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2013-02-22

... computer technology that permitted more efficient, and increasingly paperless, distribution of proxy... requires ongoing technology support, services and maintenance, and is a significant part of the total cost...

Medical technology companies broaden role to support the financial success of clinics.

PubMed

Johansson, Soren

2003-01-01

Market challenges continue to mount for hospitals and clinics, causing an unparalleled focus on profitability and return on investment for services. To support these challenges, technology suppliers that were once content to deliver and install equipment have become partners with the institutions they serve. Savvy technology companies are offering an extensive array of services that assist facilities in the planning, cost justification, implementation and ongoing support of their technology. The result is a marriage of progress and profit, resulting in solutions that enhance both the quality of care and the bottom line.

Promoting recovery in an evolving policy context: What do we know and what do we need to know about recovery support services?

PubMed Central

Laudet, Alexandre B.; Humphreys, Keith

2013-01-01

As both a concept and a movement, “recovery” is increasingly guiding substance use disorder (SUD) services and policy. One sign of this change is the emergence of recovery support services that attempt to help addicted individuals using a comprehensive continuing care model. This paper reviews the policy environment surrounding recovery support services, the needs to which they should respond, and the status of current recovery support models. We conclude that recovery support services (RSS) should be further assessed for effectiveness and cost-effectiveness, that greater efforts must be made to develop the RSS delivery workforce, and that RSS should capitalize on ongoing efforts to create a comprehensive, integrated and patient-centered health care system. As the SUD treatment system undergoes its most important transformation in at least 40 years, recovery research and the lived experience of recovery from addiction should be central to reform. PMID:23506781

The changing role of the medical technologist from technologist to information specialist.

PubMed

Miller, W G

2000-01-01

Pathology laboratory services are dependent on the laboratory information system (LIS) to organize the work, manage the operation, and communicate the results for effective laboratory medicine. For maximum efficiency, staffing for the LIS should be an integral component of laboratory operations and is facilitated by a two-tier structure. A core LIS staff provides system support and continuous services. A group of bench medical technologists have multitasking responsibilities, including LIS support for a specific laboratory work area. The two components form a team that uses staff efficiently to provide ongoing operational services and flexibility for problem solving and new functionality implementation.

Participatory planning of a primary care service for people with severe mental disorders in rural Ethiopia

PubMed Central

Mayston, Rosie; Alem, Atalay; Habtamu, Alehegn; Shibre, Teshome; Fekadu, Abebaw; Hanlon, Charlotte

2016-01-01

Little is understood about the feasibility and acceptability of primary care-based models of task-sharing care for people with severe mental disorders (SMDs) in low- and middle-income countries (LMICs). A participatory planning approach was adopted in preparation for the transition from hospital-delivered psychiatric care for SMD to a primary care-based, task-sharing model in a rural Ethiopian community. In this article, we present findings from community consultation meetings (n = 4), focus group discussions (n = 7) and in-depth interviews (n = 11) with key stakeholders (healthcare administrators and providers, caregivers, service-users and community leaders) which were carried out over a 2-year period in the context of ongoing dialogue with the community. The principle of local delivery of mental health services was agreed upon by all stakeholder groups. Key reasons for supporting local delivery were increased access for the majority due to proximity, reduced cost and reduced stress related to transportation. However, acceptance of the new service was qualified by concerns about the competence of staff to deliver a comprehensive and dependable service of equal quality to that currently provided at the hospital. Adequate training and support, as well as ensuring consistency of medication supply were identified as key components to ensure success. Encouragingly, our results suggest that there is significant support for the service change and an interest for the mobilization of community resources to support this. One of the study strengths was that we were able to present the different perspectives of multiple stakeholder groups. By nesting the study in an ongoing community-based cohort of people with SMD we were able to interview a more representative and empowered group of caregivers and service users than is often available in LMICs. Despite this, the extent to which service-users are able to express their opinions is likely limited by their marginalized role in rural Ethiopian society. PMID:26282860

The Mediation of Acculturation: Orchestrating School Leadership Development in England

ERIC Educational Resources Information Center

Wallace, Mike; Tomlinson, Michael; O'Reilly, Dermot

2011-01-01

Among western governments large-scale leadership development initiatives represent an increasingly deployed means of promoting the acculturation of school leaders to support educational reforms and ongoing improvement. England's sophisticated initiative centres on the National College for Leadership in Schools and Children's Services, a…

Building Blocks: The Next Steps for Supporting Alaska's Young Children and Their Families.

ERIC Educational Resources Information Center

Alaska State Dept. of Education and Early Development, Juneau.

As part of the ongoing efforts in the state of Alaska to improve the health and well-being of the state's young children, the Alaska Departments of Education and Early Development and Health and Social Services are collaborating to develop a plan to address the critical outcomes and strategies that will support and improve the lives of Alaska's…

Seventeen years of progress for supportive care services: A resurvey of National Cancer Institute-designated comprehensive cancer centers.

PubMed

Hammer, Sheila L; Clark, Karen; Grant, Marcia; Loscalzo, Matthew J

2015-08-01

We replicated a 1994 study that surveyed the state of supportive care services due to changes in the field and the increased need for such services. We provide an updated assessment, comparing the changes that have occurred and describing the current status of supportive care services in comprehensive cancer settings. We used Coluzzi and colleague's 60-question survey from their 1995 Journal of Clinical Oncology article to frame the 98-question survey employed in the current study. Medical and palliative care directors for the 2011 National Cancer Institute (NCI) comprehensive cancer centers were surveyed regarding their supportive care services and their subjective review of the overall effectiveness of the services provided. We achieved a 76% response rate (n = 31). The data revealed increases in the number of cancer beds in the hospitals, the degree of integration of supportive care services, the availability of complementary services, and the number of pain and palliative care services offered. There was also an overall shift toward centers becoming more patient centered, as 65% reported now having a patient and family advisory council. Our findings revealed a growing trend to offer distress screening for both outpatients and inpatients. Medical and palliative care directors' evaluations of the supportive care services they offered also significantly improved. However, the results revealed an ongoing gap in services for end-of-life care and timely referrals for hospice services. Overall, both the quantity and quality of supportive care services in the surveyed NCI-designated cancer centers has improved.

A profile of technology-assisted children and young people in north west England.

PubMed

Kirk, Susan

2008-11-01

To obtain a profile of children and young people in north west England who needed the ongoing support of medical technology. As part of a larger study, 28 community children's nursing teams in the north west of England were asked to profile the children and young people on their caseloads who needed the ongoing support of medical technology. Twenty-five teams returned data, from which a total of 591 children and young people were identified. The most prevalent technology used was gastrostomy/jejunostomy, which was used by more than two-thirds of the sample. Over a quarter of the children/young people were supported by more than one technology. The majority of the children/young people were seven years old or younger Although most had used the technology for five years or less (71 per cent), there were 164 children/ young people who had been technology-assisted for six or more years. Although there are limitations in this study, the data is nevertheless useful for planning future services and support, including identifying the numbers of young people who will be transferring to adult services. A more efficient means of collecting these data would be to systematically record long-term conditions and technology assistance in electronic health records.

How does outcome-based funding affect service delivery? An analysis of consequences within employment services for people living with serious mental illness.

PubMed

Gewurtz, Rebecca E; Cott, Cheryl; Rush, Brian; Kirsh, Bonnie

2015-01-01

This paper explores the impact of outcome-based funding on service delivery within employment services for people with serious mental illness. It draws on a case study of a policy change in the provincial disability support program in Ontario, Canada where funding for employment programs and services was changed from a fee-for-service to an outcome-based model. The findings highlight that the financial imperative for programs to meet employment targets in order to secure their funding has shifted the focus away from the provision of pre-employment supports to job development and job placements. However, there remains little attention to job matching and career development, and there is concern about access to services among those with complex barriers to employment. There is a need to reconcile tensions between the goals of outcome-based funding and on-the-ground service delivery to promote ongoing innovation in employment services for people with serious mental illness.

Cluster of Ebola Virus Disease, Bong and Montserrado Counties, Liberia.

PubMed

Nyenswah, Tolbert G; Fallah, Mosaka; Calvert, Geoffrey M; Duwor, Stanley; Hamilton, E Dutch; Mokashi, Vishwesh; Arzoaquoi, Sampson; Dweh, Emmanuel; Burbach, Ryan; Dlouhy, Diane; Oeltmann, John E; Moonan, Patrick K

2015-07-01

Lack of trust in government-supported services after the death of a health care worker with symptoms of Ebola resulted in ongoing Ebola transmission in 2 Liberia counties. Ebola transmission was facilitated by attempts to avoid cremation of the deceased patient and delays in identifying and monitoring contacts.

Preparing for an Earthquake: Information for Schools and Families

ERIC Educational Resources Information Center

Heath, Melissa Allen; Dean, Brenda

2008-01-01

Over the past decade, catastrophic earthquakes have garnered international attention regarding the need for improving immediate and ongoing support services for disrupted communities. Following the December 26, 2004 Indonesian earthquake, the Indian Ocean tsunami was responsible for displacing millions and taking the lives of an estimated 320,000…

A state policy framework for integrating health and social services.

PubMed

McGinnis, Tricia; Crawford, Maia; Somers, Stephen A

2014-07-01

Recognizing that health is determined by a variety of interrelated factors, states are looking to connect health care, public health, and social services to help achieve improved population health, better care, and reduced cost of care. This issue brief describes three essential components for integrating health, including physical and behavioral health services and public health, and social services: (1) a coordinating mechanism, (2) quality measurement and data-sharing tools, and (3) aligned financing and payment. It also presents a five-step policy framework to help states move beyond isolated pilot efforts and establish the infrastructure necessary to support ongoing integration of health and social services, particularly for Medicaid beneficiaries.

Program planning for a community pharmacy residency support service using the nominal group technique.

PubMed

Rupp, Michael T

2002-01-01

To define programmatic objectives and initial operational priorities for CommuniRes, a university-based education and support service designed to help community pharmacists successfully implement and sustain community pharmacy residency programs (CPRPs). Advisory committee of nationally recognized experts in CPRPs in a small-group planning session. CPRPs are postgraduate clinical training experiences conducted in chain and independent community pharmacies. The nominal group technique (NGT), a structured approach to group planning and decision making, was used to identify and prioritize the needs of CPRPs. Results of the NGT exercise were used as input to a brainstorming session that defined specific CommuniRes services and resources that must be developed to meet high priority needs of CPRPs. Group consensus on the priority needs of CPRPs was determined through rank order voting. The advisory committee identified 20 separate CPRP needs that it believed must be met to ensure that CPRPs will be successful and sustainable. Group voting resulted in the selection of six needs that were considered to be consensus priorities for services and resources provided through CommuniRes: image parity for CPRPs; CPRP marketing materials; attractive postresidency employment opportunities; well-defined goals, objectives, and residency job descriptions; return on investment and sources of ongoing funding for the residency; and opportunities and mechanisms for communicating/networking with other residents and preceptors. The needs-based programmatic priorities defined by the advisory committee are now being implemented through a tripartite program consisting of live training seminars for CPRP preceptors and directors, an Internet site (www.communires.com), and a host of continuing support services available to affiliated CPRP sites. Future programmatic planning will increasingly involve CPRP preceptors, directors, and former residents to determine the ongoing needs of CPRPs.

Developing User-Driven Climate Information Services to Build Resilience Amongst Groups at Risk of Drought and Flood in Arid and Semi-Arid Land Counties in Kenya

NASA Astrophysics Data System (ADS)

Githungo, W. N.; Shaka, A.; Kniveton, D.; Muithya, L.; Powell, R.; Visman, E. L.

2014-12-01

The Arid and Semi-Arid Land (ASAL) counties of Kitui and Makueni in Kenya are experiencing increasing climate variability in seasonal rainfall, including changes in the onset, cessation and distribution of the two principal rains upon which the majority of the population's small-holder farmers and livestock keepers depend. Food insecurity is prevalent with significant numbers also affected by flooding during periods of intense rainfall. As part of a multi-partner Adaptation Consortium, Kenya Meteorological Services (KMS) are developing Climate Information Services (CIS) which can better support decision making amongst the counties' principal livelihoods groups and across County Government ministries. Building on earlier pilots and stakeholder discussion, the system combines the production of climate information tailored for transmission via regional and local radio stations with the establishment of a new SMS service. SMS are provided through a network of CIS intermediaries drawn from across key government ministries, religious networks, non-governmental and community groups, aiming to achieve one SMS recipient per 3-500 people. It also introduces a demand-led, premium-rate SMS weather information service which is designed to be self-financing in the long term. Supporting the ongoing process of devolution, KMS is downscaling national forecasts for each county, and providing seasonal, monthly, weekly and daily forecasts, as well as warnings of weather-related hazards. Through collaboration with relevant ministries, government bodies and research institutions, including livestock, agriculture, drought management and health, technical advisories are developed to provide guidance on application of the climate information. The system seeks to provide timely, relevant information which can enable people to use weather and climate information to support decisions which protect life and property and build resilience to ongoing climate variability and future change.

DCASR (Defense Contract Administration Services Region) New York, Total Quality Management Plan

DTIC Science & Technology

1989-07-01

service quality measures on-going Commanders Directors 2. Investigate significant changes on-going Commanders in trends in terms of quality Directors 3...customer satisfaction on-going Commanders indicators and significance of the trends in Directors terms of improvements in product and service quality , and

Evolution of ESA's SSA Conjunction Prediction Service

NASA Astrophysics Data System (ADS)

Escobar, D.; Sancho, A. Tirado, J.; Agueda, A.; Martin, L.; Luque, F.; Fletcher, E.; Navarro, V.

2013-08-01

This paper presents the recent evolution of ESA's SSA Conjunction Prediction Service (CPS) as a result of an on-going activity in the Space Surveillance and Tracking (SST) Segment of ESA's Space Situational Awareness (SSA) Programme. The CPS is one of a number of precursor services being developed as part of the SST segment. It has been implemented as a service to provide external users with web-based access to conjunction information and designed with a service-oriented architecture. The paper encompasses the following topics: service functionality enhancements, integration with a live objects catalogue, all vs. all analyses supporting an operational concept based on low and high fidelity screenings, and finally conjunction detection and probability algorithms.

The Effectiveness of Technology-Delivered Science Instructional Coaching in Middle and High School. Working Paper

ERIC Educational Resources Information Center

Nugent, Gwen; Kunz, Gina; Houston, James; Kalutskaya, Irina; Wu, ChaoRong; Pedersen, Jon; Lee, SoonChun; DeChenne, Sue Ellen; Luo, LinLin; Berry, Brandi

2016-01-01

Although results showing coaching effectiveness are accumulating, coaching is often included with other forms of Professional Development (PD) support including teacher in-service (Powell, Diamond, Burchinal, & Koehler, 2010; Kretlow et al., 2011), access to an annotated video library (Allen et al., 2011), and access to ongoing learning…

Creating a Learning Environment for Pre-Service Teachers.

ERIC Educational Resources Information Center

Diggs, Laura L.

This paper presents statistics from ongoing research on a unique learning environment developed at the University of Missouri-Columbia College of Education (MU-CoE). MU-CoE has developed a new approach to space devoted to learning, not teaching. This new concept of progressive learning and performance support integrates interactive networked…

Behind the Brotherhood: Rewards and Challenges for Wives of Firefighters

ERIC Educational Resources Information Center

Regehr, Cheryl; Dimitropoulos, Gina; Bright, Elaine; George, Sharon; Henderson, Joscelyn

2005-01-01

Support of family is paramount to reducing the impact of highly stressful work on firefighters. Yet the degree of stress encountered by the family members, particularly spouses, resulting from ongoing job demands and exposure to traumatic situations is unclear. This qualitative study examined the effects of emergency service work on spouses of…

Prenatal Support To Educate and Counsel Pregnant Mothers with Children in a Preschool Program.

ERIC Educational Resources Information Center

Mack, Sarah L.

A health specialist working in a program providing health, social, and educational services to low-income children and families implemented and evaluated a practicum intervention designed to increase inner-city mothers' knowledge of the importance of ongoing prenatal care throughout pregnancy and to improve the mothers' health. A prenatal…

Trialling an electronic decision aid for policy developers to support ageing well.

PubMed

Cummings, Elizabeth; Ellis, Leonie; Tin, Eh Eh; Boyer, Kim; Orpin, Peter

2015-01-01

The complex process of developing policies and planning services requires the compilation and collation of evidence from multiple sources. With the increasing numbers of people living longer there will be a high demand for a wide range of aged care services to support people in ageing well. The premise of ageing well is based on providing an ageing population with quality care and resources that support their ongoing needs. These include affordable healthcare, end of life care improvement, mental health services improvement, care and support improvement for people with dementia, and support for healthy ageing. The National Health and Medical Research Council funded a research project to develop a policy tool to provide a framework to assist policy makers and service planners in the area of ageing well in rural and regional Australia. It was identified that development of an electronic version of the policy tool could be useful resulting in a small pilot development being undertaken and tested with policy makers and service planners. This paper describes the development and trialling of a tablet based application used to assess the acceptability of computerised forms for participants actively involved in policy development. It reports on the policy developer's experience of the electronic tool to support ageing well policy making based on evidence.

Consumers as mental health providers: first-person accounts of benefits and limitations.

PubMed

Mowbray, C T; Moxley, D P; Collins, M E

1998-11-01

Community support programs are increasingly establishing paid service positions designated exclusively for consumers. Project WINS (Work Incentives and Needs Study), a hybrid case management-vocational program for individuals with severe mental illness, used consumers as peer support specialists (PSSs) to supplement professional roles. Semistructured interviews were conducted with PSSs about 12 months after their employment ended. They identified substantial personal benefits specific to consumer-designated roles (e.g., a "safe" employment setting with accommodations) and general benefits from employment. Problems described were just as numerous, encompassing attitudes toward assigned peers and costs to their own well-being. Critical commentary addressed program operations (structure, supervision, and training needs) and problems in the mental health system. The authors discuss the changed sense of self that service provider roles can create for consumers and suggest that mental health administrators provide anticipatory socialization for this service innovation throughout their agencies and ongoing supports for consumers in their new roles.

Rural Australian women's legal help seeking for intimate partner violence: women intimate partner violence victim survivors' perceptions of criminal justice support services.

PubMed

Ragusa, Angela T

2013-03-01

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 applies a sociological lens by framing the IPV and legal help-seeking experiences of rural Australian women gained from 36 in-depth face-to-face interviews as socially contextualized interactions. Findings reveal police and court responses reflect broader social inequalities and rurality exacerbates concerns such as anonymity and lack of service. Cultural differences and power imbalances between survivors and formal support providers are manifested to inform future research seeking to improve survivors' willingness to engage and satisfaction with formal services. Finally, the important role police and the criminal justice system play in de-stigmatizing IPV and legitimating its unacceptability is argued a crucial, yet unrecognized, key to social change.

Pregnancy and Parenting Support for Incarcerated Women: Lessons Learned

PubMed Central

Shlafer, Rebecca J.; Gerrity, Erica; Duwe, Grant

2017-01-01

Background There are more than 200,000 incarcerated women in U.S. prisons and jails, and it is estimated that 6% to 10% are pregnant. Pregnant incarcerated women experience complex risks that can compromise their health and the health of their offspring. Objectives Identify lessons learned from a community–university pilot study of a prison-based pregnancy and parenting support program. Methods A community–university–corrections partnership was formed to provide education and support to pregnant incarcerated women through a prison-based pilot program. Evaluation data assessed women’s physical and mental health concerns and satisfaction with the program. Between October 2011 and December 2012, 48 women participated. Lessons Learned We learned that providing services for pregnant incarcerated women requires an effective partnership with the Department of Corrections, adaptations to traditional community-based participatory research (CBPR) approaches, and resources that support both direct service and ongoing evaluation. Conclusions Effective services for pregnant incarcerated women can be provided through a successful community– university–corrections partnership. PMID:26548788

Service-based health human resources planning for older adults.

PubMed

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

2013-08-01

To test a service-based health human resources (HHR) planning approach for older adults in the context of home and long term care (LTC); to create a practical template/tools for use in various jurisdictions and/or health care settings. The most serious health needs of seniors in 2 Canadian jurisdictions were identified and linked to the specific services and associated competencies required of health care providers (HCPs) to address those needs. The amounts of each service required were quantified and compared against the capacity of HCPs to perform the services, measured using a self-assessment survey, by using a previously developed analytical framework. Home and LTC sectors in Nova Scotia and Nunavut, Canada. Regulated and nonregulated HCPs were invited to complete either an online or paper-based competency self-assessment survey. Survey response rates in Nova Scotia and Nunavut were 11% (160 responses) and 20% (22 responses), respectively. Comparisons of the estimated number of seniors likely to need each service with the number who can be served by the workforces in each jurisdiction indicated that the workforces in both jurisdictions are sufficiently numerous, active, productive, and competent to provide most of the services likely to be required. However, significant gaps were identified in pharmacy services, ongoing client assessment, client/family education and involvement, and client/family functional and social supports. Service-based HHR planning is feasible for identifying gaps in services required by older adults, and can guide policy makers in planning hiring/recruitment, professional development, and provider education curricula. Implementation will require commitment of policy makers and other stakeholders, as well as ongoing evaluation of its effectiveness. More broadly, the ongoing effectiveness of the approach will depend on workforce planning being conducted in an iterative way, driven by regular reevaluation of population health needs and HHR effectiveness. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Callers’ Experiences of Contacting a National Suicide Prevention Helpline

PubMed Central

Coveney, Catherine M.; Pollock, Kristian; Armstrong, Sarah; Moore, John

2012-01-01

Background: Helplines are a significant phenomenon in the mixed economy of health and social care. Given the often anonymous and fleeting nature of caller contact, it is difficult to obtain data about their impact and how users perceive their value. This paper reports findings from an online survey of callers contacting Samaritans emotional support services. Aims: To explore the (self-reported) characteristics of callers using a national suicide prevention helpline and their reasons given for contacting the service, and to present the users’ evaluations of the service they received. Methods: Online survey of a self-selected sample of callers. Results: 1,309 responses were received between May 2008 and May 2009. There were high incidences of expressed suicidality and mental health issues. Regular and ongoing use of the service was common. Respondents used the service for complex and varied reasons and often as part of a network of support. Conclusions: Respondents reported high levels of satisfaction with the service and perceived contact to be helpful. Although Samaritans aims to provide a crisis service, many callers do not access this in isolation or as a last resort, instead contacting the organization selectively and often in tandem with other types of support. PMID:22759662

Working at the frontline in cases of elder abuse: 'it keeps me awake at night'.

PubMed

Cairns, Jane; Vreugdenhil, Anthea

2014-03-01

To explore the experiences of frontline health and welfare practitioners in working with older people experiencing abuse. In-depth interviews with 16 Tasmanian community-based health and welfare practitioners regarding their experiences of working in 49 recent cases of elder abuse. Interview transcripts were analysed using thematic analysis. All participants found working in cases of elder abuse challenging and the work itself was perceived as difficult, complex and at times dangerous. The cumulative effect of intimidating work contexts, practice dilemmas and a lack of support resulted in frustration and stress for many practitioners. Nevertheless, participants were committed to providing ongoing services and support for older people experiencing abuse. Frontline practitioners working in cases of elder abuse face significant challenges and could be better supported through strengthening organisational elder abuse policies, increased management support and more age-inclusive family violence support services. © 2013 The Authors. Australasian Journal on Ageing © 2013 ACOTA.

An Integrated Recovery-oriented Model (IRM) for mental health services: evolution and challenges.

PubMed

Frost, Barry G; Tirupati, Srinivasan; Johnston, Suzanne; Turrell, Megan; Lewin, Terry J; Sly, Ketrina A; Conrad, Agatha M

2017-01-17

Over past decades, improvements in longer-term clinical and personal outcomes for individuals experiencing serious mental illness (SMI) have been moderate, although recovery has clearly been shown to be possible. Recovery experiences are inherently personal, and recovery can be complex and non-linear; however, there are a broad range of potential recovery contexts and contributors, both non-professional and professional. Ongoing refinement of recovery-oriented models for mental health (MH) services needs to be fostered. This descriptive paper outlines a service-wide Integrated Recovery-oriented Model (IRM) for MH services, designed to enhance personally valued health, wellbeing and social inclusion outcomes by increasing access to evidenced-based psychosocial interventions (EBIs) within a service context that supports recovery as both a process and an outcome. Evolution of the IRM is characterised as a series of five broad challenges, which draw together: relevant recovery perspectives; overall service delivery frameworks; psychiatric and psychosocial rehabilitation approaches and literature; our own clinical and service delivery experience; and implementation, evaluation and review strategies. The model revolves around the person's changing recovery needs, focusing on underlying processes and the service frameworks to support and reinforce hope as a primary catalyst for symptomatic and functional recovery. Within the IRM, clinical rehabilitation (CR) practices, processes and partnerships facilitate access to psychosocial EBIs to promote hope, recovery, self-agency and social inclusion. Core IRM components are detailed (remediation of functioning; collaborative restoration of skills and competencies; and active community reconnection), together with associated phases, processes, evaluation strategies, and an illustrative IRM scenario. The achievement of these goals requires ongoing collaboration with community organisations. Improved outcomes are achievable for people with a SMI. It is anticipated that the IRM will afford MH services an opportunity to validate hope, as a critical element for people with SMI in assuming responsibility and developing skills in self-agency and advocacy. Strengthening recovery-oriented practices and policies within MH services needs to occur in tandem with wide-ranging service evaluation strategies.

Moving diabetes management from clinic to community: development of a prototype based on automated voice messaging.

PubMed

Piette, J D

1997-01-01

The purpose of this study is twofold. First, it provides a review of the literature supporting the development of a new service to help patients with diabetes and their providers manage their care. This service, automated voice messaging (AVM) with nurse follow-up, allows for systematic and intensive patient monitoring and diabetes education as well as a means of focusing clinical resources where they are most needed. Second, it provides a description of a prototype AVM-based diabetes management service that has been developed as part of two ongoing, randomized, controlled trials to test the efficacy of AVM care for patients with Type 2 diabetes. Preliminary findings from implementing this service in two large public healthcare systems suggest that AVM-supported care is feasible, desirable by clinicians and patients with diabetes, and may identify serious health problems that otherwise would go unnoted through standard means of clinic-based patient care.

21st Century Knowledge and Skills in Educator Preparation

ERIC Educational Resources Information Center

Greenhill, Valerie

2010-01-01

The purpose of this paper is to create the foundation for ongoing dialogue around how 21st century knowledge and skills can be appropriately embedded in educator preparation, and to guide the development of resources and services to support educator programs. This paper aims to: (1) Develop a blueprint for building the models, tools, resource…

Presenters in Focus: School-Based Social-Emotional and Behavior Screening--Using Data to Guide Interventions

ERIC Educational Resources Information Center

Eklund, Katie; Kilgus, Stephen

2017-01-01

Systematic screening for behavioral and social-emotional concerns at school is one way to ensure that at-risk children are identified and provided services. School psychologists play a critical role in creating multitiered systems of support that consider universal screening, early intervention, and ongoing progress monitoring to help support…

Does a School Social Worker's Gender Matter? The Experience of Pregnant and Parenting Teens

ERIC Educational Resources Information Center

Lucio, Robert; Dixon, Donald M.

2008-01-01

Nearly one million adolescent girls in the United States become pregnant annually, which has significant negative social and economic consequences. The number of teen pregnancies totals 50,000 in Florida, where state statutes require that these adolescents be provided with ongoing education and other support services in schools. While school…

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.

Building on Family Strengths: Research and Services in Support of Children and Their Families. Proceedings of the Building on Family Strengths Annual Conference (14th, Portland, Oregon, May 31-June 2, 2007) and State of the Science Report

ERIC Educational Resources Information Center

Swart, Sandra, Ed.; Friesen, Barbara, Ed.; Holman, Ariel, Ed.; Aue, Nicole, Ed.

2009-01-01

The State of the Science conference was held in May, 2007 as part of the ongoing series of national conferences, "Building on Family Strengths," conducted by the Research and Training Center on Family Support and Children's Mental Health at Portland State University. The theme of this State-of-the Science conference was "Effective…

Nature and frequency of services provided by child and family health nurses in Australia: results of a national survey.

PubMed

Schmied, Virginia; Fowler, Cathrine; Rossiter, Chris; Homer, Caroline; Kruske, Sue

2014-05-01

Australia has a system of universal child and family health (CFH) nursing services providing primary health services from birth to school entry. Herein, we report on the findings of the first national survey of CFH nurses, including the ages and circumstances of children and families seen by CFH nurses and the nature and frequency of the services provided by these nurses across Australia. A national survey of CFH nurses was conducted. In all, 1098 CFH nurses responded to the survey. Over 60% were engaged in delivering primary prevention services from a universal platform. Overall, 82.8% reported that their service made first contact with families within 2 weeks of birth, usually in the home (80.7%). The proportion of respondents providing regular support to families decreased as the child aged. Services were primarily health centre based, although 25% reported providing services in other locations (parks, preschools).The timing and location of first contact, the frequency of ongoing services and the composition of families seen by nurses varied across Australian jurisdictions. Nurses identified time constraints as the key barrier to the delivery of comprehensive services. CFH nurses play an important role in supporting families across Australia. The impact of differences in the CFH nursing provision across Australia requires further investigation. What is known about the topic? Countries that offer universal well child health services demonstrate better child health and developmental outcomes than countries that do not. Australian jurisdictions offer free, universal child and family health (CFH) nursing services from birth to school entry. What does this paper add? This paper provides nation-wide data on the nature of work undertaken by CFH nurses offering universal care. Across Australia, there are differences in the timing and location of first contact, the frequency of ongoing services and the range of families seen by nurses. What are the implications for practitioners? The impact for families of the variation in CFH nursing services offered across Australia is not known. Further research is required to investigate the outcomes of the service provision variations identified in the present study.

I have my own lease-So why the service plan again? Perspectives on service planning in supportive housing.

PubMed

Choy-Brown, Mimi; Hamovitch, Emily K; Cuervo, Carolina; Stanhope, Victoria

2016-12-01

This study aimed to understand multiple stakeholder perspectives implementing a recovery-oriented approach to service planning in supportive housing programs serving people with lived experience of mental illnesses. Multiple stakeholders (N = 57) were recruited to participate in focus groups (N = 8), including 4 with tenants, 2 with service coordinators, 1 with supervisors, and 1 with leadership. Supportive housing programs were purposively sampled from a recovery-oriented organization serving 1,500 people annually. Stakeholders' experiences with service planning and implementing a recovery-oriented approach to service planning were explored. The authors conducted inductive thematic analyses combined with a conceptual matrix, which yielded themes across and within multiple stakeholder focus groups. Three themes emerged: (a) an institutional reminder-service planning experiences elicited negative emotions and served to remind people of experiences in institutional settings, (b) one-size-fits-all service planning-stakeholders perceived the use of quality assurance tools within the planning process as rigid to others' interests beyond their own, and (c) rules and regulations-reconciling funder requirements (e.g., completion dates) while also tailoring services to tenants' particular situations challenged providers. Even in a recovery-oriented organization, findings suggest that service planning in supportive housing has limitations in responding to each tenant's iterative recovery process. Further, in this context where people can make their home, stakeholders questioned whether the very presence of ongoing service planning activities is problematic. However, tenant-service coordinator relationships predicated on mutual respect and esteem overcame some service planning limitations. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues

DTIC Science & Technology

2009-07-17

Prohibition on Recruiting or Retaining Individuals Associated with Hate Groups ........................6 Chiropractic Health Care for Members on...Policy Issues Congressional Research Service 7 Chiropractic Health Care for Members on Active Duty Background: Chiropractic is a health care approach...supporting the body’s natural ability to heal itself. Research to expand the scientific understanding of chiropractic treatment is ongoing. Section 702

Implementation of an EPN-TAP Service to Improve Accessibility to the Planetary Science Archive

NASA Astrophysics Data System (ADS)

Macfarlane, A.; Barabarisi, I.; Docasal, R.; Rios, C.; Saiz, J.; Vallejo, F.; Martinez, S.; Arviset, C.; Besse, S.; Vallat, C.

2017-09-01

The re-engineered PSA has a focus on improved access and search-ability to ESA's planetary science data. In addition to the new web interface released in January 2017, the new PSA supports several common planetary protocols in order to increase the visibility and ways in which the data may be queried and retrieved. Work is on-going to provide an EPN-TAP service covering as wide a range of parameters as possible to facilitate the discovery of scientific data and interoperability of the archive.

Human Rights and the Global Fund to Fight AIDS, Tuberculosis and Malaria: How Does a Large Funder of Basic Health Services Meet the Challenge of Rights-Based Programs?

PubMed

Jürgens, Ralf; Csete, Joanne; Lim, Hyeyoung; Timberlake, Susan; Smith, Matthew

2017-12-01

The Global Fund to Fight AIDS, Tuberculosis and Malaria was created to greatly expand access to basic services to address the three diseases in its name. From its beginnings, its governance embodied some human rights principles: civil society is represented on its board, and the country coordination mechanisms that oversee funding requests to the Global Fund include representatives of people affected by the diseases. The Global Fund's core strategies recognize that the health services it supports would not be effective or cost-effective without efforts to reduce human rights-related barriers to access and utilization of health services, particularly those faced by socially marginalized and criminalized persons. Basic human rights elements were written into Global Fund grant agreements, and various technical support measures encouraged the inclusion in funding requests of programs to reduce human rights-related barriers. A five-year initiative to provide intensive technical and financial support for the scaling up of programs to reduce these barriers in 20 countries is ongoing.

Why aren't people with young onset dementia and their supporters using formal services? Results from the INSPIRED study

PubMed Central

Withall, Adrienne; Horsfall, Ruth; Denham, Nicole; White, Fiona; Trollor, Julian; Loy, Clement; Brodaty, Henry; Sachdev, Perminder; Gonski, Peter; Demirkol, Apo; Cumming, Robert G.; Draper, Brian

2017-01-01

Background/Aims Despite reporting high levels of burden, supporters of people with young onset dementia (YOD) underuse formal community services. Previous quantitative studies in YOD are of limited utility in guiding service design because they did not consider important contextual barriers to service use. The aim of this study was to identify all relevant barriers and describe the service features considered most important to improving uptake by people with YOD and their supporters. Methods Eighty-six people with consensus-confirmed YOD (mean onset age 55.3 years) and/or their primary supporter participated in quantitative interviews, and 50 also participated in one of seven qualitative focus groups. Interview participants reported levels of community service use and reasons for non-use, functional impairment, behavioural and psychological symptoms, supporter burden, social network, and informal care provision. Focus group participants expanded on reasons for non-use and aspects of an ideal service. Results Although at least one community service was recommended to most participants (96.8%), 66.7% chose not to use one or more of these. Few of the clinical or demographic factors included here were related to service use. Qualitative analyses identified that lack of perceived need, availability, and YOD-specific barriers (including ineligibility, unaffordability, lack of security, lack of childcare) were commonly reported. Five aspects of an ideal service were noted: unique, flexibile, affordable, tailored, and promoting meaningful engagement. Conclusion People with YOD and their families report that formal community services do not meet their personal and psychological needs. Researchers can provide ongoing assessment of program feasibility, suitability, and generalisability. PMID:28723931

Human Rights and the Global Fund to Fight AIDS, Tuberculosis and Malaria

PubMed Central

Jürgens, Ralf; Lim, Hyeyoung; Timberlake, Susan; Smith, Matthew

2017-01-01

Abstract The Global Fund to Fight AIDS, Tuberculosis and Malaria was created to greatly expand access to basic services to address the three diseases in its name. From its beginnings, its governance embodied some human rights principles: civil society is represented on its board, and the country coordination mechanisms that oversee funding requests to the Global Fund include representatives of people affected by the diseases. The Global Fund’s core strategies recognize that the health services it supports would not be effective or cost-effective without efforts to reduce human rights-related barriers to access and utilization of health services, particularly those faced by socially marginalized and criminalized persons. Basic human rights elements were written into Global Fund grant agreements, and various technical support measures encouraged the inclusion in funding requests of programs to reduce human rights-related barriers. A five-year initiative to provide intensive technical and financial support for the scaling up of programs to reduce these barriers in 20 countries is ongoing. PMID:29302175

Working toward resilience: a retrospective report of actions taken in support of a New York school crisis team following 9/11.

PubMed

Johnson, Kendall; Luna, Joanne M Tortorici

2011-01-01

A retrospective report details external support rendered to a Lower Manhattan school crisis team following the 9/11/01 terrorist attack on the World Trade Center This analysis occasions an opportunity for consideration of working assumptions, the formative use of data to plan support actions, and the subsequent emergence of a collaborative approach to post-disaster team support in school settings. The nature of assessment and nature of subsequent service delivery illustrates a community resilience-based approach to school crisis management. Recommendations for such work are based upon mixed qualitative and quantitative data gathered from on-scene team members as part of the ongoing support effort.

Peace Corps Partnered Health Services Implementation Research in Global Health: Opportunity for Impact

PubMed Central

Hedrick, Chris; Ndiaye, Youssoupha; Linn, Annē

2014-01-01

Background: There is abundant evidence of the affordable, life-saving interventions effective at the local primary health care level in low- and middle-income countries (LMICs). However, the understanding of how to deliver those interventions in diverse settings is limited. Primary healthcare services implementation research is needed to elucidate the contextual factors that can influence the outcomes of interventions, especially at the local level. US universities commonly collaborate with LMIC universities, communities, and health system partners for health services research but common barriers exist. Current challenges include the capacity to establish an ongoing presence in local settings in order to facilitate close collaboration and communication. The Peace Corps is an established development organization currently aligned with local health services in many LMICs and is well-positioned to facilitate research partnerships. This article explores the potential of a community–Peace Corps–academic partnership approach to conduct local primary healthcare services implementation research. Discussion: The Peace Corps is well positioned to offer insights into local contextual factors because volunteers work closely with local leaders, have extensive trust within local communities, and have an ongoing, constant, well-integrated presence. However, the Peace Corps does not routinely conduct primary healthcare services implementation research. Universities, within the United States and locally, could benefit from the established resources and trust of the Peace Corps to conduct health services implementation research to advance access to local health services and further the knowledge of real world application of local health services in a diversity of settings. The proposed partnership would consist of (1) a local community advisory board and local health system leaders, (2) Peace Corps volunteers, and (3) a US-LMIC academic institutional collaboration. Within the proposed partnership approach, the contributions of each partner are as follows: the local community and health system leadership guides the work in consideration of local priorities and context; the Peace Corps provides logistical support, community expertise, and local trust; and the academic institutions offer professional technical and public health educational and training resources and research support. Conclusion: The Peace Corps offers the opportunity to enhance a community-academic partnership in LMICs through community-level guidance, logistical assistance, and research support for community based participatory primary health-care services implementation research that addresses local primary healthcare priorities. PMID:25568819

Peace corps partnered health services implementation research in global health: opportunity for impact.

PubMed

Dykens, Andrew; Hedrick, Chris; Ndiaye, Youssoupha; Linn, Annē

2014-09-01

There is abundant evidence of the affordable, life-saving interventions effective at the local primary health care level in low- and middle-income countries (LMICs). However, the understanding of how to deliver those interventions in diverse settings is limited. Primary healthcare services implementation research is needed to elucidate the contextual factors that can influence the outcomes of interventions, especially at the local level. US universities commonly collaborate with LMIC universities, communities, and health system partners for health services research but common barriers exist. Current challenges include the capacity to establish an ongoing presence in local settings in order to facilitate close collaboration and communication. The Peace Corps is an established development organization currently aligned with local health services in many LMICs and is well-positioned to facilitate research partnerships. This article explores the potential of a community-Peace Corps-academic partnership approach to conduct local primary healthcare services implementation research. The Peace Corps is well positioned to offer insights into local contextual factors because volunteers work closely with local leaders, have extensive trust within local communities, and have an ongoing, constant, well-integrated presence. However, the Peace Corps does not routinely conduct primary healthcare services implementation research. Universities, within the United States and locally, could benefit from the established resources and trust of the Peace Corps to conduct health services implementation research to advance access to local health services and further the knowledge of real world application of local health services in a diversity of settings. The proposed partnership would consist of (1) a local community advisory board and local health system leaders, (2) Peace Corps volunteers, and (3) a US-LMIC academic institutional collaboration. Within the proposed partnership approach, the contributions of each partner are as follows: the local community and health system leadership guides the work in consideration of local priorities and context; the Peace Corps provides logistical support, community expertise, and local trust; and the academic institutions offer professional technical and public health educational and training resources and research support. The Peace Corps offers the opportunity to enhance a community-academic partnership in LMICs through community-level guidance, logistical assistance, and research support for community based participatory primary health-care services implementation research that addresses local primary healthcare priorities.

Transforming youth mental health services and supports in Ireland.

PubMed

Illback, Robert J; Bates, Tony

2011-02-01

Young people in the Republic of Ireland do not have access to appropriate mental health services and supports, necessitating transformational change in delivery systems. Describe ongoing development and change efforts facilitated by Headstrong--The National Centre for Youth Mental Health. Discusses findings from a national needs assessment, core strategies within the change initiative, progress in system-building, and preliminary descriptive and outcome data. Five demonstration sites comprised of four counties and a city neighbourhood are operational and preliminary data are promising with respect to implementation and outcomes. Effective change initiatives require vision and leadership, competence- and capacity-building, participative planning and engagement, adequate and thoughtfully deployed resources, and a comprehensive change management approach. © 2011 Blackwell Publishing Asia Pty Ltd.

Skills, systems and supports: An Aboriginal Community Controlled Health Service (Apunipima) approach to building health promotion evaluation capacity of staff.

PubMed

Nichols, Nina; McFarlane, Kathryn; Gibson, Priscilla; Millard, Fiona; Packer, Andrew; McDonald, Malcolm

2018-04-01

Building the health promotion evaluation capacity of a workforce requires more than a focus on individual skills and confidence. We must also consider the organisational systems and supports that enable staff to embed learnings into practice. This paper describes the processes used to build health promotion evaluation capacity of staff in an Aboriginal Community Controlled Health Service (ACCHS). To build health promotion evaluation capacity three approaches were used: (i) workshops and mentoring; (ii) strengthening systems to support program reporting; and (iii) recruitment of staff with skills and experience. Pre- and post-questionnaires determined levels of individual skills and confidence, updated systems were assessed for adequacy to support new health promotion practices and surveys captured the usefulness of workshops and mentoring. There was increased participant skills and confidence. Participants completed program impact evaluation reports and results were successfully presented at national conferences. The health promotion team was then able to update in-house systems to support new health promotion practices. Ongoing collaboration with experienced in-house researchers provided basic research training and professional mentoring. Building health promotion evaluation capacity of staff in an ACCHS can be achieved by providing individual skill development, strengthening organisational systems and utilising professional support. SO WHAT?: Health promotion practitioners have an ongoing professional obligation to improve the quality of routine practice and embrace new initiatives. This report outlines a process of building evaluation capacity that promotes quality reporting of program impacts and outcomes, reflects on ways to enhance program strengths, and communicates these findings internally and to outside professional bodies. This is particularly significant for ACCHSs responsible for addressing the high burden of preventable disease in Aboriginal and Torres Strait Islander populations. © 2017 Australian Health Promotion Association.

Assessment of an Innovative Voluntary Substance Abuse Treatment Program Designed to Replace Compulsory Drug Detention Centers in Malaysia.

PubMed

Khan, Farrah; Krishnan, Archana; Ghani, Mansur A; Wickersham, Jeffrey A; Fu, Jeannia J; Lim, Sin How; Dhaliwal, Sangeeth Kaur; Kamarulzaman, Adeeba; Altice, Frederick L

2018-01-28

As part of an ongoing initiative by the Malaysian government to implement alternative approaches to involuntary detention of people who use drugs, the National Anti-Drug Agency has created new voluntary drug treatment programs known as Cure and Care (C&C) Centers that provide free access to addiction treatment services, including methadone maintenance therapy, integrated with social and health services.   We evaluated early treatment outcomes and client satisfaction among patients accessing C&C treatment and ancillary services at Malaysia's second C&C Center located in Kota Bharu, Kelantan. In June-July 2012, a cross-sectional convenience survey of 96 C&C inpatients and outpatients who entered treatment >30 days previously was conducted to assess drug use, criminal justice experience, medical co-morbidities, motivation for seeking treatment, and attitudes towards the C&C. Drug use was compared for the 30-day-period before C&C entry and the 30-day-period before the interview. Self-reported drug use levels decreased significantly among both inpatient and outpatient clients after enrolling in C&C treatment. Higher levels of past drug use, lower levels of social support, and more severe mental health issues were reported by participants who were previously imprisoned. Self-reported satisfaction with C&C treatment services was high. Conclusions/Importance: Preliminary evidence of reduced drug use and high levels of client satisfaction among C&C clients provide support for Malaysia's ongoing transition from compulsory drug detention centers (CDDCs) to these voluntary drug treatment centers. If C&C centers are successful, Malaysia plans to gradually transition away from CDDCs entirely.

