysis was used, eliciting common themes. There were four common themes: communication isolation, resource change, monotone institutional life and negative emotional response. Participants lost their previous support systems when transitioning to an aged care home and were not able to establish new ones. Routine care was provided by formal caregivers with little attention to individual needs, and minimal support was given to help maintain the older person's independence. These losses gave rise to negative emotions in some of the participants, depending on their previous lifestyle and accommodation arrangements. The extent and intensity of psychosocial changes occurring in most of the participants following their transition to an aged care home indicates the need for a review of Iranian aged care services. To assist older Iranian people adapt more readily when making the transition to aged care home and to meet their unique psychosocial needs, a family-centred approach to service delivery is recommended. © 2016 John Wiley & Sons Ltd.

Older adults' preferences for formal social support of autonomy and dependence in pain: development and validation of a scale.

PubMed

Bernardes, Sónia F; Matos, Marta; Goubert, Liesbet

2017-09-01

Chronic pain among older adults is common and often disabling. Pain-related formal social support (e.g., provided by staff at day-care centers, nursing homes), and the extent to which it promotes functional autonomy or dependence, plays a significant role in the promotion of older adults' ability to engage in their daily activities. Assessing older adults' preferences for pain-related social support for functional autonomy or dependence could contribute to increase formal social support responsiveness to individuals' needs. Therefore, this study aimed at developing and validating the preferences for formal social support of autonomy and dependence in pain inventory (PFSSADI). One hundred and sixty-five older adults with chronic musculoskeletal pain ( M age  = 79.1, 67.3% women), attending day-care centers, completed the PFSSADI, the revised formal social support for autonomy and dependence in pain inventory, and a measure of desire for (in)dependence; the PFSSADI was filled out again 6 weeks later. Confirmatory factor analyses showed a structure of two correlated factors ( r  = .56): (a) preferences for autonomy support ( α  = .99) and (b) preferences for dependence support ( α  = .98). The scale showed good test-retest reliability, sensitivity and discriminant and concurrent validity; the higher the preferences for dependence support, the higher the desire for dependence ( r  = .33) and the lower the desire for independence ( r  = -.41). The PFSSADI is an innovative tool, which may contribute to explore the role of pain-related social support responsiveness on the promotion of older adults' functional autonomy when in pain.

Development/Testing of a Monitoring System Assisting MCI Patients: The European Project INLIFE.

PubMed

Kaimakamis, Evangelos; Karavidopoulou, Vaia; Kilintzis, Vassilios; Stefanopoulos, Leandros; Papageorgiou, Valentini

2017-01-01

INLIFE is a project cofounded from the European Union aiming in prolonging independent living of elderly people with cognitive impairment based on open, seamless ICT services supporting communication, daily activities, providing health services and professional care to the elderly. The main innovation stems from ICT solutions offering 19 different services adapted on specific characteristics elderly people with mild cognitive impairment, early and later stages of Dementia, cognitive impairment and co-morbid condition, as well as their formal and informal caregivers. All services have different focus areas and are incorporated into a unified system based on cloud architecture implemented in patients of 6 European countries, including Greece. More than 1200 patients, caregivers and healthcare providers participate in the pilot testing of the project. Primary parameter for assessing the effectiveness of the interventions is their impact on the quality of life of the elderly patients and their caregivers, contributing to prolonging independent living of the affected. A special digital platform has been developed in the Greek pilot site aiming to adapt and monitor all the implemented applications. This includes a medical decision support system that receives biosignals from patients and interaction interfaces in which all participants are involved. Recruitment and patients' participation has already started in the pilot site of Thessaloniki for the services that are to be tested in Greece.

The meaning and experience of bereavement support: A qualitative interview study of bereaved family caregivers.

PubMed

Kirby, Emma; Kenny, Katherine; Broom, Alex; MacArtney, John; Good, Phillip

2017-06-21

Experiences of bereavement can be stressful and are frequently complicated by emotional, familial, and financial issues. Some-though not all-caregivers may benefit from bereavement support. While considered standard within palliative care services in Australia, bereavement support is not widely utilized by family caregivers. There is little research focused on the forms of bereavement support desired or required by family caregivers, how such care is viewed, and/or how bereavement support is experienced. This study examined the experiences of bereaved family caregivers and their impressions of and interactions with bereavement support. This paper reports on one aspect of a broader study designed to explore a range of experiences of patients and caregivers to and through palliative care. Focusing on experiences of bereavement, it draws on qualitative semistructured interviews with 15 family caregivers of palliative care patients within a specialist palliative care unit of an Australian metropolitan hospital. The interviews for this stage of the study were initiated 3-9 months after an initial interview with a family caregiver, during which time the palliative patient had died, and they covered family caregivers' experiences of bereavement and bereavement support. Interviews were digitally audiotaped and transcribed in full. A thematic analysis was conducted utilizing the framework approach wherein interview transcripts were reviewed, key themes identified, and explanations developed. The research identified four prevalent themes: (1) sociocultural constructions of bereavement support as for the incapable or socially isolated; (2) perceptions of bereavement support services as narrow in scope; (3) the "personal" character of bereavement and subsequent incompatibility with formalized support, and (4) issues around the timing and style of approaches to being offered support. Systematic pre-bereavement planning and careful communication about the services offered by palliative care bereavement support centers may improve receipt of support among bereaved family caregivers in need.

Forms of Student Support in Sweden: Past, Present and Future

ERIC Educational Resources Information Center

Stromqvist, Sture

2006-01-01

Student support consists not only of direct financial support, but also of educational provisions that are free of charge or subsidized by the state and local authorities. These provisions include formal education, as schools for young people and adults as well as higher education, and non-formal education, such as study circles and folk high…

Toronto's 2-1-1 healthcare services for immigrant populations.

PubMed

Cortinois, Andrea A; Glazier, Richard H; Caidi, Nadia; Andrews, Gavin; Herbert-Copley, Mary; Jadad, Alejandro R

2012-12-01

Although access to information on health services is particularly important for recent immigrants, numerous studies have shown that their use of information and referral services is limited. This study explores the role played by 2-1-1 Toronto in supporting recent immigrants. The study objectives were to (1) understand whether 2-1-1 Toronto is reaching and supporting recent immigrants and (2) gain a better appreciation of the information needs of this population group. A phone survey was conducted in 2005-2006 to collect information on 2-1-1 users' characteristics and levels of satisfaction. Survey data were compared (in 2006) with census data to assess their representativeness. To achieve Objective 2, semistructured qualitative interviews were conducted and analyzed in 2006-2007, with a subset of Spanish-speaking callers. Recent immigrants were overrepresented among 2-1-1 callers. However, the survey population was substantially younger and had higher levels of formal education than the general population. Health-related queries represented almost one third of the total. The survey showed very high levels of satisfaction with the service. Many interviewees described their first experiences with the Canadian healthcare system negatively. Most of them had relied on disjointed, low-quality information sources. They trusted 2-1-1 but had discovered it late. Results are mixed in terms of 2-1-1's support to immigrants. A significant percentage of users do not take full advantage of the service. The service could become the information "entry point" for recent immigrants if it was able to reach them early in the resettlement process. Proactive, community-oriented work and a more creative use of technology could help. Copyright © 2012 American Journal of Preventive Medicine. All rights reserved.

Benefits of peer support groups in the treatment of addiction

PubMed Central

Tracy, Kathlene; Wallace, Samantha P

2016-01-01

Objective Peer support can be defined as the process of giving and receiving nonprofessional, nonclinical assistance from individuals with similar conditions or circumstances to achieve long-term recovery from psychiatric, alcohol, and/or other drug-related problems. Recently, there has been a dramatic rise in the adoption of alternative forms of peer support services to assist recovery from substance use disorders; however, often peer support has not been separated out as a formalized intervention component and rigorously empirically tested, making it difficult to determine its effects. This article reports the results of a literature review that was undertaken to assess the effects of peer support groups, one aspect of peer support services, in the treatment of addiction. Methods The authors of this article searched electronic databases of relevant peer-reviewed research literature including PubMed and MedLINE. Results Ten studies met our minimum inclusion criteria, including randomized controlled trials or pre-/post-data studies, adult participants, inclusion of group format, substance use-related, and US-conducted studies published in 1999 or later. Studies demonstrated associated benefits in the following areas: 1) substance use, 2) treatment engagement, 3) human immunodeficiency virus/hepatitis C virus risk behaviors, and 4) secondary substance-related behaviors such as craving and self-efficacy. Limitations were noted on the relative lack of rigorously tested empirical studies within the literature and inability to disentangle the effects of the group treatment that is often included as a component of other services. Conclusion Peer support groups included in addiction treatment shows much promise; however, the limited data relevant to this topic diminish the ability to draw definitive conclusions. More rigorous research is needed in this area to further expand on this important line of research. PMID:27729825

Best practices of formal new graduate nurse transition programs: an integrative review.

PubMed

Rush, Kathy L; Adamack, Monica; Gordon, Jason; Lilly, Meredith; Janke, Robert

2013-03-01

The aim of this review was to identify best practices of formal new graduate nurse transition programs. This information would be useful for organizations in their support and development of formal transition programs for newly hired nurses. An integrative review of the nursing research literature (2000-2011). The literature search included PubMed (MEDLINE), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Excerpta Medica Database (Embase). Studies that dealt with programs geared toward pre-registration nursing students were removed. At least two researchers evaluated the literature to determine if the article met the inclusion and exclusion criteria. The final number of articles included in this review is 47. Cooper's (1989) five-stage approach to integrative review guided the process: problem formulation, data collection, evaluation of data points, data analysis and interpretation, presentation of results. Transition program literature was examined according to four major themes: Education (pre-registration and practice), Support/Satisfaction, Competency and Critical Thinking, and Workplace Environment. This included new graduates' retrospective accounts of their undergraduate education and examination of orientation and formal supports provided beyond the traditional unit orientation period. Transition programs included residencies, internships, mentorships, extended preceptorships, and generic programs. Common elements of programs were a specified resource person(s) for new graduates, mentor (mentorship), formal education, and peer support opportunities. The length, type of education, and supports provided varied considerably among programs, yet the presence of a transition program resulted in improved new graduate nurse retention and cost benefits. The variability in research designs limits the conclusions that can be drawn about best practices in transition programs for new graduate nurses. The presence of a formal new graduate transition program resulted in good retention and improved competency. The stronger evidence suggests that new graduate education should focus on practical skill development, preceptors should receive a level of formal training, formal support should be available at least through the difficult six to nine month post-hire period, opportunities for connection with their peers should be provided, and organizations should strive to ensure clinical units with healthy work environments. Copyright © 2012 Elsevier Ltd. All rights reserved.

The role of community centre-based arts, leisure and social activities in promoting adult well-being and healthy lifestyles.

PubMed

Jones, Mat; Kimberlee, Richard; Deave, Toity; Evans, Simon

2013-05-10

Developed countries are experiencing high levels of mental and physical illness associated with long term health conditions, unhealthy lifestyles and an ageing population. Given the limited capacity of the formal health care sector to address these public health issues, attention is turning to the role of agencies active in civil society. This paper sought to evaluate the associations between participation in community centre activities, the psycho-social wellbeing and health related behaviours. This was based on an evaluation of the South West Well-being programme involving ten organisations delivering leisure, exercise, cooking, befriending, arts and crafts activities. The evaluation consisted of a before-and-after study with 687 adults. The results showed positive changes in self-reported general health, mental health, personal and social well-being. Positive changes were associated with diet and physical activity. Some activities were different in their outcomes-especially in cases where group activities were combined with one-to-one support. The results suggest that community centre activities of this nature offer benefits that are generically supportive of health behaviour changes. Such initiatives can perform an important role in supporting the health improvement objectives of formal health care services. For commissioners and partner agencies, accessibility and participation are attractive features that are particularly pertinent to the current public health context.

Process quality indicators targeting cognitive impairment to support quality of care for older people with cognitive impairment in emergency departments.

PubMed

Schnitker, Linda M; Martin-Khan, Melinda; Burkett, Ellen; Beattie, Elizabeth R A; Jones, Richard N; Gray, Len C

2015-03-01

The objective of this study was to develop process quality indicators (PQIs) to support the improvement of care services for older people with cognitive impairment in emergency departments (ED). A structured research approach was taken for the development of PQIs for the care of older people with cognitive impairment in EDs, including combining available evidence with expert opinion (phase 1), a field study (phase 2), and formal voting (phase 3). A systematic review of the literature identified ED processes targeting the specific care needs of older people with cognitive impairment. Existing relevant PQIs were also included. By integrating the scientific evidence and clinical expertise, new PQIs were drafted and, along with the existing PQIs, extensively discussed by an advisory panel. These indicators were field tested in eight hospitals using a cohort of older persons aged 70 years and older. After analysis of the field study data (indicator prevalence, variability across sites), in a second meeting, the advisory panel further defined the PQIs. The advisory panel formally voted for selection of those PQIs that were most appropriate for care evaluation. In addition to seven previously published PQIs relevant to the care of older persons, 15 new indicators were created. These 22 PQIs were then field tested. PQIs designed specifically for the older ED population with cognitive impairment were only scored for patients with identified cognitive impairment. Following formal voting, a total of 11 PQIs were included in the set. These PQIs targeted cognitive screening, delirium screening, delirium risk assessment, evaluation of acute change in mental status, delirium etiology, proxy notification, collateral history, involvement of a nominated support person, pain assessment, postdischarge follow-up, and ED length of stay. This article presents a set of PQIs for the evaluation of the care for older people with cognitive impairment in EDs. The variation in indicator triggering across different ED sites suggests that there are opportunities for quality improvement in care for this vulnerable group. Applied PQIs will identify an emergency services' implementation of care strategies for cognitively impaired older ED patients. Awareness of the PQI triggers at an ED level enables implementation of targeted interventions to improve any suboptimal processes of care. Further validation and utility of the indicators in a wider population is now indicated. © 2015 by the Society for Academic Emergency Medicine.

VisPort: Web-Based Access to Community-Specific Visualization Functionality [Shedding New Light on Exploding Stars: Visualization for TeraScale Simulation of Neutrino-Driven Supernovae (Final Technical Report)

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

Baker, M Pauline

2007-06-30

The VisPort visualization portal is an experiment in providing Web-based access to visualization functionality from any place and at any time. VisPort adopts a service-oriented architecture to encapsulate visualization functionality and to support remote access. Users employ browser-based client applications to choose data and services, set parameters, and launch visualization jobs. Visualization products typically images or movies are viewed in the user's standard Web browser. VisPort emphasizes visualization solutions customized for specific application communities. Finally, VisPort relies heavily on XML, and introduces the notion of visualization informatics - the formalization and specialization of information related to the process and productsmore » of visualization.« less

Sons as sole caregivers for their elderly parents. How do they cope?

PubMed Central

Thompson, B.; Tudiver, F.; Manson, J.

2000-01-01

OBJECTIVE: To examine the experiences of men who are sole caregivers for their elderly parents. DESIGN: Semistructured in-depth interviews. SETTING: Family practice clinic attached to a large tertiary care centre in north central Toronto. PARTICIPANTS: A convenience sample of 10 men who identified themselves as sole caregivers in that they had no particular women assisting them with caregiving. METHOD: Interviews were analyzed by standard qualitative methods. MAIN FINDINGS: Emerging themes were the spectrum of caregiving, the experience of caregiving, and the use of formal support systems. Scope of care varied from very little to total care, including personal care. Participants described positive and negative aspects of and the nature of their relationships with those for whom they cared. Avoiding institutionalization was seen as positive; effects on work and social life were negative. Use of more than homemaking services was associated with previous hospitalization; participants complained about difficulties accessing services. CONCLUSIONS: The nature of sons' relationships with their parents and the amount of time they have available can predict how much caregiving they can undertake. Information about community support services is not readily accessible to these men. PMID:10690492

Mental health beliefs and barriers to accessing mental health services in youth aging out of foster care.

PubMed

Sakai, Christina; Mackie, Thomas I; Shetgiri, Rashmi; Franzen, Sara; Partap, Anu; Flores, Glenn; Leslie, Laurel K

2014-01-01

To examine the perspectives of youth on factors that influence mental health service use after aging out of foster care. Focus groups were conducted with youth with a history of mental health needs and previous service use who had aged out of foster care. Questions were informed by the Health Belief Model and addressed 4 domains: youth perceptions of the "threat of mental health problems," treatment benefits versus barriers to accessing mental health services, self-efficacy, and "cues to action." Data were analyzed using a modified grounded-theory approach. Youth (N = 28) reported ongoing mental health problems affecting their functioning; however, they articulated variable levels of reliance on formal mental health treatment versus their own ability to resolve these problems without treatment. Past mental health service experiences influenced whether youth viewed treatment options as beneficial. Youth identified limited self-efficacy and insufficient psychosocial supports "cueing action" during their transition out of foster care. Barriers to accessing mental health services included difficulties obtaining health insurance, finding a mental health provider, scheduling appointments, and transportation. Youths' perceptions of their mental health needs, self-efficacy, psychosocial supports during transition, and access barriers influence mental health service use after aging out of foster care. Results suggest that strategies are needed to 1) help youth and clinicians negotiate shared understanding of mental health treatment needs and options, 2) incorporate mental health into transition planning, and 3) address insurance and other systemic barriers to accessing mental health services after aging out of foster care. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

In the Aftermath: Attitudes of Anesthesiologists to Supportive Strategies After an Unexpected Intraoperative Patient Death.

PubMed

Heard, Gaylene C; Thomas, Rowan D; Sanderson, Penelope M

2016-05-01

Although most anesthesiologists will have 1 catastrophic perioperative event or more during their careers, there has been little research on their attitudes to assistive strategies after the event. There are wide-ranging emotional consequences for anesthesiologists involved in an unexpected intraoperative patient death, particularly if the anesthesiologist made an error. We used a between-groups survey study design to ask whether there are different attitudes to assistive strategies when a hypothetical patient death is caused by a drug error versus not caused by an error. First, we explored attitudes to generalized supportive strategies. Second, we examined our hypothesis that the presence of an error causing the hypothetical patient death would increase the perceived social stigma and self-stigma of help-seeking. Finally, we examined the strategies to assist help-seeking. An anonymous, mailed, self-administered survey was conducted with 1600 consultant anesthesiologists in Australia on the mailing list of the Australian and New Zealand College of Anaesthetists. The participants were randomized into "error" versus "no-error" groups for the hypothetical scenario of patient death due to anaphylaxis. Nonparametric, descriptive, parametric, and inferential tests were used for data analysis. P' is used where P values were corrected for multiple comparisons. There was a usable response rate of 48.9%. When an error had caused the hypothetical patient death, participants were more likely to agree with 4 of the 5 statements about support, including need for time off (P' = 0.003), counseling (P' < 0.001), a formal strategy for assistance (P' < 0.001), and the anesthesiologist not performing further cases that day (P' = 0.047). There were no differences between groups in perceived self-stigma (P = 0.98) or social stigma (P = 0.15) of seeking counseling, whether or not an error had caused the hypothetical patient death. Finally, when an error had caused the patient death, participants were more likely to agree with 2 of the 5 statements about help-seeking, including the need for a formal, hospital-based process that provides information on where to obtain professional counseling (P' = 0.006) and the availability of after-hours counseling services (P' = 0.035). Our participants were more likely to agree with assistive strategies such as not performing further work that day, time off, counseling, formal support strategies, and availability of after-hours counseling services, when the hypothetical patient death from anaphylaxis was due to an error. The perceived stigma toward attending counseling was not affected by the presence or absence of an error as the cause of the patient death, disproving our hypothesis.