FY2010 National Defense Authorization Act: Selected Military Personnel Policy Issues

DTIC Science & Technology

2009-11-10

Members of the Retired Reserve Who Are Not Yet Age 60 ........... 13 Chiropractic Health Care for Members on Active Duty...Personnel Policy Issues Congressional Research Service 14 Chiropractic Health Care for Members on Active Duty Background: Chiropractic is a health care...and supporting the body’s natural ability to heal itself. Research to expand the scientific understanding of chiropractic treatment is ongoing

An Application of Double-Loop Learning to Community College Remedial Education: A New Model of Integrated Supports for Ongoing Student Success

ERIC Educational Resources Information Center

Doren, Andrew T.

2013-01-01

Community colleges have multiple missions and one of them is to provide open access services to those seeking to further their education. Community colleges provide remedial courses in math, reading, and writing because many of their students do not meet entrance requirements in these core subjects. However, the usual developmental education track…

If Only "A Rose by Any Other Name Would Smell as Sweet": A Systematic Review on the Impact of Youth Work for Young People

ERIC Educational Resources Information Center

Mundy-McPherson, Stuart; Fouche, Christa; Elliot, Kim

2012-01-01

Background: Internationally there is an increasing commitment and investment to support the provision of youth work services and ongoing debate on youth worker effectiveness. However, the evidence of the impact of youth work is currently limited and disjointed. Objective: This article reports on and critically considers the results of a systematic…

Social-support needs among adolescents living with HIV in transition from pediatric to adult care in Cambodia: findings from a cross-sectional study.

PubMed

Toth, Graham; Mburu, Gitau; Tuot, Sovannary; Khol, Vohith; Ngin, Chanrith; Chhoun, Pheak; Yi, Siyan

2018-03-28

Understanding the circumstances of adolescents living with HIV is critical in designing adolescent-friendly services that will facilitate successful transition from pediatric to adult care. This study describes access, utilization and ongoing social support needs among adolescents living with HIV aged 15-17 in transition from pediatric to adult HIV care in Cambodia. A cross-sectional study was conducted among 328 adolescents, randomly selected from 11 antiretroviral therapy (ART) clinics across the country. Descriptive analyses were conducted to summarize their characteristics, access to social support and ongoing support needs among male and female adolescents. Mean age of the study participants was 15.8 (SD = 0.8) years. Just over half (55.2%) were male. Most had at least one deceased parent (mother 50.9%; father 60.5%), and majority were living with biological parents (40.8%) or relatives (49.3%). A third came from families with an ID poor card, and 21.0% were working for pay. Almost half (46.6%) reported that their family had received social support for their health care, including food support (76.5%), school allowance (62.1%), transport allowance to ART clinics (53.6%), psychosocial counseling (35.3%), vocational training (22.9%) or home visits (11.1%). Several ongoing social support needs were identified, including ongoing inability to cover health expenses unless they are supported by health insurance or health equity fund (55.0%). In addition, adolescents reported having been asked to come back earlier than their scheduled appointment (13.7%), having had to purchase their own drugs (2.7%), experiencing HIV stigma (32.0%), having been denied housing or food due to HIV (8.2%) or failing to attend school within the past month partly because of HIV (16.8%). Two-thirds did not have access to peer support groups. Social protection mechanisms are reaching some adolescents in need, while other remain without social support due to discontinuities in health and social care. Multi-sectoral interventions, supporting school attendance, adolescent-friendly clinic scheduling, reductions in child employment, mitigation of HIV-related stigma and strengthening of peer-to-peer support are required to improve coverage of social protection interventions for adolescents in transition.

Evaluation and its importance for nursing practice.

PubMed

Moule, Pam; Armoogum, Julie; Douglass, Emma; Taylor, Dr Julie

2017-04-26

Evaluation of service delivery is an important aspect of nursing practice. Service evaluation is being increasingly used and led by nurses, who are well placed to evaluate service and practice delivery. This article defines evaluation of services and wider care delivery and its relevance in NHS practice and policy. It aims to encourage nurses to think about how evaluation of services or practice differs from research and audit activity and to consider why and how they should use evaluation in their practice. A process for planning and conducting an evaluation and disseminating findings is presented. Evaluation in the healthcare context can be a complicated activity and some of the potential challenges of evaluation are described, alongside possible solutions. Further resources and guidance on evaluation activity to support nurses' ongoing development are identified.

Indigenous health: effective and sustainable health services through continuous quality improvement.

PubMed

Bailie, Ross S; Si, Damin; O'Donoghue, Lyn; Dowden, Michelle

2007-05-21

The Australian government's Healthy for Life program is supporting capacity development in Indigenous primary care using continuous quality improvement (CQI) techniques. An important influence on the Healthy for Life program has been the ABCD research project. The key features contributing to the success of the project are described. The ABCD research project: uses a CQI approach, with an ongoing cycle of gathering data on how well organisational systems are functioning, and developing and then implementing improvements; is guided by widely accepted principles of community-based research, which emphasise participation; and adheres to the principles and values of Indigenous health research and service delivery. The potential for improving health outcomes in Aboriginal and Torres Strait Islander communities using a CQI approach should be strengthened by clear clinical and managerial leadership, supporting service organisations at the community level, and applying participatory-action principles.

User needs for propagation data

NASA Technical Reports Server (NTRS)

Sullivan, Thomas M.

1993-01-01

New and refined models of radio signal propagation phenomena are needed to support studies of evolving satellite services and systems. Taking an engineering perspective, applications for propagation measurements and models in the context of various types of analyses that are of ongoing interest are reviewed. Problems that were encountered in the signal propagation aspects of these analyses are reviewed, and potential solutions to these problems are discussed. The focus is on propagation measurements and models needed to support design and performance analyses of systems in the Mobile-Satellite Service (MSS) operating in the 1-3 GHz range. These systems may use geostationary or non-geostationary satellites and Frequency Division Multiple Access (FDMA), Time Division Multiple Access Digital (TDMA), or Code Division Multiple Access (CDMA) techniques. Many of the propagation issues raised in relation to MSS are also pertinent to other services such as broadcasting-satellite (sound) at 2310-2360 MHz. In particular, services involving mobile terminals or terminals with low gain antennas are of concern.

Barriers and Facilitators to Integrating Health Service Responses to Intimate Partner Violence in Low- and Middle-Income Countries: A Comparative Health Systems and Service Analysis.

PubMed

Colombini, Manuela; Dockerty, Colleen; Mayhew, Susannah H

2017-06-01

This systematic review synthesizes 11 studies of health-sector responses to intimate partner violence (IPV) in low- and middle-income countries. The services that were most comprehensive and integrated in their responsiveness to IPV were primarily in primary health and antenatal care settings. Findings suggest that the following facilitators are important: availability of clear guidelines, policies, or protocols; management support; intersectoral coordination with clear, accessible on-site and off-site referral options; adequate and trained staff with accepting and empathetic attitudes toward survivors of IPV; initial and ongoing training for health workers; and a supportive and supervised environment in which to enact new IPV protocols. A key characteristic of the most integrated responses was the connection or "linkages" between different individual factors. Irrespective of their service entry point, what emerged as crucial was a connected systems-level response, with all elements implemented in a coordinated manner. © 2017 The Population Council, Inc.

Barriers and Facilitators to Integrating Health Service Responses to Intimate Partner Violence in Low‐ and Middle‐Income Countries: A Comparative Health Systems and Service Analysis

PubMed Central

Colombini, Manuela; Dockerty, Colleen; Mayhew, Susannah H.

2017-01-01

This systematic review synthesizes 11 studies of health‐sector responses to intimate partner violence (IPV) in low‐ and middle‐income countries. The services that were most comprehensive and integrated in their responsiveness to IPV were primarily in primary health and antenatal care settings. Findings suggest that the following facilitators are important: availability of clear guidelines, policies, or protocols; management support; intersectoral coordination with clear, accessible on‐site and off‐site referral options; adequate and trained staff with accepting and empathetic attitudes toward survivors of IPV; initial and ongoing training for health workers; and a supportive and supervised environment in which to enact new IPV protocols. A key characteristic of the most integrated responses was the connection or “linkages” between different individual factors. Irrespective of their service entry point, what emerged as crucial was a connected systems‐level response, with all elements implemented in a coordinated manner. PMID:28422291

Shifting Practices Toward Recovery-Oriented Care Through an E-Recovery Portal in Community Mental Health Care: A Mixed-Methods Exploratory Study

PubMed Central

Strand, Monica; Eng, Lillian Sofie; Børøsund, Elin; Varsi, Cecilie; Ruland, Cornelia

2017-01-01

Background Mental health care is shifting from a primary focus on symptom reduction toward personal recovery-oriented care, especially for persons with long-term mental health care needs. Web-based portals may facilitate this shift, but little is known about how such tools are used or the role they may play in personal recovery. Objective The aim was to illustrate uses and experiences with the secure e-recovery portal “ReConnect” as an adjunct to ongoing community mental health care and explore its potential role in shifting practices toward recovery. Methods ReConnect was introduced into two Norwegian mental health care communities and used for 6 months. The aim was to support personal recovery and collaboration between service users and health care providers. Among inclusion criteria for participation were long-term care needs and at least one provider willing to interact with service users through ReConnect. The portal was designed to support ongoing collaboration as each service user-provider dyad/team found appropriate and consisted of (1) a toolbox of resources for articulating and working with recovery processes, such as status/goals/activities relative to life domains (eg, employment, social network, health), medications, network map, and exercises (eg, sleep hygiene, mindfulness); (2) messaging with providers who had partial access to toolbox content; and (3) a peer support forum. Quantitative data (ie, system log, questionnaires) were analyzed using descriptive statistics. Qualitative data (eg, focus groups, forum postings) are presented relative to four recovery-oriented practice domains: personally defined recovery, promoting citizenship, working relationships, and organizational commitment. Results Fifty-six participants (29 service users and 27 providers) made up 29 service user-provider dyads. Service users reported having 11 different mental health diagnoses, with a median 2 (range 1-7) diagnoses each. The 27 providers represented nine different professional backgrounds. The forum was the most frequently used module with 1870 visits and 542 postings. Service users’ control over toolbox resources (eg, defining and working toward personal goals), coupled with peer support, activated service users in their personal recovery processes and in community engagement. Some providers (30%, 8/27) did not interact with service users through ReConnect. Dyads that used the portal resources did so in highly diverse ways, and participants reported needing more than 6 months to discover and adapt optimal uses relative to their individual and collaborative needs. Conclusions Regardless of providers’ portal use, service users’ control over toolbox resources, coupled with peer support, offered an empowering common frame of reference that represented a shift toward recovery-oriented practices within communities. Although service users’ autonomous use of the portal can eventually influence providers in the direction of recovery practices, a fundamental shift is unlikely without broader organizational commitments aligned with recovery principles (eg, quantified goals for service user involvement in care plans). PMID:28465277

Revitalizing academic-service partnerships to resolve nursing faculty shortages.

PubMed

Connolly, Maria A; Wilson, Carol Jo

2008-01-01

Vacancy rates of nursing faculty are on the increase as fewer educators are being prepared and nurses at the bedside are in short supply. Advanced practice nurses--uniquely suited to provide clinical education for undergraduate and graduate students--are underutilized. However, without release time, preparation as educators, ongoing support from education and administration, and remuneration for providing both evidence-based education and evidence-based patient care, they can hardly be expected to assume additional responsibilities. This article reviews academic-service partnerships, noting a general lack of published efficacy and cost-effectiveness data, and highlights 21st-century innovations for academia and service to share resources for the benefit of all stakeholders--especially patients and students.

The benefits of motivational interviewing and coaching for improving the practice of comprehensive family assessments in child welfare.

PubMed

Snyder, Elizabeth H; Lawrence, C Nicole; Weatherholt, Tara N; Nagy, Paul

2012-01-01

The engagement of families in child welfare services is critical for successful outcomes related to safety, permanency, and child and family well-being. Motivational interviewing (MI), an effective approach to working with individuals struggling with alcohol and drug addiction, has great appeal for use with families involved with the child welfare system. Consequently, many social service agencies are beginning to integrate MI into their training curriculum. However, research has shown that training in MI alone is not enough; ongoing coaching is crucial in order to transfer learned MI skills into practice.The current study employs qualitative interview data from case-workers in order to examine the implementation of MI and long-term coaching within the child welfare system. Findings showed that MI can be implemented successfully within the child welfare system, and that caseworkers believed MI, supported by ongoing coaching, to be a valuable tool in engaging families in the assessment process.

Pacific CRYSTAL Teacher Professional Development Models: Lessons Learned

NASA Astrophysics Data System (ADS)

van der Flier-Keller, E.; Yore, L.

2010-12-01

From 2005 to 2010 Pacific CRYSTAL (Centre for Research in Youth Science Teaching and Learning) has been engaged in community-based research fostering teacher leadership in innovative science education through a variety of approaches to teacher professional development. Pacific CRYSTAL is a University of Victoria based, NSERC funded project founded on a collaborative research model involving scentists, science educators and community members including schools, teachers, community groups and government. Pacific CRYSTAL professional development approaches embrace both in-service teachers and pre-service teachers, and include Lighthouse schools, workshops (ongoing as well as one-time), community-based partnerships in Pacific CRYSTAL research projects, teachers as researchers, and university science courses and workshops for pre-education and education students. A number of common themes, identified through these approaches, should be considered in the development and implementation of future science professional development initiatives. They include; teacher turnover, expanding and adding schools and participating teachers, teacher apprehension, building leadership capacity, further engagement of 'tourist' teachers, continuing professional support for teachers, as well as on-going mentoring.

Challenges associated with post-deployment screening for mild traumatic brain injury in military personnel.

PubMed

Iverson, Grant L; Langlois, Jean A; McCrea, Michael A; Kelly, James P

2009-11-01

There is ongoing debate regarding the epidemiology of mild traumatic brain injury (MTBI) in military personnel. Accurate and timely estimates of the incidence of brain injury and the prevalence of long-term problems associated with brain injuries among active duty service members and veterans are essential for (a) operational planning, and (b) to allocate sufficient resources for rehabilitation and ongoing services and supports. The purpose of this article is to discuss challenges associated with post-deployment screening for MTBI. Multiple screening methods have been used in military, Veterans Affairs, and independent studies, which complicate cross-study comparisons of the resulting epidemiological data. We believe that post-deployment screening is important and necessary--but no screening methodology will be flawless, and false positives and false negatives are inevitable. Additional research is necessary to refine the sequential screening methodology, with the goal of minimizing false negatives during initial post-deployment screening and minimizing false positives during follow-up evaluations.

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.

From hospital information system components to the medical record and clinical guidelines & protocols.

PubMed

Veloso, M; Estevão, N; Ferreira, P; Rodrigues, R; Costa, C T; Barahona, P

1997-01-01

This paper introduces an ongoing project towards the development of a new generation HIS, aiming at the integration of clinical and administrative information within a common framework. Its design incorporates explicit knowledge about domain objects and professional activities to be processed by the system together with related knowledge management services and act management services. The paper presents the conceptual model of the proposed HIS architecture, that supports a rich and fully integrated patient data model, enabling the implementation of a dynamic electronic patient record tightly coupled with computerised guideline knowledge bases.

Reforming funding for chronic illness: Medicare-CDM.

PubMed

Swerissen, Hal; Taylor, Michael J

2008-02-01

Chronic diseases are a major challenge for the Australian health care system in terms of both the provision of quality care and expenditure, and these challenges will only increase in the future. Various programs have been instituted under the Medicare system to provide increased funding for chronic care, but essentially these programs still follow the traditional fee-for-service model. This paper proposes a realignment and extension of current Medicare chronic disease management programs into a framework that provides general practitioners and other health professionals with the necessary "tools" for high quality care planning and ongoing management, and incorporating international models of outcome-linked funding. The integration of social support services with the Medicare system is also a necessary step in providing high quality care for patients with complex needs requiring additional support.

Supporting Military Families with Young Children throughout the Deployment Lifecycle

DTIC Science & Technology

2016-10-01

Families and Strong Parents intervention to families (N=124) 13-39 Ongoing Task 4: Conduct posttest assessment interview (+3 months from pretest ) 16...approximately one month to obtain participants from the first deploying group , and approximately 2 months for the next several deploying groups . This...Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT U.S. military service since the September 11th, 2001 terrorist attacks has placed tremendous demands on

The experiences of frequent users of crisis helplines: A qualitative interview study.

PubMed

Middleton, Aves; Gunn, Jane; Bassilios, Bridget; Pirkis, Jane

2016-11-01

To understand why some users call crisis helplines frequently. Nineteen semi-structured telephone interviews were conducted with callers to Lifeline Australia who reported calling 20 times or more in the past month and provided informed consent. Interviews were audio-recorded and transcribed verbatim. Inductive thematic analysis was used to generate common themes. Approval was granted by The University of Melbourne Human Research Ethics Committee. Three overarching themes emerged from the data and included reasons for calling, service response and calling behaviours. Respondents called seeking someone to talk to, help with their mental health issues and assistance with negative life events. When they called, they found short-term benefits in the unrestricted support offered by the helpline. Over time they called about similar issues and described reactive, support-seeking and dependent calling behaviours. Frequent users of crisis helplines call about ongoing issues. They have developed distinctive calling behaviours which appear to occur through an interaction between their reasons for calling and the response they receive from the helpline. The ongoing nature of the issues prompting frequent users to call suggests that a service model that includes a continuity of care component may be more efficient in meeting their needs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

PubMed Central

Yeandle, Sue

2016-01-01

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

The GMOS cyber(e)-infrastructure: advanced services for supporting science and policy.

PubMed

Cinnirella, S; D'Amore, F; Bencardino, M; Sprovieri, F; Pirrone, N

2014-03-01

The need for coordinated, systematized and catalogued databases on mercury in the environment is of paramount importance as improved information can help the assessment of the effectiveness of measures established to phase out and ban mercury. Long-term monitoring sites have been established in a number of regions and countries for the measurement of mercury in ambient air and wet deposition. Long term measurements of mercury concentration in biota also produced a huge amount of information, but such initiatives are far from being within a global, systematic and interoperable approach. To address these weaknesses the on-going Global Mercury Observation System (GMOS) project ( www.gmos.eu ) established a coordinated global observation system for mercury as well it retrieved historical data ( www.gmos.eu/sdi ). To manage such large amount of information a technological infrastructure was planned. This high-performance back-end resource associated with sophisticated client applications enables data storage, computing services, telecommunications networks and all services necessary to support the activity. This paper reports the architecture definition of the GMOS Cyber(e)-Infrastructure and the services developed to support science and policy, including the United Nation Environmental Program. It finally describes new possibilities in data analysis and data management through client applications.

"Not just a normal mum": a qualitative investigation of a support service for women who are pregnant subsequent to perinatal loss.

PubMed

Meredith, Pamela; Wilson, Trish; Branjerdporn, Grace; Strong, Jenny; Desha, Laura

2017-01-05

Following previous perinatal loss, women in a subsequent pregnancy may experience heightened emotions, such as anxiety and fear, with a range of longer-term implications. To support these women, the Mater Mothers' Bereavement Support Service in Brisbane, Australia, developed a Pregnancy After Loss Clinic (PALC) as a specialised hospital-based service. The present study investigated the experiences of mothers with previous perinatal loss in relation to: (a) their subsequent pregnancy-to-birth journey, and (b) the PALC service. Such research seeks to inform the ongoing development of effective perinatal services. A qualitative interview-based research design was employed with a purposive sample of 10 mothers who had previously experienced perinatal loss and who attended the Mater Mothers' PALC during their subsequent pregnancy in 2015. All mothers had subsequently delivered a live baby and were in a relationship with the father of the new baby. Women were aged between 22 and 39 years, primiparous or multiparous, and from a range of cultural backgrounds. Semi-structured interviews, conducted either at the hospital or by telephone by an experienced, independent researcher, lasted between 20 min and one hour. All interviews were audio-recorded and transcribed verbatim, with participant names changed. Interviews were analysed using content analysis by two researchers who were not involved in the service delivery or data gathering process. Seven themes were identified from the interview material: The overall experience, The unique experience of first pregnancy after loss, Support from PALC, Experiences of other services, Recommendations for PALC services, Need for alternative services, and Advice: Mother to mother. Participants spoke positively of the PALC services for themselves and their families. Anxieties over their subsequent pregnancy, and the desire for other health professionals to be more understanding were frequently raised. Recommendations were made to extend the PALC service and to develop similar services to support access for other families experiencing perinatal loss.

Assessment of an Innovative Voluntary Substance Abuse Treatment Program Designed to Replace Compulsory Drug Detention Centers in Malaysia

PubMed Central

Khan, Farrah; Krishnan, Archana; Ghani, Mansur A.; Wickersham, Jeffrey A.; Fu, Jeannia J.; Lim, Sin How; Dhaliwal, Sangeeth Kaur; Kamarulzaman, Adeeba; Altice, Frederick L.

2017-01-01

Background As part of an ongoing initiative by the Malaysian government to implement alternative approaches to involuntary detention of people who use drugs, the National Anti-Drug Agency has created new voluntary drug treatment programs known as Cure and Care (C&C) Centers that provide free access to addiction treatment services, including methadone maintenance therapy, integrated with social and health services. Objectives We evaluated early treatment outcomes and client satisfaction among patients accessing C&C treatment and ancillary services at Malaysia’s second C&C Center located in Kota Bharu, Kelantan. Methods In June–July 2012, a cross-sectional convenience survey of 96 C&C inpatients and outpatients who entered treatment >30 days previously was conducted to assess drug use, criminal justice experience, medical co-morbidities, motivation for seeking treatment, and attitudes towards the C&C. Drug use was compared for the 30-day-period before C&C entry and the 30-day-period before the interview. Results Self-reported drug use levels decreased significantly among both inpatient and outpatient clients after enrolling in C&C treatment. Higher levels of past drug use, lower levels of social support, and more severe mental health issues were reported by participants who were previously imprisoned. Self-reported satisfaction with C&C treatment services was high. Conclusions/Importance Preliminary evidence of reduced drug use and high levels of client satisfaction among C&C clients provide support for Malaysia’s ongoing transition from compulsory drug detention centers (CDDCs) to these voluntary drug treatment centers. If C&C centers are successful, Malaysia plans to gradually transition away from CDDCs entirely. PMID:28635521

The Regional Integrated Sciences and Assessments (RISA) Program, Climate Services, and Meeting the National Climate Change Adaptation Challenge

NASA Astrophysics Data System (ADS)

Overpeck, J. T.; Udall, B.; Miles, E.; Dow, K.; Anderson, C.; Cayan, D.; Dettinger, M.; Hartmann, H.; Jones, J.; Mote, P.; Ray, A.; Shafer, M.; White, D.

2008-12-01

The NOAA-led RISA Program has grown steadily to nine regions and a focus that includes both natural climate variability and human-driven climate change. The RISAs are, at their core, university-based and heavily invested in partnerships, particularly with stakeholders, NOAA, and other federal agencies. RISA research, assessment and partnerships have led to new operational climate services within NOAA and other agencies, and have become important foundations in the development of local, state and regional climate change adaptation initiatives. The RISA experience indicates that a national climate service is needed, and must include: (1) services prioritized based on stakeholder needs; (2) sustained, ongoing regional interactions with users, (3) a commitment to improve climate literacy; (4) support for assessment as an ongoing, iterative process; (5) full recognition that stakeholder decisions are seldom made using climate information alone; (6) strong interagency partnership; (7) national implementation and regional in focus; (8) capability spanning local, state, tribal, regional, national and international space scales, and weeks to millennia time scales; and (9) institutional design and scientific support flexible enough to assure the effort is nimble enough to respond to rapidly-changing stakeholder needs. The RISA experience also highlights the central role that universities must play in national climate change adaptation programs. Universities have a tradition of trusted regional stakeholder partnerships, as well as the interdisciplinary expertise - including social science, ecosystem science, law, and economics - required to meet stakeholder climate-related needs; project workforce can also shift rapidly in universities. Universities have a proven ability to build and sustain interagency partnerships. Universities excel in most forms of education and training. And universities often have proven entrepreneurship, technology transfer and private sector partnership capability.

The potential of technology for enhancing individual placement and support supported employment.

PubMed

Lord, Sarah E; McGurk, Susan R; Nicholson, Joanne; Carpenter-Song, Elizabeth A; Tauscher, Justin S; Becker, Deborah R; Swanson, Sarah J; Drake, Robert E; Bond, Gary R

2014-06-01

The potential of technology to enhance delivery and outcomes of Individual Placement and Support (IPS) supported employment. IPS supported employment has demonstrated robust success for improving rates of competitive employment among individuals with psychiatric disabilities. Still, a majority of those with serious mental illnesses are not employed (Bond, Drake, & Becker, 2012). The need to promote awareness of IPS and expand services is urgent. In this study, we describe ways that technologies may enhance delivery of IPS supported employment across the care continuum and stakeholder groups. Directions for research are highlighted. published literature, clinical observations, IPS learning collaborative. Technology has the potential to enhance direct service as well as workflow in the IPS supported employment process, which may lead to improved fidelity and client outcomes. Mobile and cloud technologies open opportunities for collaboration, self-directed care, and ongoing support to help clients obtain and maintain meaningful employment. Research is needed to evaluate efficacy of technology-based approaches for promoting client employment outcomes, to identify provider and organization barriers to using technology for IPS delivery, and to determine effective strategies for implementing technology with IPS in different settings and with diverse client audiences.

The Potential of Technology for Enhancing Individual Placement and Support Supported Employment

PubMed Central

Lord, Sarah E.; McGurk, Susan R.; Nicholson, Joanne; Carpenter-Song, Elizabeth A.; Tauscher, Justin S.; Becker, Deborah R.; Swanson, Sarah J.; Drake, Robert E.; Bond, Gary R.

2015-01-01

Topic The potential of technology to enhance delivery and outcomes of Individual Placement and Support (IPS) supported employment. Purpose IPS supported employment has demonstrated robust success for improving rates of competitive employment among individuals with psychiatric disabilities. Still, a majority of those with serious mental illnesses are not employed (Bond, Drake, & Becker, 2012). The need to promote awareness of IPS and expand services is urgent. In this study, we describe ways that technologies may enhance delivery of IPS supported employment across the care continuum and stakeholder groups. Directions for research are highlighted. Sources Used published literature, clinical observations, IPS learning collaborative. Conclusions and Implications for Practice Technology has the potential to enhance direct service as well as workflow in the IPS supported employment process, which may lead to improved fidelity and client outcomes. Mobile and cloud technologies open opportunities for collaboration, self-directed care, and ongoing support to help clients obtain and maintain meaningful employment. Research is needed to evaluate efficacy of technology-based approaches for promoting client employment outcomes, to identify provider and organization barriers to using technology for IPS delivery, and to determine effective strategies for implementing technology with IPS in different settings and with diverse client audiences. PMID:24912058

Improving Global Precipitation Product Access at the GES DISC

NASA Technical Reports Server (NTRS)

Liu, Z.; Vollmer, B.; Savtchenko, A.; Ostrenga, D.; DeShong, B.; Fang, F.; Albayrak, R,; Sherman, E.; Greene, M.; Li, A.;

Building capacity for the continuous improvement of health-promoting schools.

PubMed

Hoyle, Tena B; Samek, Beverly B; Valois, Robert F

2008-01-01

There has been much educational verbosity over the past decade related to building capacity for effective schools. However, there seems to be a scarcity of clarification about what is meant by school capacity building or how to accomplish and sustain this process. This article describes the preexisting conditions and ongoing processes in Pueblo, Colorado School District 60 (Pueblo 60) that built capacity for the development and continuous improvement of health-promoting schools. Capacity building strategies and a program-planning model for continuous improvement for health-promoting schools were used that included: (a) visionary/effective leadership and management structures, (b) extensive internal and external supports, (c) development and allocation of adequate resources, (d) supportive policies and procedures, and (e) ongoing, embedded professional development. Pueblo 60 strategically developed an infrastructure through which they successfully delivered a wide array of health programs and services. Through building organizational capacity at the school district and school level, additional school health programming can be developed and sustained.

Influencing sceptical staff to become supporters of service improvement: a qualitative study of doctors' and managers' views

PubMed Central

Gollop, R; Whitby, E; Buchanan, D; Ketley, D

2004-01-01

Objective: To explore scepticism and resistance towards changes in working practice designed to achieve service improvement. Two principal questions were studied: (1) why some people are sceptical or resistant towards improvement programmes and (2) what influences them to change their minds. Methods: Semi-structured qualitative interviews were conducted with 19 clinicians and 19 managers who held national and regional roles in two national programmes of service improvement within the NHS involving systematic organisational changes in working practices: the National Booking Programme and the Cancer Services Collaborative (now the Cancer Services Collaborative Improvement Partnership). Results: Scepticism and resistance exist in all staff groups, especially among medical staff. Reasons include personal reluctance to change, misunderstanding of the aims of improvement programmes, and a dislike of the methods by which programmes have been promoted. Sceptical staff can be influenced to become involved in improvement, but this usually takes time. Newly won support may be fragile, requiring ongoing evidence of benefits to be maintained. Conclusions: The support of health service staff, particularly doctors, is crucial to the spread and sustainability of the modernisation agenda. Scepticism and resistance are seen to hamper progress. Leaders of improvement initiatives need to recognise the impact of scepticism and resistance, and to consider ways in which staff can become positively engaged in change. PMID:15069217

Enabling System Management through Process Modeling: The Australian Defence Force Recruiting System

DTIC Science & Technology

2006-09-01

or ongoing treatment in the form of medication or support from specialists such as physiotherapy . In fact, in an average work week, there are...289,038 patient consultations with physiotherapists.77 It is logical to extrapolate that this high incidence of medication and physiotherapy treatments... Physiotherapy Services,” Australian Bureau of Statistics, August 31, 1999, 4. 78 Cooper-Stanbury, Mark “Risk Factors: That’s Life,” presentation at

A journey through meaningful use at a large academic medical center: lessons of leadership, administration, and technical implementation.

PubMed

Unger, Melissa D; Aldrich, Alison M; Hefner, Jennifer L; Rizer, Milisa K

2014-01-01

Successfully reporting meaningful use of electronic health records to the Centers for Medicare and Medicaid Services can be a challenging process, particularly for healthcare organizations with large numbers of eligible professionals. This case report describes a successful meaningful use attestation process undertaken at a major academic medical center. It identifies best practices in the areas of leadership, administration, communication, ongoing support, and technological implementation.

Shifting Practices Toward Recovery-Oriented Care Through an E-Recovery Portal in Community Mental Health Care: A Mixed-Methods Exploratory Study.

PubMed

Gammon, Deede; Strand, Monica; Eng, Lillian Sofie; Børøsund, Elin; Varsi, Cecilie; Ruland, Cornelia

2017-05-02

Mental health care is shifting from a primary focus on symptom reduction toward personal recovery-oriented care, especially for persons with long-term mental health care needs. Web-based portals may facilitate this shift, but little is known about how such tools are used or the role they may play in personal recovery. The aim was to illustrate uses and experiences with the secure e-recovery portal "ReConnect" as an adjunct to ongoing community mental health care and explore its potential role in shifting practices toward recovery. ReConnect was introduced into two Norwegian mental health care communities and used for 6 months. The aim was to support personal recovery and collaboration between service users and health care providers. Among inclusion criteria for participation were long-term care needs and at least one provider willing to interact with service users through ReConnect. The portal was designed to support ongoing collaboration as each service user-provider dyad/team found appropriate and consisted of (1) a toolbox of resources for articulating and working with recovery processes, such as status/goals/activities relative to life domains (eg, employment, social network, health), medications, network map, and exercises (eg, sleep hygiene, mindfulness); (2) messaging with providers who had partial access to toolbox content; and (3) a peer support forum. Quantitative data (ie, system log, questionnaires) were analyzed using descriptive statistics. Qualitative data (eg, focus groups, forum postings) are presented relative to four recovery-oriented practice domains: personally defined recovery, promoting citizenship, working relationships, and organizational commitment. Fifty-six participants (29 service users and 27 providers) made up 29 service user-provider dyads. Service users reported having 11 different mental health diagnoses, with a median 2 (range 1-7) diagnoses each. The 27 providers represented nine different professional backgrounds. The forum was the most frequently used module with 1870 visits and 542 postings. Service users' control over toolbox resources (eg, defining and working toward personal goals), coupled with peer support, activated service users in their personal recovery processes and in community engagement. Some providers (30%, 8/27) did not interact with service users through ReConnect. Dyads that used the portal resources did so in highly diverse ways, and participants reported needing more than 6 months to discover and adapt optimal uses relative to their individual and collaborative needs. Regardless of providers' portal use, service users' control over toolbox resources, coupled with peer support, offered an empowering common frame of reference that represented a shift toward recovery-oriented practices within communities. Although service users' autonomous use of the portal can eventually influence providers in the direction of recovery practices, a fundamental shift is unlikely without broader organizational commitments aligned with recovery principles (eg, quantified goals for service user involvement in care plans). ©Deede Gammon, Monica Strand, Lillian Sofie Eng, Elin Børøsund, Cecilie Varsi, Cornelia Ruland. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.05.2017.

Estimating the number of adults with severe and persistent mental illness who have complex, multi-agency needs.

PubMed

Whiteford, Harvey; Buckingham, Bill; Harris, Meredith; Diminic, Sandra; Stockings, Emily; Degenhardt, Louisa

2017-08-01

A population health approach to mental health service planning requires estimates that align interventions with the needs of people with mental illness. The primary objective was to estimate the number of people in Australia living with severe and persistent mental illness who have complex, multi-agency needs. The secondary objective was to describe the possible service needs of individuals with severe mental illness. We disaggregated the estimated 12-month prevalence of adults with severe mental illness into needs-based sub-groups, using multiple data sources. Possible service needs of 1825 adults with psychotic disorders and 334 adults with severe past-year affective and/or anxiety disorders were described using data from the 2010 Survey of High Impact Psychosis and 2007 National Survey of Mental Health and Wellbeing, respectively. Using best available data, we estimated that 3.3% of adults experience a severe mental illness each year, of whom one-third (1.1% of adults) experience a persistent mental illness that requires ongoing services to address residual disability. Among those with severe and persistent mental illness, one-third of adults (0.4% or 59,000 adults in 2015) have complex needs requiring multi-agency support to maximise their health, housing, social participation and personal functioning. Survey of High Impact Psychosis data indicated that among adults with psychotic disorders, use of accommodation (40%), non-government (30%) services and receipt of income support (85%) services were common, as were possible needs for support with socialising, personal care and employment. National Survey of Mental Health and Wellbeing data indicated that among individuals with severe affective and anxiety disorders, receipt of income support (37%) was common (information on accommodation and non-government support services was not available), as were possible needs for financial management and employment support. Agreed indicators of complex, multi-agency needs are required to refine these estimates. Closer alignment of information collected about possible service needs across epidemiological surveys is needed.

KSC-2012-6553

NASA Image and Video Library

2012-09-28

HOUSTON -- NASA Astronaut Lee Archambault performs an evaluation of reach and visibility of controls and displays during an end-of-year interior layout evaluation of The Boeing Company's CST-100 spacecraft. The evaluation at Boeing's Houston Product Support Center in Texas was part of the company's ongoing work supporting its funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the Commercial Crew Integrated Capability, or CCiCap, initiative. CCP is intended to lead to the availability of commercial human spaceflight services for government and commercial customers to low-Earth orbit. Future development and certification initiatives eventually will lead to the availability of human spaceflight services for NASA to send its astronauts to the International Space Station, where critical research is taking place daily. For more information about CCP, go to http://www.nasa.gov/commercialcrew. Photo credit: Boeing

Open Standards in Practice: An OGC China Forum Initiative

NASA Astrophysics Data System (ADS)

Yue, Peng; Zhang, Mingda; Taylor, Trevor; Xie, Jibo; Zhang, Hongping; Tong, Xiaochong; Yu, Jinsongdi; Huang, Juntao

2016-11-01

Open standards like OGC standards can be used to improve interoperability and support machine-to-machine interaction over the Web. In the Big Data era, standard-based data and processing services from various vendors could be combined to automate the extraction of information and knowledge from heterogeneous and large volumes of geospatial data. This paper introduces an ongoing OGC China forum initiative, which will demonstrate how OGC standards can benefit the interaction among multiple organizations in China. The ability to share data and processing functions across organizations using standard services could change traditional manual interactions in their business processes, and provide on-demand decision support results by on-line service integration. In the initiative, six organizations are involved in two “MashUp” scenarios on disaster management. One “MashUp” is to derive flood maps in the Poyang Lake, Jiangxi. And the other one is to generate turbidity maps on demand in the East Lake, Wuhan, China. The two scenarios engage different organizations from the Chinese community by integrating sensor observations, data, and processing services from them, and improve the automation of data analysis process using open standards.

Organizational Climate Partially Mediates the Effect of Culture on Work Attitudes and Staff Turnover in Mental Health Services

PubMed Central

Aarons, Gregory A.; Sawitzky, Angelina C.

2006-01-01

Staff turnover in mental health service organizations is an ongoing problem with implications for staff morale, productivity, organizational effectiveness, and implementation of innovation. Recent studies in public sector services have examined the impact of organizational culture and climate on work attitudes (i.e., job satisfaction and organizational commitment) and, ultimately, staff turnover. However, mediational models of the impact of culture and climate on work attitudes have not been examined. The present study examined full and partial mediation models of the effects of culture and climate on work attitudes and the subsequent impact of work attitudes on staff turnover. Multilevel structural equation models supported a partial mediation model in which organizational culture had both direct influence on work attitudes and indirect influence through organizational climate. Work attitudes significantly predicted one-year staff turnover rates. These findings support the contention that both culture and climate impact work attitudes and subsequent staff turnover. PMID:16544205

Person-Centeredness in Home- and Community-Based Services and Supports: Domains, Attributes, and Assisted Living Indicators.

PubMed

Zimmerman, Sheryl; Love, Karen; Cohen, Lauren W; Pinkowitz, Jackie; Nyrop, Kirsten A

2014-01-01

As a result of the Centers for Medicare & Medicaid Services (CMS) interest in creating a unifying definition of "community living" for its Medicaid Home and Community Based Services and Support (HCBS) programs, it needed clarifying descriptors of person-centered (PC) practices in assisted living to distinguish them from institutional ones. Additionally, CMS's proposed language defining "community living" had the unintended potential to exclude many assisted living communities and disadvantage residents who receive Medicaid. This manuscript describes the consensus process through which clarifying language for "community living" and a framework for HCBS PC domains, attributes, and indicators specific to assisted living were developed. It examines the validity of those domains based on literature review, surveys, and stakeholder focus groups, and identifies nine domains and 43 indicators that provide a foundation for defining and measuring PC practice in assisted living. Ongoing efforts using community-based participatory research methods are further refining and testing PC indicators for assisted living to advance knowledge, operational policies, practices, and quality outcomes.

Organizational climate partially mediates the effect of culture on work attitudes and staff turnover in mental health services.

PubMed

Aarons, Gregory A; Sawitzky, Angelina C

2006-05-01

Staff turnover in mental health service organizations is an ongoing problem with implications for staff morale, productivity, organizational effectiveness, and implementation of innovation. Recent studies in public sector services have examined the impact of organizational culture and climate on work attitudes (i.e., job satisfaction and organizational commitment) and, ultimately, staff turnover. However, mediational models of the impact of culture and climate on work attitudes have not been examined. The present study examined full and partial mediation models of the effects of culture and climate on work attitudes and the subsequent impact of work attitudes on staff turnover. Multilevel structural equation models supported a partial mediation model in which organizational culture had both direct influence on work attitudes and indirect influence through organizational climate. Work attitudes significantly predicted one-year staff turnover rates. These findings support the contention that both culture and climate impact work attitudes and subsequent staff turnover.

Re-modelled CT unit quickly up to speed.

PubMed

2011-06-01

Medical turnkey pre-installation specialist Canute International Medical Services (CIMS) recently supported provider of managed equipment services Asteral in a project to re-model the Rowan Bentall wing of Surrey's Kingston Hospital. The new CT scanning facility was developed by Asteral via an MES agreement, elements of which included two new CT scanners, major refurbishment of the existing building, and ongoing maintenance and finance. As HEJ editor Jonathan Baillie reports, despite a tight two-month schedule, the project team's expertise, and meticulous co-ordination and planning, enabled the delivery of a significantly enhanced facility on time and on budget with minimal disruption and without a single day's scanning being lost.

Practice-centred evaluation and the privileging of care in health information technology evaluation.

PubMed

Darking, Mary; Anson, Rachel; Bravo, Ferdinand; Davis, Julie; Flowers, Steve; Gillingham, Emma; Goldberg, Lawrence; Helliwell, Paul; Henwood, Flis; Hudson, Claire; Latimer, Simon; Lowes, Paul; Stirling, Ian

2014-06-05

Our contribution, drawn from our experience of the case study provided, is a protocol for practice-centred, participative evaluation of technology in the clinical setting that privileges care. In this context 'practice-centred' evaluation acts as a scalable, coordinating framework for evaluation that recognises health information technology supported care as an achievement that is contingent and ongoing. We argue that if complex programmes of technology-enabled service innovation are understood in terms of their contribution to patient care and supported by participative, capability-building evaluation methodologies, conditions are created for practitioners and patients to realise the potential of technologies and make substantive contributions to the evidence base underpinning health innovation programmes. Electronic Patient Records (EPRs) and telemedicine are positioned by policymakers as health information technologies that are integral to achieving improved clinical outcomes and efficiency savings. However, evaluating the extent to which these aims are met poses distinct evaluation challenges, particularly where clinical and cost outcomes form the sole focus of evaluation design. We propose that a practice-centred approach to evaluation - in which those whose day-to-day care practice is altered (or not) by the introduction of new technologies are placed at the centre of evaluation efforts - can complement and in some instances offer advantages over, outcome-centric evaluation models. We carried out a regional programme of innovation in renal services where a participative approach was taken to the introduction of new technologies, including: a regional EPR system and a system to support video clinics. An 'action learning' approach was taken to procurement, pre-implementation planning, implementation, ongoing development and evaluation. Participants included clinicians, technology specialists, patients and external academic researchers. Whilst undergoing these activities we asked: how can a practice-centred approach be embedded into evaluation of health information technologies? Organising EPR and telemedicine evaluation around predetermined outcome measures alone can be impractical given the complex and contingent nature of such projects. It also limits the extent to which unforeseen outcomes and new capabilities are recognised. Such evaluations often fail to improve understanding of 'when' and 'under what conditions' technology-enabled service improvements are realised, and crucially, how such innovation improves care. Our contribution, drawn from our experience of the case study provided, is a protocol for practice-centred, participative evaluation of technology in the clinical setting that privileges care. In this context 'practice-centred' evaluation acts as a scalable, coordinating framework for evaluation that recognises health information technology supported care as an achievement that is contingent and ongoing. We argue that if complex programmes of technology-enabled service innovation are understood in terms of their contribution to patient care and supported by participative, capability-building evaluation methodologies, conditions are created for practitioners and patients to realise the potential of technologies and make substantive contributions to the evidence base underpinning health innovation programmes.

Capabilities of NASA's Space Physics Data Facility as Resources to Enable the Heliophysics Virtual discipline Observatories (VxOs)

NASA Technical Reports Server (NTRS)

McGuire, Robert E.; Candey, Robert M.

2007-01-01

SPDF now supports a broad range of data, user services and other activities. These include: CDAWeb current multi-mission data graphics, listings, file subsetting and supersetting by time and parameters; SSCWeb and 3-D Java client orbit graphics, listings and conjunction queries; OMNIWeb 1/5/60 minute interplanetary parameters at Earth; product-level SPASE descriptions of data including holdings of nssdcftp; VSPO SPASE-based heliophysics-wide product site finding and data use;, standard Data format Translation Webservices (DTWS); metrics software and others. These data and services are available through standard user and application webservices interfaces, so middleware services such as the Heliophysics VxOs, and externally-developed clients or services, can readily leverage our data and capabilities. Beyond a short summary of the above, we will then conduct the talk as a conversation to evolving VxO needs and planned approach to leverage such existing and ongoing services.