Utilization of formal health services for children aged 1–5 in Aceh after the 2004 tsunami: Which children did not receive the health care they needed? Implications for other natural disaster relief efforts

PubMed Central

Rassekh, Bahie Mary; Santosham, Mathuram

2014-01-01

Aceh, Indonesia, was the hardest-hit area in the December 26, 2004 Indian Ocean earthquake and tsunami, with more than 500,000 people displaced, 120,000 people dead, and total damages and losses estimated at $4.5 billion. The relief effort following the tsunami was also immense, with billions of dollars of aid pledged to this province alone. Since then, there have been several natural disasters, including Typhoon Haiyan, which have caused great loss of life and displacement and for which these results are applicable. This study aimed to determine and assess utilization patterns of health services for children under the age of five with diarrhea, cough and difficulty breathing, fever, or skin disease and to identify determinants of formal and non-formal healthcare usage. A household survey of 1439 households was administered to caretakers of children aged 1–5 years. A sample of clusters within Banda Aceh and Aceh Besar were selected and those caretakers within the cluster who fit the inclusion criteria were interviewed. In the two weeks prior to the survey, 78.3% of respondents utilized formal health services as the first line of care for their child's illness episode. Factors significantly associated with decreased formal healthcare usage for the sick children were if the children were living in a displaced household, if the children's mother or father were not living, and if the children's caretaker was not the mother. Although utilization of formal health services for children was quite high after the tsunami, there were certain children who received significantly less care, including those who were displaced, those who were being cared for by someone other than their mother, and those for whom one or both parents had died. Among the recommendations are suggestions to target these children to ensure that they receive the health care they need. PMID:25750772

Unleashing the power of human genetic variation knowledge: New Zealand stakeholder perspectives.

PubMed

Gu, Yulong; Warren, James Roy; Day, Karen Jean

2011-01-01

This study aimed to characterize the challenges in using genetic information in health care and to identify opportunities for improvement. Taking a grounded theory approach, semistructured interviews were conducted with 48 participants to collect multiple stakeholder perspectives on genetic services in New Zealand. Three themes emerged from the data: (1) four service delivery models were identified in operation, including both those expected models involving genetic counselors and variations that do not route through the formal genetic service program; (2) multiple barriers to sharing and using genetic information were perceived, including technological, organizational, institutional, legal, ethical, and social issues; and (3) impediments to wider use of genetic testing technology, including variable understanding of genetic test utilities among clinicians and the limited capacity of clinical genetic services. Targeting these problems, information technologies and knowledge management tools have the potential to support key tasks in genetic services delivery, improve knowledge processes, and enhance knowledge networks. Because of the effect of issues in genetic information and knowledge management, the potential of human genetic variation knowledge to enhance health care delivery has been put on a "leash."

Who serves the urban poor? A geospatial and descriptive analysis of health services in slum settlements in Dhaka, Bangladesh.

PubMed

Adams, Alayne M; Islam, Rubana; Ahmed, Tanvir

2015-03-01

In Bangladesh, the health risks of unplanned urbanization are disproportionately shouldered by the urban poor. At the same time, affordable formal primary care services are scarce, and what exists is almost exclusively provided by non-government organizations (NGOs) working on a project basis. So where do the poor go for health care? A health facility mapping of six urban slum settlements in Dhaka was undertaken to explore the configuration of healthcare services proximate to where the poor reside. Three methods were employed: (1) Social mapping and listing of all Health Service Delivery Points (HSDPs); (2) Creation of a geospatial map including Global Positioning System (GPS) co-ordinates of all HSPDs in the six study areas and (3) Implementation of a facility survey of all HSDPs within six study areas. Descriptive statistics are used to examine the number, type and concentration of service provider types, as well as indicators of their accessibility in terms of location and hours of service. A total of 1041 HSDPs were mapped, of which 80% are privately operated and the rest by NGOs and the public sector. Phamacies and non-formal or traditional doctors make up 75% of the private sector while consultation chambers account for 20%. Most NGO and Urban Primary Health Care Project (UPHCP) static clinics are open 5-6 days/week, but close by 4-5 pm in the afternoon. Evening services are almost exclusively offered by private HSDPs; however, only 37% of private sector health staff possess some kind of formal medical qualification. This spatial analysis of health service supply in poor urban settlements emphasizes the importance of taking the informal private sector into account in efforts to increase effective coverage of quality services. Features of informal private sector service provision that have facilitated market penetration may be relevant in designing formal services that better meet the needs of the urban poor. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

Vocabulary services to support scientific data interoperability

NASA Astrophysics Data System (ADS)

Cox, Simon; Mills, Katie; Tan, Florence

2013-04-01

Shared vocabularies are a core element in interoperable systems. Vocabularies need to be available at run-time, and where the vocabularies are shared by a distributed community this implies the use of web technology to provide vocabulary services. Given the ubiquity of vocabularies or classifiers in systems, vocabulary services are effectively the base of the interoperability stack. In contemporary knowledge organization systems, a vocabulary item is considered a concept, with the "terms" denoting it appearing as labels. The Simple Knowledge Organization System (SKOS) formalizes this as an RDF Schema (RDFS) application, with a bridge to formal logic in Web Ontology Language (OWL). For maximum utility, a vocabulary should be made available through the following interfaces: * the vocabulary as a whole - at an ontology URI corresponding to a vocabulary document * each item in the vocabulary - at the item URI * summaries, subsets, and resources derived by transformation * through the standard RDF web API - i.e. a SPARQL endpoint * through a query form for human users. However, the vocabulary data model may be leveraged directly in a standard vocabulary API that uses the semantics provided by SKOS. SISSvoc3 [1] accomplishes this as a standard set of URI templates for a vocabulary. Any URI comforming to the template selects a vocabulary subset based on the SKOS properties, including labels (skos:prefLabel, skos:altLabel, rdfs:label) and a subset of the semantic relations (skos:broader, skos:narrower, etc). SISSvoc3 thus provides a RESTFul SKOS API to query a vocabulary, but hiding the complexity of SPARQL. It has been implemented using the Linked Data API (LDA) [2], which connects to a SPARQL endpoint. By using LDA, we also get content-negotiation, alternative views, paging, metadata and other functionality provided in a standard way. A number of vocabularies have been formalized in SKOS and deployed by CSIRO, the Australian Bureau of Meteorology (BOM) and their collaborators using SISSvoc3, including: * geologic timescale (multiple versions) * soils classification * definitions from OGC standards * geosciml vocabularies * mining commodities * hyperspectral scalars Several other agencies in Australia have adopted SISSvoc3 for their vocabularies. SISSvoc3 differs from other SKOS-based vocabulary-access APIs such as GEMET [3] and NVS [4] in that (a) the service is decoupled from the content store, (b) the service URI is independent of the content URIs This means that a SISSvoc3 interface can be deployed over any SKOS vocabulary which is available at a SPARQL endpoint. As an example, a SISSvoc3 query and presentation interface has been deployed over the NERC vocabulary service hosted by the BODC, providing a search interface which is not available natively. We use vocabulary services to populate menus in user interfaces, to support data validation, and to configure data conversion routines. Related services built on LDA have also been used as a generic registry interface, and extended for serving gazetteer information. ACKNOWLEDGEMENTS The CSIRO SISSvoc3 implementation is built using the Epimorphics ELDA platform http://code.google.com/p/elda/. We thank Jacqui Githaiga and Terry Rankine for their contributions to SISSvoc design and implementation. REFERENCES 1. SISSvoc3 Specification https://www.seegrid.csiro.au/wiki/Siss/SISSvoc30Specification 2. Linked Data API http://code.google.com/p/linked-data-api/wiki/Specification 3. GEMET https://svn.eionet.europa.eu/projects/Zope/wiki/GEMETWebServiceAPI 4. NVS 2.0 http://vocab.nerc.ac.uk/

Health-financing reforms in southeast Asia: challenges in achieving universal coverage.

PubMed

Tangcharoensathien, Viroj; Patcharanarumol, Walaiporn; Ir, Por; Aljunid, Syed Mohamed; Mukti, Ali Ghufron; Akkhavong, Kongsap; Banzon, Eduardo; Huong, Dang Boi; Thabrany, Hasbullah; Mills, Anne

2011-03-05

In this sixth paper of the Series, we review health-financing reforms in seven countries in southeast Asia that have sought to reduce dependence on out-of-pocket payments, increase pooled health finance, and expand service use as steps towards universal coverage. Laos and Cambodia, both resource-poor countries, have mostly relied on donor-supported health equity funds to reach the poor, and reliable funding and appropriate identification of the eligible poor are two major challenges for nationwide expansion. For Thailand, the Philippines, Indonesia, and Vietnam, social health insurance financed by payroll tax is commonly used for formal sector employees (excluding Malaysia), with varying outcomes in terms of financial protection. Alternative payment methods have different implications for provider behaviour and financial protection. Two alternative approaches for financial protection of the non-poor outside the formal sector have emerged-contributory arrangements and tax-financed schemes-with different abilities to achieve high population coverage rapidly. Fiscal space and mobilisation of payroll contributions are both important in accelerating financial protection. Expanding coverage of good-quality services and ensuring adequate human resources are also important to achieve universal coverage. As health-financing reform is complex, institutional capacity to generate evidence and inform policy is essential and should be strengthened. Copyright © 2011 Elsevier Ltd. All rights reserved.

Don't abandon hope all ye who enter here: The protective role of formal mentoring and learning processes on burnout in correctional officers.

PubMed

Farnese, M L; Barbieri, B; Bellò, B; Bartone, P T

2017-01-01

Within a Job Demands-Resources Model framework, formal mentoring can be conceived as a job resource expressing the organization's support for new members, which may prevent their being at risk for burnout. This research aims at understanding the protective role of formal mentoring on burnout, through the effect of increasing learning personal resources. Specifically, we hypothesized that formal mentoring enhances newcomers' learning about job and social domains related to the new work context, thus leading to lower burnout. In order to test the hypotheses, a multiple regression analysis using the bootstrapping method was used. Based on a questionnaire administered to 117 correctional officer newcomers who had a formal mentor assigned, our results confirm that formal mentoring exerts a positive influence on newcomers' adjustment, and that this in turn exerts a protective influence against burnout onset by reducing cynicism and interpersonal stress and also enhancing the sense of personal accomplishment. Confirming previous literature's suggestions, supportive mentoring and effective socialization seem to represent job and personal resources that are protective against burnout. This study provides empirical support for this relation in the prison context.

'What makes an excellent mental health doctor?' A response integrating the experiences and views of service users with critical reflections of psychiatrists.

PubMed

Gunasekara, Imani; Patterson, Sue; Scott, James G

2017-11-01

While therapeutic relationships are appropriately recognised as the foundation of mental health service, service users commonly report suboptimal experiences. With shared understanding critical to improvement in practice, we explored service users' experiences and expectations of psychiatrists and consultations, engaging psychiatrists throughout the process. Using an iterative qualitative approach we co-produced a response to the question 'what makes an excellent mental health doctor?' Experiences and expectations of psychiatrists were explored in interviews with 22 service users. Data collection, analysis and interpretation were informed by consultation with peer workers. Findings were contextualised in formal consultations with psychiatrists. As 'masters of their craft', excellent mental health doctors engage authentically with service users as people (not diagnoses). They listen, validate experiences and empathise affectively and cognitively. They demonstrate phronesis, applying clinical knowledge compassionately. Psychiatrists share service users' aspiration of equitable partnership but competing demands and 'professional boundaries' constrain engagement. Consistent delivery of the person-centred, recovery-oriented care promoted by policy and sought by service users will require substantial revision of the structure and priorities of mental health services. The insights and experiences of service users must be integral to medical education, and systems must provide robust support to psychiatrists. © 2017 John Wiley & Sons Ltd.

Employer Family-Supportive Policies: Diverse Variations on the Theme.

ERIC Educational Resources Information Center

Raabe, Phyllis H.; Gessner, John C.

1988-01-01

Examined the extent and nature of employer workplace initiatives based on interviews with New Orleans (Louisiana) employers. Bolstered other research findings of progress but continued limited workplace implementations of formal, family-supportive programs. Found modifications of formal and informal policies extended organizational family…

Digital Resource Developments for Mathematics Education Involving Homework across Formal, Non-Formal and Informal Settings

ERIC Educational Resources Information Center

Radovic, Slaviša; Passey, Don

2016-01-01

The aim of this paper is to explore further an under-developed area--how drivers of curriculum, pedagogy and assessment conceptions and practices shape the creation and uses of technologically based resources to support mathematics learning across informal, non-formal and formal learning environments. The paper considers: the importance of…

47 CFR 14.38 - Formal Complaints; General pleading requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Formal Complaints; General pleading requirements. 14.38 Section 14.38 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping, Consumer Dispute...

47 CFR 14.33 - Informal or formal complaints.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false Informal or formal complaints. 14.33 Section 14.33 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping, Consumer Dispute Assistance, and...

47 CFR 14.33 - Informal or formal complaints.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Informal or formal complaints. 14.33 Section 14.33 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping, Consumer Dispute Assistance, and...

47 CFR 14.33 - Informal or formal complaints.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Informal or formal complaints. 14.33 Section 14.33 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping, Consumer Dispute Assistance, and...

47 CFR 14.38 - Formal Complaints; General pleading requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Formal Complaints; General pleading requirements. 14.38 Section 14.38 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping, Consumer Dispute...

47 CFR 14.38 - Formal Complaints; General pleading requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false Formal Complaints; General pleading requirements. 14.38 Section 14.38 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping, Consumer Dispute...

Examining the breastfeeding support resources of the public health nursing services in Ireland.

PubMed

Mulcahy, Helen; Phelan, Agnes; Corcoran, Paul; Leahy-Warren, Patricia

2012-04-01

The aim of the study was to review breastfeeding support provided by Public Health Nurses in Ireland. The objectives were to identify the availability of appropriate guiding policies, educational preparation, attitude of Public Health Nurses and the availability and use of other supportive services. Breastfeeding rates in Ireland are among the lowest in Europe. The main source of formal support for breastfeeding mothers in the community in Ireland is from Public Health Nurses who can make referral to other non-statutory resources. The nature of this support is determined by policies guiding clinical practice and education that increases breastfeeding confidence and competence of all personnel. Consequently, an assessment of breastfeeding resources requires an analysis of all these variables. A large quantitative, cross-sectional study was conducted, involving Public Health Nurses and mothers. This paper represents the results from the perspective of Public Health Nurses. Directors of Public Health Nursing (n = 24) and Public Health Nurses (n = 204) completed self-report questionnaires by mail and online. Data were analysed using the Statistical Package for Social Sciences and reported using descriptive and inferential statistics. Public Health Nurses are well educated to support breastfeeding and have a positive attitude and a high degree of self-assessed confidence and competence. A wide variety of non-statutory support exists for breastfeeding but is not always used to their full potential. Standardising educational requirements for Public Health Nurses in supporting breastfeeding is an area that requires attention. Ultimately, service delivery in relation to supporting breastfeeding mothers would benefit from being more timely and responsive. Awareness of support resources is necessary for Public Health Nurses to make appropriate referrals for breastfeeding mothers. Furthermore, Directors of Public Health Nursing need to encourage the breastfeeding supportive role of Public Health Nurses and facilitate continuing professional development. © 2011 Blackwell Publishing Ltd.

Veterinarian challenges to providing a multi-agency response to farm animal welfare problems in Ireland: responding to the human factor.

PubMed

Devitt, C; Kelly, P; Blake, M; Hanlon, A; More, S J

2013-12-01

In 2012, the authors undertook a study of the challenges facing government and private veterinarians in responding to the human element of farm animal welfare incidents (i.e. the personal problems and difficulties of farmers that can result in farm animal neglect). This paper reports their findings and examines the role of veterinarians in responding to the difficulties of farmers. It also looks at their experiences of attempting to build a multi-agency approach involving veterinary and human support services. This paper builds on a study whereby the authors considered how social, health and attitudinal factors, as well as mental health problems, contribute to farm animal welfare incidents in Ireland. An early warning system involving relevant agencies is in place to identify and prevent farm animal welfare problems before they become critical. The literature provides examples of private veterinarians combining with support services where there are indicators of animal and human abuse. Yet there are no research examples of government or private veterinarians linking with support services to resolve farm animal welfare cases where there are social, health, and/or mental health difficulties with the herd owner. Four focus groups were conducted with government veterinarians (n = 18) and three with private veterinarians (n = 12). Government veterinarians made contact with support services to seek advice on how best to respond to the human element of farm animal welfare incidents, and/or to seek support for the herd owner. Contact between government and private veterinarians was driven by the former. Communication between agencies was influenced by individual efforts and personal contacts. Formal structures and guidelines, perceived professional capabilities in determining herd owner needs, and client confidentiality concerns among support services and private veterinarians were less influential. The fear of losing clients and the financial implications of this were also cited by private veterinarians. Family, neighbours and local support groups assisted in reaching an on-farm solution. The paper concludes with the requirements for a multi-agency approach in Ireland: the provision of tailored information and guidelines targeting government and private veterinarians and support services, and a comprehensive structure for relationship-building, planning, and cross-reporting between all the relevant agencies.

Approaches to education provision for mobile pastoralists.

PubMed

Dyer, C

2016-11-01

Experiences of mobile pastoralists often attest to a wide range of contradictions about the presumed advantages of formal education. While effort to 'reach' pastoralists has intensified under the global Education for All movement, there remain considerable difficulties in finding ways to make formal education relate to pastoralist livelihoods and complement endogenous knowledge. This paper examines how these dynamics play out across models of formal and non-formal education service provision, and identifies innovations that offer promising ways forward: Alternative Basic Education, Open and Distance Learning, and Pastoralist Field Schools.

Perceived support at work after critical incidents and its relation to psychological distress: a survey among prehospital providers.

PubMed

Gouweloos-Trines, Juul; Tyler, Mark P; Giummarra, Melita J; Kassam-Adams, Nancy; Landolt, Markus A; Kleber, Rolf J; Alisic, Eva

2017-12-01

Prehospital providers are at increased risk for psychological distress. Support at work after critical incidents is believed to be important for providers, but current guidelines are in need of more scientific evidence. This study aimed to investigate: (1) to what extent prehospital providers experience support at work; (2) whether support at work is directly associated with lower distress and (3) whether availability of a formal peer support system is related to lower distress via perceived colleague support. This cross-sectional study surveyed prehospital providers from eight western industrialised countries between June and November 2014. A supportive work environment was operationalised as perceived management and colleague support (Job Content Questionnaire), availability of a formal peer support system and having enough time to recover after critical incidents. The outcome variable was psychological distress (Kessler 10). We conducted multiple linear regression analyses and mediation analysis. Of the 813 respondents, more than half (56.2%) were at moderate to high risk of psychological distress. Participants did not consistently report support at work (eg, 39.4% were not aware of formal peer support). Perceived management support (b (unstandardised regression coefficient)=-0.01, 95% CI -0.01 to 0.00), having enough time to recover after critical incidents (b=-0.07, 95% CI -0.09 to -0.04) and perceived colleague support (b=-0.01, 95% CI -0.01 to 0.00) were related to lower distress. Availability of formal peer support was indirectly related to lower distress via increased perceived colleague support (β=-0.04, 95% CI -0.02 to -0.01). Prehospital providers at risk of psychological distress may benefit from support from colleagues and management and from having time to recover after critical incidents. Formal peer support may assist providers by increasing their sense of support from colleagues. These findings need to be verified in a longitudinal design. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effects of Extracurricular Participation on the Internalizing Problems and Intrapersonal Strengths of Youth in a System of Care.

PubMed

Abraczinskas, Michelle; Kilmer, Ryan; Haber, Mason; Cook, James; Zarrett, Nicole

2016-06-01

Although extracurricular participation has been linked to positive youth outcomes in the general population, no research to date has examined benefits for youth diagnosed with mental health challenges. Youth in systems of care (SOCs) receive a variety of services and supports that could help them capitalize on this potential for positive development, such as access to flexible funding to support recreational interests. However, research has not examined the degree to which the increased community involvement (e.g., extracurricular participation) sought in SOCs contributes to improved outcomes. This study addresses these gaps by investigating the relationships between both average and increased extracurricular participation frequency and breadth and internalizing problems and intrapersonal strengths among SOC youth. Findings revealed that, on average, higher frequency of youth participation was associated with higher intrapersonal strengths and lower internalizing problems. Increases in participation frequency were also associated with increased strengths and decreased internalizing problems. These findings suggest that efforts to implement supports for increasing extracurricular participation of SOC youth could improve their psychosocial outcomes beyond the benefits yielded via formal services. Taken together, these results provide support for advocacy efforts to integrate youth with mental health challenges into existing extracurriculars and to create new extracurricular opportunities. © Society for Community Research and Action 2016.

Fathers' Orientation to their Children's Autism Diagnosis: A Grounded Theory Study.

PubMed

Hannon, Michael D; Hannon, LaChan V

2017-07-01

Sixteen fathers of individuals with autism were interviewed to develop a grounded theory explaining how they learned about their children's autism diagnosis. Results suggest the orientation process entails at least two phases: orienting oneself and orienting others. The orienting oneself phase entailed fathers having suspicion of developmental differences, engaging in research and education activities, having their children formally evaluated; inquiring about their children's prognosis, and having curiosities about autism's etiology. The orienting others phase entailed orientating family members and orienting members of their broader communities. Recommendations for responsive service provision, support for fathers, and future research are offered.

Implementation of the Meikirch Model in Odisha, India.

PubMed

Samal, Sarangadhar

2014-08-01

The National Youth Service Action and Social Development Research Institute (NYSASDRI) has been implementing the Meikirch Model in 100 villages in the state of Odisha where rates of poverty, infant and maternal mortality are the highest in India. Although no formal evaluation yet exists, NYSASDRI staff have monitored 20 villages closely and associate great improvements in sanitation, malaria prevention, immunization, and nutrition with implementation of the Meikirch Model. NYSASDRI engaged in implementation with villagers and elders and with growing support of health practitioners, government officials, people's representative, media, social activists, and functionaries of other non-governmental organizations.

Aging in the Republic of Bulgaria.

PubMed

Pitheckoff, Natalie

2017-10-01

Bulgaria, a southeastern European nation with 7.1 million inhabitants, is ranked 4th in the world for its rate of population aging. Bulgaria has one of the highest proportions of older adults in the world with approximately 20% aged 65 and older. Three main demographic factors have led to rapid population aging. These include emigration, high death rates, and low birth rates. This "perfect storm" of demographic factors has created numerous political, social, and economic challenges for Bulgaria. For example, informal support of older adults is declining as younger generations move abroad or to urban areas for greater employment opportunities. This has increased the need for formal long-term services and supports, which can be at odds with traditional values. Additionally, economic sustainability is a major concern for the nation as population aging and de-population continues. Few gerontological organizations, scholars, or secondary datasets exist in the country. To address these challenges, more research on aging is needed to encourage economic renewal, healthy aging policies, and long-term services and supports. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Developing library bioinformatics services in context: the Purdue University Libraries bioinformationist program

PubMed Central

Rein, Diane C.

2006-01-01

Setting: Purdue University is a major agricultural, engineering, biomedical, and applied life science research institution with an increasing focus on bioinformatics research that spans multiple disciplines and campus academic units. The Purdue University Libraries (PUL) hired a molecular biosciences specialist to discover, engage, and support bioinformatics needs across the campus. Program Components: After an extended period of information needs assessment and environmental scanning, the specialist developed a week of focused bioinformatics instruction (Bioinformatics Week) to launch system-wide, library-based bioinformatics services. Evaluation Mechanisms: The specialist employed a two-tiered approach to assess user information requirements and expectations. The first phase involved careful observation and collection of information needs in-context throughout the campus, attending laboratory meetings, interviewing department chairs and individual researchers, and engaging in strategic planning efforts. Based on the information gathered during the integration phase, several survey instruments were developed to facilitate more critical user assessment and the recovery of quantifiable data prior to planning. Next Steps/Future Directions: Given information gathered while working with clients and through formal needs assessments, as well as the success of instructional approaches used in Bioinformatics Week, the specialist is developing bioinformatics support services for the Purdue community. The specialist is also engaged in training PUL faculty librarians in bioinformatics to provide a sustaining culture of library-based bioinformatics support and understanding of Purdue's bioinformatics-related decision and policy making. PMID:16888666

Developing library bioinformatics services in context: the Purdue University Libraries bioinformationist program.

PubMed

Rein, Diane C

2006-07-01

Purdue University is a major agricultural, engineering, biomedical, and applied life science research institution with an increasing focus on bioinformatics research that spans multiple disciplines and campus academic units. The Purdue University Libraries (PUL) hired a molecular biosciences specialist to discover, engage, and support bioinformatics needs across the campus. After an extended period of information needs assessment and environmental scanning, the specialist developed a week of focused bioinformatics instruction (Bioinformatics Week) to launch system-wide, library-based bioinformatics services. The specialist employed a two-tiered approach to assess user information requirements and expectations. The first phase involved careful observation and collection of information needs in-context throughout the campus, attending laboratory meetings, interviewing department chairs and individual researchers, and engaging in strategic planning efforts. Based on the information gathered during the integration phase, several survey instruments were developed to facilitate more critical user assessment and the recovery of quantifiable data prior to planning. Given information gathered while working with clients and through formal needs assessments, as well as the success of instructional approaches used in Bioinformatics Week, the specialist is developing bioinformatics support services for the Purdue community. The specialist is also engaged in training PUL faculty librarians in bioinformatics to provide a sustaining culture of library-based bioinformatics support and understanding of Purdue's bioinformatics-related decision and policy making.

Perceived Case Management Needs and Service Preferences of Frequent Emergency Department Users: Lessons Learned in a Large Urban Centre

PubMed Central

Kahan, Deborah; Poremski, Daniel; Wise-Harris, Deborah; Pauly, Daniel; Leszcz, Molyn; Wasylenki, Donald; Stergiopoulos, Vicky

2016-01-01

Objectives This study aimed to explore the service needs and preferences of frequent emergency department users with mental health and addictions concerns who participated in a brief intensive case management intervention. Methods We conducted semi-structured individual interviews with 20 frequent emergency department users with mental health and addictions challenges, 13 service providers involved in the delivery of a brief case management intervention, and a focus group with intervention case managers. Thematic analysis was used to explore perceived service user profiles, service needs and preferences of care. Results Service users experienced complex health and social needs and social isolation, while exhibiting resilience and the desire to contribute. They described multiple instances of stigmatization in interactions with healthcare professionals. Components of the brief intensive case management intervention perceived to be helpful included system navigation, advocacy, intermediation, and practical needs assistance. Frequent service users valued relational responsiveness, a non-judgmental stance, and a recovery orientation in case managers. Conclusion Interventions for frequent service users in mental health may be enhanced by focusing on the engagement of formal and informal social supports, practical needs assistance, system navigation, advocacy and intermediation, and attention to the recovery goals of service users. PMID:28002491

VIPER project

NASA Technical Reports Server (NTRS)

Kershaw, John

1990-01-01

The VIPER project has so far produced a formal specification of a 32 bit RISC microprocessor, an implementation of that chip in radiation-hard SOS technology, a partial proof of correctness of the implementation which is still being extended, and a large body of supporting software. The time has now come to consider what has been achieved and what directions should be pursued in the future. The most obvious lesson from the VIPER project was the time and effort needed to use formal methods properly. Most of the problems arose in the interfaces between different formalisms, e.g., between the (informal) English description and the HOL spec, between the block-level spec in HOL and the equivalent in ELLA needed by the low-level CAD tools. These interfaces need to be made rigorous or (better) eliminated. VIPER 1A (the latest chip) is designed to operate in pairs, to give protection against breakdowns in service as well as design faults. We have come to regard redundancy and formal design methods as complementary, the one to guard against normal component failures and the other to provide insurance against the risk of the common-cause failures which bedevil reliability predictions. Any future VIPER chips will certainly need improved performance to keep up with increasingly demanding applications. We have a prototype design (not yet specified formally) which includes 32 and 64 bit multiply, instruction pre-fetch, more efficient interface timing, and a new instruction to allow a quick response to peripheral requests. Work is under way to specify this device in MIRANDA, and then to refine the spec into a block-level design by top-down transformations. When the refinement is complete, a relatively simple proof checker should be able to demonstrate its correctness. This paper is presented in viewgraph form.

Palliative care knowledge and attitudes among oncology nurses in Qatar.

PubMed

Al-Kindi, Sadeer G; Zeinah, Ghaith F Abu; Hassan, Azza Adel

2014-08-01

Formal palliative care (PC) education is lacking in the middle eastern state of Qatar. This study was done to assess the need for PC education among oncology nurses in Qatar. In March 2012, a self-constructed questionnaire was distributed to 115 nurses at the Qatar National Center for Cancer Care and Research. A total of 115 nurses responded to the questionnaire. The majority (87.8%) were female. Although 60% had more than 10 years of work experience, only 31% had received formal training in PC, with only 6.1% having completed postgraduate training. The majority (63%) of responders attributed this issue to unavailability of PC courses rather than lack of time, interest, or financial issues. Currently, only 16.7% did not express interest in the field, with 56% showing some kind of interest. In terms of knowledge, 54% of the responders were familiar with the World Health Organization ladder for pain relief. Only 43.6% know about Palliative Performance Scale, and half of the nurses know the Edmonton Symptom Assessment System. Overall, 56% of the nurses indicated a need for training in more than 1 aspect. These aspects included training in care of the dying patients (14.6%), communication strategies (22%), caregiver support (10.6%), psychosocial care (15%), pain management (10.2%), other symptom management (13%), and other ethical/spiritual issues (14.2%). There is a clear deficiency in formal PC education among the nurses at the National Center for Cancer Care and Research, in Qatar. This is reflected by their lack of experience and exposure to PC and their mediocre knowledge in the field. This could be attributed to the fact that formal PC service was established only recently in Qatar (2008). Formal training courses in PC nursing are required. © The Author(s) 2013.

25 CFR 36.42 - Standard XV-Counseling services.

Code of Federal Regulations, 2014 CFR

2014-04-01

... objective assessment of student academic performance. Required formal tests shall be administered annually... standards, schools may use the state mandated academic achievement tests and accompanying requirements. These formal tests and their subtest contents, as well as the test-related procedures, shall include...

25 CFR 36.42 - Standard XV-Counseling services.

Code of Federal Regulations, 2012 CFR

2012-04-01

... objective assessment of student academic performance. Required formal tests shall be administered annually... standards, schools may use the state mandated academic achievement tests and accompanying requirements. These formal tests and their subtest contents, as well as the test-related procedures, shall include...

25 CFR 36.42 - Standard XV-Counseling services.

Code of Federal Regulations, 2013 CFR

2013-04-01

... objective assessment of student academic performance. Required formal tests shall be administered annually... standards, schools may use the state mandated academic achievement tests and accompanying requirements. These formal tests and their subtest contents, as well as the test-related procedures, shall include...

25 CFR 36.42 - Standard XV-Counseling services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... objective assessment of student academic performance. Required formal tests shall be administered annually... standards, schools may use the state mandated academic achievement tests and accompanying requirements. These formal tests and their subtest contents, as well as the test-related procedures, shall include...

25 CFR 36.42 - Standard XV-Counseling services.

Code of Federal Regulations, 2011 CFR

2011-04-01

... objective assessment of student academic performance. Required formal tests shall be administered annually... standards, schools may use the state mandated academic achievement tests and accompanying requirements. These formal tests and their subtest contents, as well as the test-related procedures, shall include...

5 CFR 919.740 - Are suspension proceedings formal?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Are suspension proceedings formal? 919.740 Section 919.740 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE... your representative must submit any documentary evidence you want the suspending official to consider. ...

Formal Alternative Transportation Options for Older Adults: An Assessment of Need.

PubMed

Turner, Joshua J; Adams-Price, Carolyn E; Strawderman, Lesley

2017-01-01

This study measured the need for formal alternative modes of transportation among older adults by applying traditional factors of the Behavioral Model. Survey participants who regularly drove were compared to those who could no longer drive. Race/ethnicity and self-reported health were significant predictors of perceived need for transportation services for both groups. However, income and service awareness were significant predictors only for drivers, while family proximity was a significant predictor only for non-drivers. Results suggest the importance of gaining a better understanding of the factors associated with need for senior-focused transportation services to more effectively plan such programs.

Mental Health Service Use Among Immigrants in the United States: A Systematic Review

PubMed Central

Derr, Amelia Seraphia

2016-01-01

Objective Immigrants face stressors unique to the experience of migration that may exacerbate or cause mental health problems but access care at rates far below the general population, leaving them at risk of untreated mental health conditions. This review synthesizes current findings on mental health service utilization among immigrants to inform future research efforts addressing disparities in access to care. Methods A systematic literature search of seven databases yielded 62 articles that met inclusion criteria: peer-reviewed reports of empirical studies based in the United States with an explicit focus on immigrant mental health service use. Each article was evaluated, and information was extracted by using a structured abstracting form. Results Studies have shown that immigrants from Asia, Latin America, and Africa use mental health services at lower rates than nonimmigrants, despite an equal or greater need. Lower usage has been found to be more pronounced among men, the uninsured, and the undocumented. Structural barriers to service use reported included lack of insurance, high cost, and language barriers. Studies have shown that social support is particularly important for immigrants and that those who seek help for mental health concerns tend to turn first to family, friends, or religious leaders. Conclusions Important areas for future research on disparities in mental health service use among immigrants include expanding research and analytic design to emphasize understudied groups and the heterogeneity of immigrant experiences over time, studying interventions that foster collaboration between formal and informal service sectors, and examining the role of social support in problem recognition and treatment initiation. PMID:26695493

The role of family and partnership in recovery from alcohol dependence: comparison of individuals remitting with and without formal help.

PubMed

Rumpf, Hans-Jürgen; Bischof, Gallus; Hapke, Ulfert; Meyer, Christian; John, Ulrich

2002-06-01

The aim of this study was to analyse the role of family and partnership in remission from alcohol dependence in treated (n = 50) and untreated (n = 115) individuals. Standardised questionnaires to assess social support, social pressure, coping behaviour, and self-efficacy to stay remitted were used. In both media-solicited samples, social support increased from the pre- to the post-resolution period and was stated as an important resolution maintenance factor. Remitters with formal help experienced more partnership conflicts prior to remission and tended to experience more social pressure from their partner. Social support and social pressure from the family and partner were related to an increase in cognitive coping, as hypothesised, however, only in remitters without formal help, whereas an inverse relationship was found in formal help seekers. Implications for alcohol-related interventions are discussed. Copyright 2002 S. Karger AG, Basel

Widening Our Evaluative Lenses of Formal, Facilitated, and Spontaneous Academic Development

ERIC Educational Resources Information Center

Hoessler, Carolyn; Godden, Lorraine; Hoessler, Brian

2015-01-01

As conceptions of academic development expand to encompass a more diverse and flexible set of supports, traditional approaches to evaluation, including impact studies of formal programming, become insufficient. A program may appear ineffective when evaluation ignores additional supports that interact to counteract implementation or alternatively…

The Potential of the Non-Formal Educational Sector for Supporting Chemistry Learning and Sustainability Education for All Students--A Joint Perspective from Two Cases in Finland and Germany

ERIC Educational Resources Information Center

Affeldt, Fiona; Tolppanen, Sakari; Aksela, Maija; Eilks, Ingo

2017-01-01

Non-formal education has been suggested as becoming more and more important in the last decades. As the aims of non-formal education are broad and diverse, a large variety of non-formal learning activities is available. One of the emerging fields in many countries, among them Finland and Germany, has been the establishment of non-formal laboratory…

The formal-informal patient payment mix in European countries. Governance, economics, culture or all of these?

PubMed

Tambor, Marzena; Pavlova, Milena; Golinowska, Stanisława; Sowada, Christoph; Groot, Wim

2013-12-01

Cost-sharing for health care is high on the policy agenda in many European countries that struggle with deficits in their public budget. However, such policy often meets with public opposition, which might delay or even prevent its implementation. Increased reliance on patient payments may also have adverse equity effects, especially in countries where informal patient payments are widespread. The factors which might influence the presence of both, formal and informal payments can be found in economic, governance and cultural differences between countries. The aim of this paper is to review the formal-informal payment mix in Europe and to outline factors associated with this mix. We use quantitative analyses of macro-data for 35 European countries and a qualitative description of selected country experiences. The results suggest that the presence of obligatory cost-sharing for health care services is associated with governance factors, while informal patient payments are a multi-cause phenomenon. A consensus-based policy, supported by evidence and stakeholders' engagement, might contribute to a more sustainable patient payment policy. In some European countries, the implementation of cost-sharing requires policy actions to reduce other patient payment obligations, including measures to eliminate informal payments. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Patterns of Hierarchy in Formal and Principled Moral Reasoning.

ERIC Educational Resources Information Center

Zeidler, Dana Lewis

Measurements of formal reasoning and principled moral reasoning ability were obtained from a sample of 99 tenth grade students. Specific modes of formal reasoning (proportional reasoning, controlling variables, probabilistic, correlational and combinatorial reasoning) were first examined. Findings support the notion of hierarchical relationships…

5 CFR 919.835 - Are debarment proceedings formal?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Are debarment proceedings formal? 919.835 Section 919.835 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE...) You or your representative must submit any documentary evidence you want the debarring official to...

47 CFR 14.39 - Format and content of formal complaints.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false Format and content of formal complaints. 14.39 Section 14.39 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping, Consumer Dispute Assistance, and...

47 CFR 14.39 - Format and content of formal complaints.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Format and content of formal complaints. 14.39 Section 14.39 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping, Consumer Dispute Assistance, and...

47 CFR 14.39 - Format and content of formal complaints.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Format and content of formal complaints. 14.39 Section 14.39 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping, Consumer Dispute Assistance, and...

Using Ontologies to Formalize Services Specifications in Multi-Agent Systems

NASA Technical Reports Server (NTRS)

Breitman, Karin Koogan; Filho, Aluizio Haendchen; Haeusler, Edward Hermann

2004-01-01

One key issue in multi-agent systems (MAS) is their ability to interact and exchange information autonomously across applications. To secure agent interoperability, designers must rely on a communication protocol that allows software agents to exchange meaningful information. In this paper we propose using ontologies as such communication protocol. Ontologies capture the semantics of the operations and services provided by agents, allowing interoperability and information exchange in a MAS. Ontologies are a formal, machine processable, representation that allows to capture the semantics of a domain and, to derive meaningful information by way of logical inference. In our proposal we use a formal knowledge representation language (OWL) that translates into Description Logics (a subset of first order logic), thus eliminating ambiguities and providing a solid base for machine based inference. The main contribution of this approach is to make the requirements explicit, centralize the specification in a single document (the ontology itself), at the same that it provides a formal, unambiguous representation that can be processed by automated inference machines.

Effectiveness of interventions to indirectly support food and drink intake in people with dementia: Eating and Drinking Well IN dementiA (EDWINA) systematic review.