Near Real-Time Applications of Earth Remote Sensing for Response to Meteorological Disasters

NASA Technical Reports Server (NTRS)

Molthan, Andrew L.; Burks, Jason E.; McGrath, Kevin M.; Bell, Jordan R.

2013-01-01

Numerous on-orbit satellites provide a wide range of spatial, spectral, and temporal resolutions supporting the use of their resulting imagery in assessments of disasters that are meteorological in nature. This presentation will provide an overview of recent use of Earth remote sensing by NASA's Short-term Prediction Research and Transition (SPoRT) Center in response to disaster activities in 2012 and 2013, along with case studies supporting ongoing research and development. The SPoRT Center, with support from NASA's Applied Sciences Program, has explored a variety of new applications of Earth-observing sensors to support disaster response. In May 2013, the SPoRT Center developed unique power outage composites representing the first clear sky view of damage inflicted upon Moore and Oklahoma City, Oklahoma following the devastating EF-5 tornado that occurred on May 20. Subsequent ASTER, MODIS, Landsat-7 and Landsat-8 imagery help to identify the damaged area. Higher resolution imagery of Moore, Oklahoma were provided by commercial satellites and the recently available International Space Station (ISS) SERVIR Environmental Research and Visualization System (ISERV) instrument. New techniques are being explored by the SPoRT team in order to better identify damage visible in high resolution imagery, and to monitor ongoing recovery for Moore, Oklahoma. Other applications are being developed to refine light source detections with the VIIRS day-night band and to map hail during the growing season through combination of available satellite and radar imagery. The aforementioned products and support are not useful unless they are distributed in a timely manner and within an appropriate decision support system. This presentation will provide an update on ongoing activities to support inclusion of these data sets within the NOAA National Weather Service Damage Assessment Toolkit, which allows meteorologists in the field to consult available satellite imagery while performing their damage assessment.

Near Real-­Time Applications of Earth Remote Sensing for Response to Meteorological Disasters

NASA Technical Reports Server (NTRS)

Molthan, Andrew L.; Burks, Jason E.; McGrath, Kevin M.; Bell, Jordan R.

2013-01-01

Numerous on-orbit satellites provide a wide range of spatial, spectral, and temporal resolutions supporting the use of their resulting imagery in assessments of disasters that are meteorological in nature. This presentation will provide an overview of recent use of Earth remote sensing by NASA's Short-term Prediction Research and Transition (SPoRT) Center in response to disaster activities in 2012 and 2013, along with case studies supporting ongoing research and development. The SPoRT Center, with support from NASA's Applied Sciences Program, has explored a variety of new applications of Earth-observing sensors to support disaster response. In May 2013, the SPoRT Center developed unique power outage composites representing the first clear sky view of damage inflicted upon Moore and Oklahoma City, Oklahoma following the devastating EF-5 tornado that occurred on May 20. Subsequent ASTER, MODIS, Landsat-7 and Landsat-8 imagery help to identify the damaged area. Higher resolution imagery of Moore, Oklahoma were provided by commercial satellites and the recently available International Space Station (ISS) SERVIR Environmental Research and Visualization System (ISERV) instrument. New techniques are being explored by the SPoRT team in order to better identify damage visible in high resolution imagery, and to monitor ongoing recovery for Moore, Oklahoma. Other applications are being developed to refine light source detections with the VIIRS day-night band and to map hail during the growing season through combination of available satellite and radar imagery. The aforementioned products and support are not useful unless they are distributed in a timely manner and within an appropriate decision support system. This presentation will provide an update on ongoing activities to support inclusion of these data sets within the NOAA National Weather Service Damage Assessment Toolkit, which allows meteorologists in the field to consult available satellite imagery while performing their damage assessment.

Alternative forms of transport and their use in the health services of developing countries.

PubMed

Gish, O; Walker, G

1978-01-01

During the past few years greater interest has been shown in ways in which the coverage of health services in developing countries might be increased. Frequently, it has been advocated that greater use be made of mobile health services, often using relatively sophisticated transport systems, including aircraft. The present article examines the uses to which mobility in health services has been put and the merits of different forms of transport, within the resource constraints and health "needs" of Third World countries. Our main conclusions are that for the majority of health service movement appropriate intermediate technology transport should be used (i.e. bicycle, animals, or motorcycles). The use of mechanical transport within health services with the highest benefit per unit cost is likely to be that employed in the regular supportive (not policing) visits to permanently staffed fixed basic care facilities by more highly skilled and scarce health personnel. Those clinics located closer to the regional base can usually be reached more cheaply by land transport, while those at a distance might justify the use of a light aircraft. Where aircraft are used in this supportive role, it is important they are integrated into the ongoing health services and tightly scheduled to lessen the risk of their diversion to less cost-effective activities.

An organisational change intervention for increasing the delivery of smoking cessation support in addiction treatment centres: study protocol for a randomized controlled trial.

PubMed

Bonevski, Billie; Guillaumier, Ashleigh; Shakeshaft, Anthony; Farrell, Michael; Tzelepis, Flora; Walsberger, Scott; D'Este, Catherine; Paul, Chris; Dunlop, Adrian; Searles, Andrew; Kelly, Peter; Fry, Rae; Stirling, Robert; Fowlie, Carrie; Skelton, Eliza

2016-06-14

The provision of smoking cessation support in Australian drug and alcohol treatment services is sub-optimal. This study examines the cost-effectiveness of an organisational change intervention to reduce smoking amongst clients attending drug and alcohol treatment services. A cluster-randomised controlled trial will be conducted with drug and alcohol treatment centres as the unit of randomisation. Biochemically verified (carbon monoxide by breath analysis) client 7-day-point prevalence of smoking cessation at 6 weeks will be the primary outcome measure. The study will be conducted in 33 drug and alcohol treatment services in four mainland states and territories of Australia: New South Wales, Australian Capital Territory, Queensland, and South Australia. Eligible services are those with ongoing client contact and that include pharmacotherapy services, withdrawal management services, residential rehabilitation, counselling services, and case management services. Eligible clients are those aged over 16 years who are attending their first of a number of expected visits, are self-reported current smokers, proficient in the English language, and do not have severe untreated mental illness as identified by the service staff. Control services will continue to provide usual care to the clients. Intervention group services will receive an organisational change intervention, including assistance in developing smoke-free policies, nomination of champions, staff training and educational client and service resources, and free nicotine replacement therapy in order to integrate smoking cessation support as part of usual client care. If effective, the organisational change intervention has clear potential for implementation as part of the standard care in drug and alcohol treatment centres. Australian and New Zealand Clinical Trials Registry, ACTRN12615000204549 . Registered on 3 March 2015.

Implementation of a Transdisciplinary Team for the Transition Support of Medically and Socially Complex Youth.

PubMed

Ciccarelli, Mary R; Gladstone, Erin B; Armstrong Richardson, Eprise A J

2015-01-01

This article reports the ongoing work of a statewide transition support program which serves youth ages 11 to 22 with medically complex conditions and socially complex lives. Seven years of transition support services have led to program evolution demonstrated via a descriptive summary of the patients along with both families' and primary care providers' responses to satisfaction surveys. An illustrative case is used to highlight the types of expertise needed in specialized transition service delivery for patients with significant complexity. The team's analysis of their transdisciplinary work processes further explains the work. Nearly three hundred youth with complex needs are served yearly. Families and primary care providers express high satisfaction with the support of the services. The case example shows the broad array of transition-specific services engaged beyond the usual skill set of pediatric or adult care coordination teams. Transdisciplinary team uses skills in collaboration, support, learning, and compromise within a trusting and respectful environment. They describe the shared responsibility and continuous learning of the whole team. Youth with complex medical conditions and complex social situations are at higher risk for problems during transition. Serving this population with a transdisciplinary model is time consuming and requires advanced expertise but, with those investments, we can meet the expectations of the youth, their families and primary care providers. Successful transdisciplinary teamwork requires sustained and focused investment. Further work is needed to describe the complexity of this service delivery along with distinct transition outcomes and costs comparisons. Copyright © 2015 Elsevier Inc. All rights reserved.

Applications of Satellite Remote Sensing for Response to and Recovery from Meteorological Disasters

NASA Technical Reports Server (NTRS)

Molthan, Andrew I.; Burks, Jason E.; McGrath, Kevin M.; Bell, Jordan R.

2014-01-01

Numerous on-orbit satellites provide a wide range of spatial, spectral, and temporal resolutions supporting the use of their resulting imagery in assessments of disasters that are meteorological in nature. This presentation will provide an overview of recent use of Earth remote sensing by NASA's Short-term Prediction Research and Transition (SPoRT) Center in response to disaster activities in 2012 and 2013, along with case studies supporting ongoing research and development. The SPoRT Center, with support from NASA's Applied Sciences Program, has explored a variety of new applications of Earth-observing sensors to support disaster response. In May 2013, the SPoRT Center developed unique power outage composites representing the first clear sky view of damage inflicted upon Moore and Oklahoma City, Oklahoma following the devastating EF-5 tornado that occurred on May 20. Subsequent ASTER, MODIS, Landsat-7 and Landsat-8 imagery help to identify the damaged areas. Higher resolution imagery of Moore, Oklahoma were provided by commercial satellites and the recently available International Space Station (ISS) SERVIR Environmental Research and Visualization System (ISERV) instrument. New techniques are being explored by the SPoRT team in order to better identify damage visible in high resolution imagery, and to monitor ongoing recovery for Moore, Oklahoma. This presentation will provide an overview of near real-time data products developed for dissemination to SPoRT's partners in NOAA's National Weather Service, through collaboration with the USGS and other federal agencies. Specifically, it will focus on integration of various data sets within the NOAA National Weather Service Damage Assessment Toolkit, which allows meteorologists in the field to consult available satellite imagery while performing their damage assessment.

Successful long-term maintenance following Nutrition Care Process Terminology implementation across a state-wide health-care system.

PubMed

Vivanti, Angela; O'Sullivan, Therese A; Porter, Jane; Hogg, Marion

2017-09-01

Three years following a state-wide Nutrition Care Process Terminology (NCPT) implementation project, the present study aimed to (i) assess changes in NCPT knowledge and attitudes, (ii) identify implementation barriers and enablers and (iii) seek managers' opinions post-implementation. Pre-implementation and three years post-implementation, all Queensland Government hospitals state-wide were invited to repeat a validated NCPT survey. Additionally, a separate survey sought dietetic managers' opinions regarding NCPT's use and acceptance, usefulness for patient care, role in service planning and continued use. A total of 238 dietitians completed the survey in 2011 and 82 dietitians in 2014. Use of diagnostic statement in the previous six months improved (P < 0.001). Perceptions of NCPT's importance (P < 0.020) and benefits of incorporating NCPT into practice (P = 0.029) increased. Time to complete NCPT documentation (P < 0.013) and access to mentors decreased (P < 0.001). Other areas including enhanced attitudes, familiarity, confidence, views, knowledge and incorporation into practice were sustained (P > 0.05). Key elements in sustaining NCPT implementation over three years included ongoing management support, workshops/tutorials, discussion and mentor and peer support. The most valued resources were pocket guides, ongoing workshops/tutorials and mentor support. Dietetic managers held many positive NCPT views, however, opinions differed around the usefulness of service planning, safer practice, improving patient care and facilitating communication. Some managers would not support NCPT unless it was recommended for practice. Immediate improvements following the NCPT implementation project were sustained over three years. Moving forward, a professional focus on continuing to incorporate NCPT into standard practice will provide structure for process and outcomes assessment. © 2017 State of Queensland. Nutrition and Dietetics © 2017 Dietitians Association of Australia.

A descriptive survey of cancer helplines in the United Kingdom: Who they are, the services offered, and the accessibility of those services.

PubMed

Leydon, Geraldine M; Stuart, Beth; Danquah, Lisa; Ekberg, Katie; Brindle, Lucy; Latter, Sue; Moynihan, Clare; Salmon, Peter; Howe, Sonia; Stokoe, Elizabeth; Little, Paul

2017-08-01

There are more than 1500 UK health helplines in operation, yet we have scant knowledge about the resources in place to support the seeking and delivering of cancer-related telephone help and support. This research aimed to identify and describe cancer and cancer-related helpline service provision: the number of helplines available, the variety of services provided, and the accessibility of those services. This study used online national questionnaire survey sent to 95 cancer and cancer-related helplines in the United Kingdom. A total of 69 (73%) of 95 surveyed cancer and cancer-related helplines completed the survey. Most helplines/organizations were registered charities, supported by donations; 73.5% of helplines had national coverage. Most helplines served all age-groups, ethnic groups, and men and women. Only 13.4% had a number that was free from landlines and most mobile networks, and 56.6% could only be contacted during working hours. More than 50% of helplines reported no provisions for callers with additional needs, and 55% had no clinical staff available to callers. Ongoing support and training for helpline staff was available but variable. Although cancer helplines in the United Kingdom offer reasonably broad coverage across the country, there are still potential barriers to accessibility. There are also opportunities to optimize the training of staff/volunteers across the sector. There are further prospects for helplines to enhance services and sustain appropriate and realistic quality standards. © 2016 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

A Journey through Meaningful Use at a Large Academic Medical Center: Lessons of Leadership, Administration, and Technical Implementation

PubMed Central

Unger, Melissa D.; Aldrich, Alison M.; Hefner, Jennifer L.; Rizer, Milisa K.

2014-01-01

Successfully reporting meaningful use of electronic health records to the Centers for Medicare and Medicaid Services can be a challenging process, particularly for healthcare organizations with large numbers of eligible professionals. This case report describes a successful meaningful use attestation process undertaken at a major academic medical center. It identifies best practices in the areas of leadership, administration, communication, ongoing support, and technological implementation. PMID:25593572

'Walking the tightrope': The role of peer support workers in facilitating consumers' participation in decision-making.

PubMed

Cleary, Michelle; Raeburn, Toby; Escott, Phil; West, Sancia; Lopez, Violeta

2018-05-09

In adult mental health services, the participation of consumers is essential. The aim of this study was to explore the challenges faced by peer support workers when involving mental health consumers in decision-making about their care and the strategies they employed to overcome these challenges so as to improve mental health consumers' participation in decision-making and recovery. Semi-structured individual interviews were conducted with six peer support workers currently employed in psychiatric hospitals and/or community mental health systems. Thematic analysis identified challenges related to role definition, power imbalance, doctor-centric medical approaches to care, and lack of resources. Strategies to overcome these challenges that were reported, included the following: facilitating meaningful involvement for service users, appropriate use of the lived experience, building relationships and communication, promoting rights and advocacy, and promoting professionalism of peer support workers (PSWs). Nursing staff need ongoing support and education to understand and value the varied roles of PSWs and thereby empower PSWs to engage in enhancing consumer decision-making. The roles of the PSWs should be viewed as complementary, and greater appreciation and understanding of roles would better support recovery-oriented care. © 2018 Australian College of Mental Health Nurses Inc.

Tools for Interdisciplinary Data Assimilation and Sharing in Support of Hydrologic Science

NASA Astrophysics Data System (ADS)

Blodgett, D. L.; Walker, J.; Suftin, I.; Warren, M.; Kunicki, T.

2013-12-01

Information consumed and produced in hydrologic analyses is interdisciplinary and massive. These factors put a heavy information management burden on the hydrologic science community. The U.S. Geological Survey (USGS) Office of Water Information Center for Integrated Data Analytics (CIDA) seeks to assist hydrologic science investigators with all-components of their scientific data management life cycle. Ongoing data publication and software development projects will be presented demonstrating publically available data access services and manipulation tools being developed with support from two Department of the Interior initiatives. The USGS-led National Water Census seeks to provide both data and tools in support of nationally consistent water availability estimates. Newly available data include national coverages of radar-indicated precipitation, actual evapotranspiration, water use estimates aggregated by county, and South East region estimates of streamflow for 12-digit hydrologic unit code watersheds. Web services making these data available and applications to access them will be demonstrated. Web-available processing services able to provide numerous streamflow statistics for any USGS daily flow record or model result time series and other National Water Census processing tools will also be demonstrated. The National Climate Change and Wildlife Science Center is a USGS center leading DOI-funded academic global change adaptation research. It has a mission goal to ensure data used and produced by funded projects is available via web services and tools that streamline data management tasks in interdisciplinary science. For example, collections of downscaled climate projections, typically large collections of files that must be downloaded to be accessed, are being published using web services that allow access to the entire dataset via simple web-service requests and numerous processing tools. Recent progress on this front includes, data web services for Climate Model Intercomparison Phase 5 based downscaled climate projections, EPA's Integrated Climate and Land Use Scenarios projections of population and land cover metrics, and MODIS-derived land cover parameters from NASA's Land Processes Distributed Active Archive Center. These new services and ways to discover others will be presented through demonstration of a recently open-sourced project from a web-application or scripted workflow. Development and public deployment of server-based processing tools to subset and summarize these and other data is ongoing at the CIDA with partner groups such as 52 Degrees North and Unidata. The latest progress on subsetting, spatial summarization to areas of interest, and temporal summarization via common-statistical methods will be presented.

The road to pharmacist prescribing in Alberta Health Services.

PubMed

Gray, Margaret; Mysak, Tania

2016-09-15

The implementation of policy within a health organization to support a new legislative and regulatory framework of pharmacist prescribing in the Canadian province of Alberta is described. The evolution of pharmacists' practice activities to encompass medication management through independent prescribing authority has occurred in many jurisdictions around the world. In 2007, Alberta pharmacists were granted the most progressive scope of practice in all of North America. Pursuant to a series of legislative and regulatory initiatives enacted since 2000, the provincial health authority, Alberta Health Services (AHS), has worked to (1) establish a policy framework that supports pharmacist prescribing, (2) provide opportunities for pharmacist prescribing in both inpatient and ambulatory care practice environments, and (3) provide motivation and resources for AHS pharmacists to acquire "additional prescribing authorization" (APA) that enables them to independently prescribe and manage patients' ongoing drug therapy. Pharmacists with APA currently are permitted to prescribe all medications requiring a prescription, with the exception of opiates and other controlled substances; efforts to expand pharmacist prescribing to include those medications are ongoing. Currently, nearly half of all AHS pharmacists have APA. The health authority plans to make APA a standard expectation for all clinical pharmacists working in collaborative practice settings. Opportunities provided to Alberta pharmacists by legislation have been embraced by the provincial health authority. The AHS leadership remains committed to ensuring that its pharmacists practice to the full extent of their scope of practice and actively encourages and supports them in their efforts to provide optimal patient care. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Internet Tomography in Support of Internet and Network Simulation and Emulation Modelling

NASA Astrophysics Data System (ADS)

Moloisane, A.; Ganchev, I.; O'Droma, M.

Internet performance measurement data extracted through Internet Tomography techniques and metrics and how it may be used to enhance the capacity of network simulation and emulation modelling is addressed in this paper. The advantages of network simulation and emulation as a means to aid design and develop the component networks, which make up the Internet and are fundamental to its ongoing evolution, are highlighted. The Internet's rapid growth has spurred development of new protocols and algorithms to meet changing operational requirements such as security, multicast delivery, mobile networking, policy management, and quality of service (QoS) support. Both the development and evaluation of these operational tools requires the answering of many design and operational questions. Creating the technical support required by network engineers and managers in their efforts to seek answers to these questions is in itself a major challenge. Within the Internet the number and range of services supported continues to grow exponentially, from legacy and client/server applications to VoIP, multimedia streaming services and interactive multimedia services. Services have their own distinctive requirements and idiosyncrasies. They respond differently to bandwidth limitations, latency and jitter problems. They generate different types of “conversations” between end-user terminals, back-end resources and middle-tier servers. To add to the complexity, each new or enhanced service introduced onto the network contends for available bandwidth with every other service. In an effort to ensure networking products and resources being designed and developed handling diverse conditions encountered in real Internet environments, network simulation and emulation modelling is a valuable tool, and becoming a critical element, in networking product and application design and development. The better these laboratory tools reflect real-world environment and conditions the more helpful to designers they will be.

Good practice in social care: the views of people with severe and complex needs and those who support them.

PubMed

Gridley, Kate; Brooks, Jenni; Glendinning, Caroline

2014-11-01

This paper reports findings drawn from a study of good practice in English social care for adults with disability and older people with severe and complex needs. People with severe and complex needs are a relatively small proportion of adult social care service users, but they are growing in numbers and have resource-intensive needs. The study involved qualitative research with adults with disability and older people with severe and complex needs, family carers and members of specialist organisations (n = 67), focusing on the features of social care services they considered to be good practice. Data were collected between August 2010 and June 2011. The approach to data collection was flexible, to accommodate participants' communication needs and preferences, including face-to-face and telephone interviews, Talking Mats(©) sessions and a focus group. Data were managed using Framework and analysed thematically. Features of good practice were considered at three levels: (i) everyday support; (ii) service organisation; and (iii) commissioning. Findings relating to the first two of these are presented here. Participants emphasised the importance of person-centred ways of working at all levels. Personalisation, as currently implemented in English social care, aims to shift power from professionals to service users through the allocation of personal budgets. This approach focuses very much on the role of the individual in directing his/her own support arrangements. However, participants in this study also stressed the importance of ongoing professional support, for example, from a specialist key worker or case manager to co-ordinate diverse services and ensure good practice at an organisational level. The paper argues that, despite the recent move to shift power from professionals to service users, people with the most complex needs still value support from professionals and appropriate organisational support. Without these, they risk being excluded from the benefits that personalisation, properly supported, could yield. © 2014 John Wiley & Sons Ltd.

Foreign aid or foreign investments: call for a paradigm shift in mentality and nomenclature

PubMed Central

Oleribe, Obinna Ositadimma; Nwanwanyu, Okey

2015-01-01

Funding for health care programs has over the years been an important challenge for health and health care services. However with the advent of financing, part of this problem was resolved. Through these investments, lives were saved, many destinies recovered and some obsolete systems reengineered. Major proofs of these expenditures are number of people reached and sometimes number of sites opened/supported, which in several cases, are not entirely verifiable. Sustainable development from these funds is limited, and far and in between. This is despite the fact that supports for health care and health care services have been ongoing for more than 60 years. As long as these funds are seen as aids to developing countries, they will continue to fail to achieve their primary objectives. But looking at these as investments in supported countries will significantly improve the outcome, health system impacts, as well as engineer sustainable health system strengthening and improvement. Such a re-branding will reduce the politics of support, improve effectiveness and efficiency in the use of the resources, and empower receiving nations towards better health systems. PMID:26113945

Foreign aid or foreign investments: call for a paradigm shift in mentality and nomenclature.

PubMed

Oleribe, Obinna Ositadimma; Nwanwanyu, Okey

2015-01-01

Funding for health care programs has over the years been an important challenge for health and health care services. However with the advent of financing, part of this problem was resolved. Through these investments, lives were saved, many destinies recovered and some obsolete systems reengineered. Major proofs of these expenditures are number of people reached and sometimes number of sites opened/supported, which in several cases, are not entirely verifiable. Sustainable development from these funds is limited, and far and in between. This is despite the fact that supports for health care and health care services have been ongoing for more than 60 years. As long as these funds are seen as aids to developing countries, they will continue to fail to achieve their primary objectives. But looking at these as investments in supported countries will significantly improve the outcome, health system impacts, as well as engineer sustainable health system strengthening and improvement. Such a re-branding will reduce the politics of support, improve effectiveness and efficiency in the use of the resources, and empower receiving nations towards better health systems.

Human Connectome Project Informatics: quality control, database services, and data visualization

PubMed Central

Marcus, Daniel S.; Harms, Michael P.; Snyder, Abraham Z.; Jenkinson, Mark; Wilson, J Anthony; Glasser, Matthew F.; Barch, Deanna M.; Archie, Kevin A.; Burgess, Gregory C.; Ramaratnam, Mohana; Hodge, Michael; Horton, William; Herrick, Rick; Olsen, Timothy; McKay, Michael; House, Matthew; Hileman, Michael; Reid, Erin; Harwell, John; Coalson, Timothy; Schindler, Jon; Elam, Jennifer S.; Curtiss, Sandra W.; Van Essen, David C.

2013-01-01

The Human Connectome Project (HCP) has developed protocols, standard operating and quality control procedures, and a suite of informatics tools to enable high throughput data collection, data sharing, automated data processing and analysis, and data mining and visualization. Quality control procedures include methods to maintain data collection consistency over time, to measure head motion, and to establish quantitative modality-specific overall quality assessments. Database services developed as customizations of the XNAT imaging informatics platform support both internal daily operations and open access data sharing. The Connectome Workbench visualization environment enables user interaction with HCP data and is increasingly integrated with the HCP's database services. Here we describe the current state of these procedures and tools and their application in the ongoing HCP study. PMID:23707591

A narrative review of mental health support for people during transition from incarceration to community: the grass can be greener on the other side of the fence.

PubMed

Smith-Merry, Jennifer; Mellifont, Damian; McKenzie, Kirsty; Clenaghan, Paul

2018-04-28

Despite significant need for mental health services targeting the requirements of inmates transitioning into the community there is little research about successful recovery-oriented or person-centred transition programs. This systematic narrative review brings together existing evidence to inform policymakers and practitioners about current practice in transition support, and barriers and facilitators of effective practice. We carried out a systematic narrative review of recovery-oriented or person-centred mental health support programs supporting transition from incarceration to the community. Results were obtained from a systematic search of Medline, PubMed and Scopus databases. We found 23 papers which met the paper inclusion criteria along with four other papers which were identified incidentally. Identified barriers to the implementation of effective transition support programs are: administrative problems leading to ineffective in-reach into correctional facilities or untimely support, lack of support for immediate needs meaning that inmates deprioritise their mental health needs, a lack of ongoing program resources and poor communication between correctional facilities and mental health services. Enablers for transition reflect the inverse of these barriers, alongside other successful strategies including medical home models, regionalised programs, programs which target connections with primary care, nurse-led patient-centred health programs and peer support initiatives.

Informing mental health policies and services in the EMR: cost-effective deployment of human resources to deliver integrated community-based care.

PubMed

Ivbijaro, G; Patel, V; Chisholm, D; Goldberg, D; Khoja, T A M; Edwards, T M; Enum, Y; Kolkiewic, L A

2015-09-28

For EMR countries to deliver the expectations of the Global Mental Health Action Plan 2013-2020 & the ongoing move towards universal health coverage, all health & social care providers need to innovate and transform their services to provide evidence-based health care that is accessible, cost-effective & with the best patient outcomes. For the primary and community workforce, this includes general medical practitioners, practice & community nurses, community social workers, housing officers, lay health workers, nongovernmental organizations & civil society, including community spiritual leaders/healers. This paper brings together the current best evidence to support transformation & discusses key approaches to achieve this, including skill mix and/or task shifting and integrated care. The important factors that need to be in place to support skill mix/task shifting and good integrated care are outlined with reference to EMR countries.

mobilityRERC state of the science conference: Considerations for developing an evidence base for wheeled mobility and seating service delivery.

PubMed

Cohen, Laura; Greer, Nancy; Berliner, Elise; Sprigle, Stephen

2013-11-01

This article, developed as background content for discussion during the Mobility Rehabilitation Engineering Research Center State of the Science Conference, reviews research surrounding wheeled mobility and seating (WMS) service delivery, discusses the challenges of improving clinical decision-making, and discusses research approaches used to study and improve health services in other practice areas that might be leveraged to develop the evidence base for WMS. Narrative literature review. An overview of existing research found general agreement across models of WMS service delivery but little high quality evidence to support the recommended approaches and few studies of the relationship between service delivery steps and individual patient outcomes. The definition of successful clinical decision-making is different for different stakeholders. Clinical decision-making should incorporate the best available evidence along with patient values, preferences, circumstances, and clinical expertise. To advance the evidence base for WMS service delivery, alternatives to randomized controlled trials should be considered and reliable and valid outcome measures developed. Technological advances offer tremendous opportunities for individuals with complex rehabilitation technology needs. However, with ongoing scrutiny of WMS service delivery there is an increased need for evidence to support the clinical decision-making process and to support evidence-based coverage policies for WMS services and technologies. An evidence base for wheeled mobility and seating services is an important component of the clinical decision-making process. At present, there is little evidence regarding essential components of the wheeled mobility and seating evaluation or the relationship between the evaluation process and patient outcomes. Many factors can confound this relationship and present challenges to research in this area. All stakeholders (i.e. clinicians, rehabilitation technology suppliers, manufacturers, researchers, payers, policy makers, and wheelchair users) need to work together to develop and support an evidence base for wheeled mobility and seating service delivery.

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

Electrical service reliability: the customer perspective

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

Samsa, M.E.; Hub, K.A.; Krohm, G.C.

1978-09-01

Electric-utility-system reliability criteria have traditionally been established as a matter of utility policy or through long-term engineering practice, generally with no supportive customer cost/benefit analysis as justification. This report presents results of an initial study of the customer perspective toward electric-utility-system reliability, based on critical review of over 20 previous and ongoing efforts to quantify the customer's value of reliable electric service. A possible structure of customer classifications is suggested as a reasonable level of disaggregation for further investigation of customer value, and these groups are characterized in terms of their electricity use patterns. The values that customers assign tomore » reliability are discussed in terms of internal and external cost components. A list of options for effecting changes in customer service reliability is set forth, and some of the many policy issues that could alter customer-service reliability are identified.« less

The role of the neonatal nurse practitioner in the community hospital level I nursery.

PubMed

Hatch, Julie

2012-01-01

Neonatal nurse practitioners (NNPs) have played a significant role in providing medical coverage to many of the country's Level III neonatal intensive care units (NICUs). Extensive education and experience are required for a nurse practitioner (NP) to become competent in caring for these critically ill newborns. The NNP can take this competence and experience and expand her role out into the community Level I nurseries. Clinical care of the infants and close communication with parents, pediatricians, and the area tertiary center provide a community service with the goal of keeping parents and babies together in the community hospital without compromising the health of the baby. The NNP service, with 24-hour nursery and delivery coverage, supports an ongoing obstetric service to the community hospital. The NNP's experience enables her to provide a neonatal service that encompasses a multitude of advanced practice nursing roles.

Allied health careers special resources and services program: increasing the probabilities of success for 'high risk' students in allied health career programs.

PubMed

Murtha, J P; Grimm, F M

1979-11-01

This article describes a successful developmental program specifically designed for academically "high risk" students entering a two-year community college career program in allied health. The program consisted of providing an intensive three-week instructional program to students before they entered the allied health career program, and subsequently providing an ongoing support system of tutoring, counseling and career development activities. Participants attained higher levels of academic performance and retention than nonparticipants.

Service and education share responsibility for nurses' value development.

PubMed

Schank, M J; Weis, D

2001-01-01

This article examines professional values of senior baccalaureate nursing students and practicing nurses. An important finding was that practicing nurses rated behaviors reflecting values in the American Nurses Association (ANA) Code for Nurses as more important than did senior students, thereby supporting the notion that practice contributes to value formation. The ongoing development and internalization of the nursing professions' values requires active involvement by staff development educators. The phenomena of value formation and development of professional values appear to mirror the novice to expert model.

Proposal for Development of EBM-CDSS (Evidence-Based Clinical Decision Support System) to Aid Prognostication in Terminally Ill Patients

DTIC Science & Technology

2013-10-01

monthly basis. The similar process is followed at TGH, where the research team mostly works with palliative care service. Through this process, the... Palliative Care at TGH. • We continue to regularly conduct meetings with TGH palliative care team and present the ongoing experience of our research study...to the TGH palliative care team. These meeting established a fruitful and trustful and working relationship with TGH palliative care team, which is

Partnering to run a community-based program for deaf-blind young adults.

PubMed

Riester, A E

1992-12-01

Community-based programs that assist deaf-blind young adults with living skills can be a cost effective alternative to institutional care. Their unique medical, psychosocial training, and daily living needs require services and support from a variety of agencies and providers. The elements and concepts necessary to conduct a program 24 hours a day for young adults who are deaf and blind includes sound management, realistic staff expectations for clients, developmentally appropriate activities, family participation in planning accessible medical and psychological services, and close collaboration with universities and community organizations. Management must also be sensitive to the emotional concerns of the staff and provide ongoing opportunities for supervision and training.

Introduction to the special section on communication and wartime deployment.

PubMed

Maguire, Katheryn C; Wilson, Steven R

2013-01-01

Over the past decade, the wars in Iraq and Afghanistan have taken a heavy toll on the physical, psychological, and relational health of military service members and their families. The articles included in this special section of Health Communication add to the robust, interdisciplinary body of research on the health consequences of wartime deployment by examining how communication enables the recovery process of service members and their families. Because communication processes can signal health problems, construct and promote family resiliency, and shape the content and delivery of health interventions, our discipline's theory and research can help inform ongoing efforts to support military families as the wars in Iraq and Afghanistan wind down.

Space-Based Information Services

NASA Astrophysics Data System (ADS)

Lee, C.

With useful data now beginning to flow from earth observation and navigation satellites, it is an active time for the development of space services - all types of satellites are now being put to work, not just Comsats. However derived products require a blend of innovative software design, low cost operational support and a real insight into the information needs of the customer. Science Systems is meeting this challenge through a series of on-going projects, three of which are summarised here (addressing navigation, communications and earth observation). By demonstrating a broad range of related disciplines; from monitoring and control to back-room billing; from data management to intelligent systems, Science Systems hopes to play a key role in this developing market.

Identification and status of design improvements to the NASA Shuttle EMU for International Space Station application.

PubMed

Wilde, R C; McBarron, J W; Faszcza, J J

1997-06-01

To meet the significant increase in EVA demand to support assembly and operations of the International Space Station (ISS), NASA and industry have improved the current Shuttle Extravehicular Mobility Unit (EMU), or "space suit", configuration to meet the unique and specific requirements of an orbital-based system. The current Shuttle EMU was designed to be maintained and serviced on the ground between frequent Shuttle flights. ISS will require the EMUs to meet increased EVAs out of the Shuttle Orbiter and to remain on orbit for up to 180 days without need for regular return to Earth for scheduled maintenance or refurbishment. Ongoing Shuttle EMU improvements have increased reliability, operational life and performance while minimizing ground and on-orbit maintenance cost and expendable inventory. Modifications to both the anthropomorphic mobility elements of the Space Suit Assembly (SSA) as well as to the Primary Life Support System (PLSS) are identified and discussed. This paper also addresses the status of on-going Shuttle EMU improvements and summarizes the approach for increasing interoperability of the U.S. and Russian space suits to be utilized aboard the ISS.

Spatial Data Services for Interdisciplinary Applications from the NASA Socioeconomic Data and Applications Center

NASA Astrophysics Data System (ADS)

Chen, R. S.; MacManus, K.; Vinay, S.; Yetman, G.

2016-12-01

The Socioeconomic Data and Applications Center (SEDAC), one of 12 Distributed Active Archive Centers (DAACs) in the NASA Earth Observing System Data and Information System (EOSDIS), has developed a variety of operational spatial data services aimed at providing online access, visualization, and analytic functions for geospatial socioeconomic and environmental data. These services include: open web services that implement Open Geospatial Consortium (OGC) specifications such as Web Map Service (WMS), Web Feature Service (WFS), and Web Coverage Service (WCS); spatial query services that support Web Processing Service (WPS) and Representation State Transfer (REST); and web map clients and a mobile app that utilize SEDAC and other open web services. These services may be accessed from a variety of external map clients and visualization tools such as NASA's WorldView, NOAA's Climate Explorer, and ArcGIS Online. More than 200 data layers related to population, settlements, infrastructure, agriculture, environmental pollution, land use, health, hazards, climate change and other aspects of sustainable development are available through WMS, WFS, and/or WCS. Version 2 of the SEDAC Population Estimation Service (PES) supports spatial queries through WPS and REST in the form of a user-defined polygon or circle. The PES returns an estimate of the population residing in the defined area for a specific year (2000, 2005, 2010, 2015, or 2020) based on SEDAC's Gridded Population of the World version 4 (GPWv4) dataset, together with measures of accuracy. The SEDAC Hazards Mapper and the recently released HazPop iOS mobile app enable users to easily submit spatial queries to the PES and see the results. SEDAC has developed an operational virtualized backend infrastructure to manage these services and support their continual improvement as standards change, new data and services become available, and user needs evolve. An ongoing challenge is to improve the reliability and performance of the infrastructure, in conjunction with external services, to meet both research and operational needs.

Implementation of nutrition risk screening using the Malnutrition Universal Screening Tool across a large metropolitan health service.

PubMed

Cooper, P L; Raja, R; Golder, J; Stewart, A J; Shaikh, R F; Apostolides, M; Savva, J; Sequeira, J L; Silvers, M A

2016-12-01

A standardised nutrition risk screening (NRS) programme with ongoing education is recommended for the successful implementation of NRS. This project aimed to develop and implement a standardised NRS and education process across the adult bed-based services of a large metropolitan health service and to achieve a 75% NRS compliance at 12 months post-implementation. A working party of Monash Health (MH) dietitians and a nutrition technician revised an existing NRS medical record form consisting of the Malnutrition Universal Screening Tool and nutrition management guidelines. Nursing staff across six MH hospital sites were educated in the use of this revised form and there was a formalised implementation process. Support from Executive Management, nurse educators and the Nutrition Risk Committee ensured the incorporation of NRS into nursing practice. Compliance audits were conducted pre- and post-implementation. At 12 months post-implementation, organisation-wide NRS compliance reached 34.3%. For those wards that had pre-implementation NRS performed by nursing staff, compliance increased from 7.1% to 37.9% at 12 months (P < 0.001). The improved NRS form is now incorporated into standard nursing practice and NRS is embedded in the organisation's 'Point of Care Audit', which is reported 6-monthly to the Nutrition Risk Committee and site Quality and Safety Committees. NRS compliance improved at MH with strong governance support and formalised implementation; however, the overall compliance achieved appears to have been affected by the complexity and diversity of multiple healthcare sites. Ongoing education, regular auditing and establishment of NRS routines and ward practices is recommended to further improve compliance. © 2016 The British Dietetic Association Ltd.

Evidence for the long term cost effectiveness of home care reablement programs.

PubMed

Lewin, Gill F; Alfonso, Helman S; Alan, Janine J

2013-01-01

The objectives of this study were to determine whether older individuals who participated in a reablement (restorative) program rather than immediately receiving conventional home care services had a reduced need for ongoing support and lower home care costs over the next 57 months (nearly 5 years). Data linkage was used to examine retrospectively the service records of older individuals who had received a reablement service versus a conventional home care service to ascertain their use of home care services over time. Individuals who had received a reablement service were less likely to use a personal care service throughout the follow-up period or any other type of home care over the next 3 years. This reduced use of home care services was associated with median cost savings per person of approximately AU $12,500 over nearly 5 years. The inclusion of reablement as the starting point for individuals referred for home care within Australia's reformed aged care system could increase the system's cost effectiveness and ensure that all older Australians have the opportunity to maximize their independence as they age.

ESA SSA Space Radiation Expert Service Centre: the Importance of Community Feedback

NASA Astrophysics Data System (ADS)

Crosby, Norma; Dierckxsens, Mark; Kruglanski, Michel; De Donder, Erwin; Calders, Stijn; Messios, Neophytos; Glover, Alexi

2017-04-01

End-users in a wide range of sectors both in space and on the ground are affected by space weather. In the frame of its Space Situational Awareness (SSA) programme (http://swe.ssa.esa.int/) the European Space Agency (ESA) is establishing a Space Weather (SWE) Service Network to support end-users in three ways: mitigate the effects of space weather on their systems, reduce costs, and improve reliability. Almost 40 expert groups from institutes and organisations across Europe contribute to this Network organised in five Expert Service Centres (ESCs) - Solar Weather, Heliospheric Weather, Space Radiation, Ionospheric Weather, Geomagnetic Conditions. To understand the end-user needs, the ESCs are supported by the SSCC (SSA Space Weather Coordination Centre) that offers first line support to the end-users. Here we present the mission of the Space Radiation ESC (R-ESC) (http://swe.ssa.esa.int/space-radiation) and the space domain services it supports. Furthermore, we describe how the R-ESC project complements past and ongoing projects both on national level as well as international (e.g. EU projects), emphasizing the importance of inter-disciplinary communication between different communities ranging from scientists, engineers to end-users. Such collaboration is needed if basic science is to be used most efficiently for the development of products and tools that provide end-users with what they actually need. Additionally, feedback from the various communities (projects) is also essential when defining future projects.

The COMPOSE Project

NASA Astrophysics Data System (ADS)

Balletta, P.; Biagini, M.; Gallinaro, G.; Vernucci, A.

2003-07-01

This paper provides an overview of the on-going project COMPOSE, an EC co-funded project aiming to define, specify and validate an innovative mobile-services scenario in support of travellers, and to demonstrate the effectiveness of the new proposed location-based value-added services. COMPOSE is supported by organisations belonging to numerous categories covering, as a whole, the entire value-chain of infomobility services provision to the final user. The project team comprises, in addition to the affiliations of the authors, also Teleatlas (NL), ARS T&TT (NL), Alcatel-Bell Space (B), Skysoft (P), Hitech Marketing (A) and MobileGis (IR). The paper describes the services that will be offered to users, encompassing both the pre-trip and the on-trip framework, presents the overall hybrid system architecture also including a via-satellite component based upon the Wideband-CDMA (W-CDMA) technique adopted in UMTS, discusses the access solutions envisaged for that component permitting multiple feeder-link stations to share the CDMA multiplex capacity by directly transmitting their codes to the satellite, and illustrates the results of some computer simulations intended to assess the performance of said access solutions, with regard to the effects of the inevitable up- link frequency errors and transponder non-linearity.

Continuing care and long-term substance use outcomes in managed care: early evidence for a primary care-based model.

PubMed

Chi, Felicia W; Parthasarathy, Sujaya; Mertens, Jennifer R; Weisner, Constance M

2011-10-01

How best to provide ongoing services to patients with substance use disorders to sustain long-term recovery is a significant clinical and policy question that has not been adequately addressed. Analyzing nine years of prospective data for 991 adults who entered substance abuse treatment in a private, nonprofit managed care health plan, this study aimed to examine the components of a continuing care model (primary care, specialty substance abuse treatment, and psychiatric services) and their combined effect on outcomes over nine years after treatment entry. In a longitudinal observational study, follow-up measures included self-reported alcohol and drug use, Addiction Severity Index scores, and service utilization data extracted from the health plan databases. Remission, defined as abstinence or nonproblematic use, was the outcome measure. A mixed-effects logistic random intercept model controlling for time and other covariates found that yearly primary care, and specialty care based on need as measured at the prior time point, were positively associated with remission over time. Persons receiving continuing care (defined as having yearly primary care and specialty substance abuse treatment and psychiatric services when needed) had twice the odds of achieving remission at follow-ups (p<.001) as those without. Continuing care that included both primary care and specialty care management to support ongoing monitoring, self-care, and treatment as needed was important for long-term recovery of patients with substance use disorders.

Implementing OpenMRS for patient monitoring in an HIV/AIDS care and treatment program in rural Mozambique.

PubMed

Manders, Eric-Jan; José, Eurico; Solis, Manuel; Burlison, Janeen; Nhampossa, José Leopoldo; Moon, Troy

2010-01-01

We have adopted the Open Medical Record System (OpenMRS) framework to implement an electronic patient monitoring system for an HIV care and treatment program in Mozambique. The program provides technical assistance to the Ministry of Health supporting the scale up of integrated HIV care and support services in health facilities in rural resource limited settings. The implementation is in use for adult and pediatric programs, with ongoing roll-out to cover all supported sites. We describe early experiences in adapting the system to the program needs, addressing infrastructure challenges, creating a regional support team, training data entry staff, migrating a legacy database, deployment, and current use. We find that OpenMRS offers excellent prospects for in-country development of health information systems, even in severely resource limited settings. However, it also requires considerable organizational infrastructure investment and technical capacity building to ensure continued local support.

Related Services Research for Students With Low-Incidence Disabilities: Implications for Speech-Language Pathologists in Inclusive Classrooms.