PubMed

Bunn, Diane K; Abdelhamid, Asmaa; Copley, Maddie; Cowap, Vicky; Dickinson, Angela; Howe, Amanda; Killett, Anne; Poland, Fiona; Potter, John F; Richardson, Kate; Smithard, David; Fox, Chris; Hooper, Lee

2016-05-04

Risks and prevalence of malnutrition and dehydration are high in older people but even higher in older people with dementia. In the EDWINA (Eating and Drinking Well IN dementiA) systematic review we aimed to assess effectiveness of interventions aiming to improve, maintain or facilitate food/drink intake indirectly, through food service or dining environment modification, education, exercise or behavioural interventions in people with cognitive impairment or dementia (across all settings, levels of care and support, types and degrees of dementia). We comprehensively searched Medline and twelve further databases, plus bibliographies, for intervention studies with ≥3 cognitively impaired adult participants (any type/stage). The review was conducted with service user input in accordance with Cochrane Collaboration's guidelines. We duplicated assessment of inclusion, data extraction, and validity assessment, tabulating data. Meta-analysis (statistical pooling) was not appropriate so data were tabulated and synthesised narratively. We included 56 interventions (reported in 51 studies). Studies were small and there were no clearly effective, or clearly ineffective, interventions. Promising interventions included: eating meals with care-givers, family style meals, soothing mealtime music, constantly accessible snacks and longer mealtimes, education and support for formal and informal care-givers, spaced retrieval and Montessori activities, facilitated breakfast clubs, multisensory exercise and multicomponent interventions. We found no definitive evidence on effectiveness, or lack of effectiveness, of specific interventions but studies were small and short term. A variety of promising indirect interventions need to be tested in large, high-quality RCTs, and may be approaches that people with dementia and their formal or informal care-givers would wish to try. The systematic review protocol was registered (CRD42014007611) and is published, with the full MEDLINE search strategy, on Prospero (http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014007611).

Peer support for CKD patients and carers: overcoming barriers and facilitating access.

PubMed

Taylor, Francesca; Gutteridge, Robin; Willis, Carol

2016-06-01

Peer support is valued by its users. Nevertheless, there is initial low take-up of formal peer support programmes among patients with chronic kidney disease (CKD), with fewer patients participating than expressing an interest. There is little evidence on reasons for low participation levels. Few studies have examined the perspectives of carers. To explore with CKD patients and carers their needs, wants and expectations from formal peer support and examine how barriers to participation may be overcome. Qualitative interviews with a sample of 26 CKD stage five patients and carers. Principles of Grounded Theory were applied to data coding and analysis. Six NHS Hospital Trusts. Whilst informal peer support might occur naturally and is welcomed, a range of emotional and practical barriers inhibit take-up of more formalized support. Receptivity varies across time and the disease trajectory and is associated with emotional readiness; patients and carers needing to overcome complex psychological hurdles such as acknowledging support needs. Practical barriers include limited understanding of peer support. An attractive peer relationship is felt to involve reciprocity based on sharing experiences and both giving and receiving support. Establishing rapport is linked with development of reciprocity. There is potential to facilitate active uptake of formal peer support by addressing the identified barriers. Our study suggests several facilitation methods, brought together in a conceptual model, including clinician promotion of peer support as an intervention suitable for anyone with CKD and their carers, and opportunity for choice of peer supporter. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.

An exploratory study of knowledge brokering in hospital settings: facilitating knowledge sharing and learning for patient safety?

PubMed

Waring, Justin; Currie, Graeme; Crompton, Amanda; Bishop, Simon

2013-12-01

This paper reports on an exploratory study of intra-organisational knowledge brokers working within three large acute hospitals in the English National Health Services. Knowledge brokering is promoted as a strategy for supporting knowledge sharing and learning in healthcare, especially in the diffusion of research evidence into practice. Less attention has been given to brokers who support knowledge sharing and learning within healthcare organisations. With specific reference to the need for learning around patient safety, this paper focuses on the structural position and role of four types of intra-organisational brokers. Through ethnographic research it examines how variations in formal role, location and relationships shape how they share and support the use of knowledge across organisational and occupational boundaries. It suggests those occupying hybrid organisational roles, such as clinical-managers, are often best positioned to support knowledge sharing and learning because of their 'ambassadorial' type position and legitimacy to participate in multiple communities through dual-directed relationships. Copyright © 2013 Elsevier Ltd. All rights reserved.

Home Health Aides' Perceptions of Quality Care: Goals, Challenges, and Implications for a Rapidly Changing Industry.

PubMed

Franzosa, Emily; Tsui, Emma K; Baron, Sherry

2018-02-01

Home care payment models, quality measures, and care plans are based on physical tasks workers perform, ignoring relational care that supports clients' cognitive, emotional, and social well-being. As states seek to rein in costs and improve the efficiency and quality of care, they will need to consider how to measure and support relational care. In four focus groups ( n = 27) of unionized, agency-based New York City home health aides, workers reported aide-client relationships were a cornerstone of high-quality care, and building them required communication, respect, and going the extra mile. Since much of this care was invisible outside the worker-client relationship, aides received little supervisory support and felt excluded from the formal care team. Aligning payment models with quality requires understanding the full scope of services aides provide and a quality work environment that offers support and supervision, engages aides in patient care, and gives them a voice in policy decisions.

Exploring the nature of resilience in paramedic practice: A psycho-social study.

PubMed

Clompus, S R; Albarran, J W

2016-09-01

Previous research has identified that paramedics experience high levels of stress and sickness rates which have escalated in recent years due to changes to workforce restructuring. While a number of studies have investigated resilience among healthcare professionals, there is little research exploring how paramedics address work challenges and how they become resilient. Using psycho-social methodology, seven paramedics participated in Free Association Narrative interviewing; all were based at one regional centre. In line with the study design, data analysis adopted a psycho-social approach that generated four themes and 10 sub-themes which, characterised participants' experiences. Coping and resilience was impacted upon via formal methods of support including management, debriefing and referral to outside agencies. Alongside this, more informal methods aided resilience. Informal methods included peer support, support from family and friends and the use of humour. Uniquely, this study uncovered how detachment is used to manage emotions. The study has implications for the services need to support the emotional needs of paramedics. Copyright © 2015 Elsevier Ltd. All rights reserved.

Challenges in implementing individual placement and support in the Australian mental health service and policy context.

PubMed

Stirling, Yolande; Higgins, Kate; Petrakis, Melissa

2018-02-01

Objective Although Australia's service and policy context differs from that of the US, studies have highlighted potential for individual placement and support (IPS) to support competitive employment outcomes for people with severe and persistent mental illness. The aim of the present study was to explore why the model is not yet widely available. Methods A document analysis was conducted to discern reasons for challenges in implementation of IPS practice principles within the Australian service context. Results The document analysis illustrated that although policy acknowledges the importance of increasing employment rates for people with severe and persistent mental illness, consistent measures, change indicators, direction and time frames are lacking in policy and strategy documentation. Further, IPS principles are not consistently evident in guiding operational documentation that government-funded Disability Employment Services (DES) programs are mandated to adhere to. Conclusions For IPS to be readily implemented, it is necessary for government to offer support to agencies to partner and formal endorsement of the model as a preferred approach in tendering processes. Obligations and processes must be reviewed to ensure that model fidelity is achievable within the Australian Commonwealth policy and service context for programs to achieve competitive employment rates comparable to the most successful international programs. What is known about the topic? The IPS model has been established as the most efficacious approach to support people with severe and persistent mental ill health to gain and sustain employment internationally, yet little is known as to why this model has had very limited uptake in the Australian adult mental health service and policy context. What does this paper add? This paper provides an investigation into the achievability of IPS within DES philosophical and contractual arrangements. What are the implications for practitioners? Mental health practitioners are typically skilled in their understanding of individual or micro-level challenges faced by consumers in achieving vocational goals: working with symptoms, medication side effects, motivation and anxiety. The present study was designed to offer practitioners an increased understanding of service-level factors, because these present considerable challenges to achieving sustained employment. This paper is a call for greater advocacy towards better integration of employment and mental health service delivery in the Australian policy and practice context.

Quality, Organization Design, and Standards.

ERIC Educational Resources Information Center

Gardner, James F.

1992-01-01

This paper discusses regulations and voluntary standards within the context of organizational mission and management leadership for quality in human services. Regulation is seen as a measure of organizational formalism; formalism is seen as an attribute of the machine organization; and both are contrasted to organic control organization models and…

Social capital in a lower socioeconomic palliative care population: a qualitative investigation of individual, community and civic networks and relations.

PubMed

Lewis, Joanne M; DiGiacomo, Michelle; Currow, David C; Davidson, Patricia M

2014-01-01

Lower socioeconomic populations live and die in contexts that render them vulnerable to poorer health and wellbeing. Contexts of care at the end of life are overwhelmingly determined by the capacity and nature of formal and informal networks and relations to support care. To date, studies exploring the nature of networks and relations of support in lower socioeconomic populations at the end of life are absent. This qualitative study sought to identify the nature of individual, community and civic networks and relations that defined the contexts of care for this group. Semi-structured qualitative interviews were conducted with 16 patients and 6 informal carers who identified that they had social and economic needs and were from a lower socioeconomic area. A social capital questionnaire identifying individual, community and civic networks and relations formed the interview guide. Interviews were audio-taped, transcribed and analysed using framework analysis. Participants identified that individual and community networks and relations of support were mainly inadequate to meet care needs. Specifically, data revealed: (1) individual (informal caregivers) networks and relations were small and fragile due to the nature of conflict and crisis; (2) community trust and engagement was limited and shifted by illness and caregiving; (3) and formal care services were inconsistent and provided limited practical support. Some transitions in community relations for support were noted. Levels of civic and government engagement and support were overall positive and enabled access to welfare resources. Networks and relations of support are essential for ensuring quality end of life care is achieved. Lower socioeconomic groups are at a distinct disadvantage where these networks and relations are limited, as they lack the resources necessary to augment these gaps. Understanding of the nature of assets and limitations, in networks and relations of support, is necessary to inform interventions to improve end of life care for lower socioeconomic populations.

Social capital in a lower socioeconomic palliative care population: a qualitative investigation of individual, community and civic networks and relations

PubMed Central

2014-01-01

Background Lower socioeconomic populations live and die in contexts that render them vulnerable to poorer health and wellbeing. Contexts of care at the end of life are overwhelmingly determined by the capacity and nature of formal and informal networks and relations to support care. To date, studies exploring the nature of networks and relations of support in lower socioeconomic populations at the end of life are absent. This qualitative study sought to identify the nature of individual, community and civic networks and relations that defined the contexts of care for this group. Methods Semi-structured qualitative interviews were conducted with 16 patients and 6 informal carers who identified that they had social and economic needs and were from a lower socioeconomic area. A social capital questionnaire identifying individual, community and civic networks and relations formed the interview guide. Interviews were audio-taped, transcribed and analysed using framework analysis. Results Participants identified that individual and community networks and relations of support were mainly inadequate to meet care needs. Specifically, data revealed: (1) individual (informal caregivers) networks and relations were small and fragile due to the nature of conflict and crisis; (2) community trust and engagement was limited and shifted by illness and caregiving; (3) and formal care services were inconsistent and provided limited practical support. Some transitions in community relations for support were noted. Levels of civic and government engagement and support were overall positive and enabled access to welfare resources. Conclusion Networks and relations of support are essential for ensuring quality end of life care is achieved. Lower socioeconomic groups are at a distinct disadvantage where these networks and relations are limited, as they lack the resources necessary to augment these gaps. Understanding of the nature of assets and limitations, in networks and relations of support, is necessary to inform interventions to improve end of life care for lower socioeconomic populations. PMID:24959101

Gender and the utilisation of health services in the Ashanti Region, Ghana.

PubMed

Buor, Daniel

2004-09-01

The survey seeks to structure a model for gender-based health services utilisation for the Ashanti Region of Ghana, and in addition, recommend intervention measures to ensure gender equity in the utilisation of health services. A sample size of 650 covered over 3108 houses, and the main research instruments were the questionnaire and formal interview. A multiple regression model is used for the analysis of the relationship between the complex independent variables and utilisation by gender. Results show that although females have a greater need for health services than males, they do not utilise health services as much. Secondly, whereas quality of service, health status, service cost and education have greater effect on male utilisation than females, distance and income have higher impact on female utilisation. It is recommended that, to ensure equity in health care utilisation, females be empowered through increased access to formal education and sustainable income opportunities. The introduction of a national health insurance scheme is also recommended to ensure adequate access by both sexes.

Formal Method of Description Supporting Portfolio Assessment

ERIC Educational Resources Information Center

Morimoto, Yasuhiko; Ueno, Maomi; Kikukawa, Isao; Yokoyama, Setsuo; Miyadera, Youzou

2006-01-01

Teachers need to assess learner portfolios in the field of education. However, they need support in the process of designing and practicing what kind of portfolios are to be assessed. To solve the problem, a formal method of describing the relations between the lesson forms and portfolios that need to be collected and the relations between…

You Can Make Your Facilities Services Provider Part of the College Community.

ERIC Educational Resources Information Center

Ledbetter, Randy

2002-01-01

Discusses five attributes that, when well implemented, form the framework for successful relationships between college administration and services companies: reporting relationships, Quality of Service (QoS) measures, formal reports and reviews, employee relations, and subcontractor relations. (EV)

47 CFR 63.62 - Type of discontinuance, reduction, or impairment of telephone or telegraph service requiring...

Code of Federal Regulations, 2010 CFR

2010-10-01

... impairment of telephone or telegraph service requiring formal application. 63.62 Section 63.62... LINES, NEW LINES, AND DISCONTINUANCE, REDUCTION, OUTAGE AND IMPAIRMENT OF SERVICE BY COMMON CARRIERS... Impairment § 63.62 Type of discontinuance, reduction, or impairment of telephone or telegraph service...

One Stop Student Services a Student Perspective

ERIC Educational Resources Information Center

Johannes, Cheryl Leslie

2012-01-01

Colleges and Universities have a myriad of choices in how to organize enrollment services delivery. Formalizing collaborative services to create stronger more comprehensive linkages and cross-functional service delivery in a student-centric, relationship-oriented manner is important for meeting the expectations of today's students. In support…

Service Learning in Medical Education: Project Description and Evaluation

ERIC Educational Resources Information Center

Borges, Nicole J.; Hartung, Paul J.

2007-01-01

Although medical education has long recognized the importance of community service, most medical schools have not formally nor fully incorporated service learning into their curricula. To address this problem, we describe the initial design, development, implementation, and evaluation of a service-learning project within a first-year medical…

A Belief-based Trust Model for Dynamic Service Selection

NASA Astrophysics Data System (ADS)

Ali, Ali Shaikh; Rana, Omer F.

Provision of services across institutional boundaries has become an active research area. Many such services encode access to computational and data resources (comprising single machines to computational clusters). Such services can also be informational, and integrate different resources within an institution. Consequently, we envision a service rich environment in the future, where service consumers can intelligently decide between which services to select. If interaction between service providers/users is automated, it is necessary for these service clients to be able to automatically chose between a set of equivalent (or similar) services. In such a scenario trust serves as a benchmark to differentiate between service providers. One might therefore prioritize potential cooperative partners based on the established trust. Although many approaches exist in literature about trust between online communities, the exact nature of trust for multi-institutional service sharing remains undefined. Therefore, the concept of trust suffers from an imperfect understanding, a plethora of definitions, and informal use in the literature. We present a formalism for describing trust within multi-institutional service sharing, and provide an implementation of this; enabling the agent to make trust-based decision. We evaluate our formalism through simulation.

MaROS Strategic Relay Planning and Coordination Interfaces

NASA Technical Reports Server (NTRS)

Allard, Daniel A.

2010-01-01

The Mars Relay Operations Service (MaROS) is designed to provide planning and analysis tools in support of ongoing Mars Network relay operations. Strategic relay planning requires coordination between lander and orbiter mission ground data system (GDS) teams to schedule and execute relay communications passes. MaROS centralizes this process, correlating all data relevant to relay coordination to provide a cohesive picture of the relay state. Service users interact with the system through thin-layer command line and web user interface client applications. Users provide and utilize data such as lander view periods of orbiters, Deep Space Network (DSN) antenna tracks, and reports of relay pass performance. Users upload and download relevant relay data via formally defined and documented file structures including some described in Extensible Markup Language (XML). Clients interface with the system via an http-based Representational State Transfer (ReST) pattern using Javascript Object Notation (JSON) formats. This paper will provide a general overview of the service architecture and detail the software interfaces and considerations for interface design.

'Chipping in': clinical psychologists' descriptions of their use of formulation in multidisciplinary team working.

PubMed

Christofides, Stella; Johnstone, Lucy; Musa, Meyrem

2012-12-01

To investigate clinical psychologists' accounts of their use of psychological case formulation in multidisciplinary teamwork. A qualitative study using inductive thematic analysis. Ten clinical psychologists working in community and inpatient adult mental health services who identified themselves as using formulation in their multidisciplinary team work participated in semi-structured interviews. Psychological hypotheses were described as shared mostly through informal means such as chipping in ideas during a team discussion rather than through explicit means such as staff training or case presentations that usually only took place once participants had spent time developing their role within the team. Service context and staff's prior experience were also factors in how explicitly formulation was discussed. Participants reported that they believed that this way of working, although often not formally recognized, was valuable and improved the quality of clinical services provided. More investigation into this under-researched but important area of clinical practice is needed, in order to share ideas and support good practice. ©2011 The British Psychological Society.

Caring for America's Veterans: The Power of Academic-Practice Partnership.

PubMed

Miltner, Rebecca S; Selleck, Cynthia S; Froelich, Kimberly D; Bakitas, Marie A; Cleveland, Cynthia D; Harper, Doreen C

2015-01-01

Veterans receive care across the entire health system. Therefore, the workforce needs knowledge and awareness of whether patients are Veterans and the impact of their military service on their physical and mental health. Recent reports of limitations in access for Veterans seeking health care have highlighted this need across all health care settings. Academic-practice partnerships are one mechanism to align the need for improved health care services within the Veteran population while advancing nursing practice in the Veterans Health Administration and surrounding communities. The key to strong partnerships and sustained collaboration is shared goals, mutual trust and respect, the development of formal relationships, and support of senior leadership that fosters the joint vision and mission to improve nursing care for Veterans. This article describes the evolving partnership between one Veterans Health Administration Medical Center and a School of Nursing, which aligned strategic goals across both organizations to increase the capacity and capability of services provided to Veterans.

Workplace response of companies exposed to the 9/11 World Trade Center attack: a focus-group study

PubMed Central

North, Carol S.; Pfefferbaum, Betty; Hong, Barry A.; Gordon, Mollie R.; Kim, You-Seung; Lind, Lisa; Pollio, David E.

2014-01-01

The terrorist attacks of 11 September 2001 (9/11) left workplaces in pressing need of a mental health response capability. Unaddressed emotional sequelae may be devastating to the productivity and economic stability of a company’s workforce. In the second year after the attacks, 85 employees of five highly affected agencies participated in 12 focus groups to discuss workplace mental health issues. Managers felt ill prepared to manage the magnitude and the intensity of employees’ emotional responses. Rapid return to work, provision of workplace mental health services, and peer support were viewed as contributory to emotional recovery. Formal mental health services provided were perceived as insufficient. Drawing on their post-9/11 workplace experience, members of these groups identified practical measures that they found helpful in promoting healing outside of professional mental health services. These measures, consistent with many principles of psychological first aid, may be applied by workplace leaders who are not mental health professionals. PMID:23066661

Influence of municipal policy and individual characteristics on the use of informal and formal domestic help in the Netherlands.

PubMed

Marangos, Anna Maria; Waverijn, Geeke; de Klerk, Mirjam; Iedema, Jurjen; Groenewegen, Peter P

2018-05-24

The responsibility for care and social support in the Netherlands has been decentralized to the municipalities, on the assumption that they are able to organise care and social support more effectively and efficiently. Municipalities are responsible for offering citizens the social support they need. They have policy discretion to decide how and to what extent they encourage and support the use of informal help. This article explored whether the local policy focus on informal or formal help influences the actual take-up of domestic help. Data on 567 physically disabled people who use informal or formal help in the household were linked to local policy data in 167 municipalities. We performed multilevel multinomial regression analyses. Since we expected that local policy will have more influence on people with slight or moderate disabilities, cohabitees and people aged under 75, cross-level interaction terms were included between characteristics of local policy and of individuals. The findings reveal differences between municipalities in their policy on support and differences in the use of formal or informal support between municipalities. We found no relationship between local emphasis on informal help and the use of informal help. Possible explanations: some people have a small social network, people using informal help did not apply for municipality support or even do not know the possibility exists. Copyright © 2018 Elsevier B.V. All rights reserved.

[Specifics of working with chronic mentally ill patients in Specialised Social Help Services--experiences in training and supervision meetings].

PubMed

Paszko, Jolanta; Wnek, Beata; Załuska, Maria

2004-01-01

Information was presented on the development and efficiency of The Specialised Psychiatric Social Help Services for the mentally ill in Poland. It took into consideration the specifics of this work and formal requirements for special training of the staff. The experiences of the 3.5 years of work of the specialised services in the Warszawa Targówek district (October 1997 - June 2001) were discussed. Organisational solutions and basic data about clients and staff and establishments and experiences coming from training and supervision meetings were discussed. Problems and difficulties most often experienced by the staff workers at their work with chronic mentally ill patients were described. Consideration was put from one side on the big rotation of the staff and from the other on the need of the extension of the theoretical and practical knowledge as well as of supervision and support was often mentioned in the questionnaire. A need of elaborating the programme of training and professional courses for workers of the specialised psychiatric social help services was also pointed out.

US Coast Guard GPS Information Center (GPSIC) and its function within the Civil GPS Service (CGS)

NASA Technical Reports Server (NTRS)

1993-01-01

In 1987, the U.S. Department of Defense (DOD) formally requested that the U.S. Department of Transportation (DOT) take responsibility for providing an office that would respond to nonmilitary user needs for GPS information, data, and assistance. DOT accepted this responsibility and in February 1989, named the Coast Guard as their lead agency for the project. Since that time, the U.S. Coast Guard has worked with the U.S. Space Command to develop requirements and implement a plan for providing the requested interface with the civil GPS community. The Civil GPS Service (CGS) consists of four main elements: GPS Information Center (GPSIC) - provides GPS status information to civilian users of the system: Civil GPS Service Interface Committee (CGSIC) - established to identify civil GPS user technical information needs in support of the CGS program; Differential GPS (DGPS) - Coast Guard Research and Development Project; and PPS Program Office (PPSPO) - (Under development) will administer the program allowing qualified civil users to have access to the PPS signal. Details about the services these organizations provide are described.

Measuring Integration of Cancer Services to Support Performance Improvement: The CSI Survey

PubMed Central

Dobrow, Mark J.; Paszat, Lawrence; Golden, Brian; Brown, Adalsteinn D.; Holowaty, Eric; Orchard, Margo C.; Monga, Neerav; Sullivan, Terrence

2009-01-01

Objective: To develop a measure of cancer services integration (CSI) that can inform clinical and administrative decision-makers in their efforts to monitor and improve cancer system performance. Methods: We employed a systematic approach to measurement development, including review of existing cancer/health services integration measures, key-informant interviews and focus groups with cancer system leaders. The research team constructed a Web-based survey that was field- and pilot-tested, refined and then formally conducted on a sample of cancer care providers and administrators in Ontario, Canada. We then conducted exploratory factor analysis to identify key dimensions of CSI. Results: A total of 1,769 physicians, other clinicians and administrators participated in the survey, responding to a 67-item questionnaire. The exploratory factor analysis identified 12 factors that were linked to three broader dimensions: clinical, functional and vertical system integration. Conclusions: The CSI Survey provides important insights on a range of typically unmeasured aspects of the coordination and integration of cancer services, representing a new tool to inform performance improvement efforts. PMID:20676250

Support for infants and young people with sight loss: a qualitative study of sight impairment certification and referral to education and social care services

PubMed Central

Boyce, Tammy; Dahlmann-Noor, Annegret; Bowman, Richard; Keil, Sue

2015-01-01

Objectives To examine the experience of infants, children and their parents, the role of ophthalmologists and other health, social care and education professionals in the certification and registration processes and examine the relationship between certification and referrals and pathways to support. Design Qualitative study. Setting Telephone interviews with health and, social care professionals, qualified teachers of children and young people with vision impairment (QTVIs) and parents of infants/children in England. Participants 52 health, social care and education professionals who are part of the certification or registration process. 26 parents of infants and children with vision impairment. Results Referrals to education do not require a Certificate of Vision Impairment (CVI); however, the majority of parents received support from education and social services only after an offer of the CVI, which was often dependent on having a formal diagnosis. Parents stated they wanted support sooner, particularly parents of children with additional complex needs who experienced longer delays. Areas with multidisciplinary teams and support roles such as eye clinic liaison officers (ECLOs) appeared to have more reliable referral pathways. Conclusions For infants and children with vision impairment, there should be a consistent mechanism for triggering education and social care support even with uncertainty about diagnosis and/or prognosis. All professionals involved in the certification and registration processes (ophthalmologists, optometrists, ECLOs, orthoptists, social workers, QTVIs) can better communicate the value and benefits of certification and registration. PMID:26685033

Supporting Professional Learning in a Massive Open Online Course

ERIC Educational Resources Information Center

Milligan, Colin; Littlejohn, Allison

2014-01-01

Professional learning, combining formal and on the job learning, is important for the development and maintenance of expertise in the modern workplace. To integrate formal and informal learning, professionals have to have good self-regulatory ability. Formal learning opportunities are opening up through massive open online courses (MOOCs),…

Formal Assurance Arguments: A Solution In Search of a Problem?

NASA Technical Reports Server (NTRS)

Graydon, Patrick J.

2015-01-01

An assurance case comprises evidence and argument showing how that evidence supports assurance claims (e.g., about safety or security). It is unsurprising that some computer scientists have proposed formalizing assurance arguments: most associate formality with rigor. But while engineers can sometimes prove that source code refines a formal specification, it is not clear that formalization will improve assurance arguments or that this benefit is worth its cost. For example, formalization might reduce the benefits of argumentation by limiting the audience to people who can read formal logic. In this paper, we present (1) a systematic survey of the literature surrounding formal assurance arguments, (2) an analysis of errors that formalism can help to eliminate, (3) a discussion of existing evidence, and (4) suggestions for experimental work to definitively answer the question.

Etude et simulation du protocole TTEthernet sur un sous-systeme de gestion de vols et adaptation de la planification des tâches a des fins de simulation

NASA Astrophysics Data System (ADS)

Abidi, Dhafer

TTEthernet is a deterministic network technology that makes enhancements to Layer 2 Quality-of-Service (QoS) for Ethernet. The components that implement its services enrich the Ethernet functionality with distributed fault-tolerant synchronization, robust temporal partitioning bandwidth and synchronous communication with fixed latency and low jitter. TTEthernet services can facilitate the design of scalable, robust, less complex distributed systems and architectures tolerant to faults. Simulation is nowadays an essential step in critical systems design process and represents a valuable support for validation and performance evaluation. CoRE4INET is a project bringing together all TTEthernet simulation models currently available. It is based on the extension of models of OMNeT ++ INET framework. Our objective is to study and simulate the TTEthernet protocol on a flight management subsystem (FMS). The idea is to use CoRE4INET to design the simulation model of the target system. The problem is that CoRE4INET does not offer a task scheduling tool for TTEthernet network. To overcome this problem we propose an adaptation for simulation purposes of a task scheduling approach based on formal specification of network constraints. The use of Yices solver allowed the translation of the formal specification into an executable program to generate the desired transmission plan. A case study allowed us at the end to assess the impact of the arrangement of Time-Triggered frames offsets on the performance of each type of the system traffic.

Introducing peer worker roles into UK mental health service teams: a qualitative analysis of the organisational benefits and challenges.

PubMed

Gillard, Steve G; Edwards, Christine; Gibson, Sarah L; Owen, Katherine; Wright, Christine

2013-05-24

The provision of peer support as a component of mental health care, including the employment of Peer Workers (consumer-providers) by mental health service organisations, is increasingly common internationally. Peer support is strongly advocated as a strategy in a number of UK health and social care policies. Approaches to employing Peer Workers are proliferating. There is evidence to suggest that Peer Worker-based interventions reduce psychiatric inpatient admission and increase service user (consumer) empowerment. In this paper we seek to address a gap in the empirical literature in understanding the organisational challenges and benefits of introducing Peer Worker roles into mental health service teams. We report the secondary analysis of qualitative interview data from service users, Peer Workers, non-peer staff and managers of three innovative interventions in a study about mental health self-care. Relevant data was extracted from interviews with 41 participants and subjected to analysis using Grounded Theory techniques. Organisational research literature on role adoption framed the analysis. Peer Workers were highly valued by mental health teams and service users. Non-peer team members and managers worked hard to introduce Peer Workers into teams. Our cases were projects in development and there was learning from the evolutionary process: in the absence of formal recruitment processes for Peer Workers, differences in expectations of the Peer Worker role can emerge at the selection stage; flexible working arrangements for Peer Workers can have the unintended effect of perpetuating hierarchies within teams; the maintenance of protective practice boundaries through supervision and training can militate against the emergence of a distinctive body of peer practice; lack of consensus around what constitutes peer practice can result in feelings for Peer Workers of inequality, disempowerment, uncertainty about identity and of being under-supported. This research is indicative of potential benefits for mental health service teams of introducing Peer Worker roles. Analysis also suggests that if the emergence of a distinctive body of peer practice is not adequately considered and supported, as integral to the development of new Peer Worker roles, there is a risk that the potential impact of any emerging role will be constrained and diluted.

Formal methods technology transfer: Some lessons learned

NASA Technical Reports Server (NTRS)

Hamilton, David

1992-01-01

IBM has a long history in the application of formal methods to software development and verification. There have been many successes in the development of methods, tools and training to support formal methods. And formal methods have been very successful on several projects. However, the use of formal methods has not been as widespread as hoped. This presentation summarizes several approaches that have been taken to encourage more widespread use of formal methods, and discusses the results so far. The basic problem is one of technology transfer, which is a very difficult problem. It is even more difficult for formal methods. General problems of technology transfer, especially the transfer of formal methods technology, are also discussed. Finally, some prospects for the future are mentioned.

48 CFR 42.709-5 - Waiver of the penalty.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 42.709-5 Waiver of the penalty. The... the proposal before the Government formally initiates an audit of the proposal and the contractor submits a revised proposal (an audit will be deemed to be formally initiated when the Government provides...

47 CFR 14.46 - Formal complaints not stating a cause of action; defective pleadings.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false Formal complaints not stating a cause of action; defective pleadings. 14.46 Section 14.46 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping, Consumer...

47 CFR 14.46 - Formal complaints not stating a cause of action; defective pleadings.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Formal complaints not stating a cause of action; defective pleadings. 14.46 Section 14.46 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping, Consumer...

47 CFR 14.46 - Formal complaints not stating a cause of action; defective pleadings.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Formal complaints not stating a cause of action; defective pleadings. 14.46 Section 14.46 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping, Consumer...

Positive and negative adjustment and social support of sexual assault survivors.

PubMed

Borja, Susan E; Callahan, Jennifer L; Long, Patricia J

2006-12-01

The roles of positive (i.e., growth) and negative (i.e., posttraumatic stress symptoms and general symptomatology) adjustment following adult sexual assault experience(s) were examined using a standardized definition of abuse. These reactions were explored in association with positive and negative support from formal and informal providers. Finally, using standardized measures, the collective impact of positive and negative support, formal and informal support were investigated in predicting positive and negative psychological adjustment. Both forms of informal support were found to be associated with positive outcomes. Only negative informal support was associated with posttraumatic stress symptoms. First responders should consider whether support resources are appropriate to victims' needs.

22 CFR 120.9 - Defense service.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Defense service. (a) Defense service means: (1) The furnishing of assistance (including training) to..., destruction, processing or use of defense articles; (2) The furnishing to foreign persons of any technical...) Military training of foreign units and forces, regular and irregular, including formal or informal...

31 CFR 1020.100 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... formal banking relationship established to provide or engage in services, dealings, or other financial... of credit. Account also includes a relationship established to provide a safety deposit box or other safekeeping services, or cash management, custodian, and trust services. (2) Account does not include: (i) A...

31 CFR 1020.100 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... formal banking relationship established to provide or engage in services, dealings, or other financial... of credit. Account also includes a relationship established to provide a safety deposit box or other safekeeping services, or cash management, custodian, and trust services. (2) Account does not include: (i) A...

31 CFR 1020.100 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... formal banking relationship established to provide or engage in services, dealings, or other financial... of credit. Account also includes a relationship established to provide a safety deposit box or other safekeeping services, or cash management, custodian, and trust services. (2) Account does not include: (i) A...

31 CFR 1020.100 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... formal banking relationship established to provide or engage in services, dealings, or other financial... of credit. Account also includes a relationship established to provide a safety deposit box or other safekeeping services, or cash management, custodian, and trust services. (2) Account does not include: (i) A...

Providing smoking cessation programs to homeless youth: the perspective of service providers.

PubMed

Shadel, William G; Tucker, Joan S; Mullins, Leslie; Staplefoote, Lynette

2014-10-01

There is almost no information available on cigarette smoking among homeless youth, whether they are currently receiving services for smoking cessation, and how to best help them quit. This paper presents data collected from a series of semi-structured telephone interviews with service providers from 23 shelters and drop-in centers serving homeless youth in Los Angeles County about their current smoking cessation programming, interest in providing smoking cessation services to their clients, potential barriers to providing this service, and ways to overcome these barriers. Results indicated that 84% of facilities did not offer smoking cessation services, although nearly all (91%) were interested in doing so. Barriers to implementing formal smoking cessation programs on site included lack of resources (e.g., money, personnel) to support the programs, staff training, and concern that smoking cessation may not be a high priority for homeless youth themselves. Overall, service providers seemed to prefer a less intensive smoking cessation program that could be delivered at their site by existing staff. Data from this formative needs assessment will be useful for developing and evaluating a smoking cessation treatment that could be integrated into the busy, complex environment that characterizes agencies that serve homeless youth. Copyright © 2014 Elsevier Inc. All rights reserved.

Modeling and formal representation of geospatial knowledge for the Geospatial Semantic Web

NASA Astrophysics Data System (ADS)

Huang, Hong; Gong, Jianya

2008-12-01

GML can only achieve geospatial interoperation at syntactic level. However, it is necessary to resolve difference of spatial cognition in the first place in most occasions, so ontology was introduced to describe geospatial information and services. But it is obviously difficult and improper to let users to find, match and compose services, especially in some occasions there are complicated business logics. Currently, with the gradual introduction of Semantic Web technology (e.g., OWL, SWRL), the focus of the interoperation of geospatial information has shifted from syntactic level to Semantic and even automatic, intelligent level. In this way, Geospatial Semantic Web (GSM) can be put forward as an augmentation to the Semantic Web that additionally includes geospatial abstractions as well as related reasoning, representation and query mechanisms. To advance the implementation of GSM, we first attempt to construct the mechanism of modeling and formal representation of geospatial knowledge, which are also two mostly foundational phases in knowledge engineering (KE). Our attitude in this paper is quite pragmatical: we argue that geospatial context is a formal model of the discriminate environment characters of geospatial knowledge, and the derivation, understanding and using of geospatial knowledge are located in geospatial context. Therefore, first, we put forward a primitive hierarchy of geospatial knowledge referencing first order logic, formal ontologies, rules and GML. Second, a metamodel of geospatial context is proposed and we use the modeling methods and representation languages of formal ontologies to process geospatial context. Thirdly, we extend Web Process Service (WPS) to be compatible with local DLL for geoprocessing and possess inference capability based on OWL.

Perspectives of policy and political decision makers on access to formal dementia care: expert interviews in eight European countries.

PubMed

Broda, Anja; Bieber, Anja; Meyer, Gabriele; Hopper, Louise; Joyce, Rachael; Irving, Kate; Zanetti, Orazio; Portolani, Elisa; Kerpershoek, Liselot; Verhey, Frans; Vugt, Marjolein de; Wolfs, Claire; Eriksen, Siren; Røsvik, Janne; Marques, Maria J; Gonçalves-Pereira, Manuel; Sjölund, Britt-Marie; Woods, Bob; Jelley, Hannah; Orrell, Martin; Stephan, Astrid

2017-08-03

As part of the ActifCare (ACcess to Timely Formal Care) project, we conducted expert interviews in eight European countries with policy and political decision makers, or representatives of relevant institutions, to determine their perspectives on access to formal care for people with dementia and their carers. Each ActifCare country (Germany, Ireland, Italy, The Netherlands, Norway, Portugal, Sweden, United Kingdom) conducted semi-structured interviews with 4-7 experts (total N = 38). The interview guide addressed the topics "Complexity and Continuity of Care", "Formal Services", and "Public Awareness". Country-specific analysis of interview transcripts used an inductive qualitative content analysis. Cross-national synthesis focused on similarities in themes across the ActifCare countries. The analysis revealed ten common themes and two additional sub-themes across countries. Among others, the experts highlighted the need for a coordinating role and the necessity of information to address issues of complexity and continuity of care, demanded person-centred, tailored, and multidisciplinary formal services, and referred to education, mass media and campaigns as means to raise public awareness. Policy and political decision makers appear well acquainted with current discussions among both researchers and practitioners of possible approaches to improve access to dementia care. Experts described pragmatic, realistic strategies to influence dementia care. Suggested innovations concerned how to achieve improved dementia care, rather than transforming the nature of the services provided. Knowledge gained in these expert interviews may be useful to national decision makers when they consider reshaping the organisation of dementia care, and may thus help to develop best-practice strategies and recommendations.

A Guide to Providing Social Support for Apprentices. Good Practice Guide

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2016

2016-01-01

The main purpose of this guide is to provide some ideas for employers of apprentices to provide an environment in which strong informal bases of support can succeed. Formal mentoring is an important aspect of apprenticeships; however, it is also informal mentoring--practices that are difficult to formally nurture--that plays a significant and…

Invited Reaction: Influences of Formal Learning, Personal Learning Orientation, and Supportive Learning Environment on Informal Learning

ERIC Educational Resources Information Center

Cseh, Maria; Manikoth, Nisha N.

2011-01-01

As the authors of the preceding article (Choi and Jacobs, 2011) have noted, the workplace learning literature shows evidence of the complementary and integrated nature of formal and informal learning in the development of employee competencies. The importance of supportive learning environments in the workplace and of employees' personal learning…

Perceptions of Informal and Formal Coping Strategies for Intimate Partner Violence Among Gay and Bisexual Men.

PubMed

Freeland, Ryan; Goldenberg, Tamar; Stephenson, Rob

2018-03-01

The prevalence of intimate partner violence (IPV) in same-sex male relationships has been reported to be at least as prevalent as is observed in female-male relationships. Though research has focused on understanding the prevalence and antecedents of IPV in male-male relationships, there is a paucity of data describing perceptions of coping strategies adopted by gay and bisexual men who may experience IPV. Ten focus group discussions were conducted with 64 gay and bisexual men in Atlanta, Georgia, between September 2013 and November 2013. Focus groups examined perceptions of how gay and bisexual men would respond to IPV and the IPV-coping services they would utilize. Thematic analysis was conducted to identify themes that describe how gay and bisexual men perceive existing IPV services and how they would use these services, if gay and bisexual men were to experience IPV. The results indicate that men experiencing IPV in male-male relationships do not have adequate access to IPV services that are tailored to their unique needs. As a result, there is a strong reliance on informal sources of support. Services are urgently needed to meet the unique needs of men experiencing IPV in same-sex relationships.

Mobile health (mHealth) approaches and lessons for increased performance and retention of community health workers in low- and middle-income countries: a review.