PubMed

Giangreco, Michael F

2000-07-01

When speech-language pathologists provide educationally related services for students with lowincidence disabilities who are placed in inclusive classrooms, they are asked to work with a variety of other adults. The ways in which these adults make decisions about individualizing a student's educational program, determine related services, and coordinate their activities have an impact on educational outcomes for students as well as on interprofessional interactions. This article summarizes a team process for making related services decisions called VISTA (Vermont Interdependent Services Team Approach) and a series of nine research studies pertaining to the use and impact of VISTA. It also addresses related topics, such as team size, consumer perspectives, and paraprofessional supports. Five major implications from these studies are offered concerning (a) developing a disposition of being an ongoing learner, (b) developing a shared framework among team members, (c) having a research-based process to build consensus, (d) clarifying roles, and (e) increasing involvement of families and general education teachers.

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.

22q11 deletion syndrome: Parents' and children's experiences of educational and healthcare provision in the United Kingdom.

PubMed

Cohen, Wendy; McCartney, Elspeth; Crampin, Lisa

2017-06-01

22q11 deletion syndrome (22q11DS) is a genetic syndrome, prevalence around 1:4000-1:6000 live births, with a complex array of associated features, impacting on healthcare and educational support. This study reports the perceptions of families and individuals with 22q11DS in relation to these needs. Individuals and families of those with 22q11DS were approached though two national charities - the Max Appeal and 22Crew. An initial observational survey design was used to gather views via questions probing access to healthcare and educational experiences. Thirty-four responses were received and the data subjected to descriptive analysis. Over half of the respondents were diagnosed before the age of 1. Ninety-one percent reported ongoing difficulties with learning at school, compounded by school attendance being compromised as a result of medical interventions. Individuals reported engaging heavily with educational support and a high number of health professions (mean 9.5; mode 10). Age of diagnosis of 22q11DS ranged from birth to nine years. Families had ongoing concerns about aspects of education and healthcare services, and lack of knowledge and awareness of the difficulties faced by individuals with 22q11DS was raised. Healthcare and education providers should be aware of the range of services individuals required on a regular basis so as to provide a more holistic approach to care.

PubMed Central

2012-01-01

The Walt Disney Company has never lost sight of its founder's edict: “Give the public everything you can give them.” From this simple statement, everyone at Disney strives to exceed customer expectations every day. For more than 80 years this singular pursuit of excellence in delivering consistent quality service has earned the Disney organization a world-renowned reputation and ongoing business success. Uncover some of the secrets behind the Disney service culture and processes. In this session, you will examine the time-tested model for delivering world-class Guest service and discover how attention to detail creates a consistent, successful environment for both employees and customers. You can then use these ideas to transform and improve your own organization's delivery of quality service. You will learn how to: Develop an organizational culture that supports consistent delivery of quality service.Evaluate the Disney approach and tailor it to your business.Design quality service standards and processes to raise the level of customer satisfaction.Create metrics to gauge the needs, perceptions and expectations of your customers.Enable employees, settings and processes to convey your quality service commitment.Implement a strategic plan for monitoring the delivery of seamless customer experiences.

Acquisition of Cleanroom Research Equipment to Support Ongoing DoD Programs at ASU

DTIC Science & Technology

2017-12-12

Report: Acquisition of cleanroom research equipment to support ongoing DoD programs at ASU The views, opinions and/or findings contained in this report...documentation. 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS (ES) U.S. Army Research Office P.O. Box 12211 Research Triangle Park, NC 27709...Agreement Number: W911NF-16-1-0354 Organization: Arizona State University Title: Acquisition of cleanroom research equipment to support ongoing DoD

Prehospital Care of Canine Gastric Dilatation and Volvulus.

PubMed

Palmer, Lee E

The intent of the Operational K9 (OpK9) ongoing series is to provide the Special Operations Medical Association community with clinical concepts and scientific information on preventive and prehospital emergency care relevant to the OpK9. Often the only medical support immediately available for an injured or ill OpK9 in the field is their handler or the human Special Operations Combat Medic or civilian tactical medic attached to the team (e.g., Pararescueman, 18D, SWAT medic). The information is applicable to personnel operating within the US Special Operations Command as well as civilian Tactical Emergency Medical Services communities that may have the responsibility of supporting an OpK9. 2018.

ERTS-1 DCS technical support provided by Wallops Station. [ground truth stations and DCP repair depot

NASA Technical Reports Server (NTRS)

Smith, R.

1975-01-01

Wallops Station accepted the tasks of providing ground truth to several ERTS investigators, operating a DCP repair depot, designing and building an airborne DCP Data Acquisition System, and providing aircraft underflight support for several other investigators. Additionally, the data bank is generally available for use by ERTS and other investigators that have a scientific interest in data pertaining to the Chesapeake Bay area. Working with DCS has provided a means of evaluating the system as a data collection device possibly applicable to ongoing Earth Resources Program activities in the Chesapeake Bay area as well as providing useful data and services to other ERTS investigators. The two areas of technical support provided by Wallops, ground truth stations and repair for DCPs, are briefly discussed.

Software Reuse Methods to Improve Technological Infrastructure for e-Science

NASA Technical Reports Server (NTRS)

Marshall, James J.; Downs, Robert R.; Mattmann, Chris A.

2011-01-01

Social computing has the potential to contribute to scientific research. Ongoing developments in information and communications technology improve capabilities for enabling scientific research, including research fostered by social computing capabilities. The recent emergence of e-Science practices has demonstrated the benefits from improvements in the technological infrastructure, or cyber-infrastructure, that has been developed to support science. Cloud computing is one example of this e-Science trend. Our own work in the area of software reuse offers methods that can be used to improve new technological development, including cloud computing capabilities, to support scientific research practices. In this paper, we focus on software reuse and its potential to contribute to the development and evaluation of information systems and related services designed to support new capabilities for conducting scientific research.

The Impact of Evidence-Based Practice Implementation and Fidelity Monitoring on Staff Turnover: Evidence for a Protective Effect

ERIC Educational Resources Information Center

Aarons, Gregory A.; Sommerfeld, David H.; Hecht, Debra B.; Silovsky, Jane F.; Chaffin, Mark J.

2009-01-01

Staff retention is an ongoing challenge in mental health and community-based service organizations. Little is known about the impact of evidence-based practice implementation on the mental health and social service workforce. The present study examined the effect of evidence-based practice implementation and ongoing fidelity monitoring on staff…

'The greatest feeling you get, knowing you have made a big difference': survey findings on the motivation and experiences of trained volunteer doulas in England.

PubMed

Spiby, Helen; Mcleish, Jenny; Green, Josephine; Darwin, Zoe

2016-09-29

Support from a doula is known to have physical and emotional benefits for mothers, but there is little evidence about the experiences of volunteer doulas. This research aimed to understand the motivation and experiences of volunteer doulas who have been trained to support women during pregnancy, birth and the postnatal period. A postal questionnaire survey was sent to volunteer doulas at five volunteer doula projects working in low-income areas in England. Quantitative and qualitative data were analysed in parallel using summary statistics and content analysis respectively. Eighty-nine volunteer doulas (response rate 34.5 %) from diverse backgrounds responded to the survey. Major motivators for volunteering included a desire to help others and, to a lesser extent, factors related to future employment. Most reported that the training was effective preparation for their role. They continued volunteering because they derived satisfaction from the doula role, and valued its social aspects. Their confidence, skills, employability and social connectedness had all increased, but many found the ending of the doula-mother relationship challenging. For a minority, negative aspects of their experience included time waiting to be allocated women to support and dissatisfaction with the way the doula service was run. Most respondents found the experience rewarding. To maintain doulas' motivation as volunteers, services should: ensure doulas can start supporting women as soon as possible after completing the training; consider the merits of more flexible endings to the support relationship; offer opportunities for ongoing mutual support with other doulas, and ensure active support from service staff for volunteers.

Continuity through best practice: design and implementation of a nurse-led community leg-ulcer service.

PubMed

Lorimer, Karen

2004-06-01

The design of the new service was intended to facilitate continuity. The results after the first year of the new service revealed that care was both more effective and more efficient for all types of leg ulcers (Harrison, Graham, Friedberg, & Lorimer, 2003). Healing rates had dramatically improved, the frequency of nursing visits decreased, and supply costs declined. With the new service, comprehensive standardized assessments are made at baseline on all new admissions for home leg-ulcer care, and reassessments are regularly scheduled if the condition does not improve. With the evidence-based protocol, all providers and sectors of care are "working from the same script." Specific information is obtained on the client's health history, leg-ulcer history, preferences, and social context. Continuity is further facilitated through implementation of the primary nurse model, whereby one provider is responsible for developing the care plan and for subsequent evaluation and revision. Management continuity is advanced through health-care reorganization, with the development of an expert, dedicated nursing team, a consistent approach to training and skill development, improved coordination, an interdisciplinary approach for referral and consultation, and continuous quality improvement measures for education and practice audit. A number of strategies tailored to the new service have been highly effective. Strategic alliances among the researchers, home-care authority, nursing agency, nurses, and physicians are essential to the success of both design and implementation. Ongoing interdisciplinary and intersectoral communication expedites the referral process and helps to resolve issues as they develop. The majority of physicians have been very supportive of the use of the protocol and the evidence-based service. Surveys of care recipients have been mostly positive. Nurses who have been surveyed concerning the supports to implementation of the evidence-based service have indicated the following supports: ongoing education, nursing knowledge, a supportive clinical leader, support from two specialist physicians (a dermatologist and a vascular surgeon), a dedicated nursing team, positive outcomes (improved healing rates), and regional home care and agency support. The greatest challenge has been establishing and maintaining the dedicated nursing team. Continuity is served when nurses are assigned exclusively to the leg-ulcer team, where they can continue to build expertise and skills. The nursing agency was initially reluctant to embrace the concept of a dedicated team, as it viewed wound care as a general function of all nurses. Many of the nurses trained in leg-ulcer care fulfilled a number of other specialized nursing functions. This had resource implications for the nursing agency, as other nurses needed training in various other specialized skills. There should be a balance between the size of the population being served and the size of the team, in order to maintain efficiency and sufficient exposure to skilful assessment and management of leg-ulcer care. During the first year of the leg-ulcer service a number of nurses were lost from the team for various reasons, including: outside opportunities for career advancement, the physical demands of this type of care, retirement, moving from the area, and lack of job security. In addition, the volume of nursing visits was decreased because of Ontario government cutbacks in the area of home-care services. New staff members on the team were laid off in the context of a unionized environment. The lack of long-term security and the reality of lower wages in the community sector have played havoc with recruitment and retention. A recently formed committee at the nursing agency on continuity of care, with representation from nursing, management, and administration, has identified a number of further barriers to continuity. These include fluctuating caseloads, difficulty attracting nurses to the community sector, and a unionized environment in which senior nurses displace junior nurses on low-caseload days. Strategies aimed at overcoming the barriers to continuity have been identified and are being implemented. Our experience confirms the need for evidence-based planning in order to understand the needs of the population with leg ulcers, current practices, and the organization of care prior to the restructuring of service delivery. The extensive needs assessment indicated the need for broad system changes in addition to adjustments in clinical care in order to meet best-practice guidelines. Despite ongoing barriers, the service model has improved continuity and dramatically increased the effectiveness and efficiency of leg-ulcer care in one community.

Service use and costs for persons experiencing chronic homelessness in Philadelphia: a population-based study.

PubMed

Poulin, Stephen R; Maguire, Marcella; Metraux, Stephen; Culhane, Dennis P

2010-11-01

This study is the first to examine the distribution of service utilization and costs with a population-based sample that experienced chronic homelessness in sheltered and unsheltered locations in a large U.S. city. This study used shelter and street outreach records from a large U.S. city to identify 2,703 persons who met federal criteria for chronic homelessness during a three-year period. Identifiers for these persons were matched to administrative records for psychiatric care, substance abuse treatment, and incarceration. Twenty percent of the persons who incurred the highest costs for services accounted for 60% of the total service costs of approximately $20 million a year (or approximately $12 million). Most of the costs for this quintile were for psychiatric care and jail stays. Eighty-one percent of the persons in the highest quintile had a diagnosis of a serious mental illness, and 83% of the persons in the lowest quintile had a history of substance abuse treatment without a diagnosis of a serious mental illness. Supportive housing models for people with serious mental illness who experience chronic homelessness may be associated with substantial cost offsets, because the use of acute care services diminishes in an environment of housing stability and access to ongoing support services. However, because persons with substance use issues and no recent history of mental health treatment used relatively fewer and less costly services, cost neutrality for these persons may require less service-intensive programs and smaller subsidies.

Smartkadaster: Observing Beyond Traditional Cadastre Capabilities for Malaysia

NASA Astrophysics Data System (ADS)

Isa, M. N. Bin; Hua, T. C.; Halim, N. Z. Binti Abdul

2015-10-01

The digital age for cadastral surveying started in stages, more than 20 years ago in Malaysia and JUPEM played a vital role in its successful implementation nationwide. One of the key products of cadastral survey is cadastral maps, which provide useful information for any land information system. However, as technology evolved and simplicity is familiarised, better services are anticipated and have affected how cadastral survey information are perceived. A paradigm shift is necessary where enriched cadastral information is required for multiple usage and allow real cadastral information based services to users. On that note, JUPEM is intrigued to develop a system where National Digital Cadastral Database is value added with other geospatial information for a smart and multipurpose environment and clearly be interpreted as a decision making tool with the aids of 3D realistic spatial data, namely SmartKADASTER. The SmartKADASTER is an ongoing project developed by JUPEM with the aim to establish a realistic and SMART cadastral-based spatial analysis platform for an effective planning, decision making, enabling efficiencies and enhancing communication and management to support SMART services towards SMART City enablement in Malaysia. It is developed in phases with the Federal Territory of Putrajaya and Kuala Lumpur as the initial project implementation area. This paper provides awareness and insights of the on-going development of the project and how it could benefit potential users and stakeholders.

Application of management tools to integrate ecological principles with the design of marine infrastructure.

PubMed

Dafforn, Katherine A; Mayer-Pinto, Mariana; Morris, Rebecca L; Waltham, Nathan J

2015-08-01

Globally the coastal zone is suffering the collateral damage from continuing urban development and construction, expanding resource sectors, increasing population, regulation to river flow, and on-going land change and degradation. While protection of natural coastal habitat is recommended, balancing conservation with human services is now the challenge for managers. Marine infrastructure such as seawalls, marinas and offshore platforms is increasingly used to support and provide services, but has primarily been designed for engineering purposes without consideration of the ecological consequences. Increasingly developments are seeking alternatives to hard engineering and a range of ecological solutions has begun to replace or be incorporated into marine and coastal infrastructure. But too often, hard engineering remains the primary strategy because the tools for managers to implement ecological solutions are either lacking or not supported by policy and stakeholders. Here we outline critical research needs for marine urban development and emerging strategies that seek to mitigate the impacts of marine infrastructure. We present case studies to highlight the strategic direction necessary to support management decisions internationally. Copyright © 2015 Elsevier Ltd. All rights reserved.

The LIFEspan model of transitional rehabilitative care for youth with disabilities: healthcare professionals' perspectives on service delivery.

PubMed

Hamdani, Yani; Proulx, Meghann; Kingsnorth, Shauna; Lindsay, Sally; Maxwell, Joanne; Colantonio, Angela; Macarthur, Colin; Bayley, Mark

2014-01-01

LIFEspan is a service delivery model of continuous coordinated care developed and implemented by a cross-organization partnership between a pediatric and an adult rehabilitation hospital. Previous work explored enablers and barriers to establishing the partnership service. This paper examines healthcare professionals' (HCPs') experiences of 'real world' service delivery aimed at supporting transitional rehabilitative care for youth with disabilities. This qualitative study - part of an ongoing mixed method longitudinal study - elicited HCPs' perspectives on their experiences of LIFEspan service delivery through in-depth interviews. Data were categorized into themes of service delivery activities, then interpreted from the lens of a service integration/coordination framework. Five main service delivery themes were identified: 1) addressing youth's transition readiness and capacities; 2) shifting responsibility for healthcare management from parents to youth; 3) determining services based on organizational resources; 4) linking between pediatric and adult rehabilitation services; and, 5) linking with multi-sector services. LIFEspan contributed to service delivery activities that coordinated care for youth and families and integrated inter-hospital services. However, gaps in service integration with primary care, education, social, and community services limited coordinated care to the rehabilitation sector. Recommendations are made to enhance service delivery using a systems/sector-based approach.

An explanatory model of community pharmacists' support in the secondary prevention of cardiovascular disease.

PubMed

Puspitasari, Hanni P; Costa, Daniel S J; Aslani, Parisa; Krass, Ines

2016-01-01

Community pharmacists have faced ongoing challenges in the delivery of clinical pharmacy services. Various attitudinal and environmental factors have been found to be associated with the provision of general clinical pharmacy services or services which focus on a specific condition, including cardiovascular disease (CVD). However, the interrelationship and relative influence of explanatory factors has not been investigated. To develop a model illustrating influences on CVD support provision by community pharmacists. Mail surveys were sent to a random sample of 1350 Australian community pharmacies to investigate determinants of CVD support provision. A theoretical model modified from the Theory of Planned Behavior (TPB) was used as a framework for the survey instrument. Structural equation modeling was used to determine how pharmacists' attitudes and environmental factors influence CVD support. A response rate of 15.8% (209/1320) was obtained. The model for CVD support provision by community pharmacists demonstrated good fit: χ(2)/df = 1.403, RMSEA = 0.047 (90% CI = 0.031-0.062), CFI = 0.962, TLI = 0.955 and WRMR = 0.838. Factors found to predict CVD support included: two attitudinal latent factors ("subjective norms of pharmacists' role in CVD support" and "pharmacists' perceived responsibilities in CVD support") and environmental factors i.e. pharmacy infrastructure (documentation and a private area), workload, location; government funded pharmacy practice programs; and pharmacists' involvement with Continuing Professional Development and attendance at CVD courses. Pharmacists' attitudes appeared to be the strongest predictor of CVD support provision. The TPB framework was useful in identifying "subjective norms" and "pharmacists' beliefs" as key constructs of community pharmacists' attitudes. Community pharmacies would be able to provide such an advanced clinical service if they strongly believed that this was an acknowledged part of their scope of practice, had adequate infrastructure and employed sufficient numbers of pharmacists with appropriate and relevant knowledge. Copyright © 2016 Elsevier Inc. All rights reserved.

Autonomous RPOD Technology Challenges for the Coming Decade

NASA Technical Reports Server (NTRS)

Naasz, Bo J.; Moreau, Michael C.

2012-01-01

Rendezvous Proximity Operations and Docking (RPOD) technologies are important to a wide range of future space endeavors. This paper will review some of the recent and ongoing activities related to autonomous RPOD capabilities and summarize the current state of the art. Gaps are identified where future investments are necessary to successfully execute some of the missions likely to be conducted within the next ten years. A proposed RPOD technology roadmap that meets the broad needs of NASA's future missions will be outlined, and ongoing activities at OSFC in support of a future satellite servicing mission are presented. The case presented shows that an evolutionary, stair-step technology development program. including a robust campaign of coordinated ground tests and space-based system-level technology demonstration missions, will ultimately yield a multi-use main-stream autonomous RPOD capability suite with cross-cutting benefits across a wide range of future applications.

Integrating Containers in the CERN Private Cloud

NASA Astrophysics Data System (ADS)

Noel, Bertrand; Michelino, Davide; Velten, Mathieu; Rocha, Ricardo; Trigazis, Spyridon

2017-10-01

Containers remain a hot topic in computing, with new use cases and tools appearing every day. Basic functionality such as spawning containers seems to have settled, but topics like volume support or networking are still evolving. Solutions like Docker Swarm, Kubernetes or Mesos provide similar functionality but target different use cases, exposing distinct interfaces and APIs. The CERN private cloud is made of thousands of nodes and users, with many different use cases. A single solution for container deployment would not cover every one of them, and supporting multiple solutions involves repeating the same process multiple times for integration with authentication services, storage services or networking. In this paper we describe OpenStack Magnum as the solution to offer container management in the CERN cloud. We will cover its main functionality and some advanced use cases using Docker Swarm and Kubernetes, highlighting some relevant differences between the two. We will describe the most common use cases in HEP and how we integrated popular services like CVMFS or AFS in the most transparent way possible, along with some limitations found. Finally we will look into ongoing work on advanced scheduling for both Swarm and Kubernetes, support for running batch like workloads and integration of container networking technologies with the CERN infrastructure.

Evaluating Long-term Outcomes of NHS Stop Smoking Services (ELONS): a prospective cohort study.

PubMed

Dobbie, Fiona; Hiscock, Rosemary; Leonardi-Bee, Jo; Murray, Susan; Shahab, Lion; Aveyard, Paul; Coleman, Tim; McEwen, Andy; McRobbie, Hayden; Purves, Richard; Bauld, Linda

2015-11-01

NHS Stop Smoking Services (SSSs) provide free at the point of use treatment for smokers who would like to stop. Since their inception in 1999 they have evolved to offer a variety of support options. Given the changes that have happened in the provision of services and the ongoing need for evidence on effectiveness, the Evaluating Long-term Outcomes for NHS Stop Smoking Services (ELONS) study was commissioned. The main aim of the study was to explore the factors that determine longer-term abstinence from smoking following intervention by SSSs. There were also a number of additional objectives. The ELONS study was an observational study with two main stages: secondary analysis of routine data collected by SSSs and a prospective cohort study of service clients. The prospective study had additional elements on client satisfaction, well-being and longer-term nicotine replacement therapy (NRT) use. The setting for the study was SSSs in England. For the secondary analysis, routine data from 49 services were obtained. For the prospective study and its added elements, nine services were involved. The target population was clients of these services. There were 202,804 cases included in secondary analysis and 3075 in the prospective study. A combination of behavioural support and stop smoking medication delivered by SSS practitioners. Abstinence from smoking at 4 and 52 weeks after setting a quit date, validated by a carbon monoxide (CO) breath test. Just over 4 in 10 smokers (41%) recruited to the prospective study were biochemically validated as abstinent from smoking at 4 weeks (which was broadly comparable with findings from the secondary analysis of routine service data, where self-reported 4-week quit rates were 48%, falling to 34% when biochemical validation had occurred). At the 1-year follow-up, 8% of prospective study clients were CO validated as abstinent from smoking. Clients who received specialist one-to-one behavioural support were twice as likely to have remained abstinent than those who were seen by a general practitioner (GP) practice and pharmacy providers [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.2 to 4.6]. Clients who received group behavioural support (either closed or rolling groups) were three times more likely to stop smoking than those who were seen by a GP practice or pharmacy providers (OR 3.4, 95% CI 1.7 to 6.7). Satisfaction with services was high and well-being at baseline was found to be a predictor of abstinence from smoking at longer-term follow-up. Continued use of NRT at 1 year was rare, but no evidence of harm from longer-term use was identified from the data collected. Stop Smoking Services in England are effective in helping smokers to move away from tobacco use. Using the 52-week CO-validated quit rate of 8% found in this study, we estimate that in the year 2012-13 the services supported 36,249 clients to become non-smokers for the remainder of their lives. This is a substantial figure and provides one indicator of the ongoing value of the treatment that the services provide. The study raises a number of issues for future research including (1) examining the role of electronic cigarettes (e-cigarettes) in smoking cessation for service clients [this study did not look at e-cigarette use (except briefly in the longer-term NRT study) but this is a priority for future studies]; (2) more detailed comparisons of rolling groups with other forms of behavioural support; (3) further exploration of the role of practitioner knowledge, skills and use of effective behaviour change techniques in supporting service clients to stop smoking; (4) surveillance of the impact of structural and funding changes on the future development and sustainability of SSSs; and (5) more detailed analysis of well-being over time between those who successfully stop smoking and those who relapse. Further research on longer-term use of non-combustible nicotine products that measures a wider array of biomarkers of smoking-related harm such as lung function tests or carcinogen metabolites. The National Institute for Health Research Health Technology Assessment programme. The UK Centre for Tobacco and Alcohol Studies provided funding for the longer-term NRT study.

A cluster randomized trial to evaluate external support for the implementation of positive behavioral interventions and supports by school personnel

PubMed Central

2014-01-01

Background Urban schools lag behind non-urban schools in attending to the behavioral health needs of their students. This is especially evident with regard to the level of use of evidence-based interventions with school children. Increased used of evidence-based interventions in urban schools would contribute to reducing mental health services disparities in low-income communities. School-wide positive behavioral interventions and supports (SWPBIS) is a service delivery framework that can be used to deliver universal preventive interventions and evidence-based behavioral health treatments, such as group cognitive behavioral therapy. In this article, we describe our ongoing research on creating internal capacity for program implementation. We also examine the cost-effectiveness and resulting school climate when two different levels of external support are provided to personnel as they implement a two-tier SWPBIS program. Methods/Design The study follows six K – 8 schools in the School District of Philadelphia randomly assigned to consultation support or consultation-plus-coaching support. Participants are: approximately 48 leadership team members, 180 school staff and 3,900 students in Tier 1, and 12 counselors, and 306 child participants in Tier 2. Children who meet inclusion criteria for Tier 2 will participate in group cognitive behavioral therapy for externalizing or anxiety disorders. The study has three phases, baseline/training, implementation, and sustainability. We will measure implementation outcomes, service outcomes, child outcomes, and cost. Discussion Findings from this study will provide evidence as to the appropriateness of school-wide prevention and treatment service delivery models for addressing services disparities in schools. The effectiveness and cost-effectiveness analyses of the two levels of training and consultation should help urban school districts and policymakers with the planning and deployment of cost-effective strategies for the implementation of evidence-based interventions for some of the most common behavioral health problems in school children. Trial registration ClinicalTrials.gov identifier: NCT01941069 PMID:24428904

A cluster randomized trial to evaluate external support for the implementation of positive behavioral interventions and supports by school personnel.

PubMed

Eiraldi, Ricardo; McCurdy, Barry; Khanna, Muniya; Mautone, Jennifer; Jawad, Abbas F; Power, Thomas; Cidav, Zuleyha; Cacia, Jaclyn; Sugai, George

2014-01-15

Urban schools lag behind non-urban schools in attending to the behavioral health needs of their students. This is especially evident with regard to the level of use of evidence-based interventions with school children. Increased used of evidence-based interventions in urban schools would contribute to reducing mental health services disparities in low-income communities. School-wide positive behavioral interventions and supports (SWPBIS) is a service delivery framework that can be used to deliver universal preventive interventions and evidence-based behavioral health treatments, such as group cognitive behavioral therapy. In this article, we describe our ongoing research on creating internal capacity for program implementation. We also examine the cost-effectiveness and resulting school climate when two different levels of external support are provided to personnel as they implement a two-tier SWPBIS program. The study follows six K - 8 schools in the School District of Philadelphia randomly assigned to consultation support or consultation-plus-coaching support. Participants are: approximately 48 leadership team members, 180 school staff and 3,900 students in Tier 1, and 12 counselors, and 306 child participants in Tier 2. Children who meet inclusion criteria for Tier 2 will participate in group cognitive behavioral therapy for externalizing or anxiety disorders. The study has three phases, baseline/training, implementation, and sustainability. We will measure implementation outcomes, service outcomes, child outcomes, and cost. Findings from this study will provide evidence as to the appropriateness of school-wide prevention and treatment service delivery models for addressing services disparities in schools. The effectiveness and cost-effectiveness analyses of the two levels of training and consultation should help urban school districts and policymakers with the planning and deployment of cost-effective strategies for the implementation of evidence-based interventions for some of the most common behavioral health problems in school children. ClinicalTrials.gov identifier: NCT01941069.

Barriers and facilitators of linkage to HIV care among HIV-infected young Chinese men who have sex with men: a qualitative study.

PubMed

Li, Haochu; Wei, Chongyi; Tucker, Joseph; Kang, Dianmin; Liao, Meizhen; Holroyd, Eleanor; Zheng, Jietao; Qi, Qian; Ma, Wei

2017-03-16

The Four Free and One Care Policy (HIV/AIDS-related free services) has been in place in China since 2004. However, linkage to human immunodeficiency virus (HIV) care is not yet achieved very well among people living with HIV. We conducted a qualitative study to explore individual and contextual factors that may influence a linkage to HIV care from the perspective of young HIV-infected men who have sex with men (MSM) in a highly centralized HIV care context of China. Purposive sampling was used to recruit 21 HIV-infected MSM in Shandong Province, with in-depth interviews conducted between March and July 2015. Thematic content analysis was subsequently used for data analysis. Key barriers and facilitators related to a linkage to HIV care emerged from participants' narratives. The barriers included perceived healthy status, low health literacy, and stigma associated with receiving HIV care. The facilitators included an awareness of responsibility, knowledge associated with health literacy, social support, and trusting and relying on services provided by the Center for Disease Control and Prevention (CDC) and the government. These were related to the quality of current HIV counselling and testing, service promotion, and the cost and placement of these HIV services. In order to improve the MSM linkage to HIV care in China, it is imperative to improve the quality of the current on-going counselling and testing. Further critical linkage support includes increasing supportive services among local CDC systems, designated hospitals and community-based organizations (CBOs), and more financial support for HIV/AIDS related testing, medical checkups and treatments.

Traffic Flow Management and Optimization

NASA Technical Reports Server (NTRS)

Rios, Joseph Lucio

2014-01-01

This talk will present an overview of Traffic Flow Management (TFM) research at NASA Ames Research Center. Dr. Rios will focus on his work developing a large-scale, parallel approach to solving traffic flow management problems in the national airspace. In support of this talk, Dr. Rios will provide some background on operational aspects of TFM as well a discussion of some of the tools needed to perform such work including a high-fidelity airspace simulator. Current, on-going research related to TFM data services in the national airspace system and general aviation will also be presented.

Cyberinfrastructure for Aircraft Mission Support

NASA Technical Reports Server (NTRS)

Freudinger, Lawrence C.

2010-01-01

Forth last several years NASA's Airborne Science Program has been developing and using infrastructure and applications that enable researchers to interact with each other and with airborne instruments via network communications. Use of these tools has increased near realtime situational awareness during field operations, resulting it productivity improvements, improved decision making, and the collection of better data. Advances in pre-mission planning and post-mission access have also emerged. Integrating these capabilities with other tools to evolve coherent service-oriented enterprise architecture for aircraft flight and test operations is the subject of ongoing efforts.

Working with families of children with special needs: the parent adviser scheme.

PubMed

Buchan, L; Clemerson, J; Davis, H

1988-01-01

This paper describes a project in which an attempt is made to provide regular, ongoing support and counselling for families of children with severe developmental delays and intellectual or physical impairments. This service is available to both English speaking and Bangladeshi families, and is concerned with the needs of the whole family, not just the child. Professionals already working in this field are trained in counselling skills and then work in partnership with the families, attempting to develop a respectful, open relationship based upon active listening.

A Clinical Librarian-Nursing Partnership to Bridge Clinical Practice and Research in an Oncology Setting.

PubMed

Ginex, Pamela K; Hernandez, Marisol; Vrabel, Mark

2016-09-01

Nurses in clinical settings in which evidence-based, individualized care is expected are often the best resource to identify important clinical questions and gaps in practice. These nurses are frequently challenged by a lack of resources to fully develop their questions and identify the most appropriate methods to answer them. A strategic and ongoing partnership between medical library services and nursing can support nurses as they embark on the process of answering these questions and, ultimately, improving patient care and clinical outcomes

2017 National Standards for Diabetes Self-Management Education and Support.

PubMed

Beck, Joni; Greenwood, Deborah A; Blanton, Lori; Bollinger, Sandra T; Butcher, Marcene K; Condon, Jo Ellen; Cypress, Marjorie; Faulkner, Priscilla; Fischl, Amy Hess; Francis, Theresa; Kolb, Leslie E; Lavin-Tompkins, Jodi M; MacLeod, Janice; Maryniuk, Melinda; Mensing, Carolé; Orzeck, Eric A; Pope, David D; Pulizzi, Jodi L; Reed, Ardis A; Rhinehart, Andrew S; Siminerio, Linda; Wang, Jing

2018-02-01

Purpose The purpose of this study is to review the literature for Diabetes Self-Management Education and Support (DSMES) to ensure the National Standards for DSMES (Standards) align with current evidence-based practices and utilization trends. Methods The 10 Standards were divided among 20 interdisciplinary workgroup members. Members searched the current research for diabetes education and support, behavioral health, clinical, health care environment, technical, reimbursement, and business practice for the strongest evidence that guided the Standards revision. Results Diabetes Self-Management Education and Support facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. The evidence indicates that health care providers and people affected by diabetes are embracing technology, and this is having a positive impact of DSMES access, utilization, and outcomes. Conclusion Quality DSMES continues to be a critical element of care for all people with diabetes. The DSMES services must be individualized and guided by the concerns, preferences, and needs of the person affected by diabetes. Even with the abundance of evidence supporting the benefits of DSMES, it continues to be underutilized, but as with other health care services, technology is changing the way DSMES is delivered and utilized with positive outcomes.

2017 National Standards for Diabetes Self-Management Education and Support.

PubMed

Beck, Joni; Greenwood, Deborah A; Blanton, Lori; Bollinger, Sandra T; Butcher, Marcene K; Condon, Jo Ellen; Cypress, Marjorie; Faulkner, Priscilla; Fischl, Amy Hess; Francis, Theresa; Kolb, Leslie E; Lavin-Tompkins, Jodi M; MacLeod, Janice; Maryniuk, Melinda; Mensing, Carolé; Orzeck, Eric A; Pope, David D; Pulizzi, Jodi L; Reed, Ardis A; Rhinehart, Andrew S; Siminerio, Linda; Wang, Jing

2017-10-01

Purpose The purpose of this study is to review the literature for Diabetes Self-Management Education and Support (DSMES) to ensure the National Standards for DSMES (Standards) align with current evidence-based practices and utilization trends. Methods The 10 Standards were divided among 20 interdisciplinary workgroup members. Members searched the current research for diabetes education and support, behavioral health, clinical, health care environment, technical, reimbursement, and business practice for the strongest evidence that guided the Standards revision. Results Diabetes Self-Management Education and Support facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. The evidence indicates that health care providers and people affected by diabetes are embracing technology, and this is having a positive impact of DSMES access, utilization, and outcomes. Conclusion Quality DSMES continues to be a critical element of care for all people with diabetes. The DSMES services must be individualized and guided by the concerns, preferences, and needs of the person affected by diabetes. Even with the abundance of evidence supporting the benefits of DSMES, it continues to be underutilized, but as with other health care services, technology is changing the way DSMES is delivered and utilized with positive outcomes.

Evaluation of the Dawson College Shooting Psychological Intervention: Moving Toward a Multimodal Extensive Plan

PubMed Central

Séguin, Monique; Chawky, Nadia; Lesage, Alain; Boyer, Richard; Guay, Stéphane; Bleau, Pierre; Miquelon, Paule; Szkrumelak, Nadia; Steiner, Warren; Roy, Denise

2013-01-01

In 2006, following the shooting at Dawson College, the authorities implemented an intervention plan. This provided an opportunity to analyze the responses to services offered, and afforded a learning opportunity, which led to the proposal of an extensive multimodal short- and long-term psychological plan for future needs. Both quantitative and qualitative data were gathered 18 months after the event, involving the participation of 948 students and staff. Mental health problems and the perception of services offered after the shooting were investigated, using standardized measures. Second, focus groups and individual interviews were conducted among a subgroup of participants (support team members; teachers and employees; students and parents) and permitted to gather data on services received and services required. Individual report of events, the extent of psychological impact and services offered and received were analyzed in terms of the following dimensions: intervention philosophy, training, ongoing offer of services and finally, detection and outreach. A significant incidence of disorders and a high rate of exacerbation of preexisting mental disorders were observed within the 18 months following the shooting. Postimmediate and short-term intervention appeared adequate, but the long-term collective vision toward community support and availability of mental health services were lacking. Lessons learned from this evaluation and other school shootings suggest that preparedness and long-term community responses are often overlooked. A multimodal extensive plan is proposed based on a theoretical model from which interventions strategies could be drawn. PMID:24795790

Characteristics of HIV Care and Treatment in PEPFAR-Supported Sites

PubMed Central

Filler, Scott; Berruti, Andres A.; Menzies, Nick; Berzon, Rick; Ellerbrock, Tedd V.; Ferris, Robert; Blandford, John M.

2011-01-01

Background The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has supported the extension of HIV care and treatment to 2.4 million individuals by September 2009. With increasing resources targeted toward scale-up, it is important to understand the characteristics of current PEPFAR-supported HIV care and treatment sites. Methods Forty-five sites in Botswana, Ethiopia, Nigeria, Uganda, and Vietnam were sampled. Data were collected retrospectively from successive 6-month periods of site operations, through reviews of facility records and interviews with site personnel between April 2006 and March 2007. Facility size and scale-up rate, patient characteristics, staffing models, clinical and laboratory monitoring, and intervention mix were compared. Results Sites added a median of 293 patients per quarter. By the evaluation’s end, sites supported a median of 1,649 HIV patients, 922 of them receiving antiretroviral therapy (ART). Patients were predominantly adult (97.4%) and the majority (96.5%) were receiving regimens based on nonnucleoside reverse transcriptase inhibitors (NNRTIs). The ratios of physicians to patients dropped substantially as sites matured. ART patients were commonly seen monthly or quarterly for clinical and laboratory monitoring, with CD4 counts being taken at 6-month intervals. One-third of sites provided viral load testing. Cotrimoxazole prophylaxis was the most prevalent supportive service. Conclusions HIV treatment sites scaled up rapidly with the influx of resources and technical support through PEPFAR, providing complex health services to progressively expanding patient cohorts. Human resources are stretched thin, and delivery models and intervention mix differ widely between sites. Ongoing research is needed to identify best-practice service delivery models. PMID:21346585

Aboriginal parent support: A partnership approach.

PubMed

Munns, Ailsa; Toye, Christine; Hegney, Desley; Kickett, Marion; Marriott, Rhonda; Walker, Roz

2018-02-01

This study was positioned within a larger action research study relating to a peer-led Aboriginal home visiting parent support program in an urban Western Australian setting. The aims for this study component were to identify program elements, exploring participants' perceptions of the program's suitability, feasibility, acceptability and effectiveness to inform program model recommendations and add to the body of knowledge on effective Aboriginal peer-led program models. The ability of Aboriginal parents to develop positive family environments is crucial, with parent support needing to be reflexive to local needs and sociocultural influences. Culturally appropriate service provision needs meaningful and acceptable strategies. This study was situated within a critical paradigm supporting Participatory Action Research methodology, using Action Learning Sets as the participant engagement and data collection setting. Within ten Action Learning Sets, focus group interviews were carried out with Aboriginal peer support workers, a non-Aboriginal parent support worker, an Aboriginal program coordinator, an Aboriginal education support officer and non-Aboriginal program managers (n = 8), and individual interviews with parents (n = 2) and community agencies (n = 4). Data were analysed using thematic analysis. Five themes were derived from peer support worker and community agency cohorts: peer support worker home visiting skills; responding to impacts of social determinants of health; client support and engagement; interagency collaboration; and issues addressing program sustainability. Parent responses augmented these themes. Participants identified five key elements relating to peer-led home visiting support for Aboriginal parents. These are uniquely placed to inform ongoing program development as there is little additional evidence in wider national and international contexts. Engagement with communities and peer support workers to develop culturally relevant partnerships with Aboriginal families is integral to contemporary child health practice. Ongoing nurse support is needed for peer support worker role development. Indigenous Australian peoples are people who identify as Aboriginal or Torres Strait Islander. Respectfully, throughout this paper, they will be described as Aboriginal. © 2017 John Wiley & Sons Ltd.

Outreach: the western New York Hospital Library Services Program, 1985-1989.

PubMed Central

Birkinbine, L A; Bertuca, C A

1991-01-01

The Hospital Library Services Program (HLSP) in western New York, during the period covered by its first five-year plan, 1984-1989, is recounted and described. This ongoing program is funded annually by a New York State grant and hospital participation fees. It is designed to support access to biomedical information for health care professionals through a grant program for hospitals with staffed libraries and a circuit program for hospitals without library staffing or without libraries. Hospitals participating in the grant program contribute funds and receive grants for collection development. Hospitals participating in the circuit program pay a participation fee and receive regularly scheduled, documented, circuit librarian visits; a collection development grant; and a grant for contract library services. The program contracts with the State University of New York at Buffalo's (UB) Health Sciences Library to provide computerized literature searches; interlibrary loan (ILL) of journal articles, books, and audiovisuals; and ILL referrals. PMID:1958912

Reducing chronic obstructive pulmonary disease readmissions: the role of the durable medical equipment provider.

PubMed

Messenger, Robert W

2012-01-01

Exacerbation and frequent rehospitalization in chronic obstructive pulmonary disease exacts a heavy toll on the US health care system. To address these issues, new initiatives have been proposed that are largely based on financial penalties to promote patient education and postdischarge care. However, as laudable as these goals are, improving outcomes in the chronic obstructive pulmonary disease population is more confounding than it may first appear. Chronic hypoxia, cognitive dysfunction, poor nutrition, and economic disadvantage are just a few of the challenges that require creative solutions and ongoing support. Case managers need to utilize all the potential products and services that can assist in improving outcomes for these patients. Durable medical equipment providers are often viewed as purveyors of medical equipment that offer little in the form of clinical support. However, in many cases these providers represent an overlooked resource that provides individualized, highly structured patient education and ongoing support programs. The challenge is in identifying those durable medical equipment providers that offer patients contemporary technology, and have both the resources and the commitment to provide patient support that is amenable to the goals of the hospital. This article reviews many of the confounding issues that contribute to the frequent rehospitalization of chronic obstructive pulmonary disease patients. Recommendations to improve patient education and oxygen therapy outcomes are provided along with suggestions to aid in the vetting of durable medical equipment providers. Acute care hospitals, long-term acute care hospitals, extended care facilities, integrated delivery systems. 1. An understanding of the complex variables that play in the management of chronic obstructive pulmonary disease will help the case manager to plan an effective course of care. 2. Case managers need to ensure that patients receive long-term oxygen technology that supports their lifestyle, promotes compliance, and ultimately achieves the desired outcomes. 3. Case managers must advocate for coordinated, ongoing patient education and stress the need for continuing reinforcement. 4. Case managers must ensure that patients under their care be matched with durable medical equipment providers that provide the technology and support that favors positive clinical outcomes.

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.

What makes a house a home? An evaluation of a supported housing project for individuals with long-term psychiatric backgrounds.

PubMed

Boydell, K M; Everett, B

1992-01-01

Supported housing (as distinct from supportive housing) emphasizes the values of consumer choice; independence; participation; permanence; normalcy; and flexible, ongoing supports. As a model, it has only recently become popular in the literature and therefore little is known of its effectiveness in serving people with long-term psychiatric backgrounds. In 1989, Homeward Projects, a community mental health agency located in Metropolitan Toronto, established a supported housing project. Homeward included an evaluative component in its program from the outset. In order to give equal weight to the tenants' opinions, both quantitative and qualitative methodologies were employed. In the quantitative component, residential milieu, social support, and service delivery were examined. The qualitative component involved an ethnographic study which allowed the tenants to voice their experiences of living in such a setting. Results provided a rich understanding of the model. Overall, the tenants eventually came to describe their house as a home.

Clinicians, security and information technology support services in practice settings--a pilot study.

PubMed

Fernando, Juanita

2010-01-01

This case study of 9 information technology (IT) support staff in 3 Australian (Victoria) public hospitals juxtaposes their experiences at the user-level of eHealth security in the Natural Hospital Environment with that previously reported by 26 medical, nursing and allied healthcare clinicians. IT support responsibilities comprised the entire hospital, of which clinician eHealth security needs were only part. IT staff believed their support tasks were often fragmented while work responsibilities were hampered by resources shortages. They perceived clinicians as an ongoing security risk to private health information. By comparison clinicians believed IT staff would not adequately support the private and secure application of eHealth for patient care. Preliminary data analysis suggests the tension between these cohorts manifests as an eHealth environment where silos of clinical work are disconnected from silos of IT support work. The discipline-based silos hamper health privacy outcomes. Privacy and security policies, especially those influencing the audit process, will benefit by further research of this phenomenon.

From prevention to nursing home care: a comprehensive national audit of stroke care.