PubMed

Källander, Karin; Tibenderana, James K; Akpogheneta, Onome J; Strachan, Daniel L; Hill, Zelee; ten Asbroek, Augustinus H A; Conteh, Lesong; Kirkwood, Betty R; Meek, Sylvia R

2013-01-25

Mobile health (mHealth) describes the use of portable electronic devices with software applications to provide health services and manage patient information. With approximately 5 billion mobile phone users globally, opportunities for mobile technologies to play a formal role in health services, particularly in low- and middle-income countries, are increasingly being recognized. mHealth can also support the performance of health care workers by the dissemination of clinical updates, learning materials, and reminders, particularly in underserved rural locations in low- and middle-income countries where community health workers deliver integrated community case management to children sick with diarrhea, pneumonia, and malaria. Our aim was to conduct a thematic review of how mHealth projects have approached the intersection of cellular technology and public health in low- and middle-income countries and identify the promising practices and experiences learned, as well as novel and innovative approaches of how mHealth can support community health workers. In this review, 6 themes of mHealth initiatives were examined using information from peer-reviewed journals, websites, and key reports. Primary mHealth technologies reviewed included mobile phones, personal digital assistants (PDAs) and smartphones, patient monitoring devices, and mobile telemedicine devices. We examined how these tools could be used for education and awareness, data access, and for strengthening health information systems. We also considered how mHealth may support patient monitoring, clinical decision making, and tracking of drugs and supplies. Lessons from mHealth trials and studies were summarized, focusing on low- and middle-income countries and community health workers. The review revealed that there are very few formal outcome evaluations of mHealth in low-income countries. Although there is vast documentation of project process evaluations, there are few studies demonstrating an impact on clinical outcomes. There is also a lack of mHealth applications and services operating at scale in low- and middle-income countries. The most commonly documented use of mHealth was 1-way text-message and phone reminders to encourage follow-up appointments, healthy behaviors, and data gathering. Innovative mHealth applications for community health workers include the use of mobile phones as job aides, clinical decision support tools, and for data submission and instant feedback on performance. With partnerships forming between governments, technologists, non-governmental organizations, academia, and industry, there is great potential to improve health services delivery by using mHealth in low- and middle-income countries. As with many other health improvement projects, a key challenge is moving mHealth approaches from pilot projects to national scalable programs while properly engaging health workers and communities in the process. By harnessing the increasing presence of mobile phones among diverse populations, there is promising evidence to suggest that mHealth can be used to deliver increased and enhanced health care services to individuals and communities, while helping to strengthen health systems.

Experience of using mHealth to link village doctors with physicians: lessons from Chakaria, Bangladesh.

PubMed

Khan, Nazib Uz Zaman; Rasheed, Sabrina; Sharmin, Tamanna; Ahmed, Tanvir; Mahmood, Shehrin Shaila; Khatun, Fatema; Hanifi, Sma; Hoque, Shahidul; Iqbal, Mohammad; Bhuiya, Abbas

2015-08-05

Bangladesh is facing serious shortage of trained health professionals. In the pluralistic healthcare system of Bangladesh, formal health care providers constitute only 5 % of the total workforce; the rest are informal health care providers. Information Communication Technologies (ICTs) are increasingly seen as a powerful tool for linking the community with formal healthcare providers. Our study assesses an intervention that linked village doctors (a cadre of informal health care providers practising modern medicine) to formal doctors through call centres from the perspective of the village doctors who participated in the intervention. The study was conducted in Chakaria, a remote rural area in south-eastern Bangladesh during April-May 2013. Twelve village doctors were selected purposively from a pool of 55 village doctors who participated in the mobile health (mHealth) intervention. In depth interviews were conducted to collect data. The data were manually analysed using themes that emerged. The village doctors talked about both business benefits (access to formal doctors, getting support for decision making, and being entitled to call trained doctors) and personal benefits (both financial and non-financial). Some of the major barriers mentioned were technical problems related to accessing the call centre, charging consultation fees, and unfamiliarity with the call centre physicians. Village doctors saw many benefits to having a business relationship with the trained doctors that the mHealth intervention provided. mHealth through call centres has the potential to ensure consultation services to populations through existing informal healthcare providers in settings with a shortage of qualified healthcare providers.

Involving users and carers in the assessment of preregistration nursing students' clinical nursing practice: a strategy for patient empowerment and quality improvement?

PubMed

Haycock-Stuart, Elaine; Donaghy, Eddie; Darbyshire, Chris

2016-07-01

To examine (1) nursing lecturers' and (2) preregistration nursing students' perspectives of user and carer involvement in the formal assessment of preregistration nursing students' clinical practice. The involvement of service users and carers in the assessment of clinical practice in nursing education is a recent phenomenon. The Nursing and Midwifery Council Standards in the UK clearly reflect a shift in thinking from paternalistic approaches to person-centred approaches. This shift in thinking includes service user and carer involvement in student nursing assessment and there is evidence that this is being developed in several countries. Located in the interpretive paradigm, data from a two-staged, multicentre qualitative study are presented. Interpretive analysis of semi-structured, one to one interviews with nursing lecturers (n = 15) and focus groups with nursing students (n = 51) across 11 Higher Educational Institutions. There is a strong commitment for working alongside service users and carers in the education and training of nursing students; however, involving service users and carers in formal practice assessment is identified as more challenging compared with other areas of service user/carer involvement. Service user/carers should provide feedback/review or comment, but not necessarily formal, summative 'assessment'. The evidence base for involving users and carers in assessment is limited. Involvement of users and carers in providing feedback to nursing students is welcomed. However, concerns exist about the preparedness of users and carers for formal clinical assessment. Discussion and clarification with clinical mentors and user and carer groups is necessary to understand if they agree with the policy direction of user and carer involvement in the assessment of nursing students. Quality assurance concerns are raised by students and lecturers when involving user and carer in assessing nursing students' clinical skills. Mentors are seen as key to this process, but little is known about their perspectives. © 2016 John Wiley & Sons Ltd.

42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

Code of Federal Regulations, 2011 CFR

2011-10-01

... an institution for mental diseases. 440.10 Section 440.10 Public Health CENTERS FOR MEDICARE... for mental diseases. (a) Inpatient hospital services means services that— (1) Are ordinarily furnished... and treatment of patients with disorders other than mental diseases; (ii) Is licensed or formally...

42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

Code of Federal Regulations, 2010 CFR

2010-10-01

... an institution for mental diseases. 440.10 Section 440.10 Public Health CENTERS FOR MEDICARE... for mental diseases. (a) Inpatient hospital services means services that— (1) Are ordinarily furnished... and treatment of patients with disorders other than mental diseases; (ii) Is licensed or formally...

42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

Code of Federal Regulations, 2012 CFR

2012-10-01

... an institution for mental diseases. 440.10 Section 440.10 Public Health CENTERS FOR MEDICARE... for mental diseases. (a) Inpatient hospital services means services that— (1) Are ordinarily furnished... and treatment of patients with disorders other than mental diseases; (ii) Is licensed or formally...

42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

Code of Federal Regulations, 2014 CFR

2014-10-01

... an institution for mental diseases. 440.10 Section 440.10 Public Health CENTERS FOR MEDICARE... for mental diseases. (a) Inpatient hospital services means services that— (1) Are ordinarily furnished... and treatment of patients with disorders other than mental diseases; (ii) Is licensed or formally...

42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

Code of Federal Regulations, 2013 CFR

2013-10-01

... an institution for mental diseases. 440.10 Section 440.10 Public Health CENTERS FOR MEDICARE... for mental diseases. (a) Inpatient hospital services means services that— (1) Are ordinarily furnished... and treatment of patients with disorders other than mental diseases; (ii) Is licensed or formally...

Incorporating Professional Service as a Component of General Chemistry Laboratory by Demonstrating Chemistry to Elementary Students

ERIC Educational Resources Information Center

Theall, Rachel A. Morgan; Bond, Marcus R.

2013-01-01

Formalized participation in professional service is not often part of the college experience, especially for first-year students in chemistry courses. When service opportunities are offered, they are most often through elective credit, upper-level courses, extracurricular clubs, and the rare service-learning courses. We have successfully…

Mechanisms for Institutionalizing Service-Learning and Community Partner Outcomes

ERIC Educational Resources Information Center

Stater, Keely Jones; Fotheringham, Eric

2009-01-01

Using data on service-learning partnerships from 255 universities receiving Learn and Serve America Grants in 2005, we ask (1) how different strategies used to institutionalize service-learning shape the perceived impact of the partnership on community groups, (2) how the level of service-learning program formality affects the perceived impact of…

Taking a Hard Look at Formal Mentoring Programs: A Consideration of the Potential Challenges Facing Women.

ERIC Educational Resources Information Center

Blake-Beard, Stacy D.

2001-01-01

Comparison of women in formal and informal mentoring relationships showed that formal mentoring often led to unrealistic expectations; unbalanced focus on proteges; difficulty managing relationships among supervisors, proteges, and mentors; and damage from gossip. Informal mentoring may provide psychosocial and career support without these…

Patient experience in a coordinated care model featuring diabetes self-management education integrated into the patient-centered medical home.

PubMed

Janiszewski, Debra; O'Brian, Catherine A; Lipman, Ruth D

2015-08-01

The purpose of this study is to gain insight about patient experience of diabetes self-management education in a patient-centered medical home. Six focus groups consisting of 37 people with diabetes, diverse in race and ethnicity, were conducted at 3 sites. Participants described their experience in the program and their challenges in diabetes self-management; they also suggested services to meet their diabetes care needs. The most common theme was ongoing concerns about care and support. There was much discussion about the value of the support provided by health navigators integrated in the diabetes health care team. Frequent concerns expressed by participants centered on personal challenges in engaging in healthy lifestyle behaviors. Ongoing programmatic support of self-management goals was widely valued. Individuals who received health care in a patient-centered medical home and could participate in diabetes self-management education with integrated support valued both activities. The qualitative results from this study suggest need for more formalized exploration of effective means to meet the ongoing support needs of people with diabetes. © 2015 The Author(s).

Survey of northern informal and formal mental health practitioners

PubMed Central

O'Neill, Linda; George, Serena; Sebok, Stefanie

2013-01-01

Background This survey is part of a multi-year research study on informal and formal mental health support in northern Canada involving the use of qualitative and quantitative data collection and analysis methods in an effort to better understand mental health in a northern context. Objective The main objective of the 3-year study was to document the situation of formal and informal helpers in providing mental health support in isolated northern communities in northern British Columbia, northern Alberta, Yukon, Northwest Territories and Nunavut. The intent of developing a survey was to include more participants in the research and access those working in small communities who would be concerned regarding confidentiality and anonymity due to their high profile within smaller populations. Design Based on the in-depth interviews from the qualitative phase of the project, the research team developed a survey that reflected the main themes found in the initial qualitative analysis. The on-line survey consisted of 26 questions, looking at basic demographic information and presenting lists of possible challenges, supports and client mental health issues for participants to prioritise. Results Thirty-two participants identified various challenges, supports and client issues relevant to their mental health support work. A vast majority of the respondents felt prepared for northern practice and had some level of formal education. Supports for longevity included team collaboration, knowledgeable supervisors, managers, leaders and more opportunities for formal education, specific training and continuity of care to support clients. Conclusion For northern-based research in small communities, the development of a survey allowed more participants to join the larger study in a way that protected their identity and confidentiality. The results from the survey emphasise the need for team collaboration, interdisciplinary practice and working with community strengths as a way to sustain mental health support workers in the North. PMID:23984276

Assessment of the experiences and coping strategies of people working in the informal sector in their quest to access health care services: the case of Dar es Salaam, Tanzania.

PubMed

Munga, Michael A; Gideon, Gilbert M

2009-02-01

Addressing inequities in health care provision and financing has been at the center stage of Health Sector Reform (HSR) discussions since the early 1980s. The poor, women, and informal health sector workers in most developing countries are rarely covered by formal health insurance mechanisms that are meant to ensure access to essential health services. They are also sidelined in formal banking and credit systems due to their being predominantly low income earners, with little resources to meet eligibility criteria for borrowing and also to be considered creditworthy. In light of this fact, the present paper analyzes both quantitative and qualitative data in an attempt to explore and discuss the experiences and coping strategies of women and men employed in the informal sector economy in their daily attempts to access health care services. The paper employs Malaria as a tracer disease and gender as a unit of analysis. Analysis indicated the significance, as perceived by interviewees, of both informal credit networks and formal insurance and banking systems as important shock-absorbers for vulnerable populations in their struggle to access basic health services in times of need. The paper further highlights and discusses diverse coping strategies that households employ in dealing with illness-related costs and a greater willingness to be integrated into both formal and informal financial mechanisms. The paper finally concludes that the government must take the following steps: 1) enhance existing formal and communitybased initiatives to make them sustainable, 2) devise ways to reduce the lack of flexibility in membership requirements for insurance schemes/financial institutions, and 3) reduce perverse incentives inherent in the health system that may prevent people from seeking membership in available insurance mechanisms. In addition, deliberate steps must be taken by the government to employ 'targeted measures' to ensure that health care access is improved and sustained particularly for vulnerable populations.

The Setting is the Service: How the Architecture of Sober Living Residences Supports Community Based Recovery

PubMed Central

Wittman, Fried; Jee, Babette; Polcin, Douglas L.; Henderson, Diane

2014-01-01

The architecture of residential recovery settings is an important silent partner in the alcohol/drug recovery field. The settings significantly support or hinder recovery experiences of residents, and shape community reactions to the presence of sober living houses (SLH) in ordinary neighborhoods. Grounded in the principles of Alcoholics Anonymous, the SLH provides residents with settings designed to support peer based recovery; further, these settings operate in a community context that insists on sobriety and strongly encourages attendance at 12-step meetings. Little formal research has been conducted to show how architectural features of the recovery setting – building appearance, spatial layouts, furnishings and finishes, policies for use of the facilities, physical care and maintenance of the property, neighborhood features, aspects of location in the city – function to promote (or retard) recovery, and to build (or detract from) community support. This paper uses a case-study approach to analyze the architecture of a community-based residential recovery service that has demonstrated successful recovery outcomes for its residents, is popular in its community, and has achieved state-wide recognition. The Environmental Pattern Language (Alexander, Ishikawa, & Silverstein, 1977) is used to analyze its architecture in a format that can be tested, critiqued, and adapted for use by similar programs in many communities, providing a model for replication and further research. PMID:25328377

The Setting is the Service: How the Architecture of Sober Living Residences Supports Community Based Recovery.

PubMed

Wittman, Fried; Jee, Babette; Polcin, Douglas L; Henderson, Diane

2014-07-01

The architecture of residential recovery settings is an important silent partner in the alcohol/drug recovery field. The settings significantly support or hinder recovery experiences of residents, and shape community reactions to the presence of sober living houses (SLH) in ordinary neighborhoods. Grounded in the principles of Alcoholics Anonymous, the SLH provides residents with settings designed to support peer based recovery; further, these settings operate in a community context that insists on sobriety and strongly encourages attendance at 12-step meetings. Little formal research has been conducted to show how architectural features of the recovery setting - building appearance, spatial layouts, furnishings and finishes, policies for use of the facilities, physical care and maintenance of the property, neighborhood features, aspects of location in the city - function to promote (or retard) recovery, and to build (or detract from) community support. This paper uses a case-study approach to analyze the architecture of a community-based residential recovery service that has demonstrated successful recovery outcomes for its residents, is popular in its community, and has achieved state-wide recognition. The Environmental Pattern Language (Alexander, Ishikawa, & Silverstein, 1977) is used to analyze its architecture in a format that can be tested, critiqued, and adapted for use by similar programs in many communities, providing a model for replication and further research.

Substitution of Formal and Informal Home Care Service Use and Nursing Home Service Use: Health Outcomes, Decision-Making Preferences, and Implications for a Public Health Policy.

PubMed

Chen, Chia-Ching; Yamada, Tetsuji; Nakashima, Taeko; Chiu, I-Ming

2017-01-01

The purposes of this study are: (1) to empirically identify decision-making preferences of long-term health-care use, especially informal and formal home care (FHC) service use; (2) to evaluate outcomes vs. costs based on substitutability of informal and FHC service use; and (3) to investigate health outcome disparity based on substitutability. The methods of ordinary least squares, a logit model, and a bivariate probit model are used by controlling for socioeconomic, demographic, and physical/mental health factors to investigate outcomes and costs based substitutability of informal and formal health-care use. The data come from the 2013 Japanese Study of Aging and Retirement (JSTAR), which is designed by Keizai-Sangyo Kenkyu-jo, Hitotsubashi University, and the University of Tokyo. The JSTAR is a globally comparable data survey of the elderly. There exists a complement relationship between the informal home care (IHC) and community-based FHC services, and the elasticity's ranges from 0.18 to 0.22. These are reasonable results, which show that unobservable factors are positively related to IHC and community-based FHC, but negatively related to nursing home (NH) services based on our bivariate probit model. Regarding health-care outcome efficiency issue, the IHC is the best one among three types of elderly care: IHC, community-based FHC, and NH services. Health improvement/outcome of elderly with the IHC is heavier concentrated on IHC services than the elderly care services by community-based FHC and NH care services. Policy makers need to address a diversity of health outcomes and efficiency of services based on providing services to elderly through resource allocation to the different types of long-term care. A provision of partial or full compensation for elderly care at home is recommendable and a viable option to improve their quality of lives.

FORMAL AND ON-THE JOB TRAINING IN MILITARY OCCUPATIONS.

ERIC Educational Resources Information Center

BATEMAN, C.W.

A MODEL IS CONSTRUCTED TO DETERMINE THE BEST PROPORTION OF FORMAL AND ON-THE-JOB TRAINING IN MILITARY OCCUPATIONS. SPECIAL CONSIDERATION IS GIVEN TO THE UNIQUE SITUATION OF ENLISTED PERSONNEL'S FIXED LENGTH OF SERVICE, THE SMALL PERCENTAGE OF RE-ENLISTMENT, AND THE NECESSITY OF TRAINING ALL ENLISTEES FOR ASSIGNED OCCUPATIONS. THE MODEL FORMULA…

A Comparative Analysis of Recidivism with Propensity Score Matching of Informal and Formal Juvenile Probationers

ERIC Educational Resources Information Center

Onifade, Eyitayo; Wilkins, Jeffrey; Davidson, William; Campbell, Christina; Petersen, Jodi

2011-01-01

Given service costs and evidence suggesting mixing young offenders of different risk levels increases recidivism, this study determined the extent to which differential disposition and risk determined subsequent recidivism. Furthermore, this study entailed a comparison of offense outcomes for informal probationers (n = 581) and formal probationers…

7 CFR 51.23 - Report of inspection results prior to issuance of formal report.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 2 2012-01-01 2012-01-01 false Report of inspection results prior to issuance of formal report. 51.23 Section 51.23 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETIN...

7 CFR 52.22 - Report of inspection results prior to issuance of formal report.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 2 2013-01-01 2013-01-01 false Report of inspection results prior to issuance of formal report. 52.22 Section 52.22 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETIN...

7 CFR 51.23 - Report of inspection results prior to issuance of formal report.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 2 2013-01-01 2013-01-01 false Report of inspection results prior to issuance of formal report. 51.23 Section 51.23 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETIN...

7 CFR 52.22 - Report of inspection results prior to issuance of formal report.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 2 2011-01-01 2011-01-01 false Report of inspection results prior to issuance of formal report. 52.22 Section 52.22 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETIN...

7 CFR 51.23 - Report of inspection results prior to issuance of formal report.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 2 2011-01-01 2011-01-01 false Report of inspection results prior to issuance of formal report. 51.23 Section 51.23 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETIN...

7 CFR 52.22 - Report of inspection results prior to issuance of formal report.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 2 2012-01-01 2012-01-01 false Report of inspection results prior to issuance of formal report. 52.22 Section 52.22 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETIN...

7 CFR 52.22 - Report of inspection results prior to issuance of formal report.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 2 2014-01-01 2014-01-01 false Report of inspection results prior to issuance of formal report. 52.22 Section 52.22 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETIN...

7 CFR 51.23 - Report of inspection results prior to issuance of formal report.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 2 2014-01-01 2014-01-01 false Report of inspection results prior to issuance of formal report. 51.23 Section 51.23 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETIN...