PubMed

Horgan, Frances; McGee, Hannah; Hickey, Anne; Whitford, David L; Murphy, Sean; Royston, Maeve; Cowman, Seamus; Shelley, Emer; Conroy, Ronan M; Wiley, Miriam; O'Neill, Desmond

2011-01-01

Many countries are developing national audits of stroke care. However, these typically focus on stroke care from acute event to hospital discharge rather than the full spectrum from prevention to long-term care. We report on a comprehensive national audit of stroke care in the community and hospitals in the Republic of Ireland. The findings provide insights into the wider needs of people with stroke and their families, a basis for developing stroke-appropriate health strategies, and a global model for the evaluation of stroke services. Six national surveys were completed: general practitioners (prevention and primary care), hospital organisational and clinical audit of 2,570 consecutive stroke admissions (acute and hospital care), allied health professionals and public health nurses (discharge to community care), nursing homes (needs of patients discharged to long-term care), and patient and carers (post-hospital phase of rehabilitation and ongoing care). The audit identified substantial deficits in a number of areas including primary prevention, emergency assessment/investigation and treatment in hospital, discharge planning, rehabilitation and ongoing secondary prevention, and communication with patients and families. There was a lack of coordination and communication between the acute and community services, with a dearth of therapy services in both home and nursing home settings. This multi-faceted national stroke audit facilitated multiple perspectives on the continuum of stroke prevention and care. An overall synthesis of surveys supports the development of a multidisciplinary perspective in planning the development of comprehensive stroke services at the national level, and may assist in regional and global development of stroke strategies. Copyright © 2011 S. Karger AG, Basel.

42 CFR 460.192 - Ongoing monitoring after trial period.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Federal/State Monitoring § 460.192 Ongoing monitoring after trial period. (a...

An ongoing process: a qualitative study of how the alcohol-dependent free themselves of addiction through progressive abstinence.

PubMed

Yeh, Mei-Yu; Che, Hui-Lian; Wu, Shu-Mei

2009-11-24

Most people being treated for alcoholism are unable to successfully quit drinking within their treatment programs. In few cases do we know the full picture of how abstinence is achieved in Taiwan. We tracked processes of abstinence in alcohol-dependency disorders, based on study evidence and results. This research explores the process of recovery from the viewpoint of the alcohol-dependent. Semi-structured interviews were conducted in two different settings, using purpose sampling, during 2003-2004. The data were analyzed using content analysis. Participants were 32 adults, purposefully selected from an Alcoholics Anonymous group and a psychiatric hospital in North Taiwan. We found that the abstinence process is an ongoing process, in which the alcohol-dependent free themselves of addiction progressively. This process never ends or resolves in complete recovery. We have identified three stages in the struggle against alcoholism: the Indulgence, Ambivalence and Attempt (IAA) cycle, in which the sufferer is trapped in a cycle of attempting to give up and failing; the Turning Point, in which a Personal Nadir is reached, and the Ongoing Process of abstinence, in which a constant effort is made to remain sober through willpower and with the help of support groups. We also discuss Influencing Factors that can derail abstinence attempts, pushing the sufferer back into the IAA cycle. This study provides important points of reference for alcohol and drug service workers and community healthcare professionals in Taiwan, casting light on the abstinence process and providing a basis for intervention or rehabilitation services.

An ongoing process: A qualitative study of how the alcohol-dependent free themselves of addiction through progressive abstinence

PubMed Central

2009-01-01

Background Most people being treated for alcoholism are unable to successfully quit drinking within their treatment programs. In few cases do we know the full picture of how abstinence is achieved in Taiwan. We tracked processes of abstinence in alcohol-dependency disorders, based on study evidence and results. This research explores the process of recovery from the viewpoint of the alcohol-dependent. Methods Semi-structured interviews were conducted in two different settings, using purpose sampling, during 2003-2004. The data were analyzed using content analysis. Participants were 32 adults, purposefully selected from an Alcoholics Anonymous group and a psychiatric hospital in North Taiwan. Results We found that the abstinence process is an ongoing process, in which the alcohol-dependent free themselves of addiction progressively. This process never ends or resolves in complete recovery. We have identified three stages in the struggle against alcoholism: the Indulgence, Ambivalence and Attempt (IAA) cycle, in which the sufferer is trapped in a cycle of attempting to give up and failing; the Turning Point, in which a Personal Nadir is reached, and the Ongoing Process of abstinence, in which a constant effort is made to remain sober through willpower and with the help of support groups. We also discuss Influencing Factors that can derail abstinence attempts, pushing the sufferer back into the IAA cycle. Conclusion This study provides important points of reference for alcohol and drug service workers and community healthcare professionals in Taiwan, casting light on the abstinence process and providing a basis for intervention or rehabilitation services. PMID:19930698

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.

Eliciting Provider and Patient Perspectives on New Obesity Management Services in a Team-Based Primary Care Organization.

PubMed

Royall, Dawna; Brauer, Paula; Atta-Konadu, Edwoba; Dwyer, John J M; Edwards, A Michelle; Hussey, Tracy; Kates, Nick

2017-09-01

Both providers and patients may have important insights to inform the development of obesity prevention and management services in Canadian primary care settings. In this formative study, insights for new obesity management services were sought from both providers and patients in 1 progressive citywide organization (150 physicians, team services, separate offices). Seven focus groups with interprofessional health providers (n = 56) and 4 focus groups with patients (n = 34) were conducted. Two clinical vignettes (adult, child) were used to focus discussion. Four analysts coded for descriptive content and interpretative themes on possible tools and care processes using NVivo. Participants identified numerous strategies for care processes, most of which could be categorized into 1 or more of 11 themes: 6 directed at clinical care of patients (raising awareness, screening, clinical care, skill building, ongoing support, and social/peer support) and 5 directed at the organization (coordination/collaboration, creating awareness among health professionals, adding new expertise to the team, marketing, and lobbying/advocacy). The approach was successful in generating an extensive list of diverse activities to be considered for implementation studies. Both patients and providers identified that multiple strategies and systems approaches will be needed to address obesity management in primary care.

KSC-2013-3081

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068284 - John Elbon, vice president for Space Exploration for The Boeing Company, addresses the media before the unveiling of a CST-100 mock-up at the company's Houston Product Support Center. This test version is optimized to support five crew members and will allow the company to evaluate crew safety, interfaces, communications, maneuverability and ergonomics. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

KSC-2013-3089

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068324 - Kathy Lueders, NASA deputy manager for the Commercial Crew Program, is interviewed by the media during the unveiling of a CST-100 mock-up at the company's Houston Product Support Center. This test version is optimized to support five crew members and will allow the company to evaluate crew safety, interfaces, communications, maneuverability and ergonomics. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

KSC-2013-3083

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068290 - Kathy Lueders, NASA deputy manager for the Commercial Crew Program, addresses the media before the unveiling of a CST-100 mock-up at the company's Houston Product Support Center. This test version is optimized to support five crew members and will allow the company to evaluate crew safety, interfaces, communications, maneuverability and ergonomics. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

KSC-2013-3084

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068296 - John Mulholland, vice president and program manager, Commercial Crew, for The Boeing Company, addresses the media before the unveiling of a CST-100 mock-up at the company's Houston Product Support Center. This test version is optimized to support five crew members and will allow the company to evaluate crew safety, interfaces, communications, maneuverability and ergonomics. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

KSC-2013-3082

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068287 - John Elbon, vice president for Space Exploration for The Boeing Company, addresses the media before the unveiling of a CST-100 mock-up at the company's Houston Product Support Center. This test version is optimized to support five crew members and will allow the company to evaluate crew safety, interfaces, communications, maneuverability and ergonomics. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

Work environment stressors, social support, anxiety, and depression among secondary school teachers.

PubMed

Mahan, Pamela L; Mahan, Michael P; Park, Na-Jin; Shelton, Christie; Brown, Kathleen C; Weaver, Michael T

2010-05-01

Work environment stress, a salient health and safety issue for secondary school teachers, school administrators, parents, and students, was examined in 168 teachers from two urban and five suburban high schools. The purpose of this study was to examine relationships between ongoing and episodic stressors and anxiety and depression, as well as the extent to which anxiety and depression may be predicted by stressors and coworker and supervisor support. The Ongoing Stressor Scale (OSS) and the Episodic Stressor Scale (ESS), the Coworker and Supervisor Contents of Communication Scales (COCS), the State Anxiety inventory (S-Anxiety), and the Center for Epidemiological Studies Depression Scale (CES-D) were used to measure the variables. Ongoing and episodic stressors were significantly and positively associated with anxiety and depression. Ongoing stressors and coworker support were significant in explaining anxiety and depression among secondary school teachers. Coworker support had an inverse relationship to anxiety and depression.

KSC-2013-3092

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068344 - NASA astronaut Randy Bresnik gets into position in The Boeing Company's CST-100 spacecraft for a fit check evaluation at the company's Houston Product Support Center. Bresnik's fit check will help evaluate a crew's maneuverability in the spacecraft and test communications. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

KSC-2013-3088

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068317 - NASA astronaut Serena Aunon exits The Boeing Company's CST-100 spacecraft following a fit check evaluation at the company's Houston Product Support Center. Aunon's fit check will help evaluate a crew's maneuverability in the spacecraft and test communications. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

KSC-2013-3080

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068269 - NASA astronaut Serena Aunon prepares to enter The Boeing Company's CST-100 spacecraft for a fit check evaluation at the company's Houston Product Support Center. Aunon's fit check will help evaluate a crew's maneuverability in the spacecraft and test communications. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

KSC-2013-3091

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068333 - NASA astronaut Randy Bresnik prepares to enter The Boeing Company's CST-100 spacecraft for a fit check evaluation at the company's Houston Product Support Center. Bresnik's fit check will help evaluate a crew's maneuverability in the spacecraft and test communications. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

KSC-2013-3078

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068260 - NASA astronaut Serena Aunon suits up for a fit check evaluation of The Boeing Company's CST-100 spacecraft at the company's Houston Product Support Center. Aunon's fit check will help evaluate a crew's maneuverability in the spacecraft and test communications. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

Exploring which patients without return of spontaneous circulation following ventricular fibrillation out-of-hospital cardiac arrest should be transported to hospital?

PubMed

Stub, Dion; Nehme, Ziad; Bernard, Stephen; Lijovic, Marijana; Kaye, David M; Smith, Karen

2014-03-01

Currently many emergency medical services (EMS) that provide advanced cardiac life support (ACLS) at scene do not routinely transport out-of-hospital cardiac arrest (OHCA) patients without sustained return of spontaneous circulation (ROSC). This is due to logistical difficulties and historical poor outcomes. However, new technology for mechanical chest compression has made transport to hospital safer and extracorporeal membrane oxygenation during cardiopulmonary resuscitation (ECPR) enabling further intervention, may result in ROSC. We aimed to explore the characteristics and outcomes of patients with OHCA who were transported to hospital with ongoing CPR in the absence of ROSC, who might benefit from this new technology. The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for adult OHCA with an initial shockable rhythm between 2003 and 2012. There were 5593 OHCA meeting inclusion criteria. Analysis was performed on 3095 (55%) of patients who did not achieve sustained ROSC in the field. Of these only 589 (20%) had ongoing CPR to hospital. There was a significant decline in rates of transport over the study period. Predictors of transport with ongoing CPR included younger patients, decreased time to first shock and intermittent ROSC prior to transport. Survival to hospital discharge occurred in 52 (9%) of patients who had ongoing CPR to hospital. In an EMS that provides ACLS at scene, patients without ROSC in the field who receive CPR to hospital have poor outcomes. Developing a system which provides safe transport with ongoing CPR to a hospital that provides ECPR, should be considered. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Developing cessation interventions for the social and community service setting: a qualitative study of barriers to quitting among disadvantaged Australian smokers.

PubMed

Bryant, Jamie; Bonevski, Billie; Paul, Christine; O'Brien, Jon; Oakes, Wendy

2011-06-24

Smoking rates remain unacceptably high among individuals who are socially disadvantaged. Social and community service organisations (SCSO) are increasingly interested in providing smoking cessation support to clients, however little is known about the best way to assist disadvantaged smokers to quit in this setting. This study aimed to explore barriers and facilitators to quitting within the conceptual framework of the PRECEDE model to identify possible interventions appropriate to the social and community service setting. Semi-structured focus groups were conducted with clients attending five community welfare organisations located in New South Wales, Australia. Thirty-two clients participated in six focus groups. A discussion guide was used to explore the barriers and facilitators to smoking and smoking cessation including: current smoking behaviour, motivation to quit, past quit attempts, barriers to quitting and preferences for cessation support. Focus groups were audio-taped, transcribed and analysed using thematic analysis techniques. Participants were current smokers and most expressed a desire to quit. Factors predisposing continued smoking included perceived benefits of smoking for stress relief, doubting of ability to quit, fear of gaining weight, and poor knowledge and scepticism about available quit support. The high cost of nicotine replacement therapy was a barrier to its use. Continual exposure to smoking in personal relationships and in the community reinforced smoking. Participants expressed a strong preference for personalised quit support. Disadvantaged smokers in Australia express a desire to quit smoking, but find quitting difficult for a number of reasons. SCSOs may have a role in providing information about the availability of quit support, engaging disadvantaged smokers with available quit support, and providing personalised, ongoing support.

Habilitation Services for Developmentally Disabled Persons.

ERIC Educational Resources Information Center

Flexer, Robert W.

1983-01-01

Developmental disabilities are reviewed from the standpoint of definition, service systems, and interventions. Definitions from relevant laws outline population characteristics and required services. Intensive, comprehensive, coordinated ongoing delivery mechanisms are emphasized, including vocational, residential, and generic services. General…

Using computer decision support systems in NHS emergency and urgent care: ethnographic study using normalisation process theory

PubMed Central

2013-01-01

Background Information and communication technologies (ICTs) are often proposed as ‘technological fixes’ for problems facing healthcare. They promise to deliver services more quickly and cheaply. Yet research on the implementation of ICTs reveals a litany of delays, compromises and failures. Case studies have established that these technologies are difficult to embed in everyday healthcare. Methods We undertook an ethnographic comparative analysis of a single computer decision support system in three different settings to understand the implementation and everyday use of this technology which is designed to deal with calls to emergency and urgent care services. We examined the deployment of this technology in an established 999 ambulance call-handling service, a new single point of access for urgent care and an established general practice out-of-hours service. We used Normalization Process Theory as a framework to enable systematic cross-case analysis. Results Our data comprise nearly 500 hours of observation, interviews with 64 call-handlers, and stakeholders and documents about the technology and settings. The technology has been implemented and is used distinctively in each setting reflecting important differences between work and contexts. Using Normalisation Process Theory we show how the work (collective action) of implementing the system and maintaining its routine use was enabled by a range of actors who established coherence for the technology, secured buy-in (cognitive participation) and engaged in on-going appraisal and adjustment (reflexive monitoring). Conclusions Huge effort was expended and continues to be required to implement and keep this technology in use. This innovation must be understood both as a computer technology and as a set of practices related to that technology, kept in place by a network of actors in particular contexts. While technologies can be ‘made to work’ in different settings, successful implementation has been achieved, and will only be maintained, through the efforts of those involved in the specific settings and if the wider context continues to support the coherence, cognitive participation, and reflective monitoring processes that surround this collective action. Implementation is more than simply putting technologies in place – it requires new resources and considerable effort, perhaps on an on-going basis. PMID:23522021

Service on demand for ISS users

NASA Astrophysics Data System (ADS)

Hüser, Detlev; Berg, Marco; Körtge, Nicole; Mildner, Wolfgang; Salmen, Frank; Strauch, Karsten

2002-07-01

Since the ISS started its operational phase, the need of logistics scenarios and solutions, supporting the utilisation of the station and its facilities, becomes increasingly important. Our contribution to this challenge is a SERVICE On DEMAND for ISS users, which offers a business friendly engineering and logistics support for the resupply of the station. Especially the utilisation by commercial and industrial users is supported and simplified by this service. Our industrial team, consisting of OHB-System and BEOS, provides experience and development support for space dedicated hard- and software elements, their transportation and operation. Furthermore, we operate as the interface between customer and the envisaged space authorities. Due to a variety of tailored service elements and the ongoing servicing, customers can concentrate on their payload content or mission objectives and don't have to deal with space-specific techniques and regulations. The SERVICE On DEMAND includes the following elements: ITR is our in-orbit platform service. ITR is a transport rack, used in the SPACEHAB logistics double module, for active and passive payloads on subrack- and drawer level of different standards. Due to its unique late access and early retrieval capability, ITR increases the flexibility concerning transport capabilities to and from the ISS. RIST is our multi-functional test facility for ISPR-based experiment drawer and locker payloads. The test program concentrates on physical and functional interface and performance testing at the payload developers site prior to the shipment to the integration and launch. The RIST service program comprises consulting, planning and engineering as well. The RIST test suitcase is planned to be available for lease or rent to users, too. AMTSS is an advanced multimedia terminal consulting service for communication with the space station scientific facilities, as part of the user home-base. This unique ISS multimedia kit combines communication technologies, software tools and hardware to provide a simple and cost-efficient access to data from the station, using the interconnection ground subnetwork. BEOLOG is our efficient ground logistics service for the transportation of payload hardware and support equipment from the user location to the launch/landing sites for the ISS service flights and back home. The main function of this service is the planning and organisation of all packaging, handling, storage & transportation tasks according to international rules. In conclusion, we offer novel service elements for logistics ground- and flight-infrastructure, dedicated for ISS users. These services can be easily adapted to the needs of users and are suitable for other μg- platforms as well.

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.

Callers’ attitudes and experiences of UK breastfeeding helpline support

PubMed Central

2013-01-01

Background Breastfeeding peer support, is considered to be a key intervention for increasing breastfeeding duration rates. Whilst a number of national organisations provide telephone based breastfeeding peer support, to date there have been no published evaluations into callers’ experiences and attitudes of this support. In this study we report on the descriptive and qualitative insights provided by 908 callers as part of an evaluation of UK-based breastfeeding helpline(s). Methods A structured telephone interview, incorporating Likert scale responses and open-ended questions was undertaken with 908 callers over May to August, 2011 to explore callers’ experiences of the help and support received via the breastfeeding helpline(s). Results Overall satisfaction with the helpline was high, with the vast majority of callers’ recalling positive experiences of the help and support received. Thematic analysis was undertaken on all qualitative and descriptive data recorded during the evaluation, contextualised within the main areas addressed within the interview schedule in terms of ‘contact with the helplines’; ‘experiences of the helpline service’, ‘perceived effectiveness of support provision’ and ‘impact on caller wellbeing’. Conclusion Callers valued the opportunity for accessible, targeted, non-judgmental and convenient support. Whilst the telephone support did not necessarily influence women’s breastfeeding decisions, the support they received left them feeling reassured, confident and more determined to continue breastfeeding. We recommend extending the helpline service to ensure support can be accessed when needed, and ongoing training and support for volunteers. Further advertising and promotion of the service within wider demographic groups is warranted. PMID:23628104

Location, Location, Location: Characteristics and Services of Long-Stay Home Care Recipients in Retirement Homes Compared to Others in Private Homes and Long-Term Care Homes

PubMed Central

Sinn, Chi-Ling Joanna; Grinchenko, Galina; Blums, Jane; Peirce, Tom; Hirdes, John

2017-01-01

We examine recipients of publicly funded ongoing care in a single Ontario jurisdiction who reside in three different settings: long-stay home care patients in private homes and apartments, other patients in retirement homes and residents of long-term care homes, using interRAI assessment instruments. Among home care patients, those in retirement homes have higher proportions of dementia and moderate cognitive impairment, less supportive informal care systems as well as more personal care and nursing services above those provided by the public home care system, more frequent but shorter home support visits and lower than expected public home care expenditures. These lower expenditures may be because of efficiency of care delivery or by retirement homes providing some services otherwise provided by the public home care system. Although persons in each setting are mostly older adults with high degrees of frailty and medical complexity, long-term care home residents show distinctly higher needs. We estimate that 40% of retirement home residents are long-stay home care patients, and they comprise about one in six of this Community Care Access Centre's long-stay patients. PMID:28277206

Location, Location, Location: Characteristics and Services of Long-Stay Home Care Recipients in Retirement Homes Compared to Others in Private Homes and Long-Term Care Homes.

PubMed

Poss, Jeffrey W; Sinn, Chi-Ling Joanna; Grinchenko, Galina; Blums, Jane; Peirce, Tom; Hirdes, John

2017-02-01

We examine recipients of publicly funded ongoing care in a single Ontario jurisdiction who reside in three different settings: long-stay home care patients in private homes and apartments, other patients in retirement homes and residents of long-term care homes, using interRAI assessment instruments. Among home care patients, those in retirement homes have higher proportions of dementia and moderate cognitive impairment, less supportive informal care systems as well as more personal care and nursing services above those provided by the public home care system, more frequent but shorter home support visits and lower than expected public home care expenditures. These lower expenditures may be because of efficiency of care delivery or by retirement homes providing some services otherwise provided by the public home care system. Although persons in each setting are mostly older adults with high degrees of frailty and medical complexity, long-term care home residents show distinctly higher needs. We estimate that 40% of retirement home residents are long-stay home care patients, and they comprise about one in six of this Community Care Access Centre's long-stay patients. Copyright © 2017 Longwoods Publishing.

Progress of Interoperability in Planetary Research for Geospatial Data Analysis

NASA Astrophysics Data System (ADS)

Hare, T. M.; Gaddis, L. R.

2015-12-01

For nearly a decade there has been a push in the planetary science community to support interoperable methods of accessing and working with geospatial data. Common geospatial data products for planetary research include image mosaics, digital elevation or terrain models, geologic maps, geographic location databases (i.e., craters, volcanoes) or any data that can be tied to the surface of a planetary body (including moons, comets or asteroids). Several U.S. and international cartographic research institutions have converged on mapping standards that embrace standardized image formats that retain geographic information (e.g., GeoTiff, GeoJpeg2000), digital geologic mapping conventions, planetary extensions for symbols that comply with U.S. Federal Geographic Data Committee cartographic and geospatial metadata standards, and notably on-line mapping services as defined by the Open Geospatial Consortium (OGC). The latter includes defined standards such as the OGC Web Mapping Services (simple image maps), Web Feature Services (feature streaming), Web Coverage Services (rich scientific data streaming), and Catalog Services for the Web (data searching and discoverability). While these standards were developed for application to Earth-based data, they have been modified to support the planetary domain. The motivation to support common, interoperable data format and delivery standards is not only to improve access for higher-level products but also to address the increasingly distributed nature of the rapidly growing volumes of data. The strength of using an OGC approach is that it provides consistent access to data that are distributed across many facilities. While data-steaming standards are well-supported by both the more sophisticated tools used in Geographic Information System (GIS) and remote sensing industries, they are also supported by many light-weight browsers which facilitates large and small focused science applications and public use. Here we provide an overview of the interoperability initiatives that are currently ongoing in the planetary research community, examples of their successful application, and challenges that remain.

Effectiveness of an Ongoing, Community-Based Breast Cancer Prevention Program for Korean American Women.

PubMed

Koh, Eun; Choi, Ga-Young; Cho, Ji Young

2016-02-01

The study evaluates the effectiveness of an ongoing, community-based breast cancer prevention program offered by a local social services agency in the Washington, DC, metropolitan area. Korean American women who participated in this breast cancer prevention program were compared with those who did not participate in their knowledge, attitude, and screening behaviors. The study found that the intervention group was more knowledgeable on breast cancer and related services and reported more positive attitudes toward breast cancer screening services than the comparison group. The participants in the intervention group were also more likely to plan to receive a mammogram than those in the comparison group. However, significant differences were not observed in the two groups in their intention to receive a clinical breast examination. The study findings suggest that an ongoing, community-based breast cancer prevention program can be an effective method of addressing breast cancer prevention disparities observed among Korean American women.

On-going collaborative priority-setting for research activity: a method of capacity building to reduce the research-practice translational gap.

PubMed

Cooke, Jo; Ariss, Steven; Smith, Christine; Read, Jennifer

2015-05-07

International policy suggests that collaborative priority setting (CPS) between researchers and end users of research should shape the research agenda, and can increase capacity to address the research-practice translational gap. There is limited research evidence to guide how this should be done to meet the needs of dynamic healthcare systems. One-off priority setting events and time-lag between decision and action prove problematic. This study illustrates the use of CPS in a UK research collaboration called Collaboration and Leadership in Applied Health Research and Care (CLAHRC). Data were collected from a north of England CLAHRC through semi-structured interviews with 28 interviewees and a workshop of key stakeholders (n = 21) including academics, NHS clinicians, and managers. Documentary analysis of internal reports and CLAHRC annual reports for the first two and half years was also undertaken. These data were thematically coded. Methods of CPS linked to the developmental phase of the CLAHRC. Early methods included pre-existing historical partnerships with on-going dialogue. Later, new platforms for on-going discussions were formed. Consensus techniques with staged project development were also used. All methods demonstrated actual or potential change in practice and services. Impact was enabled through the flexibility of research and implementation work streams; 'matched' funding arrangements to support alignment of priorities in partner organisations; the size of the collaboration offering a resource to meet project needs; and the length of the programme providing stability and long term relationships. Difficulties included tensions between being responsive to priorities and the possibility of 'drift' within project work, between academics and practice, and between service providers and commissioners in the health services. Providing protected 'matched' time proved difficult for some NHS managers, which put increasing work pressure on them. CPS is more time consuming than traditional approaches to project development. CPS can produce needs-led projects that are bedded in services using a variety of methods. Contributing factors for effective CPS include flexibility in use and type of available resources, flexible work plans, and responsive leadership. The CLAHRC model provides a translational infrastructure that enables CPS that can impact on healthcare systems.

The battle within: understanding the physiology of war-zone stress exposure.

PubMed

Bruner, Victoria E; Woll, Pamela

2011-01-01

Faced with pervasive loss, life threat, and moral conflict in the field of battle, the human body and brain adapt to extraordinary circumstances in extraordinary ways. These adaptations come at a high price, and many men and women returning from Iraq and Afghanistan are paying that price every day. For the clinician who seeks to help, an understanding of the physiology of war-zone stress and resilience is an essential foundation, both for recovery from post-traumatic stress disorder and other conditions, and for addressing the stigma and shame that keep many service members and veterans from seeking and accepting the help and support they need. This article explores ways in which the body and brain adapt to war-zone stress, resulting challenges, and implications for clinical services and ongoing recovery.

Improving health visitor emollient prescribing using a CQUIN-based approach.

PubMed

Brooks, Christina; Khatau, Tejas

2015-12-01

Prescribing is an essential element of health visiting practice. This initiative used the payment framework of Commissioning for Quality and Innovation (CQUIN) to develop health visiting practice across a large health visiting workforce in the East Midlands. A focus on emollient prescribing practice was agreed and a guidance booklet regarding preferred emollient products was produced, based on the local formulary Each health visitor benefitted from receiving additional training and was given a guidance booklet to inform their practice. Targets were set for each quarter to demonstrate an improved prescribing adherence to the preferred product list.The targets were achieved for each quarter. Prescribing rates and confidence improved across the service. Therefore, it was demonstrated that specific guidance and ongoing support can improve prescribing practice within the health visiting service.

Suicide mortality at time of armed conflict in Ukraine.

PubMed

Yur'yev, Andriy; Yur'yeva, Lyudmyla

2015-12-01

The purpose of this review is to explore the dynamics of suicide mortality rates in Ukraine during an ongoing armed conflict between 2014 and 2015. Suicide mortality data were obtained by reviewing annual analytical releases from the State Service for Emergent Situations of Ukraine and annual release of Russian Federal Service of State Statistics. Suicide mortality in mainland Ukraine and in the Crimea region demonstrated a mild decrease, whereas suicide mortality in the regions directly involved in the armed conflict demonstrated a prominent decrease. The results of this review support Durkheim theory. The limitation of this review includes general concern about quality of data at time of armed conflict in the country. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Research on polar bears in Alaska, 1983-1985

USGS Publications Warehouse

Amstrup, Steven C.

1986-01-01

Research on the ecology and status of polar bear populations in Alaska has continued since 1967. Research was a joint U.S. Fish and Wildlife Service/Alaska Department of Fish and Game effort until passage of the Marine Mammal Protection Act in 1972, and has been largely a Federal effort since then. In 1985, Alaskan polar beer research continues to be carried out by the Research Division of the U.S. Fish and Wildlife Service (DOI). A recent reorganization removed authority for ecological research in Alaska from the Denver Wildlife Research Center, and vested it with the newly created Alaska Office of Fish and Wildlife Research. This new research office is the center for Federal fish and Wildlife related research throughout the state of Alaska and in its coastal waters.Although the responsibility for polar bear research lies with the U.S. Fish and Wildlife Service, numerous other organizations and agencies deserve mention for their cooperation and support of the ongoing research. These include: the U.S. National Oceanic and Atmospheric Administration (DOC), The U.S. Minerals Management Service (DOI), The Canadian Wildlife Service, The Northwest Territories Wildlife Service, the Yukon Wildlife Service, Dome Petroleum Ltd, Gulf Canada, and the Alaska Department of Fish and game.

Perceptions of the care received from Australian palliative care services: A caregiver perspective.

PubMed

Pidgeon, Tanya M; Johnson, Claire E; Lester, Leanne; Currow, David; Yates, Patsy; Allingham, Samuel F; Bird, Sonia; Eagar, Kathy

2018-04-01

ABSTRACTBackground:Caregiver satisfaction and experience surveys help health professionals to understand, measure, and improve the quality of care provided for patients and their families. Our aim was to explore caregiver perceptions of the care received from Australian specialist palliative care services. Caregivers of patients receiving palliative care in services registered with Australia's Palliative Care Outcomes Collaboration were invited to participate in a caregiver survey. The survey included the FAMCARE-2 and four items from the Ongoing Needs Identification: Caregiver Profile questionnaire. Surveys were completed by 1,592 caregivers from 49 services. Most respondents reported high satisfaction and positive experiences. Caregivers receiving care from community-based palliative care teams were less satisfied with the management of physical symptoms and comfort (odds ratio [OR] = 0.29; 95% confidence interval [CI95%] = 0.14, 0.59), with patient psychological care (OR = 0.56; CI95% = 0.32, 0.98), and with family support (OR = 0.52; CI95% = 0.35, 0.77) than caregivers of patients in an inpatient setting. If aged over 60 years, caregivers were less likely to have their information needs met regarding available support services (OR = 0.98; CI95% = 0.97, 0.98) and carer payments (OR = 0.99; CI95% = 0.98, 1.00). Also, caregivers were less likely to receive adequate information about carer payments if located in an outer regional area (OR = 0.41; CI95% = 0.25, 0.64). With practical training, caregivers receiving care from community services reported inadequate information provision to support them in caring for patients (OR = 0.60; CI95% = 0.45, 0.81). While our study identified caregivers as having positive and satisfactory experiences across all domains of care, there is room for improvement in the delivery of palliative care across symptom management, as well as patient and caregiver support, especially in community settings. Caregiver surveys can facilitate the identification and evaluation of both patients' and caregivers' experiences, satisfaction, distress, and unmet needs.

Supporting the Thesis Writing Process of International Research Students through an Ongoing Writing Group

ERIC Educational Resources Information Center

Li, Linda Y.; Vandermensbrugghe, Joelle

2011-01-01

Evidence from research suggests writing support is particularly needed for international research students who have to tackle the challenges of thesis writing in English as their second language in Western academic settings. This article reports the development of an ongoing writing group to support the thesis writing process of international…

Improving vocational rehabilitation services for injured workers in Washington State.

PubMed

Sears, Jeanne M; Wickizer, Thomas M; Schulman, Beryl A

2014-06-01

Workers who incur permanent impairments or have ongoing medical restrictions due to injuries or illnesses sustained at work may require support from vocational rehabilitation programs in order to return to work. Vocational rehabilitation programs implemented within workers' compensation settings are costly, and effective service delivery has proven challenging. The Vocational Improvement Project, a 5.5-year pilot program beginning in 2008, introduced major changes to the Washington State workers' compensation-based vocational rehabilitation program. In the evaluation of this pilot program, set within a large complex system characterized by competing stakeholder interests, we assessed effects on system efficiency and employment outcomes for injured workers. While descriptive in nature, this evaluation provided evidence that several of the intended outcomes were attained, including: (1) fewer repeat referrals, (2) fewer delays, (3) increased choice for workers, and (4) establishment of statewide partnerships to improve worker outcomes. There remains substantial room for further improvement. Retraining plan completion rates remain under 60% and only half of workers earned any wages within two years of completing their retraining plan. Ongoing communication with stakeholders was critical to the successful conduct and policy impact of this evaluation, which culminated in a 3-year extension of the pilot program through June 2016. Copyright © 2013 Elsevier Ltd. All rights reserved.

An Evaluation of the Decision-Making Capacity Assessment Model.

PubMed

Brémault-Phillips, Suzette C; Parmar, Jasneet; Friesen, Steven; Rogers, Laura G; Pike, Ashley; Sluggett, Bryan

2016-09-01

The Decision-Making Capacity Assessment (DMCA) Model includes a best-practice process and tools to assess DMCA, and implementation strategies at the organizational and assessor levels to support provision of DMCAs across the care continuum. A Developmental Evaluation of the DMCA Model was conducted. A mixed methods approach was used. Survey ( N = 126) and focus group ( N = 49) data were collected from practitioners utilizing the Model. Strengths of the Model include its best-practice and implementation approach, applicability to independent practitioners and inter-professional teams, focus on training/mentoring to enhance knowledge/skills, and provision of tools/processes. Post-training, participants agreed that they followed the Model's guiding principles (90%), used problem-solving (92%), understood discipline-specific roles (87%), were confident in their knowledge of DMCAs (75%) and pertinent legislation (72%), accessed consultative services (88%), and received management support (64%). Model implementation is impeded when role clarity, physician engagement, inter-professional buy-in, accountability, dedicated resources, information sharing systems, and remuneration are lacking. Dedicated resources, job descriptions inclusive of DMCAs, ongoing education/mentoring supports, access to consultative services, and appropriate remuneration would support implementation. The DMCA Model offers practitioners, inter-professional teams, and organizations a best-practice and implementation approach to DMCAs. Addressing barriers and further contextualizing the Model would be warranted.

An Evaluation of the Decision-Making Capacity Assessment Model

PubMed Central

Brémault-Phillips, Suzette C.; Parmar, Jasneet; Friesen, Steven; Rogers, Laura G.; Pike, Ashley; Sluggett, Bryan

2016-01-01

Background The Decision-Making Capacity Assessment (DMCA) Model includes a best-practice process and tools to assess DMCA, and implementation strategies at the organizational and assessor levels to support provision of DMCAs across the care continuum. A Developmental Evaluation of the DMCA Model was conducted. Methods A mixed methods approach was used. Survey (N = 126) and focus group (N = 49) data were collected from practitioners utilizing the Model. Results Strengths of the Model include its best-practice and implementation approach, applicability to independent practitioners and inter-professional teams, focus on training/mentoring to enhance knowledge/skills, and provision of tools/processes. Post-training, participants agreed that they followed the Model’s guiding principles (90%), used problem-solving (92%), understood discipline-specific roles (87%), were confident in their knowledge of DMCAs (75%) and pertinent legislation (72%), accessed consultative services (88%), and received management support (64%). Model implementation is impeded when role clarity, physician engagement, inter-professional buy-in, accountability, dedicated resources, information sharing systems, and remuneration are lacking. Dedicated resources, job descriptions inclusive of DMCAs, ongoing education/mentoring supports, access to consultative services, and appropriate remuneration would support implementation. Conclusions The DMCA Model offers practitioners, inter-professional teams, and organizations a best-practice and implementation approach to DMCAs. Addressing barriers and further contextualizing the Model would be warranted. PMID:27729947

The medical libraries of Vietnam--a service in transition.

PubMed

Brennen, P W

1992-07-01

The medical libraries of Vietnam maintain high profiles within their institutions and are recognized by health care professionals and administrators as an important part of the health care system. Despite the multitude of problems in providing even a minimal level of medical library services, librarians, clinicians, and researchers nevertheless are determined that enhanced services be made available. Currently, services can be described as basic and unsophisticated, yet viable and surprisingly well organized. The lack of hard western currency required to buy materials and the lack of library technology will be major obstacles to improving information services. Vietnam, like many developing nations, is about to enter a period of technological upheaval, which ultimately will result in a transition from the traditional library limited by walls to a national resource that will rely increasingly on electronic access to international knowledge networks. Technology such as CD-ROM, Integrated Services Digital Network (ISDN), and satellite telecommunication networks such as Internet can provide the technical backbone to provide access to remote and widely distributed electronic databases to support the information needs of the health care community. Over the long term, access to such databases likely will be cost-effective, in contrast to the assuredly astronomical cost of building a comparable domestic print collection. The advent of new, low-cost electronic technologies probably will revolutionize health care information services in developing nations. However, for the immediate future, the medical libraries of Vietnam will require ongoing sustained support from the international community, so that minimal levels of resources will be available to support the information needs of the health care community. It is remarkable, and a credit to the determination of Vietnam's librarians that, in a country with a legacy of war, economic deprivation, and international isolation, they have somehow managed to provide a sound basic level of information services for health care professionals.

The medical libraries of Vietnam--a service in transition.

PubMed Central

Brennen, P W

1992-01-01

The medical libraries of Vietnam maintain high profiles within their institutions and are recognized by health care professionals and administrators as an important part of the health care system. Despite the multitude of problems in providing even a minimal level of medical library services, librarians, clinicians, and researchers nevertheless are determined that enhanced services be made available. Currently, services can be described as basic and unsophisticated, yet viable and surprisingly well organized. The lack of hard western currency required to buy materials and the lack of library technology will be major obstacles to improving information services. Vietnam, like many developing nations, is about to enter a period of technological upheaval, which ultimately will result in a transition from the traditional library limited by walls to a national resource that will rely increasingly on electronic access to international knowledge networks. Technology such as CD-ROM, Integrated Services Digital Network (ISDN), and satellite telecommunication networks such as Internet can provide the technical backbone to provide access to remote and widely distributed electronic databases to support the information needs of the health care community. Over the long term, access to such databases likely will be cost-effective, in contrast to the assuredly astronomical cost of building a comparable domestic print collection. The advent of new, low-cost electronic technologies probably will revolutionize health care information services in developing nations. However, for the immediate future, the medical libraries of Vietnam will require ongoing sustained support from the international community, so that minimal levels of resources will be available to support the information needs of the health care community. It is remarkable, and a credit to the determination of Vietnam's librarians that, in a country with a legacy of war, economic deprivation, and international isolation, they have somehow managed to provide a sound basic level of information services for health care professionals. PMID:1525617

42 CFR 456.22 - Sample basis evaluation of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 456.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: All Medicaid Services § 456... available services and facilities the Medicaid agency must have procedures for the on-going evaluation, on a...

Implementation and evolution of a regional chronic disease self-management program.

PubMed

Liddy, Clare; Johnston, Sharon; Nash, Kate; Irving, Hannah; Davidson, Rachel

2016-08-15

To establish a comprehensive, community-based program to improve and sustain self-management support for individuals with chronic diseases and complement office-based strategies to support behaviour change. Health service delivery organizations. The Champlain Local Health Integration Network (LHIN), a health district in Eastern Ontario. We created Living Healthy Champlain (LHC), a regional organization providing peer leader training and coordination for the group Stanford Chronic Disease Self-Management Program (CDSMP); skills training and mentorship in behaviour change approaches for health care providers; and support to organizations to integrate self-management support into routine practice. We used the RE-AIM framework to evaluate the overall program's impact by exploring its reach, effectiveness, adoption, implementation and maintenance. A total of 232 Stanford CDSMP sessions (63 during the pilot project and 169 post-pilot) have been held at 127 locations in 24 cities across the Champlain LHIN, reaching approximately 4,000 patients. The effectiveness of the service was established through ongoing evidence reviews, a focus group and a pre-post utilization study of the pilot. LHC trained over 300 peer volunteers to provide the Stanford CDSMP sessions, 98 of whom continue to activelyhost workshops. An additional 1,327 providers have been trained in other models of self-management support, such as Health Coaching and Motivational Interviewing. Over the study period, LHC grew from a small pilot project to a regional initiative with sustainable provincial funding and was adopted by the province as a model for similar service delivery across Ontario. A community-based self-management program working in partnership with primary care can be effectively and broadly implemented in support of patients living with chronic conditions.

Mental illness research in the Gulf Cooperation Council: a scoping review.

PubMed

Hickey, Jason E; Pryjmachuk, Steven; Waterman, Heather

2016-08-04

Rapid growth and development in recent decades has seen mental health and mental illness emerge as priority health concerns for the Gulf Cooperation Council (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates). As a result, mental health services in the region are being redefined and expanded. However, there is a paucity of local research to guide ongoing service development. Local research is important because service users' experience of mental illness and mental health services are linked to their sociocultural context. In order for service development to be most effective, there is a need for increased understanding of the people who use these services.This article aims to review and synthesize mental health research from the Gulf Cooperation Council. It also seeks to identify gaps in the literature and suggest directions for future research. A scoping framework was used to conduct this review. To identify studies, database searches were undertaken, regional journals were hand-searched, and reference lists of included articles were examined. Empirical studies undertaken in the Gulf Cooperation Council that reported mental health service users' experience of mental illness were included. Framework analysis was used to synthesize results. Fifty-five studies met inclusion criteria and the following themes were identified: service preferences, illness (symptomology, perceived cause, impact), and recovery (traditional healing, family support, religion). Gaps included contradictory findings related to the supportive role of the Arabic extended family and religion, under-representation of women in study samples, and limited attention on illness management outside of the hospital setting.From this review, it is clear that the sociocultural context in the region is linked to service users' experience of mental illness. Future research that aims to fill the identified gaps and develop and test culturally appropriate interventions will aid practice and policy development in the region.

Can women determine the success of early medical termination of pregnancy themselves?

PubMed

Cameron, S T; Glasier, A; Johnstone, A; Dewart, H; Campbell, A

2015-01-01

To determine the outcome of early medical termination of pregnancy (TOP) among women who choose a "self assessment" follow up comprising a self-performed low sensitivity urine pregnancy test with instructions on signs/symptoms that mandate contacting the TOP service. A retrospective review of computer databases of 1726 women choosing self-assessment after early medical TOP (<9 weeks) in the UK. The main outcome measures were (a) number of women choosing self-assessment, (b) contact rates with TOP service and (c) time to presentation with an ongoing pregnancy (failed TOP). Ninety-six percent of women having an early medical TOP and going home to expel the pregnancy chose self-assessment. Two percent of women made unscheduled visits to the TOP service. One hundred and eighty-eight women (11%) telephoned the service about concerns related to complications or the success of treatment. There were eight ongoing pregnancies (0.5%; 95% confidence interval 0.2-0.9%). Four were detected within 4 weeks of treatment; the remainder were not detected until one or more missed menses after the procedure. Most women having an early medical TOP, who go home to expel the pregnancy, choose self-assessment. Relatively few women make unscheduled visits or telephone the TOP service. Most ongoing pregnancies are recognized at an early stage, although late presentation (as with all methods of follow up) does still occur. If women are given clear instructions on how and when to conduct a urine pregnancy test and on signs/symptoms that mandate contacting the TOP service, then they can confirm the success of early medical TOP themselves. Late presentation due to failure to recognize an ongoing pregnancy is rare. Copyright © 2014 Elsevier Inc. All rights reserved.

'Strategic approach' can reveal benefits.

PubMed

Baillie, Jonathan

2011-01-01

Speaking at last October's Healthcare Estates 2010 conference in Manchester, Peter Haggarty, assistant director, Health Facilities Scotland, outlined some of the key steps and priorities for large healthcare providers seeking to establish and implement an effective asset management strategy, focusing particularly on work ongoing in this area in the Scottish public health service. While any radical change to a large healthcare organisation's existing asset management practices could be "challenging", both for the organisation itself, and for its staff, with "sufficient planning, persistence, and support", such changes could, he told delegates, often result in "unanticipated benefits". HEJ editor Jonathan Baillie reports.

Towards Legitimate Nursing Work? Historical Discursive Constructions of Abortion in The Canadian Nurse, 1950-1965.

PubMed

Haney, Catherine

2014-01-01

To the detriment of women's health, the abortion work of nurses in Canada has gone largely unexamined and is not well understood. This historical discourse analysis examines discursive constructions of nurses' abortion work and ongoing renegotiations of professional identity in The Canadian Nurse from 1950 to 1965. By investigating what has shaped and continues to inform nurses' understandings and enactment of abortion work over time, I hope to contribute to a foundation from which to evaluate contemporary abortion services and to foster conditions that support nurses in providing safe abortion care.