78 FR 19492 - Draft Guidance for Industry on Formal Meetings Between FDA and Biosimilar Biological Product...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-D-0286] Draft Guidance for Industry on Formal Meetings Between FDA and Biosimilar Biological Product Sponsors or... Drug Administration (FDA) is announcing the availability of a draft guidance for industry entitled...

Ecosystem services and economic theory: integration for policy-relevant research.

PubMed

Fisher, Brendan; Turner, Kerry; Zylstra, Matthew; Brouwer, Roy; de Groot, Rudolf; Farber, Stephen; Ferraro, Paul; Green, Rhys; Hadley, David; Harlow, Julian; Jefferiss, Paul; Kirkby, Chris; Morling, Paul; Mowatt, Shaun; Naidoo, Robin; Paavola, Jouni; Strassburg, Bernardo; Yu, Doug; Balmford, Andrew

2008-12-01

It has become essential in policy and decision-making circles to think about the economic benefits (in addition to moral and scientific motivations) humans derive from well-functioning ecosystems. The concept of ecosystem services has been developed to address this link between ecosystems and human welfare. Since policy decisions are often evaluated through cost-benefit assessments, an economic analysis can help make ecosystem service research operational. In this paper we provide some simple economic analyses to discuss key concepts involved in formalizing ecosystem service research. These include the distinction between services and benefits, understanding the importance of marginal ecosystem changes, formalizing the idea of a safe minimum standard for ecosystem service provision, and discussing how to capture the public benefits of ecosystem services. We discuss how the integration of economic concepts and ecosystem services can provide policy and decision makers with a fuller spectrum of information for making conservation-conversion trade-offs. We include the results from a survey of the literature and a questionnaire of researchers regarding how ecosystem service research can be integrated into the policy process. We feel this discussion of economic concepts will be a practical aid for ecosystem service research to become more immediately policy relevant.

Unchartered innovation? Local reforms of national formal water management in the Mkoji sub-catchment, Tanzania

NASA Astrophysics Data System (ADS)

Mehari, Abraham; Koppen, Barbara Van; McCartney, Matthew; Lankford, Bruce

Tanzania is currently attempting to improve water resources management through formal water rights and water fees systems, and formal institutions. The water rights system is expected to facilitate water allocation. The water fees system aims at cost-recovery for water resources management services. To enhance community involvement in water management, Water User Associations (WUAs) are being established and, in areas with growing upstream-downstream conflicts, apex bodies of all users along the stressed river stretch. The Mkoji sub-catchment (MSC) in the Rufiji basin is one of the first where these formal water management systems are being attempted. This paper analyzes the effectiveness of these systems in the light of their expected merits and the consequences of the juxtaposition of contemporary laws with traditional approaches. The study employed mainly qualitative, but also quantitative approaches on social and technical variables. Major findings were: (1) a good mix of formal (water fees and WUAs) and traditional (rotation-based water sharing, the Zamu) systems improved village-level water management services and reduced intra-scheme conflicts; (2) the water rights system has not brought abstractions into line with allocations and (3) so far, the MSC Apex body failed to mitigate inter-scheme conflicts. A more sophisticated design of allocation infrastructure and institutions is recommended.

A telemedicine support for diabetes management: the T-IDDM project.

PubMed

Bellazzi, R; Larizza, C; Montani, S; Riva, A; Stefanelli, M; d'Annunzio, G; Lorini, R; Gomez, E J; Hernando, E; Brugues, E; Cermeno, J; Corcoy, R; de Leiva, A; Cobelli, C; Nucci, G; Del Prato, S; Maran, A; Kilkki, E; Tuominen, J

2002-08-01

In the context of the EU funded Telematic Management of Insulin-Dependent Diabetes Mellitus (T-IDDM) project, we have designed, developed and evaluated a telemedicine system for insulin dependent diabetic patients management. The system relies on the integration of two modules, a Patient Unit (PU) and a Medical Unit (MU), able to communicate over the Internet and the Public Switched Telephone Network. Using the PU, patients are allowed to automatically download their monitoring data from the blood glucose monitoring device, and to send them to the hospital data-base; moreover, they are supported in their every day self monitoring activity. The MU provides physicians with a set of tools for data visualization, data analysis and decision support, and allows them to send messages and/or therapeutic advice to the patients. The T-IDDM service has been evaluated through the application of a formal methodology, and has been used by European patients and physicians for about 18 months. The results obtained during the project demonstration, even if obtained on a pilot study of 12 subjects, show the feasibility of the T-IDDM telemedicine service, and seem to substantiate the hypothesis that the use of the system could present an advantage in the management of insulin dependent diabetic patients, by improving communications and, potentially, clinical outcomes.

Uncovering Ecosystem Service Bundles through Social Preferences

PubMed Central

Martín-López, Berta; Iniesta-Arandia, Irene; García-Llorente, Marina; Palomo, Ignacio; Casado-Arzuaga, Izaskun; Amo, David García Del; Gómez-Baggethun, Erik; Oteros-Rozas, Elisa; Palacios-Agundez, Igone; Willaarts, Bárbara; González, José A.; Santos-Martín, Fernando; Onaindia, Miren; López-Santiago, Cesar; Montes, Carlos

2012-01-01

Ecosystem service assessments have increasingly been used to support environmental management policies, mainly based on biophysical and economic indicators. However, few studies have coped with the social-cultural dimension of ecosystem services, despite being considered a research priority. We examined how ecosystem service bundles and trade-offs emerge from diverging social preferences toward ecosystem services delivered by various types of ecosystems in Spain. We conducted 3,379 direct face-to-face questionnaires in eight different case study sites from 2007 to 2011. Overall, 90.5% of the sampled population recognized the ecosystem’s capacity to deliver services. Formal studies, environmental behavior, and gender variables influenced the probability of people recognizing the ecosystem’s capacity to provide services. The ecosystem services most frequently perceived by people were regulating services; of those, air purification held the greatest importance. However, statistical analysis showed that socio-cultural factors and the conservation management strategy of ecosystems (i.e., National Park, Natural Park, or a non-protected area) have an effect on social preferences toward ecosystem services. Ecosystem service trade-offs and bundles were identified by analyzing social preferences through multivariate analysis (redundancy analysis and hierarchical cluster analysis). We found a clear trade-off among provisioning services (and recreational hunting) versus regulating services and almost all cultural services. We identified three ecosystem service bundles associated with the conservation management strategy and the rural-urban gradient. We conclude that socio-cultural preferences toward ecosystem services can serve as a tool to identify relevant services for people, the factors underlying these social preferences, and emerging ecosystem service bundles and trade-offs. PMID:22720006

Uncovering ecosystem service bundles through social preferences.

PubMed

Martín-López, Berta; Iniesta-Arandia, Irene; García-Llorente, Marina; Palomo, Ignacio; Casado-Arzuaga, Izaskun; Amo, David García Del; Gómez-Baggethun, Erik; Oteros-Rozas, Elisa; Palacios-Agundez, Igone; Willaarts, Bárbara; González, José A; Santos-Martín, Fernando; Onaindia, Miren; López-Santiago, Cesar; Montes, Carlos

2012-01-01

Ecosystem service assessments have increasingly been used to support environmental management policies, mainly based on biophysical and economic indicators. However, few studies have coped with the social-cultural dimension of ecosystem services, despite being considered a research priority. We examined how ecosystem service bundles and trade-offs emerge from diverging social preferences toward ecosystem services delivered by various types of ecosystems in Spain. We conducted 3,379 direct face-to-face questionnaires in eight different case study sites from 2007 to 2011. Overall, 90.5% of the sampled population recognized the ecosystem's capacity to deliver services. Formal studies, environmental behavior, and gender variables influenced the probability of people recognizing the ecosystem's capacity to provide services. The ecosystem services most frequently perceived by people were regulating services; of those, air purification held the greatest importance. However, statistical analysis showed that socio-cultural factors and the conservation management strategy of ecosystems (i.e., National Park, Natural Park, or a non-protected area) have an effect on social preferences toward ecosystem services. Ecosystem service trade-offs and bundles were identified by analyzing social preferences through multivariate analysis (redundancy analysis and hierarchical cluster analysis). We found a clear trade-off among provisioning services (and recreational hunting) versus regulating services and almost all cultural services. We identified three ecosystem service bundles associated with the conservation management strategy and the rural-urban gradient. We conclude that socio-cultural preferences toward ecosystem services can serve as a tool to identify relevant services for people, the factors underlying these social preferences, and emerging ecosystem service bundles and trade-offs.

Library Service to the Spanish Speaking.

ERIC Educational Resources Information Center

Peterson, Anita R.

This manual was developed to formalize Inglewood Public Library's existing policies and programs regarding library services to the Spanish speaking, and to define future program goals. The introduction discusses why such services have been initiated, why the manual was developed, and the potential benefits the manual has for library…

Identifying and addressing the support needs of family caregivers of people with motor neurone disease using the Carer Support Needs Assessment Tool.

PubMed

Aoun, Samar M; Deas, Kathleen; Kristjanson, Linda J; Kissane, David W

2017-02-01

Family caregivers of people with motor neurone disease (MND) experience adverse health outcomes as a result of their caregiving experience. This may be alleviated if their support needs are identified and addressed in a systematic and timely manner. The objective of the present study was to assess the feasibility and relevance of the Carer Support Needs Assessment Tool (CSNAT) in home-based care during the period of caregiving from the perspectives of the family caregivers of people with MND and their service providers. The study was conducted during 2014 in Western Australia. Some 30 family caregivers and 4 care advisors participated in trialing the CSNAT intervention, which involved two visits from care advisors (6-8 weeks apart) to identify and address support needs. The feedback from family caregivers was obtained via telephone interviews and that of care advisors via a self-administered questionnaire. A total of 24 caregivers completed the study (80% completion rate) and identified the highest support priorities as "knowing what to expect in the future," "knowing who to contact if concerned," and "equipment to help care." The majority found that this assessment process adequately addressed their needs and gave them a sense of validation, reassurance, and empowerment. Care advisors advocated the CSNAT approach as an improvement over standard practice, allowing them to more clearly assess needs, to offer a more structured follow-up, and to focus on the caregiver and family. The CSNAT approach for identifying and addressing family caregivers' support needs was found to be relevant and feasible by MND family caregivers and care advisors. The tool provided a formal structure to facilitate discussions with family caregivers and thus enable needs to be addressed. Such discussions can also inform an evidence base for the ongoing development of services, ensuring that new and improved services are designed to meet the explicit needs of the family caregivers of people with a motor neurone disease.

Health systems facilitators and barriers to the integration of HIV and chronic disease services: a systematic review.

PubMed

Watt, Nicola; Sigfrid, Louise; Legido-Quigley, Helena; Hogarth, Sue; Maimaris, Will; Otero-García, Laura; Perel, Pablo; Buse, Kent; McKee, Martin; Piot, Peter; Balabanova, Dina

2017-11-01

Integration of services for patients with more than one diagnosed condition has intuitive appeal but it has been argued that the empirical evidence to support it is limited. We report the findings of a systematic review that sought to identify health system factors, extrinsic to the integration process, which either facilitated or hindered the integration of services for two common disorders, HIV and chronic non-communicable diseases. Findings were initially extracted and organized around a health system framework, followed by a thematic cross-cutting analysis and validation steps. Of the 150 articles included, 67% (n = 102) were from high-income countries. The articles explored integration with services for one or several chronic disorders, the most studied being alcohol or substance use disorders (47.7%), and mental health issues (29.5%). Four cross-cutting themes related to the health system were identified. The first and most common theme was the requirement for effective collaboration and coordination: formal and informal productive relationships throughout the system between providers and within teams, and between staff and patients. The second was the need for adequate and appropriately skilled and incentivized health workers-with the right expertise, training and operational support for the programme. The third was the need for supportive institutional structures and dedicated resources. The fourth was leadership in terms of political will, effective managerial oversight and organizational culture, indicating that actual implementation is as important as programme design. A fifth theme, outside the health system, but underpinning all aspects of the system operation, was that placing the patient at the centre of service delivery and responding holistically to their diverse needs. This was an important facilitator of integration. These findings confirm that integration processes in service delivery depend substantially for their success on characteristics of the health systems in which they are embedded. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Health systems facilitators and barriers to the integration of HIV and chronic disease services: a systematic review

PubMed Central

Watt, Nicola; Sigfrid, Louise; Legido-Quigley, Helena; Hogarth, Sue; Maimaris, Will; Otero-García, Laura; Perel, Pablo; Buse, Kent; McKee, Martin; Piot, Peter; Balabanova, Dina

2017-01-01

Abstract Integration of services for patients with more than one diagnosed condition has intuitive appeal but it has been argued that the empirical evidence to support it is limited. We report the findings of a systematic review that sought to identify health system factors, extrinsic to the integration process, which either facilitated or hindered the integration of services for two common disorders, HIV and chronic non-communicable diseases. Findings were initially extracted and organized around a health system framework, followed by a thematic cross-cutting analysis and validation steps. Of the 150 articles included, 67% (n = 102) were from high-income countries. The articles explored integration with services for one or several chronic disorders, the most studied being alcohol or substance use disorders (47.7%), and mental health issues (29.5%). Four cross-cutting themes related to the health system were identified. The first and most common theme was the requirement for effective collaboration and coordination: formal and informal productive relationships throughout the system between providers and within teams, and between staff and patients. The second was the need for adequate and appropriately skilled and incentivized health workers—with the right expertise, training and operational support for the programme. The third was the need for supportive institutional structures and dedicated resources. The fourth was leadership in terms of political will, effective managerial oversight and organizational culture, indicating that actual implementation is as important as programme design. A fifth theme, outside the health system, but underpinning all aspects of the system operation, was that placing the patient at the centre of service delivery and responding holistically to their diverse needs. This was an important facilitator of integration. These findings confirm that integration processes in service delivery depend substantially for their success on characteristics of the health systems in which they are embedded. PMID:28666336

Personal Learning Environments, Social Media, and Self-Regulated Learning: A Natural Formula for Connecting Formal and Informal Learning

ERIC Educational Resources Information Center

Dabbagh, Nada; Kitsantas, Anastasia

2012-01-01

A Personal Learning Environment or PLE is a potentially promising pedagogical approach for both integrating formal and informal learning using social media and supporting student self-regulated learning in higher education contexts. The purpose of this paper is to (a) review research that support this claim, (b) conceptualize the connection…

Personal and Social Support Factors Involved in Students' Decision to Participate in Formal Academic Mentoring

ERIC Educational Resources Information Center

Larose, Simon; Cyrenne, Diane; Garceau, Odette; Harvey, Marylou; Guay, Frederic; Deschenes, Claire

2009-01-01

In this study, we examined the role of personal and social support factors involved in students' decision to participate in formal academic mentoring. Three hundred and eighteen students completing Grade 11 and planning to study sciences in college filled out a questionnaire and were then asked to participate in an academic mentoring program…

[Nursing home placement of people with dementia: a secondary analysis of qualitative data and literature review on perspectives of informal caregivers and healthcare professionals].

PubMed

Nguyen, Natalie; Renom-Guiteras, Anna; Meyer, Gabriele; Stephan, Astrid

2018-06-01

Background: Nursing home placement of people with dementia can become necessary when informal care is no longer sufficient. Informal carers experience the transition period as an additional burden. Aim: Experiences and views of informal carers and healthcare professionals regarding the transition from people with dementia to a nursing home are investigated to improve the support for informal carers. Method: This secondary analysis included data from all five focus groups with n = 30 informal carers and healthcare professionals conducted as part of the “RightTimePlaceCare” project. To supplement the material which resulted from a single interview question, a literature analysis with the same focus was conducted. Results: The merged results indicated that informal carers needed professional support early on at home until after the nursing home placement. Concerns regarding nursing homes, financial aspects and family related issues were important aspects in the decision making. Healthcare professionals recommended provision of early guidance regarding those matters and making own experiences with nursing homes. Healthcare professionals should serve as mediators during the transition process and improve the collaboration between service providers. Conclusions: Empowering families to make informed choices could be facilitated by offering advice at home about their options for formal support services, financial support, and housing solutions. Healthcare professionals should support caregivers to make a decision, coordinate the placement and to cope with the new situation.

Formal ontology for natural language processing and the integration of biomedical databases.

PubMed

Simon, Jonathan; Dos Santos, Mariana; Fielding, James; Smith, Barry

2006-01-01

The central hypothesis underlying this communication is that the methodology and conceptual rigor of a philosophically inspired formal ontology can bring significant benefits in the development and maintenance of application ontologies [A. Flett, M. Dos Santos, W. Ceusters, Some Ontology Engineering Procedures and their Supporting Technologies, EKAW2002, 2003]. This hypothesis has been tested in the collaboration between Language and Computing (L&C), a company specializing in software for supporting natural language processing especially in the medical field, and the Institute for Formal Ontology and Medical Information Science (IFOMIS), an academic research institution concerned with the theoretical foundations of ontology. In the course of this collaboration L&C's ontology, LinKBase, which is designed to integrate and support reasoning across a plurality of external databases, has been subjected to a thorough auditing on the basis of the principles underlying IFOMIS's Basic Formal Ontology (BFO) [B. Smith, Basic Formal Ontology, 2002. http://ontology.buffalo.edu/bfo]. The goal is to transform a large terminology-based ontology into one with the ability to support reasoning applications. Our general procedure has been the implementation of a meta-ontological definition space in which the definitions of all the concepts and relations in LinKBase are standardized in the framework of first-order logic. In this paper we describe how this principles-based standardization has led to a greater degree of internal coherence of the LinKBase structure, and how it has facilitated the construction of mappings between external databases using LinKBase as translation hub. We argue that the collaboration here described represents a new phase in the quest to solve the so-called "Tower of Babel" problem of ontology integration [F. Montayne, J. Flanagan, Formal Ontology: The Foundation for Natural Language Processing, 2003. http://www.landcglobal.com/].

Physics graduate students' perceptions of the value of teaching

NASA Astrophysics Data System (ADS)

Verley, Jim D.

An exploratory study was undertaken to examine the perceptions of physics graduate students regarding teaching and their institutional and departmental support for their teaching efforts. A Likert survey was developed and distributed to 249 physics graduate students at four Rocky Mountain institutions of higher education. The survey was distributed through individual physics department email lists to prevent spam and virus blockers from removing the survey email. Of those 249 receiving the survey 132 students responded (53%) and of those responding 50% gave written comments about their perceptions of the value of teaching. Two of the institutions surveyed have some level of formal teaching development and assistance programming available to the graduate students and two had no formal programs in place either departmentally or institutionally. Both quantitative and qualitative analysis was utilized to examine the survey questions, demographic information and an open-ended question regarding the students' personal perceptions of teaching. Results of the survey analysis indicate that this group of physics graduate students perceive and place a high value on the importance of teaching. The results of the study also indicate that while there was high awareness by the student population of formal programs to aid in their teaching efforts, it did not translate into a high value placed on teaching by the institutions or departments from the student perspective. Students at those institutions that maintain formal programs for teaching development and support, while aware of those programs, often perceive departmental support for their teaching efforts to be lacking and feel unable to accommodate a personal interest in teaching because of a departmental focus on research. The students attending the institution with no formal institutional or departmental programs for teaching had the highest perceived value on its departmental teaching and support for teaching compared to those institutions with formal programs in place.

The role of a community coalition in the development of health services for the poor and uninsured.

PubMed

Bibeau, D L; Howell, K A; Rife, J C; Taylor, M L

1996-01-01

Access to primary health care for indigent citizens presents a dilemma for many communities in the United States. In response, communities have developed a variety of strategies to effectively deal with the problem. This article describes the evolution of a small free clinic into a comprehensive primary care clinic developed through the actions of a community-based coalition. The clinic originated within an umbrella organization for indigent residents as free medical service provided at a night shelter by a local physician once a week. Through a coalition of business, religious, medical, hospital, foundation, lay volunteer, county health department, and chamber of commerce representatives, the service was enlarged into a formal clinic operation with a small staff and volunteers providing services for about 3,500 patient visits each year. As the demand for services increased beyond resources, an expanded coalition created HealthServe Medical Center, a comprehensive primary care clinic operating 40 hours per week. The HealthServe Board is currently active in supporting service delivery at the clinic, with plans to serve 24,000 medical and dental visits annually by mid-1995. The evolution process was based upon the characteristics of effective community coalitions and the commitment of individuals from diverse community sectors.