A Primer on Electric Utilities, Deregulation, and Restructuring of U.S. Electricity Markets

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

Warwick, William M.

2002-06-03

This primer is offered as an introduction to utility restructuring to better prepare readers for ongoing changes in public utilities and associated energy markets. It is written for use by individuals with responsibility for the management of facilities that use energy, including energy managers, procurement staff, and managers with responsibility for facility operations and budgets. The primer was prepared by the Pacific Northwest National Laboratory under sponsorship from the U.S. Department of Energy?s Federal Energy Management Program. The impetus for this primer originally came from the Government Services Administration who supported its initial development.

KSC-2013-3086

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068304 - Chris Ferguson, director of Crew and Mission Operations for The Boeing Company and former NASA astronaut, is interviewed by the media during the unveiling of a CST-100 mock-up at the company's Houston Product Support Center. This test version is optimized to support five crew members and will allow the company to evaluate crew safety, interfaces, communications, maneuverability and ergonomics. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

KSC-2013-3087

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068310 - Chris Ferguson, director of Crew and Mission Operations for The Boeing Company and former NASA astronaut, discusses the fit check evaluation of the CST-100 mock-up with the media during its unveiling at the company's Houston Product Support Center. This test version is optimized to support five crew members and will allow the company to evaluate crew safety, interfaces, communications, maneuverability and ergonomics. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

KSC-2013-3085

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068300 - Chris Ferguson, director of Crew and Mission Operations for The Boeing Company and former NASA astronaut, addresses the media before the unveiling of a CST-100 mock-up at the company's Houston Product Support Center. This test version is optimized to support five crew members and will allow the company to evaluate crew safety, interfaces, communications, maneuverability and ergonomics. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

Integration of National Laboratory and Low-Activity Waste Pre-Treatment System Technology Service Providers - 16435

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

Subramanian, Karthik H.; Thien, Michael G.; Wellman, Dawn M.

The National Laboratories are a critical partner and provide expertise in numerous aspects of the successful execution of the Direct-Feed Low Activity Waste Program. The National Laboratories are maturing the technologies of the Low-Activity Waste Pre-Treatment System (LAWPS) consistent with DOE Order 413.3B “Program and Project Management for the Acquisition of Capital Assets” expectations. The National Laboratories continue to mature waste forms, i.e. glass and secondary waste grout, for formulations and predictions of long-term performance as inputs to performance assessments. The working processes with the National Laboratories have been developed in procurements, communications, and reporting to support the necessary delivery-basedmore » technology support. The relationship continues to evolve from planning and technology development to support of ongoing operations and integration of multiple highly coordinated facilities.« less

Guided by Theory, Informed by Practice: Training and Support for the Good Behavior Game, a Classroom-based Behavior Management Strategy

PubMed Central

Poduska, Jeanne M.; Kurki, Anja

2015-01-01

Moving evidence-based practices for classroom behavior management into real-world settings is a high priority for education and public health. This paper describes the development and use of a model of training and support for the Good Behavior Game (GBG), one of the few preventive interventions shown to have positive outcomes for elementary school children lasting through to young adulthood, ages 19–21, including reductions in the use of drugs and alcohol, school-based mental health services, and suicide ideation and attempts. We first describe the conceptual framework guiding the development of the model of training and support. Data on implementation of the model, from an ongoing trial of GBG being conducted in partnership with the Houston Independent School District, are then presented. We end with a discussion of the lessons learned and the implications for the next stage of research and practice. PMID:26236144

Utilizing Remote Sensing Data to Ascertain Soil Moisture Applications and Air Quality Conditions

NASA Technical Reports Server (NTRS)

Leptoukh, Gregory; Kempler, Steve; Teng, William; Friedl, Lawrence; Lynnes, Chris

2009-01-01

Recognizing the significance of NASA remote sensing Earth science data in monitoring and better understanding our planet's natural environment, NASA Earth Applied Sciences has implemented the 'Decision Support Through Earth Science Research Results' program. Several applications support systems through collaborations with benefiting organizations have been implemented. The Goddard Earth Sciences Data and Information Services Center (GES DISC) has participated in this program on two projects (one complete, one ongoing), and has had opportune ad hoc collaborations utilizing NASA Earth science data. GES DISC's understanding of Earth science missions and resulting data and information enables the GES DISC to identify challenges that come with bringing science data to research applications. In this presentation we describe applications research projects utilizing NASA Earth science data and a variety of resulting GES DISC applications support system project experiences. In addition, defining metrics that really evaluate success will be exemplified.

Reciprocity of agonistic support in ravens.

PubMed

Fraser, Orlaith N; Bugnyar, Thomas

2012-01-01

Cooperative behaviour through reciprocation or interchange of valuable services in primates has received considerable attention, especially regarding the timeframe of reciprocation and its ensuing cognitive implications. Much less, however, is known about reciprocity in other animals, particularly birds. We investigated patterns of agonistic support (defined as a third party intervening in an ongoing conflict to attack one of the conflict participants, thus supporting the other) in a group of 13 captive ravens, Corvus corax. We found support for long-term, but not short-term, reciprocation of agonistic support. Ravens were more likely to support individuals who preened them, kin and dominant group members. These results suggest that ravens do not reciprocate on a calculated tit-for-tat basis, but aid individuals from whom reciprocated support would be most useful and those with whom they share a good relationship. Additionally, dyadic levels of agonistic support and consolation (postconflict affiliation from a bystander to the victim) correlated strongly with each other, but we found no evidence to suggest that receiving agonistic support influences the victim's likelihood of receiving support (consolation) after the conflict ends. Our findings are consistent with an emotionally mediated form of reciprocity in ravens and provide additional support for convergent cognitive evolution in birds and mammals.

Key Features Of Peer Support In Chronic Disease Prevention And Management.

PubMed

Fisher, Edwin B; Ballesteros, Juana; Bhushan, Nivedita; Coufal, Muchieh M; Kowitt, Sarah D; McDonough, A Manuela; Parada, Humberto; Robinette, Jennifer B; Sokol, Rebeccah L; Tang, Patrick Y; Urlaub, Diana

2015-09-01

Peer support from community health workers, promotores de salud, and others through community and health care organizations can provide social support and other assistance that enhances health. There is substantial evidence for both the effectiveness and the cost-effectiveness of peer support, as well as for its feasibility, reach, and sustainability. We discuss findings from Peers for Progress, a program of the American Academy of Family Physicians Foundation, to examine when peer support does not work, guide dissemination of peer support programs, and help integrate approaches such as e-health into peer support. Success factors for peer support programs include proactive implementation, attention to participants' emotions, and ongoing supervision. Reaching those whom conventional clinical and preventive services too often fail to reach; reaching whole populations, such as people with diabetes, rather than selected samples; and addressing behavioral health are strengths of peer support that can help achieve health care that is efficient and of high quality. Challenges for policy makers going forward include encouraging workforce development, balancing quality control with maintaining key features of peer support, and ensuring that underresourced organizations can develop and manage peer support programs. Project HOPE—The People-to-People Health Foundation, Inc.

Support of an Active Science Project by a Large Information System: Lessons for the EOS Era

NASA Technical Reports Server (NTRS)

Angelici, Gary L.; Skiles, J. W.; Popovici, Lidia Z.

1993-01-01

The ability of large information systems to support the changing data requirements of active science projects is being tested in a NASA collaborative study. This paper briefly profiles both the active science project and the large information system involved in this effort and offers some observations about the effectiveness of the project support. This is followed by lessons that are important for those participating in large information systems that need to support active science projects or that make available the valuable data produced by these projects. We learned in this work that it is difficult for a large information system focused on long term data management to satisfy the requirements of an on-going science project. For example, in order to provide the best service, it is important for all information system staff to keep focused on the needs and constraints of the scientists in the development of appropriate services. If the lessons learned in this and other science support experiences are not applied by those involved with large information systems of the EOS (Earth Observing System) era, then the final data products produced by future science projects may not be robust or of high quality, thereby making the conduct of the project science less efficacious and reducing the value of these unique suites of data for future research.

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.

In search of wellness: allied health professionals' understandings of wellness in childhood disability services.

PubMed

Breen, Lauren J; Wildy, Helen; Saggers, Sherry; Millsteed, Jeannine; Raghavendra, Parimala

2011-01-01

Wellness approaches are not routine in childhood disability services, despite theoretical and empirical support and an increasing demand for them from health consumers and disability activists. We aimed to investigate how health professionals define or understand wellness and its practice in the context of childhood disability. A qualitative, interpretive approach was taken. Semi-structured interviews were conducted with 23 health professionals (allied health therapists and managers) providing early intervention and ongoing therapy within four Australian childhood health and disability services. Years of experience providing services to children with disabilities and their families ranged from 6 months to 30 years (M=9.41, SD=9.04). The data revealed a noteworthy impediment to incorporating wellness into practice - the difficulties in the allied health professionals reaching consensus in defining wellness. There appeared to be distinct differences between the four services, while there appeared to be no appreciable difference based on the individual professional's years of experience or allied health discipline. The effect of organisational culture should be considered in efforts to embed wellness in childhood health and disability services in order to address client well-being, empowerment, choice, independence and rights to meaningful and productive lives. © 2011 Informa UK, Ltd.

Early adolescent deaf boys: a biopsychosocial approach.

PubMed

Feinstein, C B

1983-01-01

In this chapter I have reviewed observations from clinical consultation and group-therapy work with early adolescent deaf boys in a special day school for the deaf. I have stressed how problems in communication exert a profound effect on the lives of these youngsters, both by virtue of their past and present influence on family life and by their ongoing effect on peer-group processes and academic adjustment. Primary consideration was given to certain "here and now" aspects of these boys' lives: ongoing problems in the social fabric of their home and school; narcissistic vulnerabilities and defenses against shame; and language-processing difficulties. The ways in which these problems undermine the supportive effect of the peer group at a time when it plays a particularly important role in development were reviewed. By emphasizing current sources of difficulty, using a biopsychosocial approach, I hope to point out fruitful opportunities for significant psychiatric intervention in a psychiatrically vulnerable population whose needs for professional service have never been met.

Returning home: resettlement of formerly abducted children in Northern Uganda.

PubMed

Corbin, Joanne N

2008-06-01

This exploratory qualitative study considers the subjective resettlement experiences of children forced into armed conflict in Northern Uganda from the perspectives of 11 former child combatants and 11 adult community members. A thematic analysis was performed on the narrative data. The bioecological model was used to provide a conceptual framework for key themes. Major findings included the overarching impact of ongoing armed conflict on returnees' lives, the important role of the family in supporting children's resettlement, the harassment of former child soldiers by community members, and the community's inability to support systematically the returning children in tangible ways. This study recommends that humanitarian services at all levels strengthen the capacity of families to care for the material and psychoemotional needs of former child soldiers within their communities.

KSC-2013-3076

NASA Image and Video Library

2013-07-22

HOUSTON - NASA astronaut Serena Aunon puts on her orange launch-and-entry suit for a fit check evaluation of The Boeing Company's CST-100 spacecraft at the company's Houston Product Support Center. Aunon's fit check will help evaluate a crew's maneuverability in the spacecraft and test communications. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

KSC-2013-3090

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068329 - NASA astronaut Randy Bresnik is interviewed by the media before he enters The Boeing Company's CST-100 spacecraft for a fit check evaluation at the company's Houston Product Support Center. Bresnik's fit check will help evaluate a crew's maneuverability in the spacecraft and test communications. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

KSC-2013-3079

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068264 - NASA astronaut Serena Aunon's boots are covered before she enters The Boeing Company's CST-100 spacecraft for a fit check evaluation at the company's Houston Product Support Center. Aunon's fit check will help evaluate a crew's maneuverability in the spacecraft and test communications. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

45 CFR 1301.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... provides ongoing comprehensive child development services. Independent auditor means an individual... Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD START...

45 CFR 1301.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... provides ongoing comprehensive child development services. Independent auditor means an individual... Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD START...

45 CFR 1301.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... provides ongoing comprehensive child development services. Independent auditor means an individual... Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD START...

The economic rationale of public and private sector roles in the provision of animal health services.

PubMed

Ahuja, V

2004-04-01

In the changing market environment of livestock products, the delivery of animal health services is emerging as an important priority area for enhancing the competitiveness of poor livestock producers. At the same time, governments are continuing to face serious budgetary difficulties and are finding it difficult to expand the reach of these services or improve service quality. In this context of a changing environment and dwindling public resources, this paper revisits the economic framework that has thus far guided thinking about public and private sector roles in the provision of animal health services and examines the ongoing debate on livestock service delivery for the poor. The paper highlights the importance of strong institutions and appropriate legislation for regulating behaviour and enforcing contracts and re-emphasises the idea, which is supported by economic theory, that there is a need for task sharing between the public and private sectors. The paper further emphasizes the need for: a) integrating the debate on livestock service delivery with the larger debate on political economy and institutional development, and b) ensuring service access in poor marginal areas by working through membership organisations, self-help groups and civil society organisations, and by promoting the use of para-professionals and community-based animal health delivery systems.

Integrated multimedia information system on interactive CATV network

NASA Astrophysics Data System (ADS)

Lee, Meng-Huang; Chang, Shin-Hung

1998-10-01

In the current CATV system architectures, they provide one- way delivery of a common menu of entertainment to all the homes through the cable network. Through the technologies evolution, the interactive services (or two-way services) can be provided in the cable TV systems. They can supply customers with individualized programming and support real- time two-way communications. With a view to the service type changed from the one-way delivery systems to the two-way interactive systems, `on demand services' is a distinct feature of multimedia systems. In this paper, we present our work of building up an integrated multimedia system on interactive CATV network in Shih Chien University. Besides providing the traditional analog TV programming from the cable operator, we filter some channels to reserve them as our campus information channels. In addition to the analog broadcasting channel, the system also provides the interactive digital multimedia services, e.g. Video-On- Demand (VOD), Virtual Reality, BBS, World-Wide-Web, and Internet Radio Station. These two kinds of services are integrated in a CATV network by the separation of frequency allocation for the analog broadcasting service and the digital interactive services. Our ongoing work is to port our previous work of building up a VOD system conformed to DAVIC standard (for inter-operability concern) on Ethernet network into the current system.

A theoretical framework to support research of health service innovation.

PubMed

Fox, Amanda; Gardner, Glenn; Osborne, Sonya

2015-02-01

Health service managers and policy makers are increasingly concerned about the sustainability of innovations implemented in health care settings. The increasing demand on health services requires that innovations are both effective and sustainable; however, research in this field is limited, with multiple disciplines, approaches and paradigms influencing the field. These variations prevent a cohesive approach, and therefore the accumulation of research findings, in the development of a body of knowledge. The purpose of this paper is to provide a thorough examination of the research findings and provide an appropriate theoretical framework to examine sustainability of health service innovation. This paper presents an integrative review of the literature available in relation to sustainability of health service innovation and provides the development of a theoretical framework based on integration and synthesis of the literature. A theoretical framework serves to guide research, determine variables, influence data analysis and is central to the quest for ongoing knowledge development. This research outlines the sustainability of innovation framework; a theoretical framework suitable for examining the sustainability of health service innovation. If left unaddressed, health services research will continue in an ad hoc manner, preventing full utilisation of outcomes, recommendations and knowledge for effective provision of health services. The sustainability of innovation theoretical framework provides an operational basis upon which reliable future research can be conducted.

Model for Service Delivery for Developmental Disorders in Low-Income Countries.

PubMed

Hamdani, Syed Usman; Minhas, Fareed Aslam; Iqbal, Zafar; Rahman, Atif

2015-12-01

As in many low-income countries, the treatment gap for developmental disorders in rural Pakistan is near 100%. We integrated social, technological, and business innovations to develop and pilot a potentially sustainable service for children with developmental disorders in 1 rural area. Families with developmental disorders were identified through a mobile phone-based interactive voice response system, and organized into "Family Networks." "Champion" family volunteers were trained in evidence-based interventions. An Avatar-assisted Cascade Training and information system was developed to assist with training, implementation, monitoring, and supervision. In a population of ∼30,000, we successfully established 1 self-sustaining Family Network consisting of 10 trained champion family volunteers working under supervision of specialists, providing intervention to 70 families of children with developmental disorders. Each champion was responsible for training and providing ongoing support to 5 to 7 families from his or her village, and the families supported each other in management of their children. A pre-post evaluation of the program indicated that there was significant improvement in disability and socioemotional difficulties in the child, reduction in stigmatizing experiences, and greater family empowerment to seek services and community resources for the child. There was no change in caregivers' well-being. To replicate this service more widely, a social franchise model has been developed whereby the integrated intervention will be "boxed" up and passed on to others to replicate with appropriate support. Such integrated social, technological, and business innovations have the potential to be applied to other areas of health in low-income countries. Copyright © 2015 by the American Academy of Pediatrics.

Making an impact: an adventure into international pharmacy.

PubMed

Hitch, William; Ransom, Matthew

2009-01-01

To support a medical team, organized by Shoulder to Shoulder, with pharmacy services in an effort to expand ongoing health care to a rural community in Honduras. Pharmacy services in a temporary medical clinic in a schoolhouse in Colomarigua, a small mountain village in Honduras. Pharmacy services and medical care to address acute care needs of the people of Colomarigua, Honduras, during a week-long clinic. Interpreters assisted with patient counseling. Medication labels with pictures that connected doses to mealtimes increased patient understanding and the potential for medications to be dosed correctly. Fill lines were drawn on delivery devices for pediatric suspensions. An effort was made to avoid polypharmacy by communicating with physicians about the different prescriptions that were being prescribed in each household. Not applicable. Not applicable. We created a temporary clinic with a pharmacy and provided medical care to more than 600 children and adults in the surrounding regions. The medical team identified need for a feeding program, and local Shoulder to Shoulder teams began activities to support the community's development. Education programs were initiated to allow promising local children access to higher education. Challenges to providing optimal pharmaceutical care included language barriers, space and flow of the pharmacy, and a limited formulary. Benefits included gaining a whole new perspective on pharmacotherapy, health, and the importance of service to those in need whether abroad or at home.

Collaborative youth mental health service users, immigration, poverty, and family environment.

PubMed

Nadeau, Lucie; Lecompte, Vanessa; Johnson-Lafleur, Janique; Pontbriand, Annie; Rousseau, Cécile

2018-05-01

This article examines the association between immigration, poverty and family environment, and the emotional and behavioral problems reported by youth and their family receiving mental health (MH) services within a collaborative care model in a multiethnic neighborhood. Participants in this study were 140 parent-child dyads that are part of an ongoing longitudinal project looking at the association between individual, familial, social and organizational factors, and outcomes of youth receiving MH services in local health and social service organizations in the Montreal area. Measures included in this study were collected at the initial phase of the longitudinal project (Time 0). Parents completed a sociodemographic questionnaire and the Family Environment Scale (FES), and both parents and children completed the Strength and Difficulties questionnaire (SDQ). Results suggest that the family environment, especially family conflicts, has a significant role in the MH problems of children seeking help in collaborative MH services. In this specific population, results also show a trend, but not a statistically significant association, between poverty or immigration and emotional and behavioral problems. They suggest as well that boys show more MH problems, although this could be a contamination effect (parents' perspective). The results support the importance of interventions that not only target the child symptomatology but also address family dynamics, especially conflicts. Collaborative care models may be particularly well suited to allow for a coherent consideration of family environmental factors in youth mental health and to support primary care settings in addressing these issues.

An Evaluation of Trauma Focused Cognitive Behavioral Therapy for Children in Zambia

PubMed Central

Murray, Laura K; Familiar, Itziar; Skavenski, Stephanie; Jere, Elizabeth; Cohen, Judy; Imasiku, Mwiya; Mayeya, John; Bass, Judith K; Bolton, Paul

2013-01-01

Objectives To monitor and evaluate the feasibility of implementing Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) to address trauma and stress-related symptoms in orphans and vulnerable children (OVC) in Zambia as part of ongoing programming within a non-governmental organization (NGO). Methods As part of ongoing programming, voluntary care-workers administered locally validated assessments to identify children who met criteria for moderate to severe trauma symptomatology. Local lay counselors implemented TF-CBT with identified families, while participating in ongoing supervision. Fifty-eight children and adolescents aged 5–18 completed the TF-CBT treatment, with pre- and post-assessments. Results The mean number of traumas reported by the treatment completers (N=58) was 4.11. Post assessments showed significant reductions in severity of trauma symptoms (p<0.0001), and severity of shame symptoms (p<0.0001). Conclusions Our results suggest that TF-CBT is a feasible treatment option in Zambia for OVC. A decrease in symptoms suggests that a controlled trial is warranted. Implementation factors monitored suggest that it is feasible to integrate and evaluate evidence-based mental health assessments and intervention into programmatic services run by an NGO in low/middle resource countries. Results also support the effectiveness of implementation strategies such as task shifting, and the apprenticeship model of training and supervision. PMID:23768939

Organizational attributes that assure optimal utilization of public health nurses.

PubMed

Meagher-Stewart, Donna; Underwood, Jane; MacDonald, Mary; Schoenfeld, Bonnie; Blythe, Jennifer; Knibbs, Kristin; Munroe, Val; Lavoie-Tremblay, Mélanie; Ehrlich, Anne; Ganann, Rebecca; Crea, Mary

2010-01-01

Optimal utilization of public health nurses (PHNs) is important for strengthening public health capacity and sustaining interest in public health nursing in the face of a global nursing shortage. To gain an insight into the organizational attributes that support PHNs to work effectively, 23 focus groups were held with PHNs, managers, and policymakers in diverse regions and urban and rural/remote settings across Canada. Participants identified attributes at all levels of the public health system: government and system-level action, local organizational culture of their employers, and supportive management practices. Effective leadership emerged as a strong message throughout all levels. Other organizational attributes included valuing and promoting public health nursing; having a shared vision, goals, and planning; building partnerships and collaboration; demonstrating flexibility and creativity; and supporting ongoing learning and knowledge sharing. The results of this study highlight opportunities for fostering organizational development and leadership in public health, influencing policies and programs to optimize public health nursing services and resources, and supporting PHNs to realize the full scope of their competencies.

Informal Assessment as a Tool for Supporting Parent Partnerships

ERIC Educational Resources Information Center

Darragh, Johnna

2009-01-01

Many strategies contribute to forming co-constructed relationships. However, one of the most effective tools that supports co-construction is ongoing assessment, which provides a common base (knowledge of the child) on which families and professionals can build relationships. As a part of this ongoing assessment, informal strategies--including…

Enhancing the Practicum Experience for Pre-service Chemistry Teachers Through Collaborative CoRe Design with Mentor Teachers

NASA Astrophysics Data System (ADS)

Hume, Anne; Berry, Amanda

2013-10-01

This paper reports findings from an ongoing study exploring how the Content Representation (CoRe) design can be used as a tool to help chemistry student teachers begin acquiring the professional knowledge required to become expert chemistry teachers. Phase 2 of the study, reported in this paper, investigated how collaboration with school-based mentors (associate teachers) on teaching practice (practicum) might impact on this process and student teachers' development of their pedagogical content knowledge (PCK). The collaboration involved identifying and discussing pedagogical issues related to a practicum-teaching topic using a student teacher's draft CoRe as a starting point and ongoing focus for the professional dialogue. Practicum offered an opportunity for aspects of student teachers' PCK, as embodied in their draft CoRes, to be explored and expanded upon in classroom programmes with the support and input of associate teachers. The findings were influenced by different contextual factors; however, the student teachers found their CoRes to be very useful frameworks for engaging in focussed professional dialogue with their teaching mentors. They valued the expertise, currency of knowledge and mentoring of their associates and reported positively about the contribution this support made to their PCK development via the CoRe design process and the transformation of the CoRe into classroom teaching.

The Roles of System and Organizational Leadership in System-Wide Evidence-Based Intervention Sustainment: A Mixed-Method Study.

PubMed

Aarons, Gregory A; Green, Amy E; Trott, Elise; Willging, Cathleen E; Torres, Elisa M; Ehrhart, Mark G; Roesch, Scott C

2016-11-01

If evidence-based interventions (EBIs) are not sustained, investments are wasted and public health impact is limited. Leadership has been suggested as a key determinant of implementation and sustainment; however, little empirical work has examined this factor. This mixed-methods study framed using the Exploration, Preparation, Implementation, Sustainment (EPIS) conceptual framework examines leadership in both the outer service system context and inner organizational context in eleven system-wide implementations of the same EBI across two U.S. states and 87 counties. Quantitative data at the outer context (i.e., system) and inner context (i.e., team) levels demonstrated that leadership predicted future sustainment and differentiated between sites with full, partial, or no sustainment. In the outer context positive sustainment leadership was characterized as establishing a project's mission and vision, early and continued planning for sustainment, realistic project plans, and having alternative strategies for project survival. Inner context frontline transformational leadership predicted sustainment while passive-avoidant leadership predicted non-sustainment. Qualitative results found that sustainment was associated with outer context leadership characterized by engagement in ongoing supportive EBI championing, marketing to stakeholders; persevering in these activities; taking action to institutionalize the EBI with funding, contracting, and system improvement plans; and fostering ongoing collaboration between stakeholders at state and county, and community stakeholder levels. For frontline leadership the most important activities included championing the EBI and providing practical support for service providers. There was both convergence and expansion that identified unique contributions of the quantitative and qualitative methods. Greater attention to leadership in both the outer system and inner organizational contexts is warranted to enhance EBI implementation and sustainment.

The Roles of System and Organizational Leadership in System-Wide Evidence-Based Intervention Sustainment: A Mixed-Method Study

PubMed Central

Aarons, Gregory A.; Green, Amy E.; Trott, Elise; Willging, Cathleen E.; Torres, Elisa M.; Ehrhart, Mark G.; Roesch, Scott C.

2017-01-01

If evidence-based interventions (EBIs) are not sustained, investments are wasted and public health impact is limited. Leadership has been suggested as a key determinant of implementation and sustainment; however, little empirical work has examined this factor. This mixed-methods study framed using the Exploration, Preparation, Implementation, Sustainment (EPIS) conceptual framework examines leadership in both the outer service system context and inner organizational context in eleven system-wide implementations of the same EBI across two U.S. states and 87 counties. Quantitative data at the outer context (i.e., system) and inner context (i.e., team) levels demonstrated that leadership predicted future sustainment and differentiated between sites with full, partial, or no sustainment. In the outer context positive sustainment leadership was characterized as establishing a project’s mission and vision, early and continued planning for sustainment, realistic project plans, and having alternative strategies for project survival. Inner context frontline transformational leadership predicted sustainment while passive-avoidant leadership predicted non-sustainment. Qualitative results found that sustainment was associated with outer context leadership characterized by engagement in ongoing supportive EBI championing, marketing to stakeholders; persevering in these activities; taking action to institutionalize the EBI with funding, contracting, and system improvement plans; and fostering ongoing collaboration between stakeholders at state and county, and community stakeholder levels. For frontline leadership the most important activities included championing the EBI and providing practical support for service providers. There was both convergence and expansion that identified unique contributions of the quantitative and qualitative methods. Greater attention to leadership in both the outer system and inner organizational contexts is warranted to enhance EBI implementation and sustainment. PMID:27439504

Using social media for support and feedback by mental health service users: thematic analysis of a twitter conversation.

PubMed

Shepherd, Andrew; Sanders, Caroline; Doyle, Michael; Shaw, Jenny

2015-02-19

Internet based social media websites represent a growing space for interpersonal interaction. Research has been conducted in relation to the potential role of social media in the support of individuals with physical health conditions. However, limited research exists exploring such utilisation by individuals with experience of mental health problems. It could be proposed that access to wider support networks and knowledge could be beneficial for all users, although this positive interpretation has been challenged. The present study focusses on a specific discussion as a case study to assess the role of the website www.twitter.com as a medium for interpersonal communication by individuals with experience of mental disorder and possible source of feedback to mental health service providers. An electronic search was performed to identify material contributing to an online conversation entitled #dearmentalhealthprofessionals. Output from the search strategy was combined in such a way that repeated material was eliminated and all individual material anonymised. The remaining textual material was reviewed and combined in a thematic analysis to identify common themes of discussion. 515 unique communications were identified relating to the specified conversation. The majority of the material related to four overarching thematic headings: The impact of diagnosis on personal identity and as a facilitator for accessing care; Balance of power between professional and service user; Therapeutic relationship and developing professional communication; and Support provision through medication, crisis planning, service provision and the wider society. Remaining material was identified as being direct expression of thanks, self-referential in its content relating to the on-going conversation or providing a link to external resources and further discussion. The present study demonstrates the utility of online social media as both a discursive space in which individuals with experience of mental disorder may share information and develop understanding, and a medium of feedback to mental health service providers. Further research is required to establish potential individual benefit from the utilisation of such networks, its suitability as a means of service provision feedback and the potential role for, and user acceptability of, mental health service providers operating within the space.

Implementation of a mental health medication management intervention in Australian community pharmacies: Facilitators and challenges.

PubMed

Hattingh, H Laetitia; Kelly, Fiona; Fowler, Jane; Wheeler, Amanda J

Community pharmacists are in an ideal position to promote and provide mental health medication management services. However, formalised or structured pharmacy services to support consumers with mental health conditions are scarce. Australian mental health consumers indicated a need for targeted community pharmacy mental health services which presented an opportunity to develop an intervention that were integrated with remunerated professional services. The study aimed to pilot a mental health medication management intervention in Australian community pharmacies. Pharmacists worked in partnership with consumers, carers and mental health workers over three to six months to set and support achievement of individual goals related to medicines use, physical health and mental wellbeing. This paper provides a comparison of community pharmacies that successfully delivered the intervention with those that did not and identifies facilitators and challenges to service implementation. One hundred pharmacies opted to pilot the delivery of the intervention in three Australian states (Queensland, Western Australia and northern New South Wales). Of those, 55 successfully delivered the intervention (completers) whilst 45 were unsuccessful (non-completers). A mixed methods approach, including quantitative pharmacy surveys and qualitative semi-structured interviews, was used to gather data from participating pharmacies. Following intervention development, 142 pharmacists and 21 pharmacy support staff attended training workshops, received resource kits and ongoing support from consumer and pharmacist mentors throughout intervention implementation. Baseline quantitative data was collected from each pharmacy on staff profile, volume of medicines dispensed, the range of professional services delivered and relationships with health professionals. At the completion of the study participants were invited to complete an online exit survey and take part in a semi-structured interview that explored their experiences of intervention implementation and delivery. Twenty-nine staff members from completer pharmacies returned exit surveys and interviews were conducted with 30 staff from completer and non-completer pharmacies. Descriptive analyses of quantitative data and thematic analyses of qualitative data were used to compare completers and non-completers. Baseline similarities included numbers of general and mental health prescriptions dispensed and established professional services. However, there was greater prevalence of diabetes management, opioid substitution services, and relationships with mental health services in completer pharmacies. Key facilitators for completers included pharmacy owner/manager support, staff buy-in and involvement, intervention flexibility, recruitment immediately following training, integration of intervention with existing services, changes to workflow, and regular consumer contact. Key barriers for both groups included lack of pharmacy owner/manager support or staff buy-in, time constraints, privacy limitations and pilot project associated paperwork. Insights into factors that underpinned successful intervention implementation and delivery should inform effective strategies for similar future studies and allocation of pharmacy mental health service delivery resources. Copyright © 2017 Elsevier Inc. All rights reserved.

A service-oriented approach to assessing the infrastructure value index.

PubMed

Amaral, R; Alegre, H; Matos, J S

Many national and regional administrations are currently facing challenges to ensure long-term sustainability of urban water services, as infrastructures continue to accumulate alarming levels of deferred maintenance and rehabilitation. The infrastructure value index (IVI) has proven to be an effective tool to support long-term planning, in particular by facilitating the ability to communicate and to create awareness. It is given by the ratio between current value of an infrastructure and its replacement cost. Current value is commonly estimated according to an asset-oriented approach, which is based on the concept of useful life of individual components. The standard values assumed for the useful lives can vary significantly, which leads to valuations that are just as different. Furthermore, with water companies increasingly focused on the customer, effective service-centric asset management is essential now more than ever. This paper shows results of on-going research work, which aims to explore a service-oriented approach for assessing the IVI. The paper presents the fundamentals underlying this approach, discusses and compares results obtained from both perspectives and points to challenges that still need to be addressed.

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.

Substance abuse treatment management information systems: balancing federal, state, and service provider needs.

PubMed

Camp, J M; Krakow, M; McCarty, D; Argeriou, M

1992-01-01

There is increased interest in documenting the characteristics and treatment outcomes of clients served with Alcohol, Drug Abuse, and Mental Health Block Grant funds. The evolution of federal client-based management systems for substance abuse treatment services demonstrates that data collection systems are important but require continued support. A review of the Massachusetts substance abuse management information system illustrates the utility of a client-based data set. The development and implementation of a comprehensive information system require overcoming organizational barriers and project delays, fostering collaborative efforts among staff from diverse agencies, and employing considerable resources. In addition, the need to develop mechanisms for increasing the reliability of the data and ongoing training for the users is presented. Finally, three applications of the management information system's role in shaping policy are reviewed: developing services for special populations (communities of color, women, and pregnant substance abusers, and injection drug users), utilizing MIS data for evaluation purposes, and determining funding allocations.

Competing health policies: insurance against universal public systems

PubMed Central

Laurell, Asa Ebba Cristina

2016-01-01

Objectives: This article analyzes the content and outcome of ongoing health reforms in Latin America: Universal Health Coverage with Health Insurance, and the Universal and Public Health Systems. It aims to compare and contrast the conceptual framework and practice of each and verify their concrete results regarding the guarantee of the right to health and access to required services. It identifies a direct relationship between the development model and the type of reform. The neoclassical-neoliberal model has succeeded in converting health into a field of privatized profits, but has failed to guarantee the right to health and access to services, which has discredited the governments. The reform of the progressive governments has succeeded in expanding access to services and ensuring the right to health, but faces difficulties and tensions related to the permanence of a powerful, private, industrial-insurance medical complex and persistence of the ideologies about medicalized 'good medicine'. Based on these findings, some strategies to strengthen unique and supportive public health systems are proposed. PMID:26959328

Implementation and quality assessment of a pharmacy services call center for outpatient pharmacies and specialty pharmacy services in an academic health system.

PubMed

Rim, Matthew H; Thomas, Karen C; Chandramouli, Jane; Barrus, Stephanie A; Nickman, Nancy A

2018-05-15

The implementation and quality assessment of a pharmacy services call center (PSCC) for outpatient pharmacies and specialty pharmacy services within an academic health system are described. Prolonged wait times in outpatient pharmacies or hold times on the phone affect the ability of pharmacies to capture and retain prescriptions. To support outpatient pharmacy operations and improve quality, a PSCC was developed to centralize handling of all outpatient and specialty pharmacy calls. The purpose of the PSCC was to improve the quality of pharmacy telephone services by (1) decreasing the call abandonment rate, (2) improving the speed of answer, (3) increasing first-call resolution, (4) centralizing all specialty pharmacy and prior authorization calls, (5) increasing labor efficiency and pharmacy capacities, (6) implementing a quality evaluation program, and (7) improving workplace satisfaction and retention of outpatient pharmacy staff. The PSCC centralized pharmacy calls from 9 pharmacy locations, 2 outpatient clinics, and a specialty pharmacy. Since implementation, the PSCC has achieved and maintained program goals, including improved abandonment rate, speed of answer, and first-call resolution. A centralized 24-7 support line for specialty pharmacy patients was also successfully established. A quality calibration program was implemented to ensure service quality and excellent patient experience. Additional ongoing evaluations measure the impact of the PSCC on improving workplace satisfaction and retention of outpatient pharmacy staff. The design and implementation of the PSCC have significantly improved the health system's patient experiences, efficiency, and quality. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Integrating Engineering Data Systems for NASA Spaceflight Projects

NASA Technical Reports Server (NTRS)

Carvalho, Robert E.; Tollinger, Irene; Bell, David G.; Berrios, Daniel C.

2012-01-01

NASA has a large range of custom-built and commercial data systems to support spaceflight programs. Some of the systems are re-used by many programs and projects over time. Management and systems engineering processes require integration of data across many of these systems, a difficult problem given the widely diverse nature of system interfaces and data models. This paper describes an ongoing project to use a central data model with a web services architecture to support the integration and access of linked data across engineering functions for multiple NASA programs. The work involves the implementation of a web service-based middleware system called Data Aggregator to bring together data from a variety of systems to support space exploration. Data Aggregator includes a central data model registry for storing and managing links between the data in disparate systems. Initially developed for NASA's Constellation Program needs, Data Aggregator is currently being repurposed to support the International Space Station Program and new NASA projects with processes that involve significant aggregating and linking of data. This change in user needs led to development of a more streamlined data model registry for Data Aggregator in order to simplify adding new project application data as well as standardization of the Data Aggregator query syntax to facilitate cross-application querying by client applications. This paper documents the approach from a set of stand-alone engineering systems from which data are manually retrieved and integrated, to a web of engineering data systems from which the latest data are automatically retrieved and more quickly and accurately integrated. This paper includes the lessons learned through these efforts, including the design and development of a service-oriented architecture and the evolution of the data model registry approaches as the effort continues to evolve and adapt to support multiple NASA programs and priorities.

A pilot study of distributed knowledge management and clinical decision support in the cloud.

PubMed

Dixon, Brian E; Simonaitis, Linas; Goldberg, Howard S; Paterno, Marilyn D; Schaeffer, Molly; Hongsermeier, Tonya; Wright, Adam; Middleton, Blackford

2013-09-01

Implement and perform pilot testing of web-based clinical decision support services using a novel framework for creating and managing clinical knowledge in a distributed fashion using the cloud. The pilot sought to (1) develop and test connectivity to an external clinical decision support (CDS) service, (2) assess the exchange of data to and knowledge from the external CDS service, and (3) capture lessons to guide expansion to more practice sites and users. The Clinical Decision Support Consortium created a repository of shared CDS knowledge for managing hypertension, diabetes, and coronary artery disease in a community cloud hosted by Partners HealthCare. A limited data set for primary care patients at a separate health system was securely transmitted to a CDS rules engine hosted in the cloud. Preventive care reminders triggered by the limited data set were returned for display to clinician end users for review and display. During a pilot study, we (1) monitored connectivity and system performance, (2) studied the exchange of data and decision support reminders between the two health systems, and (3) captured lessons. During the six month pilot study, there were 1339 patient encounters in which information was successfully exchanged. Preventive care reminders were displayed during 57% of patient visits, most often reminding physicians to monitor blood pressure for hypertensive patients (29%) and order eye exams for patients with diabetes (28%). Lessons learned were grouped into five themes: performance, governance, semantic interoperability, ongoing adjustments, and usability. Remote, asynchronous cloud-based decision support performed reasonably well, although issues concerning governance, semantic interoperability, and usability remain key challenges for successful adoption and use of cloud-based CDS that will require collaboration between biomedical informatics and computer science disciplines. Decision support in the cloud is feasible and may be a reasonable path toward achieving better support of clinical decision-making across the widest range of health care providers. Published by Elsevier B.V.

Tinnitus referral pathways within the National Health Service in England: a survey of their perceived effectiveness among audiology staff

PubMed Central

2011-01-01

Background In the UK, audiology services deliver the majority of tinnitus patient care, but not all patients experience the same level of service. In 2009, the Department of Health released a Good Practice Guide to inform commissioners about key aspects of a quality tinnitus service in order to promote equity of tinnitus patient care in UK primary care, audiology, and in specialist multi-disciplinary centres. The purpose of the present research was to evaluate utilisation and opinions on pathways for the referral of tinnitus patients to and from English Audiology Departments. Methods We surveyed all audiology staff engaged in providing tinnitus services across England. A 36-item questionnaire was mailed to 351 clinicians in all 163 National Health Service (NHS) Trusts identified as having a tinnitus service. 138 clinicians responded. The results presented here describe experiences and opinions of the current patient pathways to and from the audiology tinnitus service. Results The most common referral pathway was from general practice to a hospital-based Ear, Nose & Throat department and from there to a hospital-based audiology department (64%). Respondents considered the NHS tinnitus referral process to be generally effective (67%), but expressed needs for improving GP referral and patients' access to services. 'Open access' to the audiology clinic was rarely an option for patients (9%), nor was the opportunity to access specialist counselling provided by clinical psychology (35%). To decrease the number of inappropriate referrals, 40% of respondents called for greater awareness by referrers about the audiology tinnitus service. Conclusions Respondents in the present survey were generally satisfied with the tinnitus referral system. However, they highlighted some potential targets for service improvement including 1] faster and more appropriate referral from GPs, to be achieved through education on tinnitus referral criteria, 2] improved access to psychological services through audiologist training, and 3] ongoing support from tinnitus support groups, national charities, or open access to the tinnitus clinic for existing patients. PMID:21733188

Tinnitus referral pathways within the National Health Service in England: a survey of their perceived effectiveness among audiology staff.

PubMed

Gander, Phillip E; Hoare, Derek J; Collins, Luke; Smith, Sandra; Hall, Deborah A

2011-07-06

In the UK, audiology services deliver the majority of tinnitus patient care, but not all patients experience the same level of service. In 2009, the Department of Health released a Good Practice Guide to inform commissioners about key aspects of a quality tinnitus service in order to promote equity of tinnitus patient care in UK primary care, audiology, and in specialist multi-disciplinary centres. The purpose of the present research was to evaluate utilisation and opinions on pathways for the referral of tinnitus patients to and from English Audiology Departments. We surveyed all audiology staff engaged in providing tinnitus services across England. A 36-item questionnaire was mailed to 351 clinicians in all 163 National Health Service (NHS) Trusts identified as having a tinnitus service. 138 clinicians responded. The results presented here describe experiences and opinions of the current patient pathways to and from the audiology tinnitus service. The most common referral pathway was from general practice to a hospital-based Ear, Nose & Throat department and from there to a hospital-based audiology department (64%). Respondents considered the NHS tinnitus referral process to be generally effective (67%), but expressed needs for improving GP referral and patients' access to services. 'Open access' to the audiology clinic was rarely an option for patients (9%), nor was the opportunity to access specialist counselling provided by clinical psychology (35%). To decrease the number of inappropriate referrals, 40% of respondents called for greater awareness by referrers about the audiology tinnitus service. Respondents in the present survey were generally satisfied with the tinnitus referral system. However, they highlighted some potential targets for service improvement including 1] faster and more appropriate referral from GPs, to be achieved through education on tinnitus referral criteria, 2] improved access to psychological services through audiologist training, and 3] ongoing support from tinnitus support groups, national charities, or open access to the tinnitus clinic for existing patients.

Impact of land use on the biodiversity integrity of the moist sub-biome of the grassland biome, South Africa.

PubMed

O'Connor, T G; Kuyler, P

2009-01-01

South Africa's moist grassland harbours globally significant biodiversity, supplies essential ecosystem services, supports crop and livestock agriculture, forestry and settlement, yet is poorly conserved. Ongoing transformation and limited opportunity for expanding the protected area network require instead that biodiversity conservation is 'mainstreamed' within other land uses. This exercise sought to identify the relative compatibility of 10 land uses (conservation, livestock or game ranching, tourism/recreation, rural settlement, dryland cropping, irrigated cropping, dairy farming, plantation forestry, and urban settlement) with maintaining biodiversity integrity. This was assessed using 46 indicators for biodiversity integrity that covered landscape composition, structure, and functioning. Data was integrated into a single measure per land use through application of the analytic hierarchy process, with supporting information gained from interviews with experts. The rank order of importance amongst indicators was landscape structure, functioning and composition. Consistent differences among land uses for all three categories revealed two clear groupings. Conservation, livestock or game ranching had the lowest impact and retained substantial natural asset, while that for tourism/recreation was intermediate. All other land uses had a severe impact. Impact on biodiversity integrity depended mainly on the extent of transformation and fragmentation, which accounted for the greatest impact on habitats and species, and impairment of landscape functioning. It is suggested that a strategic intervention for maintaining biodiversity integrity of moist grassland is to support livestock or game ranching and limit ongoing urban sprawl.

Interprofessional learning modules at Dalhousie University.

PubMed

Johnston, G; Banks, S

2000-01-01

Interprofessional education has been advocated to improve teamwork in the health sector. This paper reports on the first two years of operational experience by a School of Health Services Administration (SHSA) with three-hour interprofessional learning modules (IPLMs). SHSA students participated along with students from nursing, medicine, social work, physiotherapy, occupational therapy, pharmacy, speech language pathology, audiology, dental hygiene, dentistry, leisure studies, health education and kinesiology. The five IPLMs required for SHSA students were: professional roles and values, integrity in scholarly activity, disability, interpersonal violence and HIV/AIDS. This article describes the development, delivery and evaluation of these modules from an SHSA perspective. The IPLMs' evaluation findings indicated that IPLMs are worthwhile, but have taken years and ongoing senior management support to operationalize; inclusion of health services administration is worthwhile but challenging; vigilance is needed to retain an IP rather than module content focus; and faculty and facilitator development, along with student preparation and debriefing, is required. Student feedback was favourable; faculty members have gained by their involvement; and field practitioner support has been sustained. Evaluation and reflection are critical to IPLM evolution. The norms, strengths and constraints of the university must be taken into account, and thus IPLMs must be adapted for each educational setting. Schools of health services administration must decide whether they wish to be involved in interprofessional learning.

Building foundations for the future: the NHS Scotland advanced practice succession planning development pathway.

PubMed

Currie, Kay; Grundy, Maggie

2011-10-01

To highlight implications for managers from the implementation of a national advanced practice succession planning development pathway within Scotland. Internationally, advanced practice posts have often developed in an ad-hoc manner, with little organizational attention to succession planning. Evaluation of a pilot national succession planning development pathway identified mechanisms which facilitate or hamper effective planning for advanced practice roles. A responsive evaluation design incorporating semi-structured questionnaires to pathway participants (n = 15) and semi-structured telephone interviews with case-site pathway participants (n = 7) and their line managers. Managers believed the development pathway was worthwhile; however, there was limited strategic planning to match individuals' development to service need. Practitioners generally perceived managers as interested in their development, although levels of practical support varied. There is concern from both managers and practitioners regarding ongoing funding for advanced practice development. The present evaluation study reiterates the need for organizational commitment to succession planning including robust service needs analysis mechanisms and adequate funding for development processes. Nurse managers are viewed as the 'gatekeepers' to opportunities for developing advanced nurse practitioners; scare resources must be targeted effectively to support succession planning through the development of selected individuals for future advanced practice posts, justified by service need. © 2011 Blackwell Publishing Ltd.

Initial and Ongoing Teacher Preparation and Support: Current Problems and Possible Solutions

ERIC Educational Resources Information Center

Johnson, Harold A.

2013-01-01

The effective initial preparation and ongoing support of teachers of students who are deaf and hard of hearing has always been a difficult and controversial task. Changes in student demographic characteristics and educational settings, combined with the rapidly diminishing number and diversity of deaf education teacher preparation (DETP) programs,…

Characteristics and service needs of women and babies admitted to residential parenting units in New South Wales: a mixed methods study.

PubMed

Priddis, Holly; Thornton, Charlene; Fowler, Cathrine; Schmied, Virginia; Tooher, Jane; Dickinson, Marie; Dahlen, Hannah Grace

2018-04-27

This study aims to examine the characteristics and service needs of women and babies admitted to Residential Parenting Services (RPS) in the first year following birth in New South Wales (NSW), Australia. In Australia there is a tiered system to support maternal, child and family health, which includes residential parenting services (RPS). Sequential explanatory mixed methods design. Individual patient data were obtained from a random review of 10% of all medical records (n = 300 of 3011 admissions) of women with an infant of less than 12 months of age who were admitted to RPS in 2013. Following review of the medical records, qualitative data were collected via interviews with eight women who accessed RPS. Chi square analysis and student t-testing were used to analyse quantitative data. Qualitative data were analysed using a descriptive interpretive approach. An integrative approach was taken in reporting the findings RESULTS: Women admitted to the RPS were on average 32 years of age, were Australian born (72%), had a university qualification (40%) and most were employed. The majority of women were primiparous (60%), and had a vaginal birth (61%). Women with male infants were much more likely to be admitted to the RPS (58%) compared to the NSW male to female ratio (51.3% versus 48.7%). Over 50% of women reported mental health issues with 27% having an Edinburgh Postnatal Depression Scale score ≥13 on admission. The primary reason women sought parenting support were for sleep and settling (83%). During their stay, services used by women included social workers (44%), psychologists (52%) and psychiatrists (4.5%). Women who access RPS report psychosocial and mental health issues. Services provided by RPS support women during this challenging early parenting period by providing multidisciplinary, holistic and peer support. A high prevalence of mental health issues identified in this study indicated a need for ongoing training and support for RPS staff. Ensuring clinicians have the appropriate skill sets to best support their clientele will maximise the outcomes for women and families who access RPS during the early parenting period. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Evaluation of an ongoing psychoeducational inflammatory bowel disease support group in an adult outpatient setting.

PubMed

McMaster, Kristin; Aguinaldo, Laika; Parekh, Nimisha K

2012-01-01

Previous studies assessing efficacy of support groups for patients with inflammatory bowel disease showed mixed results in terms of attendance and overall effectiveness. In this study, researchers evaluated the use of an ongoing open psychoeducational support group for adult patients with inflammatory bowel disease in an outpatient tertiary setting. The sample consisted of 18 adults who have attended more than 2 meetings of the support group. Topics addressed in the support group include complementary medicine, diet and nutrition, the psychological impact of inflammatory bowel disease, medication and side effects, and insurance/disability. Participants were asked to complete the Client Satisfaction Questionnaire, Multidimensional Support Scale, 11 general demographic questions, and a brief open-ended qualitative questionnaire developed by the researchers. Results demonstrated that participants reported very high satisfaction with the support group and rated the adequacy of peer support from others with inflammatory bowel disease higher than support from family/friends and professionals. A majority of group members reported joining the group for mutual support and education; this expectation was met through the psychoeducational structure of the group. This study demonstrates the potential for success of an ongoing psychoeducational inflammatory bowel disease support group for adult patients and their caregivers.

Examination of England's New Medicine Service (NMS) of complex health care interventions in community pharmacy.

PubMed

Latif, Asam; Waring, Justin; Watmough, Deborah; Barber, Nick; Chuter, Anthony; Davies, James; Salema, Nde-Eshimuni; Boyd, Matthew J; Elliott, Rachel A

Community pharmacies are increasingly commissioned to deliver new, complex health interventions in response to the growing demands on family doctors and secondary health care services. Little is known about how these complex interventions are being accommodated and translated into the community pharmacy setting and whether their aims and objectives are realized in practice. The New Medicine Service (NMS) is a complex medicine management intervention that aims to support patients' adherence to newly prescribed medicines for a long-term condition. This study explores the recent implementation of the NMS in community pharmacies across England. It also seeks to understand how the service is becoming manifest in practice and what lessons can be learned for future service implementation. Structured, organizational ethnographic observations and in situ workplace interviews with pharmacists and support staff were undertaken within 23 English community pharmacies. Additionally, one-to-one, semi-structured interviews were carried out with 47 community pharmacists and 11 general practitioners (GPs). Observational and interview data were transcribed and analyzed thematically and guided by Damschroder's consolidated framework for implementation research. The NMS workload had been implemented and absorbed into pharmacists' daily routines alongside existing responsibilities with no extra resources and little evidence of reduction in other responsibilities. Pharmacists were pragmatic, simplifying, and adapting the NMS to facilitate its delivery and using discretion to circumvent perceived non-essential paperwork. Pharmacist understanding of the NMS was found to impact on what they believed should be achieved from the service. Despite pharmacists holding positive views about the value of the NMS, not all were convinced of its perceived benefits and necessity, with reports that many consultations did not identify any problems with the patients' medicines. GPs were generally supportive of the initiative but were unaware of the service or potential benefits. Poorly developed existing pharmacist-GP relationships impeded implementation. This study identifies the multifaceted and complex processes involved in implementing a new community pharmacy service in England. Community pharmacy workflow, infrastructure, and public and professional relationships all affect NMS implementation. Greater prior engagement with the pharmacy workforce and GPs, robust piloting and a phased rollout together with ongoing support and updates, are potentials strategies to ensure future implementation of pharmacy services meet their intended aims in practice. Copyright © 2015 Elsevier Inc. All rights reserved.

A service model for delivering care closer to home.

PubMed

Dodd, Joanna; Taylor, Charlotte Elizabeth; Bunyan, Paul; White, Philippa Mary; Thomas, Siân Myra; Upton, Dominic

2011-04-01

Upton Surgery (Worcestershire) has developed a flexible and responsive service model that facilitates multi-agency support for adult patients with complex care needs experiencing an acute health crisis. The purpose of this service is to provide appropriate interventions that avoid unnecessary hospital admissions or, alternatively, provide support to facilitate early discharge from secondary care. Key aspects of this service are the collaborative and proactive identification of patients at risk, rapid creation and deployment of a reactive multi-agency team and follow-up of patients with an appropriate long-term care plan. A small team of dedicated staff (the Complex Care Team) are pivotal to coordinating and delivering this service. Key skills are sophisticated leadership and project management skills, and these have been used sensitively to challenge some traditional roles and boundaries in the interests of providing effective, holistic care for the patient.This is a practical example of early implementation of the principles underlying the Department of Health's (DH) recent Best Practice Guidance, 'Delivering Care Closer to Home' (DH, July 2008) and may provide useful learning points for other general practice surgeries considering implementing similar models. This integrated case management approach has had enthusiastic endorsement from patients and carers. In addition to the enhanced quality of care and experience for the patient, this approach has delivered value for money. Secondary care costs have been reduced by preventing admissions and also by reducing excess bed-days. The savings achieved have justified the ongoing commitment to the service and the staff employed in the Complex Care Team. The success of this service model has been endorsed recently by the 'Customer Care' award by 'Management in Practice'. The Surgery was also awarded the 'Practice of the Year' award for this and a number of other customer-focussed projects.

42 CFR 137.338 - Must funds from other sources be incorporated into a construction project agreement?

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL... Secretary must include funds from other agencies as permitted by law, whether on an ongoing or a one-time...

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 sustainable infrastructure management: knowledge-based service-oriented computing framework for visual analytics

NASA Astrophysics Data System (ADS)

Vatcha, Rashna; Lee, Seok-Won; Murty, Ajeet; Tolone, William; Wang, Xiaoyu; Dou, Wenwen; Chang, Remco; Ribarsky, William; Liu, Wanqiu; Chen, Shen-en; Hauser, Edd

2009-05-01

Infrastructure management (and its associated processes) is complex to understand, perform and thus, hard to make efficient and effective informed decisions. The management involves a multi-faceted operation that requires the most robust data fusion, visualization and decision making. In order to protect and build sustainable critical assets, we present our on-going multi-disciplinary large-scale project that establishes the Integrated Remote Sensing and Visualization (IRSV) system with a focus on supporting bridge structure inspection and management. This project involves specific expertise from civil engineers, computer scientists, geographers, and real-world practitioners from industry, local and federal government agencies. IRSV is being designed to accommodate the essential needs from the following aspects: 1) Better understanding and enforcement of complex inspection process that can bridge the gap between evidence gathering and decision making through the implementation of ontological knowledge engineering system; 2) Aggregation, representation and fusion of complex multi-layered heterogeneous data (i.e. infrared imaging, aerial photos and ground-mounted LIDAR etc.) with domain application knowledge to support machine understandable recommendation system; 3) Robust visualization techniques with large-scale analytical and interactive visualizations that support users' decision making; and 4) Integration of these needs through the flexible Service-oriented Architecture (SOA) framework to compose and provide services on-demand. IRSV is expected to serve as a management and data visualization tool for construction deliverable assurance and infrastructure monitoring both periodically (annually, monthly, even daily if needed) as well as after extreme events.

Barriers and facilitators to tobacco cessation in a nationwide sample of addiction treatment programs

PubMed Central

Pagano, Anna; Tajima, Barbara; Guydish, Joseph

2016-01-01

Introduction Smoking rates among addiction treatment clients are 3–4 times higher than those of the general population. Recent studies indicate that ceasing tobacco use during treatment may improve recovery outcomes. Across the United States, publicly funded addiction treatment programs vary widely in terms of their tobacco policies and tobacco cessation services offered to clients. Methods The study reported here is the qualitative component of a larger study. Twenty-four programs were recruited from a random sample of publicly funded programs participating in the NIDA Clinical Trials Network. Semistructured interviews were administered by phone to program directors. ATLAS.ti software was used to facilitate thematic analysis of interview transcripts. Findings While all directors expressed interest in helping clients to quit smoking, they cited numerous barriers to implementing tobacco policies and services. These included smoking culture, client resistance, lack of resources, staff smoking, and environmental barriers. Directors also cited several factors that they believed would support tobacco cessation. These included financial support, enhanced leadership, and state mandates against smoking in addiction treatment programs. Conclusion Addiction treatment programs are beginning to place more emphasis on tobacco cessation during treatment. However, furthering this goal requires substantial infrastructural and cultural change. These qualitative study findings may help to inform Single State Agencies (SSAs) to support publicly funded addiction treatment programs in their tobacco cessation efforts. In order to maximize effectiveness, state-level policies regarding tobacco cessation during treatment should be informed by ongoing dialogue between service providers and SSAs. PMID:27296658

A qualitative comparative analysis of well-managed school sanitation in Bangladesh

PubMed Central

2014-01-01

Background Continued management of sanitation and hygiene services, post-intervention, is a global challenge, particularly in the school-setting. This situation threatens anticipated impacts of school sanitation and hygiene investments. To improve programming and policies, and increase the effectiveness of limited development resources, we seek to understand how and why some schools have well-managed sanitation post-intervention, while others do not. Methods Based on in-depth qualitative data from 16 case schools in Meherpur, Bangladesh, we employ fuzzy-set qualitative comparative analysis to identify the necessary and sufficient conditions, or combinations of conditions (referred to as pathways), that lead to either well-managed or poorly managed school sanitation. We include posited sustainability determinants from the literature and factors that emerged from the cases themselves in the analysis. Results We identified three distinct pathways sufficient to support well-managed services, providing multiple options for how well-managed school sanitation could be encouraged. Two of these are applicable to both government and non-government schools: (1) quality construction, financial community support and a champion; and (2) quality construction, financial government support, a maintenance plan and school management committee involvement. On-going financial support for operations and maintenance was identified as a necessary condition for continued service management, which was absent from many schools with poorly managed services. However, financial support was insufficient alone and other conditions are needed in conjunction, including quality construction and incentivizing conditions, such as school management committee involvement in sanitation specifically, a sanitation champion, and/or one teacher clearly responsible for toilet maintenance. Surprisingly, the number of students per toilet (ranging from 18–95 students) and toilet age (ranging from 8–32 months) had no significant effect on sanitation conditions. Conclusions Findings corroborate those from a similar study in Belize, and comparison suggests the need for financial community support and the possibly tenuous reliance on local champions in the absence of adequate government support for operations and maintenance. Sub-determinants to the necessary conditions are also discussed which have implications for school sanitation in Bangladesh and may have broader relevance for other low-income countries though further research is needed. PMID:24397540

A qualitative comparative analysis of well-managed school sanitation in Bangladesh.

PubMed

Chatterley, Christie; Javernick-Will, Amy; Linden, Karl G; Alam, Kawser; Bottinelli, Laure; Venkatesh, Mohini

2014-01-08

Continued management of sanitation and hygiene services, post-intervention, is a global challenge, particularly in the school-setting. This situation threatens anticipated impacts of school sanitation and hygiene investments. To improve programming and policies, and increase the effectiveness of limited development resources, we seek to understand how and why some schools have well-managed sanitation post-intervention, while others do not. Based on in-depth qualitative data from 16 case schools in Meherpur, Bangladesh, we employ fuzzy-set qualitative comparative analysis to identify the necessary and sufficient conditions, or combinations of conditions (referred to as pathways), that lead to either well-managed or poorly managed school sanitation. We include posited sustainability determinants from the literature and factors that emerged from the cases themselves in the analysis. We identified three distinct pathways sufficient to support well-managed services, providing multiple options for how well-managed school sanitation could be encouraged. Two of these are applicable to both government and non-government schools: (1) quality construction, financial community support and a champion; and (2) quality construction, financial government support, a maintenance plan and school management committee involvement. On-going financial support for operations and maintenance was identified as a necessary condition for continued service management, which was absent from many schools with poorly managed services. However, financial support was insufficient alone and other conditions are needed in conjunction, including quality construction and incentivizing conditions, such as school management committee involvement in sanitation specifically, a sanitation champion, and/or one teacher clearly responsible for toilet maintenance. Surprisingly, the number of students per toilet (ranging from 18-95 students) and toilet age (ranging from 8-32 months) had no significant effect on sanitation conditions. Findings corroborate those from a similar study in Belize, and comparison suggests the need for financial community support and the possibly tenuous reliance on local champions in the absence of adequate government support for operations and maintenance. Sub-determinants to the necessary conditions are also discussed which have implications for school sanitation in Bangladesh and may have broader relevance for other low-income countries though further research is needed.

Hotel shows health system keys to service excellence.

PubMed

2003-08-01

Ritz-Carlton partnership part of broader program pursuing service excellence. Nearly 600 system leaders will participate in day-long seminars. GE, Harvard serve as strategic partners for ongoing educational efforts.

Implementing a Primary Healthcare Framework: The Importance of Nursing Leadership in Developing and Maintaining a Brain Tumor Support Group.

PubMed

Nichols, Linda J; Wright, Kylie M

2015-08-01

Although brain tumor support groups have been available internationally for many years, Liverpool Hospital in Australia has not traditionally provided this service. As a leadership initiative, the development of a brain tumor support group that incorporates a primary healthcare framework is a sustainable approach that showcases the role of nursing leaders in changing attitudes and improving outcomes. The purpose of this review of the literature and reflection of clinical experience is to explore nursing leadership within brain tumor-specific support groups. This article will showcase a nurse-led group that incorporated a coordinated approach to delivering patient-centered care. The initiation of activities and interventions that reflected the five tenets of primary health care resulted in improved outcomes for individuals and their family caregivers throughout the trajectory of their illness. Vital to the success of this project was moving from a standalone leader to building collective and collaborative leadership more conducive to facilitating change. The support group successfully demonstrated that individuals and family caregivers may see ongoing and long-term improvements during and following treatment.

20 CFR 653.108 - State agency self-monitoring.

Code of Federal Regulations, 2010 CFR

2010-04-01

... compliance with JS regulations in serving MSFWs on an ongoing basis. The State Administrator shall have... Advocate shall: (1) Conduct an ongoing review of the delivery of services and protections afforded by JS... required reports, management information, the JS complaint system or otherwise are reviewed as soon as...

Experiences in Bridging the Gap between Science and Decision Making at NASA's GSFC Earth Science Data and Information Services Center (GES DISC)

NASA Technical Reports Server (NTRS)

Kempler, Steven; Teng, Bill; Friedl, Lawrence; Lynnes, Chris; Leptoukh, Gregory

2008-01-01

Recognizing the significance of NASA remote sensing Earth science data in monitoring and better understanding our planet s natural environment, NASA has implemented the Decision Support Through Earth Science Research Results program (NASA ROSES solicitations). a) This successful program has yielded several monitoring, surveillance, and decision support systems through collaborations with benefiting organizations. b) The Goddard Space Flight Center (GSFC) Earth Sciences Data and Information Services Center (GES DISC) has participated in this program on two projects (one complete, one ongoing), and has had opportune ad hoc collaborations gaining much experience in the formulation, management, development, and implementation of decision support systems utilizing NASA Earth science data. c) In addition, GES DISC s understanding of Earth science missions and resulting data and information, including data structures, data usability and interpretation, data interoperability, and information management systems, enables the GES DISC to identify challenges that come with bringing science data to decision makers. d) The purpose of this presentation is to share GES DISC decision support system project experiences in regards to system sustainability, required data quality (versus timeliness), data provider understanding of how decisions are made, and the data receivers willingness to use new types of information to make decisions, as well as other topics. In addition, defining metrics that really evaluate success will be exemplified.

Towards a Community-Based Dementia Care Strategy: A Perspective from Quebec.

PubMed

Godard-Sebillotte, Claire; Vedel, Isabelle; Bergman, Howard

Morton-Chang et al. highlighted in their article the key strategic pillars of a community-based dementia care strategy: put "people first," support informal caregiving and enable "ground up" innovation and change. In our commentary, we draw upon our experience as authors of the Quebec Alzheimer Plan and evaluators of its implementation by the Quebec Ministry of Health and Social Services (MSSS). To us, a sustainable dementia care strategy entails a patient-centred approach, grounded in primary care, caring for persons with dementia at every stage of the disease. Implementation of such a strategy requires an ongoing effort to allow innovation adoption by clinicians and organizations.

Primary Care Collaborative Memory Clinics: Building Capacity for Optimized Dementia Care.

PubMed

Lee, Linda; Hillier, Loretta M; Molnar, Frank; Borrie, Michael J

2017-01-01

Increasingly, primary care collaborative memory clinics (PCCMCs) are being established to build capacity for person-centred dementia care. This paper reflects on the significance of PCCMCs within the system of care for older adults, supported with data from ongoing evaluation studies. Results highlight timelier access to assessment with a high proportion of patients being managed in primary care within a person-centred approach to care. Enhancing primary care capacity for dementia care with interprofessional and collaborative care will strengthen the system's ability to respond to increasing demands for service and mitigate the growth of wait times to access geriatric specialist assessment.

An 8 Meter Monolithic UV/Optical Space Telescope

NASA Technical Reports Server (NTRS)

Stahl, H. Philip; Postman, Marc

2008-01-01

The planned Ares V launch vehicle with its 10 meter fairing and at least 55,600 kg capacity to Earth Sun L2 enables entirely new classes of space telescopes. A consortium from NASA, Space Telescope Science Institute, and aerospace industry are studying an 8-meter monolithic primary mirror UV/optical/NIR space telescope to enable new astrophysical research that is not feasible with existing or near-term missions, either space or ground. This paper briefly reviews the science case for such a mission and presents the results of an on-going technical feasibility study, including: optical design; structural design/analysis including primary mirror support structure, sun shade and secondary mirror support structure; thermal analysis; launch vehicle performance and trajectory; spacecraft including structure, propulsion, GN&C, avionics, power systems and reaction wheels; operations & servicing; mass budget and cost.

KSC-2013-3077

NASA Image and Video Library

2013-07-22

HOUSTON - JSC2013e068259 - NASA astronaut Serena Aunon prepares for a fit check evaluation of The Boeing Company's CST-100 spacecraft at the company's Houston Product Support Center. Assisting her is Andrea Gilkey, a human factors engineer with The Boeing Company. Aunon's fit check will help evaluate a crew's maneuverability in the spacecraft and test communications. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

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.

Multistrategy childcare-based intervention to improve compliance with nutrition guidelines versus usual care in long day care services: a study protocol for a randomised controlled trial

PubMed Central

Seward, Kirsty; Finch, Meghan; Wiggers, John; Wyse, Rebecca; Jones, Jannah; Gillham, Karen; Yoong, Sze Lin

2016-01-01

Introduction Interventions to improve child diet are recommended as dietary patterns developed in childhood track into adulthood and influence the risk of chronic disease. For child health, childcare services are required to provide foods to children consistent with nutrition guidelines. Research suggests that foods and beverages provided by services to children are often inconsistent with nutrition guidelines. The primary aim of this study is to assess, relative to a usual care control group, the effectiveness of a multistrategy childcare-based intervention in improving compliance with nutrition guidelines in long day care services. Methods and analysis The study will employ a parallel group randomised controlled trial design. A sample of 58 long day care services that provide all meals (typically includes 1 main and 2 mid-meals) to children while they are in care, in the Hunter New England region of New South Wales, Australia, will be randomly allocated to a 6-month intervention to support implementation of nutrition guidelines or a usual care control group in a 1:1 ratio. The intervention was designed to overcome barriers to the implementation of nutrition guidelines assessed using the theoretical domains framework. Intervention strategies will include the provision of staff training and resources, audit and feedback, ongoing support and securing executive support. The primary outcome of the trial will be the change in the proportion of long day care services that have a 2-week menu compliant with childcare nutrition guidelines, measured by comprehensive menu assessments. As a secondary outcome, child dietary intake while in care will also be assessed. To assess the effectiveness of the intervention, the measures will be undertaken at baseline and ∼6 months postbaseline. Ethics and dissemination The study was approved by the Hunter New England Human Research Ethics Committee. Study findings will be disseminated widely through peer-reviewed publications. PMID:27301484

A Road Map for Empowering Undergraduates to Practice Service Leadership through Service-Learning in Teams

ERIC Educational Resources Information Center

Snell, Robin Stanley; Chan, Maureen Yin Lee; Ma, Carol Hok Ka; Chan, Carman Ka Man

2015-01-01

We present a road map for providing course-embedded service-learning team projects as opportunities for undergraduates to practice as service leaders in Asia and beyond. Basic foundations are that projects address authentic problems or needs, partner organization representatives (PORs) indicate availability for ongoing consultation, students…

Leveraging community support for Education and Outreach: The IRIS E&O Program

NASA Astrophysics Data System (ADS)

Taber, J.; Hubenthal, M.; Wysession, M. E.

2009-12-01

The IRIS E&O Program was initiated 10 years ago, some 15 years after the creation of the IRIS Consortium, as IRIS members increasingly recognized the fundamental need to communicate the results of scientific research more effectively and to attract more students to study Earth science. Since then, IRIS E&O has received core funding through successive 5-year cooperative agreements with NSF, based on proposals submitted by IRIS. While a small fraction of the overall Consortium budget, this consistent funding has allowed the development of strong, long-term elements within the E&O Program, including summer internships, IRIS/USGS museum displays, seismographs in schools, IRIS/SSA Distinguished Lecture series, and professional development for middle school and high school teachers. Reliable funding has allowed us to develop expertise in these areas due to the longevity of the programs and the continuous improvement resulting from ongoing evaluations. Support from Consortium members, including volunteering time and expertise, has been critical for the program, as the Consortium has to continually balance the value of E&O products versus equipment and data services for seismology research. The E&O program also provides service to the Consortium, such as PIs being able to count on and leverage IRIS resources when defining the broader impacts of their own research. The reliable base has made it possible to build on the core elements with focused and innovative proposals, allowing, for example, the expansion of our internship program into a full REU site. Developing collaborative proposals with other groups has been a key strategy where IRIS E&O's long-term viability can be combined with expertise from other organizations to develop new products and services. IRIS can offer to continue to reliably deliver and maintain products after the end of a 2-3 year funding cycle, which can greatly increase the reach of the project. Consortium backing has also allowed us to establish an educational fund in honor of the late John Lahr. This fund, which is comprised of individual donations, is being used to provide seismographs to schools along with professional development and ongoing support from the E&O program. We are also developing a plan for attracting larger private and/or foundation funds for new E&O activities, leveraging the reputation of a long-term program.

Practice-centred evaluation and the privileging of care in health information technology evaluation

PubMed Central

2014-01-01

Background Electronic Patient Records (EPRs) and telemedicine are positioned by policymakers as health information technologies that are integral to achieving improved clinical outcomes and efficiency savings. However, evaluating the extent to which these aims are met poses distinct evaluation challenges, particularly where clinical and cost outcomes form the sole focus of evaluation design. We propose that a practice-centred approach to evaluation - in which those whose day-to-day care practice is altered (or not) by the introduction of new technologies are placed at the centre of evaluation efforts – can complement and in some instances offer advantages over, outcome-centric evaluation models. Methods We carried out a regional programme of innovation in renal services where a participative approach was taken to the introduction of new technologies, including: a regional EPR system and a system to support video clinics. An ‘action learning’ approach was taken to procurement, pre-implementation planning, implementation, ongoing development and evaluation. Participants included clinicians, technology specialists, patients and external academic researchers. Whilst undergoing these activities we asked: how can a practice-centred approach be embedded into evaluation of health information technologies? Discussion Organising EPR and telemedicine evaluation around predetermined outcome measures alone can be impractical given the complex and contingent nature of such projects. It also limits the extent to which unforeseen outcomes and new capabilities are recognised. Such evaluations often fail to improve understanding of ‘when’ and ‘under what conditions’ technology-enabled service improvements are realised, and crucially, how such innovation improves care. Summary Our contribution, drawn from our experience of the case study provided, is a protocol for practice-centred, participative evaluation of technology in the clinical setting that privileges care. In this context ‘practice-centred’ evaluation acts as a scalable, coordinating framework for evaluation that recognises health information technology supported care as an achievement that is contingent and ongoing. We argue that if complex programmes of technology-enabled service innovation are understood in terms of their contribution to patient care and supported by participative, capability-building evaluation methodologies, conditions are created for practitioners and patients to realise the potential of technologies and make substantive contributions to the evidence base underpinning health innovation programmes. PMID:24903604

Reciprocity of agonistic support in ravens

PubMed Central

Fraser, Orlaith N.; Bugnyar, Thomas

2012-01-01

Cooperative behaviour through reciprocation or interchange of valuable services in primates has received considerable attention, especially regarding the timeframe of reciprocation and its ensuing cognitive implications. Much less, however, is known about reciprocity in other animals, particularly birds. We investigated patterns of agonistic support (defined as a third party intervening in an ongoing conflict to attack one of the conflict participants, thus supporting the other) in a group of 13 captive ravens, Corvus corax. We found support for long-term, but not short-term, reciprocation of agonistic support. Ravens were more likely to support individuals who preened them, kin and dominant group members. These results suggest that ravens do not reciprocate on a calculated tit-for-tat basis, but aid individuals from whom reciprocated support would be most useful and those with whom they share a good relationship. Additionally, dyadic levels of agonistic support and consolation (postconflict affiliation from a bystander to the victim) correlated strongly with each other, but we found no evidence to suggest that receiving agonistic support influences the victim’s likelihood of receiving support (consolation) after the conflict ends. Our findings are consistent with an emotionally mediated form of reciprocity in ravens and provide additional support for convergent cognitive evolution in birds and mammals. PMID:22298910

NASA AND ESA Partnership on the Multi-Purpose Crew Vehicle Service Module

NASA Technical Reports Server (NTRS)

Free, James M.; Schubert, Kathleen; Grantier, Julie

2012-01-01

In March 2011, NASA and ESA made a decision to partially offset the European obligations deriving from the extension of the ISS Program until the end of 2020 with different means than ATVs, following the ATV-5 mission foreseen in mid-2014. NASA and ESA considered a number of barter options, and concluded that the provision by ESA of the Service Module and Spacecraft Adaptor for the NASA Multi-Purpose Crew Vehicle (MPCV) was the barter element with the most interest. A joint ESA - NASA working group was established to assess the feasibility of Europe developing this Module based on ATV heritage. The working group was supported by European and US industry namely Astrium, TAS-I and Lockheed-Martin. This paper gives an overview of the results of the on-going study as well as its projected utilization for the global space exploration endeavour.

Measuring the impact of long-term medicines use from the patient perspective.

PubMed

Krska, Janet; Morecroft, Charles W; Rowe, Philip H; Poole, Helen

2014-08-01

Polypharmacy is increasing, seemingly inexorably, and inevitably the associated difficulties for individual patients of coping with multiple medicines rise with it. Using medicines is one aspect of the burden associated with living with a chronic condition. It is becoming increasingly important to measure this burden particularly that relating to multiple long-term medicines. Pharmacists and other health professionals provide a myriad of services designed to optimise medicines use, ostensibly aiming to help and support patients, but in reality many such services focus on the medicines, and seek to improve adherence rather than reducing the burden for the patient. We believe that the patient perspective and experience of medicines use is fundamental to medicines optimisation and have developed an instrument which begins to quantify these experiences. The instrument, the Living with Medicines Questionnaire, was generated using qualitative findings with patients, to reflect their perspective. Further development is ongoing, involving researchers in multiple countries.

KSC-2013-3511

NASA Image and Video Library

2013-09-04

LAS VEGAS, Nev. – Engineers prepare a mock-up of The Boeing Company's CST-100 spacecraft for the third and final series of simulated contingency water landing scenarios at Bigelow Aerospace's headquarters near Las Vegas. The CST-100 is designed for ground landings, but could splash down on the water, if necessary. The tests are part of the company’s ongoing work supporting its funded Space Act Agreement with NASA’s Commercial Crew Program, or CCP, during the Commercial Crew Integrated Capability, or CCiCap, initiative. CCP is intended to lead to the availability of commercial human spaceflight services for government and commercial customers to low-Earth orbit. Future development and certification initiatives eventually will lead to the availability of human spaceflight services for NASA to send its astronauts to the International Space Station, where critical research is taking place daily. For more information about CCP, go to http://www.nasa.gov/commercialcrew. Photo credit: Boeing/Kelly George

KSC-2013-3513

NASA Image and Video Library

2013-09-04

LAS VEGAS, Nev. – A mock-up of The Boeing Company's CST-100 spacecraft is prepared for the third and final series of simulated contingency water landing scenarios at Bigelow Aerospace's headquarters near Las Vegas. The CST-100 is designed for ground landings, but could splash down on the water, if necessary. The tests are part of the company’s ongoing work supporting its funded Space Act Agreement with NASA’s Commercial Crew Program, or CCP, during the Commercial Crew Integrated Capability, or CCiCap, initiative. CCP is intended to lead to the availability of commercial human spaceflight services for government and commercial customers to low-Earth orbit. Future development and certification initiatives eventually will lead to the availability of human spaceflight services for NASA to send its astronauts to the International Space Station, where critical research is taking place daily. For more information about CCP, go to http://www.nasa.gov/commercialcrew. Photo credit: Boeing/Kelly George

KSC-2013-3510

NASA Image and Video Library

2013-09-04

LAS VEGAS, Nev. – An engineer prepares a mock-up of The Boeing Company's CST-100 spacecraft for the third and final series of simulated contingency water landing scenarios at Bigelow Aerospace's headquarters near Las Vegas. The CST-100 is designed for ground landings, but could splash down on the water, if necessary. The tests are part of the company’s ongoing work supporting its funded Space Act Agreement with NASA’s Commercial Crew Program, or CCP, during the Commercial Crew Integrated Capability, or CCiCap, initiative. CCP is intended to lead to the availability of commercial human spaceflight services for government and commercial customers to low-Earth orbit. Future development and certification initiatives eventually will lead to the availability of human spaceflight services for NASA to send its astronauts to the International Space Station, where critical research is taking place daily. For more information about CCP, go to http://www.nasa.gov/commercialcrew. Photo credit: Boeing/Kelly George

KSC-2013-3512

NASA Image and Video Library

2013-09-04

LAS VEGAS, Nev. – A mock-up of The Boeing Company's CST-100 spacecraft floats following the third and final series of simulated contingency water landing scenarios at Bigelow Aerospace's headquarters near Las Vegas. The CST-100 is designed for ground landings, but could splash down on the water, if necessary. The tests are part of the company’s ongoing work supporting its funded Space Act Agreement with NASA’s Commercial Crew Program, or CCP, during the Commercial Crew Integrated Capability, or CCiCap, initiative. CCP is intended to lead to the availability of commercial human spaceflight services for government and commercial customers to low-Earth orbit. Future development and certification initiatives eventually will lead to the availability of human spaceflight services for NASA to send its astronauts to the International Space Station, where critical research is taking place daily. For more information about CCP, go to http://www.nasa.gov/commercialcrew. Photo credit: Boeing/Kelly George

It's Just (Academic) Business: A Use Case in Improving Informatics Operations with Business Intelligence.

PubMed

McIntosh, Leslie D; Zabarovskaya, Connie; Uhlmansiek, Mary

2015-01-01

Academic biomedical informatics cores are beholden to funding agencies, institutional administration, collaborating researchers, and external agencies for ongoing funding and support. Services provided and translational research outcomes are increasingly important to monitor, report and analyze, to demonstrate value provided to the organization and the greater scientific community. Thus, informatics operations are also business operations. As such, adopting business intelligence practices offers an opportunity to improve the efficiency of evaluation efforts while fulfilling reporting requirements. Organizing informatics development documentation, service requests, and work performed with adaptable tools have greatly facilitated these and related business activities within our informatics center. Through the identification and measurement of key performance indicators, informatics objectives and results are now quickly and nimbly assessed using dashboards. Acceptance of the informatics operation as a business venture and the adoption of business intelligence strategies has allowed for data-driven decision making, faster corrective action, and greater transparency for interested stakeholders.

Public and private funding of general practice services for children and adolescents in New Zealand.

PubMed

Dovey, Susan; Tilyard, Murray; Cunningham, Wayne; Williamson, Martyn

2011-11-01

To measure public and private funding of general practice services for New Zealand children. Computerized records from 111 general practices provided private payments for 118,905 general practice services to children aged 6-17 years. Government subsidies and public insurance payments provided public funding amounts for seven services. Overall and for each service we estimated the ratio of public:private payments (RPPP). 64.0% of annual expenditure was public, 36.0% private, (RPPP=1:0.56). General medical consultations were 67.2% of services (RPPP=1:0.57); 15.3% were injury-related (RPPP=1:0.36); 5.2% were prescribing services (all private); 4.9% were immunizations (RPPP=1:0.12); 2.9% were nursing (RPPP=1:1.33); 4.4% were administration (all private); and 0.1% were for maternity care (RPPP=1:0.007). Before capitation funding, public and private funding levels for general medical consultations were similar (RPPP=1:0.93) but after capitation public payments more than doubled (RPPP=1:0.40). There is a complex of pattern of public and private payments for general practice services for children and adolescents in New Zealand. Both funding sources are critical. Capitation funding changed the balance substantially but did not remove ongoing reliance on private funding to support general practice care for children. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Individual Placement and Support in Spinal Cord Injury: A Longitudinal Observational Study of Employment Outcomes.

PubMed

Ottomanelli, Lisa; Goetz, Lance L; Barnett, Scott D; Njoh, Eni; Dixon, Thomas M; Holmes, Sally Ann; LePage, James P; Ota, Doug; Sabharwal, Sunil; White, Kevin T

2017-08-01

To determine the effects of a 24-month program of Individual Placement and Support (IPS) supported employment (SE) on employment outcomes for veterans with spinal cord injury (SCI). Longitudinal, observational multisite study of a single-arm, nonrandomized cohort. SCI centers in the Veterans Health Administration (n=7). Veterans with SCI (N=213) enrolled during an episode of either inpatient hospital care (24.4%) or outpatient care (75.6%). More than half the sample (59.2%) had a history of traumatic brain injury (TBI). IPS SE for 24 months. Competitive employment. Over the 24-month period, 92 of 213 IPS participants obtained competitive jobs for an overall employment rate of 43.2%. For the subsample of participants without TBI enrolled as outpatients (n=69), 36 obtained competitive jobs for an overall employment rate of 52.2%. Overall, employed participants averaged 38.2±29.7 weeks of employment, with an average time to first employment of 348.3±220.0 days. Nearly 25% of first jobs occurred within 4 to 6 months of beginning the program. Similar employment characteristics were observed in the subsample without TBI history enrolled as outpatients. Almost half of the veterans with SCI participating in the 24-month IPS program as part of their ongoing SCI care achieved competitive employment, consistent with their expressed preferences at the start of the study. Among a subsample of veterans without TBI history enrolled as outpatients, employment rates were >50%. Time to first employment was highly variable, but quite long in many instances. These findings support offering continued IPS services as part of ongoing SCI care to achieve positive employment outcomes. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A mixed method evaluation of adult tier 2 lifestyle weight management service provision across a county in Northern England.

PubMed

Ells, L; Watson, P; Carlebach, S; O'Malley, C; Jones, D; Machaira, T; Whittaker, V; Clements, H; Walker, P; Needham, K; Summerbell, C; Coulton, V; Araujo-Soares, V

2018-06-01

Adult obesity in the UK remains a public health priority. Current guidance recommends local areas provide multicomponent interventions to treat adults with overweight and obesity; however, there is currently a dearth of published evidence on the evaluation of these programmes. This study reports on a mixed method evaluation of seven tier 2 weight management programmes funded by a local authority in the North of England through their public health grant (a lifestyle multicomponent weight management programme for the treatment of adults with overweight and obesity, but not severe obesity, or obesity with severe co-morbidities). Data collected from over 2000 participants demonstrated that the proportion of participants achieving 5% initial body weight loss was comparable to that reported in recent UK weight management trials. Two services exceeded national criteria of 30% of participants achieving 5% initial body weight loss at 12 weeks, although long term data was limited. Greater weight loss was also observed in participants aged 35-44 and those without co-morbidities. This study provides important learning points for improvements in real world weight management services, these include: standardised data collection and management tools; staff training and communication requirements; the importance of programmes that are joined up to wider support services; and the importance of providing ongoing peer and provider support, continuous monitoring and feedback, and physical activities tailored to user needs. © 2018 World Obesity Federation.

Employment for adults with autism spectrum disorders: A retrospective review of a customized employment approach.

PubMed

Wehman, Paul; Brooke, Valerie; Brooke, Alissa Molinelli; Ham, Whitney; Schall, Carol; McDonough, Jennifer; Lau, Stephanie; Seward, Hannah; Avellone, Lauren

2016-01-01

Over the past few decades, there has been an increase in prevalence of children with autism spectrum disorders (ASD), and those children are now becoming young adults in need of competitive integrated employment (CIE). Customized employment (CE) is one pathway to employment that has been successful for other individuals with developmental disabilities (DD), though research has been very limited on the effectiveness with individuals with ASD. This paper provides a retrospective review of 64 individuals with ASD who came to our program from 2009 to 2014 for supported employment services as referred by the state vocational rehabilitation services agency. Employment specialists engaged in situational assessment, discovery, job development, customized job descriptions, on-site training and support, positive behavioral supports, and job retention techniques. The employment specialists were responsible for tracking their actual time spent working directly with or for the jobseeker with autism spectrum disorders (ASD). All vocational rehabilitation clients with ASD served during this time successfully secured CIE, and maintained their employment with ongoing supports, with intensity of support time decreasing over time. The majority (63/64, 98.4%) of individuals successfully secured CIE through the use of supported employment, in 72 unique employment positions. Of the majority of the individuals who secured employment, 77% (50) individuals indicated that they had never worked before and additional 18% (12) reported having short intermittent histories of employment. Despite this lack of employment experience, in all cases the jobseeker directed the job search and ultimately the job selection. Copyright © 2016 Elsevier Ltd. All rights reserved.

Marketing small animal theriogenology services--one perspective.

PubMed

Barber, J A

2007-08-01

Once a decision is made to add small animal theriogenology services to a practice, marketing strategies must be developed and implemented to attract clients to the new services. Marketing strategies for the niche market of theriogenology include start-up marketing methods, referral programs, internal marketing, and continued marketing. Marketing theriogenology services is a dynamic, ongoing process that never ends.

InTASC Model Core Teaching Standards and Learning Progressions for Teachers 1.0: A Resource for Ongoing Teacher Development

ERIC Educational Resources Information Center

Council of Chief State School Officers, 2013

2013-01-01

The Council of Chief State School Officers (CCSSO), through its Interstate Teacher Assessment and Support Consortium (InTASC), offers this set of combined resources that define and support ongoing teacher effectiveness to ensure students reach college and career ready standards. This document includes the "InTASC Model Core Teaching…

Telecommunications and navigation systems design for manned Mars exploration missions

NASA Astrophysics Data System (ADS)

Hall, Justin R.; Hastrup, Rolf C.

1989-06-01

This paper discusses typical manned Mars exploration needs for telecommunications, including preliminary navigation support functions. It is a brief progress report on an ongoing study program within the current NASA JPL Deep Space Network (DSN) activities. A typical Mars exploration case is defined, and support approaches comparing microwave and optical frequency performance for both local in situ and Mars-earth links are described. Optical telecommunication and navigation technology development opportunities in a Mars exploration program are also identified. A local Mars system telecommunication relay and navigation capability for service support of all Mars missions has been proposed as part of an overall solar system communications network. The effects of light-time delay and occultations on real-time mission decision-making are discussed; the availability of increased local mass data storage may be more important than increasing peak data rates to earth. The long-term frequency use plan will most likely include a mix of microwave, millimeter-wave and optical link capabilities to meet a variety of deep space mission needs.

Telecommunications and navigation systems design for manned Mars exploration missions

NASA Technical Reports Server (NTRS)

Hall, Justin R.; Hastrup, Rolf C.