NASE 2015: Implementation of a Management Quality System

NASA Astrophysics Data System (ADS)

Ros, Rosa Maria; García, Beatriz; Santa Maria, Delia

2015-08-01

ISO 29990:2010, Learning services for non-formal education and training - Basic requirements for service providers, proposes enhance transparency and allow comparison on a worldwide basis of learning services, offering a single alternative backed by international consensus to the huge variety of national service and management standards which now exists in the field of non-formal learning. The objective of ISO 29990:2010 is to provide a generic model for quality professional practice and performance, and a common reference for learning service providers and their clients in the design, development and delivery of non-formal education, training and development.NASE project, which was born as a consequence of the implementation of IAU-10 Years Strategic Plan and it is in agreement with the proposal to increase the interest and efforts of IAU on schools before the university and constitutes good objective for the implementation of ISO 29990-2010.Taking into account the main objectives of the Strategic Plan, it is possible to remark that NASE acts on all the education levels, and had, during the past 5 years a big impact because Ministries of Education, Universities and Planetariums are involved. After 5 years NASE organized more than 60 courses in about 20 countries distributed in America, Africa, Asia and Europe. In many countries local governments changed their curriculum according NASE course contents (i.e. Nicaragua, Argentina and Honduras).The knowledge obtained by teachers is evaluated by the department of education of the local government or universities who participated. NASE acts as part of the Professional formation of Professors in Science and in this sense is a Program directed to the Tertiary and University Education.After 5 years of development, we present the implementation of a Quality Management System, according to ISO 29990:2010, devoted to Learning services for non-formal education and training. Basic requirements for service providers, and show that an Educational Program as NASE can also rich the international management standard levels’, demonstrating that knowledge is a factor of economic growing in the World.

A country for old men? Long-term home care utilization in Europe.

PubMed

Balia, Silvia; Brau, Rinaldo

2014-10-01

This paper investigates long-term home care utilization in Europe. Data from the first wave of the Survey on Health, Ageing and Retirement (SHARE) on formal (nursing care and paid domestic help) and informal care (support provided by relatives) are used to study the probability and the quantity of both types of care. The overall process is framed in a fully simultaneous equation system that takes the form of a bivariate two-part model where the reciprocal interaction between formal and informal care is estimated. Endogeneity and unobservable heterogeneity are addressed using a common latent factor approach. The analysis of the relative impact of age and disability on home care utilization is enriched by the use of a proximity to death (PtD) indicator built using the second wave of SHARE. All these indicators are important predictors of home care utilization. In particular, a strong significant effect of PtD is found in the paid domestic help and informal care models. The relationship between formal and informal care moves from substitutability to complementarity depending on the type of care considered, and the estimated effects are small in absolute size. This might call for a reconsideration of the effectiveness of incentives for informal care as instruments to reduce public expenditure for home care services. Copyright © 2013 John Wiley & Sons, Ltd.

Preserving the Pyramid of STI Using Buckets

NASA Technical Reports Server (NTRS)

Nelson, Michael L.; Maly, Kurt

2004-01-01

The product of research projects is information. Through the life cycle of a project, information comes from many sources and takes many forms. Traditionally, this body of information is summarized in a formal publication, typically a journal article. While formal publications enjoy the benefits of peer review and technical editing, they are also often compromises in media format and length. As such, we consider a formal publication to represent an abstract to a larger body of work: a pyramid of scientific and technical information (STI). While this abstract may be sufficient for some applications, an in-depth use or analysis is likely to require the supporting layers from the pyramid. We have developed buckets to preserve this pyramid of STI. Buckets provide an archive- and protocol-independent container construct in which all related information objects can be logically grouped together, archived, and manipulated as a single object. Furthermore, buckets are active archival objects and can communicate with each other, people, or arbitrary network services. Buckets are an implementation of the Smart Object, Dumb Archive (SODA) DL model. In SODA, data objects are more important than the archives that hold them. Much of the functionality traditionally associated with archives is pushed down into the objects, such as enforcing terms and conditions, negotiating display, and content maintenance. In this paper, we discuss the motivation, design, and implication of bucket use in DLs with respect to grey literature.

Assessment and rehabilitation of driver skills: subjective experiences of people with multiple sclerosis and health professionals.

PubMed

Archer, Cherie; Morris, Libby; George, Stacey

2014-01-01

It is acknowledged in the literature that the physical and cognitive effects of the degenerative neurological condition of multiple sclerosis can impact upon driver safety. The aim of this study was to identify the experiences and needs of people with multiple sclerosis in relation to driver assessment and rehabilitation. Focus group discussions were conducted with people with multiple sclerosis (MS) who were: currently driving; no longer licensed or no longer driving and health professionals. The four themes that emerged from the data were: (1) from self-management to formal assessment - a journey of uncertainty and emotional dilemmas; (2) lost independence with grieving and adjustment by self and family; (3) alternative transport is challenging and unsatisfactory; (4) gaps in information and services exist. The results of this study highlight the need for ongoing support in relation to driving for people with MS, ranging from support for self-management, driving assessment and retraining, and preparation for loss of license. Standardised information needs to be developed and health professionals and licensing authorities require knowledge and skills to ensure driver assessment and rehabilitation processes and resources can better meet the needs of people with MS. There is a need for health professionals to examine driving in people with MS in a holistic manner taking into account the context for the person and the supports available. Self-management and self-assessment emerged as a preferred approach for the participants in this study, indicating that health professionals may need to engage with the process. Tools to support self-assessment of driving abilities for people with MS require further research. Indicators for review and formal assessment of driving abilities is needed. Alternative forms of transport require further investigation and improvement for people with MS.

Privatization of solid waste collection services: Lessons from Gaborone.

PubMed

Bolaane, Benjamin; Isaac, Emmanuel

2015-06-01

Formal privatization of solid waste collection activities has often been flagged as a suitable intervention for some of the challenges of solid waste management experienced by developing countries. Proponents of outsourcing collection to the private sector argue that in contrast to the public sector, it is more effective and efficient in delivering services. This essay is a comparative case study of efficiency and effectiveness attributes between the public and the formal private sector, in relation to the collection of commercial waste in Gaborone. The paper is based on analysis of secondary data and key informant interviews. It was found that while, the private sector performed comparatively well in most of the chosen indicators of efficiency and effectiveness, the public sector also had areas where it had a competitive advantage. For instance, the private sector used the collection crew more efficiently, while the public sector was found to have a more reliable workforce. The study recommends that, while formal private sector participation in waste collection has some positive effects in terms of quality of service rendered, in most developing countries, it has to be enhanced by building sufficient capacity within the public sector on information about services contracted out and evaluation of performance criteria within the contracting process. Copyright © 2015 Elsevier Ltd. All rights reserved.

(abstract) Formal Inspection Technology Transfer Program

NASA Technical Reports Server (NTRS)

Welz, Linda A.; Kelly, John C.

1993-01-01

A Formal Inspection Technology Transfer Program, based on the inspection process developed by Michael Fagan at IBM, has been developed at JPL. The goal of this program is to support organizations wishing to use Formal Inspections to improve the quality of software and system level engineering products. The Technology Transfer Program provides start-up materials and assistance to help organizations establish their own Formal Inspection program. The course materials and certified instructors associated with the Technology Transfer Program have proven to be effective in classes taught at other NASA centers as well as at JPL. Formal Inspections (NASA tailored Fagan Inspections) are a set of technical reviews whose objective is to increase quality and reduce the cost of software development by detecting and correcting errors early. A primary feature of inspections is the removal of engineering errors before they amplify into larger and more costly problems downstream in the development process. Note that the word 'inspection' is used differently in software than in a manufacturing context. A Formal Inspection is a front-end quality enhancement technique, rather than a task conducted just prior to product shipment for the purpose of sorting defective systems (manufacturing usage). Formal Inspections are supporting and in agreement with the 'total quality' approach being adopted by many NASA centers.

Service Learning's Foothold in Communication Scholarship.

ERIC Educational Resources Information Center

Panici, Daniel; Lasky, Kathryn

2002-01-01

Considers how much of an impact service learning pedagogies have had among those who teach journalism and mass communication. Attempts to fill the research void by assessing the current state of this pedagogical movement within the journalism/mass communication discipline, and suggests that a formal process for incorporating service learning into…

31 CFR 29.105 - Computation of time.

Code of Federal Regulations, 2011 CFR

2011-07-01

... annuity computation purposes— (i) The service of a participant under the Police and Firefighters Plan who... pay (LWOP) that is creditable service. (1) Under the Police and Firefighters Plan, credit is allowed...'s credit under a formal leave system; and (ii) The service of a participant under the Teachers Plan...

31 CFR 29.105 - Computation of time.

Code of Federal Regulations, 2013 CFR

2013-07-01

... annuity computation purposes— (i) The service of a participant under the Police and Firefighters Plan who... pay (LWOP) that is creditable service. (1) Under the Police and Firefighters Plan, credit is allowed...'s credit under a formal leave system; and (ii) The service of a participant under the Teachers Plan...

31 CFR 29.105 - Computation of time.

Code of Federal Regulations, 2012 CFR

2012-07-01

... annuity computation purposes— (i) The service of a participant under the Police and Firefighters Plan who... pay (LWOP) that is creditable service. (1) Under the Police and Firefighters Plan, credit is allowed...'s credit under a formal leave system; and (ii) The service of a participant under the Teachers Plan...

31 CFR 29.105 - Computation of time.

Code of Federal Regulations, 2014 CFR

2014-07-01

... annuity computation purposes— (i) The service of a participant under the Police and Firefighters Plan who... pay (LWOP) that is creditable service. (1) Under the Police and Firefighters Plan, credit is allowed...'s credit under a formal leave system; and (ii) The service of a participant under the Teachers Plan...

Incorporating Multifaceted Mental Health Prevention Services in Community Sectors-of-Care

ERIC Educational Resources Information Center

Gewirtz, Abigail H.; August, Gerald J.

2008-01-01

This article proposes a framework for embedding prevention services into community sectors-of-care. Community sectors-of-care include both formal and grassroot organizations distributed throughout a community that provide various resources and services to at-risk children and their families. Though the child population served by these…

A Taxonomical Structure for Classifying the Services Procured by the Federal Government

DTIC Science & Technology

1991-12-01

is the Direct Recipient of I,J the Service? People versus Things 2. Relationships with Customers a. Nature of Service Delivery. U Continuous delivery...versus Discrete transactions b. Type of Relationship between the Service Organization and Its Customers . "Membership" versus No Formal relationship 3...were conducted to determine the relationship between characteristics and services. Cluster analysis was used to group services into categories with

Lessons learned from community-based participatory research: establishing a partnership to support lesbian, gay, bisexual and transgender ageing in place.

PubMed

Wright, Leslie A; King, Diane K; Retrum, Jessica H; Helander, Kenneth; Wilkins, Shari; Boggs, Jennifer M; Portz, Jennifer Dickman; Nearing, Kathryn; Gozansky, Wendolyn S

2017-06-01

Due to a history of oppression and lack of culturally competent services, lesbian, gay, bisexual and transgender (LGBT) seniors experience barriers to accessing social services. Tailoring an evidence-based ageing in place intervention to address the unique needs of LGBT seniors may decrease the isolation often faced by this population. To describe practices used in the formation of a community-based participatory research (CBPR), partnership involving social workers, health services providers, researchers and community members who engaged to establish a LGBT ageing in place model called Seniors Using Supports To Age In Neighborhoods (SUSTAIN). A case study approach was employed to describe the partnership development process by reflecting on past meeting minutes, progress reports and interviews with SUSTAIN's partners. Key partnering practices utilized by SUSTAIN included (i) development of a shared commitment and vision; (ii) identifying partners with intersecting spheres of influence in multiple communities of identity (ageing services, LGBT, health research); (iii) attending to power dynamics (e.g. equitable sharing of funds); and (iv) building community capacity through reciprocal learning. Although the partnership dissolved after 4 years, it served as a successful catalyst to establish community programming to support ageing in place for LGBT seniors. Multi-sector stakeholder involvement with capacity to connect communities and use frameworks that formalize equity was key to establishing a high-trust CBPR partnership. However, lack of focus on external forces impacting each partner (e.g. individual organizational strategic planning, community funding agency perspectives) ultimately led to dissolution of the SUSTAIN partnership even though implementation of community programming was realized. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Teachers' Experiences With and Perceptions of Students With Attention Deficit/hyperactivity Disorder.

PubMed

Lawrence, Kay; Estrada, Robin Dawson; McCormick, Jessica

The purpose of this research was to examine teacher experiences with and perceptions of students with attention deficit/hyperactivity disorder (ADHD). Teachers are integral in helping these children learn effectively and foster healthy relationships, yet little is known about their interactions with these children. Semi structured interviews were conducted with a purposive sample of fourteen currently practicing or retired elementary and middle schools teachers in North Carolina and South Carolina. All interviews were audio-recorded then analyzed for common themes. Participants obtained ADHD information from in-services or peer interaction, rather than formal education. Culture and gender influenced teacher perceptions, and ADHD classroom strategies were based on anecdotal experience. Teachers experienced guilt and worry while negotiating student needs, school system constraints, and family issues. While teachers have developed effective coping mechanisms through informal means, formal education and support will help teachers better serve students with ADHD. Pediatric nurses in many settings can benefit from better understanding how teachers perceive and interact with students who have attentional issues. Copyright © 2017 Elsevier Inc. All rights reserved.

Information governance in NHS's NPfIT: a case for policy specification.

PubMed

Becker, Moritz Y

2007-01-01

The National Health Service's (NHS's) National Programme for Information Technology (NPfIT) in the UK with its proposed nation-wide online health record service poses serious technical challenges, especially with regard to access control and patient confidentiality. The complexity of the confidentiality requirements and their constantly evolving nature (due to changes in law, guidelines and ethical consensus) make traditional technologies such as role-based access control (RBAC) unsuitable. Furthermore, a more formal approach is also needed for debating about and communicating on information governance, as natural-language descriptions of security policies are inherently ambiguous and incomplete. Our main goal is to convince the reader of the strong benefits of employing formal policy specification in nation-wide electronic health record (EHR) projects. Many difficulties could be alleviated by specifying the requirements in a formal authorisation policy language such as Cassandra. The language is unambiguous, declarative and machine-enforceable, and is based on distributed constrained Datalog. Cassandra is interpreted within a distributed Trust Management environment, where digital credentials are used for establishing mutual trust between strangers. To demonstrate how policy specification can be applied to NPfIT, we translate a fragment of natural-language NHS specification into formal Cassandra rules. In particular, we present policy rules pertaining to the management of Clinician Sealed Envelopes, the mechanism by which clinical patient data can be concealed in the nation-wide EHR service. Our case study exposes ambiguities and incompletenesses in the informal NHS documents. We strongly recommend the use of trust management and policy specification technology for the implementation of nation-wide EHR infrastructures. Formal policies can be used for automatically enforcing confidentiality requirements, but also for specification and communication purposes. Formalising the requirements also reveals ambiguities and missing details in the currently used informal specification documents.

Provision and perceived quality of mental health services for older care home residents in England: a national survey.

PubMed

Stewart, Karen; Hargreaves, Claire; Jasper, Rowan; Challis, David; Tucker, Sue; Wilberforce, Mark

2018-02-01

This study examined the nature, extent and perceived quality of the support provided by community mental health teams for older people (CMHTsOP) to care home residents. A postal survey was sent to all CMHTsOP in England. Information was collected about teams' staffing and their involvement in case finding, assessment, medication reviews, care planning and training as well as team managers' rating of the perceived quality of the service they provided for care home residents. Data were analysed using chi-squared tests of association and ordinal regression. Responses were received from 225 (54%) CMHTsOP. Only 18 per cent of these teams contained staff with allocated time for care home work. Services for care home residents varied considerably between teams. Two-fifths of teams provided formal training to care home staff. Team managers were more likely to perceive the quality of their service to care homes as good if they had a systematic process in place for reviewing antipsychotic drugs or routine mental health reviews, including contact with a GP. The findings suggested that more evidence is needed on the best approach for supporting care home residents with mental health needs. Areas to consider are the potential benefits of training to care home staff and regular mental health reviews, utilising links between GPs and CMHTsOP. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

A cluster-randomized controlled knowledge translation feasibility study in Alberta community pharmacies using the PARiHS framework: study protocol.

PubMed

Rosenthal, Meagen M; Tsuyuki, Ross T; Houle, Sherilyn Kd

2015-01-01

Despite evidence of benefit for pharmacist involvement in chronic disease management, the provision of these services in community pharmacy has been suboptimal. The Promoting Action on Research Implementation in Health Services (PARiHS) framework suggests that for knowledge translation to be effective, there must be evidence of benefit, a context conducive to implementation, and facilitation to support uptake. We hypothesize that while the evidence and context components of this framework are satisfied, that uptake into practice has been insufficient because of a lack of facilitation. This protocol describes the rationale and methods of a feasibility study to test a facilitated pharmacy practice intervention based on the PARiHS framework, to assist community pharmacists in increasing the number of formal and documented medication management services completed for patients with diabetes, dyslipidemia, and hypertension. A cluster-randomized before-after design will compare ten pharmacies from within a single organization, with the unit of randomization being the pharmacy. Pharmacies will be randomized to facilitated intervention based on the PARiHS framework or usual practice. The Alberta Context Tool will be used to establish the context of practice in each pharmacy. Pharmacies randomized to the intervention will receive task-focused facilitation from an external facilitator, with the goal of developing alternative team processes to allow the greater provision of medication management services for patients with diabetes, hypertension, and dyslipidemia. The primary outcome will be a process evaluation of the needs of community pharmacies to provide more clinical services, the acceptability and uptake of modifications made, and the willingness of pharmacies to participate. Secondary outcomes will include the change in the number of formal and documented medication management services in the aforementioned chronic conditions provided 6 months before, versus after, the intervention between the two groups, and identification of feasible quantitative outcomes for evaluating the effect of the intervention on patient care outcomes. To date, the study has identified and enrolled the ten pharmacies required and initiated the intervention process. This study will be the first to examine the role of facilitation in pharmacy practice, with the goal of scalable and sustainable practice change. Clinicaltrials.gov identifier NCT02191111.

Involvement of inpatient mental health clients in the practical training and assessment of mental health nursing students: Can it benefit clients and students?

PubMed

Debyser, Bart; Grypdonck, Mieke H F; Defloor, Tom; Verhaeghe, Sofie T L

2011-02-01

Even though the central position of the client has been recognized in psychiatric nursing education, the client is seldom formally involved in the feedback provided to students during practical training. This research paper focuses on three questions: (1) What conditions support the gathering of meaningful client feedback to enhance the student's learning process and client's wellbeing? (2) Does the use of the practical model for client feedback lead to positive experiences, and if so, under what conditions? (3) To what extent is a client's feedback on the student's work performance, consistent with feedback from the mentor (nurse from the ward), the teacher and the student? Based on a literature review, participatory observation and contacts with experts, a practical model was developed to elicit client feedback. Using this model in two psychiatric inpatient services, clients were actively and formally involved in providing feedback to four, final year psychiatric nursing students. Clients, nurses, teachers and students were interviewed and data were analysed using a qualitative explorative research approach. Analyses revealed that client feedback becomes meaningful in a safe environment created by the psychiatric nurse. Client feedback generates a learning effect for the student and supports the student's recognition of the value and vulnerability of the psychiatric client. Copyright © 2010 Elsevier Ltd. All rights reserved.