1989-01-01

This paper discusses typical manned Mars exploration needs for telecommunications, including preliminary navigation support functions. It is a brief progress report on an ongoing study program within the current NASA JPL Deep Space Network (DSN) activities. A typical Mars exploration case is defined, and support approaches comparing microwave and optical frequency performance for both local in situ and Mars-earth links are described. Optical telecommunication and navigation technology development opportunities in a Mars exploration program are also identified. A local Mars system telecommunication relay and navigation capability for service support of all Mars missions has been proposed as part of an overall solar system communications network. The effects of light-time delay and occultations on real-time mission decision-making are discussed; the availability of increased local mass data storage may be more important than increasing peak data rates to earth. The long-term frequency use plan will most likely include a mix of microwave, millimeter-wave and optical link capabilities to meet a variety of deep space mission needs.

42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

Code of Federal Regulations, 2010 CFR

2010-10-01

... Qualified Health Maintenance Organizations: Services § 417.106 Quality assurance program; Availability, accessibility, and continuity of basic and supplemental health services. (a) Quality assurance program. Each HMO or CMP must have an ongoing quality assurance program for its health services that meets the...

75 FR 38579 - Self-Regulatory Organizations; National Securities Clearing Corporation; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-02

... To Enhance the Process for Transfers Through the Automated Customer Account Transfer Service June 25... NSCC's process for transfers through the Automated Customer Account Transfer Service (``ACATS''). II... services and to effect customer account transfers within specified time frames. \\4\\ CNS is an ongoing...

31 CFR 103.20 - Reports by money services businesses of suspicious transactions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... immediate attention, such as ongoing money laundering schemes, the money services business shall immediately... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Reports by money services businesses of suspicious transactions. 103.20 Section 103.20 Money and Finance: Treasury Regulations Relating to...

Formerly Homeless People Had Lower Overall Health Care Expenditures After Moving Into Supportive Housing.

PubMed

Wright, Bill J; Vartanian, Keri B; Li, Hsin-Fang; Royal, Natalie; Matson, Jennifer K

2016-01-01

The provision of supportive housing is often recognized as important public policy, but it also plays a role in health care reform. Health care costs for the homeless reflect both their medical complexity and psychosocial risk factors. Supportive housing attempts to moderate both by providing stable places to live along with on-site integrated health services. In this pilot study we used a mixture of survey and administrative claims data to evaluate outcomes for formerly homeless people who were living in a supportive housing facility in Oregon between 2010 and 2014. Results from the claims analysis showed significantly lower overall health care expenditures for the people after they moved into supportive housing. Expenditure changes were driven primarily by reductions in emergency and inpatient care. Survey data suggest that the savings were not at the expense of quality: Respondents reported improved access to care, stronger primary care connections, and better subjective health outcomes. Together, these results indicate a potential association between supportive housing and reduced health care costs that warrants deeper consideration as part of ongoing health care reforms. Project HOPE—The People-to-People Health Foundation, Inc.

Working Memory in the Service of Executive Control Functions.

PubMed

Mansouri, Farshad A; Rosa, Marcello G P; Atapour, Nafiseh

2015-01-01

Working memory is a type of short-term memory which has a crucial cognitive function that supports ongoing and upcoming behaviors, allowing storage of information across delay periods. The content of this memory may typically include tangible information about features such as the shape, color or texture of an object, and its location and motion relative to the body, as well as phonological information. The neural correlate of working memory has been found in different brain areas that are involved in organizing perceptual or motor functions. In particular, neuronal activity in prefrontal areas encodes task-related information corresponding to working memory across delay periods, and lesions in the prefrontal cortex severely affect the ability to retain this type of memory. Recent studies have further expanded the scope and possible role of working memory by showing that information of a more abstract nature (including a behavior-guiding rule, or the occurrence of a conflict in information processing) can also be maintained in short-term memory, and used for adjusting the allocation of executive control in dynamic environments. It has also been shown that neuronal activity in the prefrontal cortex encodes and maintains information about such abstract entities. These findings suggest that the prefrontal cortex plays crucial roles in the organization of goal-directed behavior by supporting many different mnemonic processes, which maintain a wide range of information required for the executive control of ongoing and upcoming behaviors.

It Is Time to Rethink Central Auditory Processing Disorder Protocols for School-Aged Children.

PubMed

DeBonis, David A

2015-06-01

The purpose of this article is to review the literature that pertains to ongoing concerns regarding the central auditory processing construct among school-aged children and to assess whether the degree of uncertainty surrounding central auditory processing disorder (CAPD) warrants a change in current protocols. Methodology on this topic included a review of relevant and recent literature through electronic search tools (e.g., ComDisDome, PsycINFO, Medline, and Cochrane databases); published texts; as well as published articles from the Journal of the American Academy of Audiology; the American Journal of Audiology; the Journal of Speech, Language, and Hearing Research; and Language, Speech, and Hearing Services in Schools. This review revealed strong support for the following: (a) Current testing of CAPD is highly influenced by nonauditory factors, including memory, attention, language, and executive function; (b) the lack of agreement regarding the performance criteria for diagnosis is concerning; (c) the contribution of auditory processing abilities to language, reading, and academic and listening abilities, as assessed by current measures, is not significant; and (d) the effectiveness of auditory interventions for improving communication abilities has not been established. Routine use of CAPD test protocols cannot be supported, and strong consideration should be given to redirecting focus on assessing overall listening abilities. Also, intervention needs to be contextualized and functional. A suggested protocol is provided for consideration. All of these issues warrant ongoing research.

Domestic violence and abuse: an exploration and evaluation of a domestic abuse nurse specialist role in acute health care services.

PubMed

McGarry, Julie

2017-08-01

The aim of this study was to explore the experiences of clinical staff in responding to disclosure of domestic violence and abuse, and to evaluate the effectiveness of training and support provided by a dedicated Domestic Abuse Nurse Specialist across one acute National Health Service Trust in the UK. The impact of domestic violence and abuse is well documented and is far reaching. Health care professionals have a key role to play in the effective identification and management of abuse across a range of settings. However, there is a paucity of evidence regarding the constituents of effective support for practitioners within wider nonemergency hospital-based services. A qualitative approach semi-structured interviews (n = 11) with clinical staff based in one acute care Trust in the UK. Interviews were informed by an interview guide and analysed using the Framework approach. The organisation of the nurse specialist role facilitated a more cohesive approach to management at an organisational level with training and ongoing support identified as key facets of the role by practitioners. Time constraints were apparent in terms of staff training and this raises questions with regard to the status continuing professional development around domestic violence and abuse. Domestic violence and abuse continues to exert a significant and detrimental impact on the lives and health of those who encounter abuse. Health care services in the UK and globally are increasingly on the frontline in terms of identification and management of domestic violence and abuse. This is coupled with the growing recognition of the need for adequate support structures to be in place to facilitate practitioners in providing effective care for survivors of domestic violence and abuse. This study provides an approach to the expansion of existing models and one which has the potential for further exploration and application in similar settings. © 2016 John Wiley & Sons Ltd.

Trends in hospital librarianship and hospital library services: 1989 to 2006.

PubMed

Thibodeau, Patricia L; Funk, Carla J

2009-10-01

The research studied the status of hospital librarians and library services to better inform the Medical Library Association's advocacy activities. The Vital Pathways Survey Subcommittee of the Task Force on Vital Pathways for Hospital Librarians distributed a web-based survey to hospital librarians and academic health sciences library directors. The survey results were compared to data collected in a 1989 survey of hospital libraries by the American Hospital Association in order to identify any trends in hospital libraries, roles of librarians, and library services. A web-based hospital library report form based on the survey questions was also developed to more quickly identify changes in the status of hospital libraries on an ongoing basis. The greatest change in library services between 1989 and 2005/06 was in the area of access to information, with 40% more of the respondents providing access to commercial online services, 100% more providing access to Internet resources, and 28% more providing training in database searching and use of information resources. Twenty-nine percent (n = 587) of the 2005/06 respondents reported a decrease in staff over the last 5 years. Survey data support reported trends of consolidation of hospitals and hospital libraries and additions of new services. These services have likely required librarians to acquire new skills. It is hoped that future surveys will be undertaken to continue to study these trends.

Trends in hospital librarianship and hospital library services: 1989 to 2006

PubMed Central

Thibodeau, Patricia L.; Funk, Carla J.

2009-01-01

Objective: The research studied the status of hospital librarians and library services to better inform the Medical Library Association's advocacy activities. Methods: The Vital Pathways Survey Subcommittee of the Task Force on Vital Pathways for Hospital Librarians distributed a web-based survey to hospital librarians and academic health sciences library directors. The survey results were compared to data collected in a 1989 survey of hospital libraries by the American Hospital Association in order to identify any trends in hospital libraries, roles of librarians, and library services. A web-based hospital library report form based on the survey questions was also developed to more quickly identify changes in the status of hospital libraries on an ongoing basis. Results: The greatest change in library services between 1989 and 2005/06 was in the area of access to information, with 40% more of the respondents providing access to commercial online services, 100% more providing access to Internet resources, and 28% more providing training in database searching and use of information resources. Twenty-nine percent (n = 587) of the 2005/06 respondents reported a decrease in staff over the last 5 years. Conclusions: Survey data support reported trends of consolidation of hospitals and hospital libraries and additions of new services. These services have likely required librarians to acquire new skills. It is hoped that future surveys will be undertaken to continue to study these trends. PMID:19851491

Long-term recovery trajectory after stroke: an ongoing negotiation between body, participation and self.

PubMed

Arntzen, Cathrine; Borg, Tove; Hamran, Torunn

2015-01-01

Research has mainly focused on the first year of recovery trajectory after stroke, but there is limited knowledge about how stroke survivors manage their long-term everyday lives. This study seeks to fill this gap by exploring the long-term (1-13 years) negotiations of stroke survivors when they experience progress, wellbeing and faith in the future. Repeated in-depth interviews were conducted with nine people living with moderate impairment after stroke and their closest relatives. Concepts from phenomenology and critical psychology constituted the frame of reference of the study. The long-term stroke recovery trajectory can be understood as a process of struggling to overcome tensions between three phenomena under ongoing change: the lived body, participation in everyday life and sense of self. During the recovery process, stroke survivors experience progress, well-being and faith in the future when moving towards renewed relationships, characterised by (1) a modified habitual body, (2) repositioned participation in specific everyday life contexts and (3) a transformed sense of self. This study stresses the importance of developing new forms of professional support during the long-term recovery trajectory, to stimulate and increase interaction and coherence in the relationship between the stroke survivor's bodily perception, participation in everyday life and sense of self. The study deepening how the long-term recovery trajectory after stroke is about ongoing embodied, practical and socially situated negotiations. The study demonstrates that the recovery trajectory is a long term process of learning where the stroke survivor, as an embodied agent, gradually modifies new bodily habits, re-position participation and transforming of the self. Health personnel are usually available in the acute and early rehabilitation period. The three phenomenons under ongoing change; "body", "participation" and "self" are at this point just about being moved toward a renewed and a more coherent relationship in the stroke survivor long-lasting everyday life situated recovery trajectory. Available rehabilitation services at the municipal level supporting stroke survivors and relatives practical, social and interpersonal long-term challenges in everyday life can be important for minimizing their struggles and for promoting the experience progress, wellbeing and faith in the future.

A supported employment linkage intervention for people with schizophrenia who want a chance to work.

PubMed

Solar, Ann

2014-06-01

Investigate feasibility and development of a linkage intervention to the evidence-based Individual Placement and Support (IPS) approach to supported employment (SE) for patients with schizophrenia on a mental health unit who want to work in competitive employment. Literature review about the evidence-based IPS approach to SE in schizophrenia and why it might not be implemented in mental health services. Analysis of 10 adult mental health unit multidisciplinary staff interviews for categories in the literature review of IPS implementation barriers and whether these barriers could be overcome. There was lack of full staff knowledge of the IPS approach to SE. However, all staff knew respect for patient choice was paramount, community employment programs existed for the disabled, an outreach linkage process to such a program and ongoing support for people with schizophrenia would be required. There was staff ambivalence about SE for patients with schizophrenia. Despite staff ambivalence about SE for people with schizophrenia there was still enough staff knowledge and openness to shape an IPS linkage intervention from a staff perspective. © The Royal Australian and New Zealand College of Psychiatrists 2014.

A case for increased private sector involvement in Ireland's national animal health services

PubMed Central

2008-01-01

Non-regulatory animal health issues, such as Johne's disease, infectious bovine rhinotracheitis (IBR) and mastitis will become increasing important, with ongoing globalisation of markets in animals and animal products. In response, Ireland may need to broaden the scope of its national animal health services. However, there have been concerns about the respective roles and responsibilities (both financial and otherwise) of government and industry in any such moves. This paper argues the case for increased private sector involvement in Ireland's national animal health services, based both on theoretical considerations and country case studies (the Netherlands and Australia). The Dutch and Australian case studies present examples of successful partnerships between government and industry, including systems and processes to address non-regulatory animal health issues. In each case, the roles and responsibilities of government are clear, as are the principles underpinning government involvement. Furthermore, the roles and responsibilities (financial and otherwise) of the Dutch and Australian industry are determined through enabling legislation, providing both legitimacy and accountability. There are constraints on the use of EU and national government funds to support non-regulatory animal health services in EU member states (such as Ireland and the Netherlands). PMID:21851708

A Good Idea May Not Be Good Enough: Stakeholder Buy In to QuitConnect, a National Smokers' Registry.

PubMed

Macauda, Mark M; Thrasher, James F; Saul, Jessie E; Celestino, Paula; Cummings, K Michael; Strayer, Scott M

2017-01-01

To examine interest and concerns among those who fund and operate state-run smoking cessation helplines (quitlines) about the concept of creating a centralized smokers' registry that could be used to reengage smokers after they receive initial quitline support services. We conducted 3, hour-long focus groups with stakeholders, covering the perceived benefits and barriers to creating a smokers' registry. The focus groups were conducted via telephone. Three groups participated: quitline service providers (n = 14), quitline funders (n = 9), and national quitline partners (n = 8). Data collection: Focus groups were recorded, transcribed, and coded for major relevant themes. Analysis Strategies: We used a grounded theory approach. Stakeholders were generally positive about the concept of a centralized smokers' registry (ie, QuitConnect), especially with its potential to link relapsed smokers to ongoing research studies designed to help smokers achieve abstinence from tobacco. However, stakeholders expressed concern about QuitConnect duplicating services already offered by state quitlines. Despite a common goal, many state quitline stakeholders had strong reservations about the creation of a centralized smokers' registry unless they could see clear evidence that the registry added value and was not duplicative of their existing services.

A case for increased private sector involvement in Ireland's national animal health services.

PubMed

More, Simon J

2008-02-01

Non-regulatory animal health issues, such as Johne's disease, infectious bovine rhinotracheitis (IBR) and mastitis will become increasing important, with ongoing globalisation of markets in animals and animal products. In response, Ireland may need to broaden the scope of its national animal health services. However, there have been concerns about the respective roles and responsibilities (both financial and otherwise) of government and industry in any such moves. This paper argues the case for increased private sector involvement in Ireland's national animal health services, based both on theoretical considerations and country case studies (the Netherlands and Australia). The Dutch and Australian case studies present examples of successful partnerships between government and industry, including systems and processes to address non-regulatory animal health issues. In each case, the roles and responsibilities of government are clear, as are the principles underpinning government involvement. Furthermore, the roles and responsibilities (financial and otherwise) of the Dutch and Australian industry are determined through enabling legislation, providing both legitimacy and accountability. There are constraints on the use of EU and national government funds to support non-regulatory animal health services in EU member states (such as Ireland and the Netherlands).

A systematic approach to very important person preparedness for a trauma center.

PubMed

Bulson, Julie; Mattice, Connie; Bulson, Timothy

2012-01-01

Hospitals across the United States are more involved in disaster/rapid response planning than ever. This collaboration is often driven by continuing federal and state preparedness and all-hazards planning efforts that provide cooperative agreement and/or grant support. These efforts currently include programs administered by the US assistant secretary for preparedness and response, the US Centers for Disease Control and Prevention, the US Department of Defense, and the US Department of Homeland Security. Beyond legislated support or mandates, key emergency management regulations governing hospital-specific disaster planning and response activities are required of hospitals by The Joint Commission, the largest national hospital accrediting body. Despite this ongoing, heightened awareness and inclusion of health care in local and regional emergency response planning, there is 1 partnership to yet strengthen: the relationship between community trauma centers and US Secret Service staff responsible for White House travel and health care contingency plans. One Michigan hospital system designed a program that has made preevent communications and preparedness for rapid very important person response with the Secret Service as important as other local all-hazards planning; the evolution of this partnership is the focus of this article.

Role of community health workers in type 2 diabetes mellitus self-management: A scoping review.

PubMed

Egbujie, Bonaventure Amandi; Delobelle, Peter Arthur; Levitt, Naomi; Puoane, Thandi; Sanders, David; van Wyk, Brian

2018-01-01

Globally the number of people with Type 2 diabetes mellitus (T2DM) has risen significantly over the last few decades. Aligned to this is a growing use of community health workers (CHWs) to deliver T2DM self-management support with good clinical outcomes especially in High Income Countries (HIC). Evidence and lessons from these interventions can be useful for Low- and Middle-Income countries (LMICs) such as South Africa that are experiencing a marked increase in T2DM prevalence. This study aimed to examine how CHW have been utilized to support T2DM self-management globally, their preparation for and supervision to perform their functions. The review was guided by a stepwise approach outlined in the framework for scoping reviews developed by Arksey and O'Malley. Peer reviewed scientific and grey literature was searched using a string of keywords, selecting English full-text articles published between 2000 and 2015. Articles were selected using inclusion criteria, charted and content analyzed. 1008 studies were identified of which 54 full text articles were selected. Most (53) of the selected studies were in HIC and targeted mostly minority populations in low resource settings. CHWs were mostly deployed to provide education, support, and advocacy. Structured curriculum based education was the most frequently reported service provided by CHWs to support T2DM self-management. Support services included informational, emotional, appraisal and instrumental support. Models of CHW care included facility linked nurse-led CHW coordination, facility-linked CHW led coordination and standalone CHW interventions without facility interaction. CHWs play several roles in T2DM self-management, including structured education, ongoing support and health system advocacy. Preparing and coordinating CHWs for these roles is crucial and needs further research and strengthening.

KSC-2013-3074

NASA Image and Video Library

2013-07-22

HOUSTON - NASA astronaut Serena Aunon and Andrea Gilkey, a human factors engineer with The Boeing Company, tag up before Aunon puts on her orange launch-and-entry suit for a fit check evaluation of the CST-100 spacecraft at the company's Houston Product Support Center. Aunon's fit check will help evaluate a crew's maneuverability in the spacecraft and test communications. Boeing's CST-100 is being designed to transport crew members or a mix of crew and cargo to low-Earth-orbit destinations, including the International Space Station. The evaluation is part of the ongoing work supporting Boeing's funded Space Act Agreement with NASA's Commercial Crew Program, or CCP, during the agency's Commercial Crew Integrated Capability, or CCiCap, initiative. CCiCap is intended to make commercial human spaceflight services available for government and commercial customers. To learn more about CCP, visit http://www.nasa.gov/commercialcrew. Photo credit: NASA/Robert Markowitz

Health care of youth aging out of foster care.

PubMed

2012-12-01

Youth transitioning out of foster care face significant medical and mental health care needs. Unfortunately, these youth rarely receive the services they need because of lack of health insurance. Through many policies and programs, the federal government has taken steps to support older youth in foster care and those aging out. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Pub L No. 110-354) requires states to work with youth to develop a transition plan that addresses issues such as health insurance. In addition, beginning in 2014, the Patient Protection and Affordable Care Act of 2010 (Pub L No. 111-148) makes youth aging out of foster care eligible for Medicaid coverage until age 26 years, regardless of income. Pediatricians can support youth aging out of foster care by working collaboratively with the child welfare agency in their state to ensure that the ongoing health needs of transitioning youth are met.

A model of integrated health care in a poverty-impacted community in New York City: Importance of early detection and addressing potential barriers to intervention implementation.

PubMed

Acri, Mary C; Bornheimer, Lindsay A; O'Brien, Kyle; Sezer, Sara; Little, Virna; Cleek, Andrew F; McKay, Mary M

2016-04-01

Disruptive behavior disorders (DBDs) are chronic, impairing, and costly behavioral health conditions that are four times more prevalent among children of color living in impoverished communities as compared to the general population. This disparity is largely due to the increased exposure to stressors related to low socioeconomic status including community violence, unstable housing, under supported schools, substance abuse, and limited support systems. However, despite high rates and greater need, there is a considerably lower rate of mental health service utilization among these youth. Accordingly, the current study aims to describe a unique model of integrated health care for ethnically diverse youth living in a New York City borough. With an emphasis on addressing possible barriers to implementation, integrated models for children have the potential to prevent ongoing mental health problems through early detection and intervention.

Peer support for people with chronic conditions in rural areas: a scoping review.

PubMed

Lauckner, Heidi M; Hutchinson, Susan L

2016-01-01

Chronic conditions are a growing healthcare concern. People living in rural regions are particularly affected because many barriers exist to accessing services and supports. Peer support for chronic condition self-management, where people living with chronic conditions learn about how to care for themselves and maintain their health from people also living with chronic conditions, is one approach gaining recognition. What remains unknown are the unique challenges and strategies associated with peer support for chronic condition self-management in rural contexts. In order to inform the development of peer supports in the authors' local context in rural eastern Canada, a scoping review was undertaken to discover community-based peer support initiatives for adults in rural settings living with chronic conditions. The authors followed established scoping review methods to answer the research question What is known from the existing literature about the key features and potential formats of community-based peer support initiatives for adults living with chronic conditions in rural settings? Six databases (CINAHL, PubMed, Sociological Abstracts, Embase, Cochrane Libraries and PsycInfo) were searched using the following concepts: chronic conditions, peer support, community-based and rural context. Two researchers reviewed the titles and/or abstracts of the 1978 articles retrieved from the initial search to include articles that were in English, published in 2000 to 2014, and that explicitly discussed rural programs/interventions with peers that were community-based. The initial screen excluded 1907 articles, leaving 71 articles, which were read by two research members in light of the inclusion/exclusion criteria. Thirteen articles representing 10 separate programs were included and analyzed using qualitative content analysis. Included programs were from the USA, Australia and Canada. A range of formats (telecommunications only, in-person meetings only, or a combination of both) were used. Peer leaders had varied experiences with chronic conditions and received training in content and facilitation skills. Peer leaders were provided with ongoing support. Program participants received training on chronic conditions, and programs provided opportunities for social support and the development of new skills. Programs focused on creating social connections, reducing stigma, ensuring relevance and promoting empowerment. Of the nine programs that reported outcomes, eight reported positive outcomes and one reported mixed results. Consistent with the extant literature, the programs identified unique issues faced by people with chronic conditions in rural areas that these programs addressed. The key findings of this scoping review are as follows: 1. A combination of telecommunications with some face-to-face meetings can support the accessibility of peer support programs in rural areas. 2. Core elements of these programs are the provision of social support and skill development. 3. Peer leaders benefit from skills training and ongoing support. 4. Sustainability of such programs is complex and requires multiple strategies. Cultural relevance, ongoing support and the use of telecommunications were key features of rural peer support programs. Guiding questions to facilitate a community consultation around these findings are provided. Peer support chronic condition self-management programs require further research.

Short Report. Audit of Conscious Sedation Provision in a Salaried Dental Service.

PubMed

Jones, Stephen G

2016-01-01

Clinical audit is a tool that may be used to improve the quality of care and outcomes for patients in a health care setting as well as a mechanism for clinicians to reflect on their performance. The audit described in this short report involved the collection and analysis of data related to the administration of 1,756 conscious sedations, categorised as standard techniques, by clinicians employed by an NHS Trust-based dental service during the year 2014. Data collected included gender, age and medical status of subject, the type of care delivered, the dose of drug administered and the quality of the achieved sedation and any sedation-related complications. This was the first time that a service-wide clinical audit had been undertaken with the objective of determining the safety and effectiveness of this aspect of care provision. Evaluation of the analysed data supported the perceived view that such care was being delivered satisfactorily. This on-going audit will collect data during year 2016 on the abandonment of clinical sessions, in which successful sedation had been achieved, due to the failure to obtain adequate local anaesthesia.

Changing the system by changing the workforce: employing consumers to increase access, cultural diversity, and engagement.

PubMed

Wenz-Gross, Melodie; Irsfeld, Toni DuBrino; Twomey, Tammy; Perez, Ana; Thompson, Judith; Wally, Martha; Colleton, Barbara; Kroell, Christine; McKeown, Steven K; Metz, Peter

2012-06-01

Services to families have traditionally been delivered in a medical model. This presents challenges including workforce shortages, lack of cultural diversity, lack of training in strength-based work, and difficulty in successfully engaging and retaining families in the therapy process. The system of care (SOC) effort has worked to establish formal roles for caregivers in SOC to improve services. This paper provides an example of one community's efforts to change the SOC by expanding the roles available to caregivers in creating systems change. It describes the model developed by Communities of Care (CoC), a SOC in Central Massachusetts, and its evolution over a 10 year period. First person accounts by system partners, caregivers hired into professional roles as well as a family receiving services, demonstrate how hiring caregivers at all levels can change systems and change lives, not only for those being served but for the caregiver/professionals doing the work. It also demonstrates, however, that change at the system level is incremental, takes time, and can be fleeting unless an ongoing effort is made to support and sustain those changes.

Exploring example models of cross-sector, sessional employment of pharmacists to improve medication management and pharmacy support in rural hospitals.

PubMed

Tan, Amy Cw; Emmerton, Lynne M; Hattingh, Laetitia; La Caze, Adam

2015-01-01

Many rural hospitals in Australia are not large enough to sustain employment of a full-time pharmacist, or are unable to recruit or retain a full-time pharmacist. The absence of a pharmacist may result in hospital nurses undertaking medication-related roles outside their scope of practice. A potential solution to address rural hospitals' medication management needs is contracted part-time ('sessional') employment of a local pharmacist external to the hospital ('cross-sector'). The aim of this study was to explore the roles and experiences of pharmacists in their provision of sessional services to rural hospitals with no on-site pharmacist and explore how these roles could potentially address shortfalls in medication management in rural hospitals. A qualitative study was conducted to explore models with pharmacists who had provided sessional services to a rural hospital. A semi-structured interview guide was informed by a literature review, preliminary research and stakeholder consultation. Participants were recruited via advertisement and personal contacts. Consenting pharmacists were interviewed between August 2012 and January 2013 via telephone or Skype for 40-55 minutes. Thirteen pharmacists with previous or ongoing hospital sessional contracts in rural communities across Australia and New Zealand participated. Most commonly, the pharmacists provided weekly services to rural hospitals. All believed the sessional model was a practical solution to increase hospital access to pharmacist-mediated support and to address medication management gaps. Roles perceived to promote quality use of medicines were inpatient consultation services, medicines information/education to hospital staff, assistance with accreditation matters and system reviews, and input into pharmaceutical distribution activities. This study is the first to explore the concept of sessional rural hospital employment undertaken by pharmacists in Australia and New Zealand. Insights from participants revealed that their sessional employment model increased access to pharmacist-mediated medication management support in rural hospitals. The contracting arrangements and scope of services may be evaluated and adapted in other rural hospitals.

Bridging the Gap between Health and Social Care for Rare Diseases: Key Issues and Innovative Solutions.

PubMed

Castro, Raquel; Senecat, Juliette; de Chalendar, Myriam; Vajda, Ildikó; Dan, Dorica; Boncz, Béata

2017-01-01

Bridging the gaps between health and social care for rare diseases is not only necessary but crucial to increase the life expectancy, quality of life and autonomy of people living with a rare disease, supporting them in the full realisation of their fundamental human rights.The complexity of rare diseases, their strong relation to disability and the current unmet social and daily life needs of people living with a rare disease must not be underestimated and require urgent attention from all stakeholders involved in care provision, from healthcare to social and community services.The Commission Expert Group Recommendations to Support the Incorporation of Rare Diseases into Social Services and Policies, adopted unanimously in April 2016, by the representatives of European Member States and the other rare disease stakeholders, clearly set the tone for the need to promote measures that facilitate multidisciplinary, holistic, continuous, person-centred and participative care provision to people living with rare diseases.These recommendations, sided by other recent policy developments at European and national levels, represent an important policy step into approaching rare diseases' complex challenges in regards to holistic care provision.Innovative approaches aiming at bridging the gap between health, social and community service and support providers are currently being developed and tested in different European countries: standards of care, networks of expertise, case management services, one-stop-shop services, amongst others.These ongoing pilot approaches, presented in this chapter, have the power to inspire future policies and the effective and efficient implementation of holistic care pathways for people living with a rare disease, bringing about significant changes for patients, carers, care providers, competent authorities and the society at large.Nonetheless, the challenges to fully address this issue remain numerous and other key issues will also need to be taken into account when moving forward with the implementation of measures that aim at bridging the gaps between care providers and providing holistic care to people living with a rare disease.

Fostering a "Feeling of Worth" Among Vulnerable HIV Populations: The Role of Linkage to Care Specialists.

PubMed

Broaddus, Michelle R; Owczarzak, Jill; Schumann, Casey; Koester, Kimberly A

2017-10-01

To address barriers to adequate engagement in medical care among people living with HIV, Wisconsin's AIDS/HIV Program created a new position, the Linkage to Care (LTC) Specialist. Specialists provide intensive, short-term case management and patient navigation services for small caseloads of individuals at high risk of disengaging with medical care. Clients are eligible if they are newly diagnosed with HIV or new to medical care, recently released from incarceration, recently out of care, nonadherent to scheduled medical care visits, or have detectable viral load while in care. Interviews with 30 clients of Specialists were conducted to understand experiences with the program and medical care. Common themes included the ability of Specialists to navigate complex systems of care and support services, the unique role Specialists played in their clients' lives, and the challenges of transitioning out of the program. Although the primary goal of Specialists is to address barriers to medical care, they often adopted a holistic approach that also included housing, financial assistance, and other social determinants of health. Descriptions of the Specialist's role in implementation manuals focus on their functional roles and the services provided. However, clients often discussed the emotional support they received, especially for clients without strong social support networks. Many clients also desired an ongoing relationship with their Specialists even after discharge, but had been able to establish independence and self-efficacy. The LTC Specialists are resource-intensive considering their small caseloads, but fill an important gap in existing, often overtaxed case management systems.

Barriers and Facilitators to Tobacco Cessation in a Nationwide Sample of Addiction Treatment Programs.

PubMed

Pagano, Anna; Tajima, Barbara; Guydish, Joseph

2016-08-01

Smoking rates among addiction treatment clients are 3-4 times higher than those of the general population. Recent studies indicate that ceasing tobacco use during treatment may improve recovery outcomes. Across the United States, publicly funded addiction treatment programs vary widely in terms of their tobacco policies and tobacco cessation services offered to clients. The study reported here is the qualitative component of a larger study. Twenty-four programs were recruited from a random sample of publicly funded programs participating in the NIDA Clinical Trials Network. Semi-structured interviews were administered by phone to program directors. ATLAS.ti software was used to facilitate thematic analysis of interview transcripts. While all directors expressed interest in helping clients to quit smoking, they cited numerous barriers to implementing tobacco policies and services. These included smoking culture, client resistance, lack of resources, staff smoking, and environmental barriers. Directors also cited several factors that they believed would support tobacco cessation. These included financial support, enhanced leadership, and state mandates against smoking in addiction treatment programs. Addiction treatment programs are beginning to place more emphasis on tobacco cessation during treatment. However, furthering this goal requires substantial infrastructural and cultural change. These qualitative study findings may help to inform Single State Agencies (SSAs) to support publicly funded addiction treatment programs in their tobacco cessation efforts. In order to maximize effectiveness, state-level policies regarding tobacco cessation during treatment should be informed by ongoing dialogue between service providers and SSAs. Copyright © 2016 Elsevier Inc. All rights reserved.

In pursuit of change: Conceptualizing the social work response to LGBTQ microaggressions in health settings.

PubMed

Kia, Hannah; MacKinnon, Kinnon Ross; Legge, Melissa Marie

2016-01-01

Despite the emergence of research on microaggressions targeting lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) communities in recent years, there remains an insufficiency of theoretical literature in this area. In this article, we draw on the works of Michel Foucault to conceptualize the effects of microaggressive practices on LGBTQ people accessing health and other social services, and generate insight into strategies these groups use to resist these effects. We emphasize the need for social workers, particularly those in health care settings, to support these communities' ongoing attempts at challenging the effects of microaggression, and to this end, outline several implications of our analysis for social work practice.

Development of a hospital reiki training program: training volunteers to provide reiki to patients, families, and staff in the acute care setting.

PubMed

Hahn, Julie; Reilly, Patricia M; Buchanan, Teresa M

2014-01-01

Creating a healing and healthy environment for patients, families, and staff is an ongoing challenge. As part of our hospital's Integrative Care Program, a Reiki Volunteer Program has helped to foster a caring and healing environment, providing a means for patients, family, and staff to reduce pain and anxiety and improve their ability to relax and be present. Because direct care providers manage multiple and competing needs at any given time, they may not be available to provide Reiki when it is needed. This program demonstrates that a volunteer-based program can successfully support nurses in meeting patient, family, and staff demand for Reiki services.

Standard of Care for Neuropsychological Monitoring in Pediatric Neuro-Oncology: Lessons From the Children's Oncology Group (COG).

PubMed

Walsh, Karin S; Noll, Robert B; Annett, Robert D; Patel, Sunita K; Patenaude, Andrea F; Embry, Leanne

2016-02-01

As the mortality of pediatric cancers has decreased, focus on neuropsychological morbidities of treatment sequelae have increased. Neuropsychological evaluations are essential diagnostic tools that assess cognitive functioning and neurobiological integrity. These tests provide vital information to support ongoing medical care, documenting cognitive morbidity and response to interventions. We frame standards for neuropsychological monitoring of pediatric patients with CNS malignancy or who received cancer-directed therapies involving the CNS and discuss billing for these services in the United States in the context of clinical research. We describe a cost-effective, efficient model of neuropsychological monitoring that may increases access to neuropsychological care. © 2015 Wiley Periodicals, Inc.

New Global Precipitation Products and Data Service Updates at the NASA GES DISC

NASA Technical Reports Server (NTRS)

Liu, Z.; Ostrenga, D.; Savtchenko, A.; DeShong, B.; Greene, M.; Vollmer, B.; Kempler, S.

2016-01-01

This poster describes recent updates of the ongoing GPM data service activities at the NASA Goddard Earth Sciences (GES) Data and Information Services Center(DISC) to facilitate access and exploration of GPM, TRMM and other NASA precipitation datasets for the global community. The poster contains -Updates on GPM products and data services -New features in Giovanni for precipitation data visualization -Precipitation data and service outreach activities.

An ecosystem services framework to support both practical conservation and economic development.

PubMed

Tallis, Heather; Kareiva, Peter; Marvier, Michelle; Chang, Amy

2008-07-15

The core idea of the Millennium Ecosystem Assessment is that the human condition is tightly linked to environmental condition. This assertion suggests that conservation and development projects should be able to achieve both ecological and social progress without detracting from their primary objectives. Whereas "win-win" projects that achieve both conservation and economic gains are a commendable goal, they are not easy to attain. An analysis of World Bank projects with objectives of alleviating poverty and protecting biodiversity revealed that only 16% made major progress on both objectives. Here, we provide a framework for anticipating win-win, lose-lose, and win-lose outcomes as a result of how people manage their ecosystem services. This framework emerges from detailed explorations of several case studies in which biodiversity conservation and economic development coincide and cases in which there is joint failure. We emphasize that scientific advances around ecosystem service production functions, tradeoffs among multiple ecosystem services, and the design of appropriate monitoring programs are necessary for the implementation of conservation and development projects that will successfully advance both environmental and social goals. The potentially bright future of jointly advancing ecosystem services, conservation, and human well-being will be jeopardized unless a global monitoring effort is launched that uses the many ongoing projects as a grand experiment.

An ecosystem services framework to support both practical conservation and economic development

PubMed Central

Tallis, Heather; Kareiva, Peter; Marvier, Michelle; Chang, Amy

2008-01-01

The core idea of the Millennium Ecosystem Assessment is that the human condition is tightly linked to environmental condition. This assertion suggests that conservation and development projects should be able to achieve both ecological and social progress without detracting from their primary objectives. Whereas “win–win” projects that achieve both conservation and economic gains are a commendable goal, they are not easy to attain. An analysis of World Bank projects with objectives of alleviating poverty and protecting biodiversity revealed that only 16% made major progress on both objectives. Here, we provide a framework for anticipating win–win, lose–lose, and win–lose outcomes as a result of how people manage their ecosystem services. This framework emerges from detailed explorations of several case studies in which biodiversity conservation and economic development coincide and cases in which there is joint failure. We emphasize that scientific advances around ecosystem service production functions, tradeoffs among multiple ecosystem services, and the design of appropriate monitoring programs are necessary for the implementation of conservation and development projects that will successfully advance both environmental and social goals. The potentially bright future of jointly advancing ecosystem services, conservation, and human well-being will be jeopardized unless a global monitoring effort is launched that uses the many ongoing projects as a grand experiment. PMID:18621702

A framework for predicting impacts on ecosystem services ...

EPA Pesticide Factsheets

Protection of ecosystem services is increasingly emphasized as a risk-assessment goal, but there are wide gaps between current ecological risk-assessment endpoints and potential effects on services provided by ecosystems. The authors present a framework that links common ecotoxicological endpoints to chemical impacts on populations and communities and the ecosystem services that they provide. This framework builds on considerable advances in mechanistic effects models designed to span multiple levels of biological organization and account for various types of biological interactions and feedbacks. For illustration, the authors introduce 2 case studies that employ well-developed and validated mechanistic effects models: the inSTREAM individual-based model for fish populations and the AQUATOX ecosystem model. They also show how dynamic energy budget theory can provide a common currency for interpreting organism-level toxicity. They suggest that a framework based on mechanistic models that predict impacts on ecosystem services resulting from chemical exposure, combined with economic valuation, can provide a useful approach for informing environmental management. The authors highlight the potential benefits of using this framework as well as the challenges that will need to be addressed in future work. The framework introduced here represents an ongoing initiative supported by the National Institute of Mathematical and Biological Synthesis (NIMBioS; http://www.nimbi

Dementia in Ontario: Prevalence and Health Services Utilization

ERIC Educational Resources Information Center

Tranmer, J. E.; Croxford, R.; Coyte, P. C.

2003-01-01

To understand the impact of ongoing reform of mental health and dementia care in Ontario, an examination of prevalence and health services utilization rates is needed. However, there exists a gap in current prevalence and health services research specific to dementia care in Ontario. The objective of this study was to address these concerns using…

Pre-Service Teachers' Mental Constructions of Concepts in Matrix Algebra

ERIC Educational Resources Information Center

Ndlovu, Zanele; Brijlall, Deonarain

2015-01-01

This study is part of ongoing research in undergraduate mathematics education. The study was guided by the belief that understanding the mental constructions the pre-service teachers make when learning matrix algebra concepts leads to improved instructional methods. In this preliminary study the data was collected from 85 pre-service teachers…

Service-Learning's Ongoing Journey as a Method of Instruction: Implications for School-Based Agricultural Education

ERIC Educational Resources Information Center

Roberts, Richie; Edwards, M. Craig

2015-01-01

American education's journey has witnessed the rise and fall of various progressive education approaches, including service-learning. In many respects, however, service-learning is still undergoing formation and adoption as a teaching method, specifically in School-Based, Agricultural Education (SBAE). For this reason, the interest existed to…

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

ERIC Educational Resources Information Center

Barker, Richard W.

1996-01-01

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

An Evaluation of Parent Aide Programs.

ERIC Educational Resources Information Center

Andrews, Mary P.; Swanson, Jane F.

A descriptive-comparative study was designed to document the service delivery functions and impacts of three different parent-aide programs ongoing in Michigan. The study took place over the period of summer 1978 to summer 1979. The programs involved in the study were the Genesee County Department of Social Services' Volunteer Services Parent-Aide…

Staff Perspectives of Service User Involvement on Two Clinical Psychology Training Courses

ERIC Educational Resources Information Center

Clarke, Simon P.; Holttum, Sue

2013-01-01

This study investigated both negative and positive staff perspectives of service user involvement on two clinical psychology training courses as part of an ongoing process of service evaluation. Ten clinical psychology staff from two training courses were interviewed over the telephone by a current trainee clinical psychologist using a…

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

Online intervention, 'MePlusMe', supporting mood, wellbeing, study skills, and everyday functioning in students in higher education: a protocol for a feasibility study.

PubMed

Papadatou-Pastou, Marietta; Goozée, Rhianna; Barley, Elizabeth A; Haddad, Mark; Tzotzoli, Patapia

2015-01-01

Psychological and study skill difficulties faced by students in higher education can lead to poor academic performance, sub-optimal mental health, reduced study satisfaction, and drop out from study. At the same time, higher education institutions' support services are costly, oversubscribed, and struggle to meet demand whilst facing budget reductions. The purpose of the proposed study is to evaluate the acceptability of a new online intervention, MePlusMe, aimed at students in higher education facing mild to moderate psychological and/or study skill difficulties. The study will also assess the feasibility of proposed recruitment and outcome assessment protocols for a future trial of effectiveness. The system supports self-management strategies alongside ongoing monitoring facilitated by a messaging service, as well as featuring a built-in community of student users. It is based on current clinical guidelines for the management of common mental health problems, together with best practice from the educational field. Two hundred and forty two students will be recruited to a within-subjects, repeated measures study conducted over 8 weeks. Self-report measures of depression and anxiety symptoms, mental wellbeing, academic self-efficacy, and everyday functioning will be collected at baseline, and then at 2, 4, and 8 weeks. During this period, students will have access to the intervention system. UK higher education institutions Bournemouth University and University of Warwick will participate in the study. Data on student satisfaction and engagement will also be collected. Study findings will help to determine the most appropriate primary outcome and the required sample size for a future trial. This study will evaluate the acceptability of an online intervention system for students facing psychological and/or study skill difficulties and will test recruitment procedures and outcome measures for a future trial of effectiveness. The system is designed to be implemented as a stand-alone service or a service complementary to student support services, which is accessible to the majority of students and effective in improving student experience at higher education institutions.

Breaking down barriers to eye care for Indigenous people: a new scheme for delivery of eye care in Victoria.

PubMed

Napper, Genevieve; Fricke, Tim; Anjou, Mitchell D; Jackson, A Jonathan

2015-09-01

This report describes the implementation of and outcomes from a new spectacle subsidy scheme and de-centralised care options for Aboriginal and Torres Strait Islander peoples in Victoria, Australia. The Victorian Aboriginal Spectacle Subsidy Scheme (VASSS) commenced in 2010, as an additional subsidy to the long-established Victorian Eyecare Service (VES). The Victorian Aboriginal Spectacle Subsidy Scheme aimed to improve access to and uptake of affordable spectacles and eye examinations by Indigenous Victorians. The scheme is overseen by a committee convened by the Victorian Government's Department of Health and Human Services and includes eye-health stakeholders from the Aboriginal community and government, not-for-profit, university and Aboriginal communities. Key features of the Victorian Aboriginal Spectacle Subsidy Scheme include reduced and certain patient co-payments of $10, expanded spectacle frame range, broadened eligibility and community participation in service design and implementation. We describe the services implemented by the Australian College of Optometry (ACO) in Victoria and their impact on access to eye-care services. In 2014, optometric services were available at 36 service sites across Victoria, including 21 Aboriginal Health Services (AHS) sites. Patient services have increased from 400 services per year in 2009, to 1,800 services provided in 2014. During the first three years of the Victorian Aboriginal Spectacle Subsidy Scheme program (2010 to 2013), 4,200 pairs of glasses (1,400 pairs per year) were provided. Further funding to 2016/17 will lift the number of glasses to be delivered to 6,600 pairs (1,650 per year). This compares to population projected needs of 2,400 pairs per year. Overcoming the barriers to using eye-care services by Indigenous people can be difficult and resource intensive; however the Victorian Aboriginal Spectacle Subsidy Scheme provides an example of positive outcomes achieved through carefully designed and targeted approaches that engender sector and stakeholder support. Sustained support for the Victorian Aboriginal Spectacle Subsidy Scheme at a level that meets population needs is an ongoing challenge. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

A Systematic Review of Reviews Evaluating Technology-Enabled Diabetes Self-Management Education and Support.

PubMed

Greenwood, Deborah A; Gee, Perry M; Fatkin, Kathy J; Peeples, Malinda

2017-09-01

Since the introduction of mobile phones, technology has been increasingly used to enable diabetes self-management education and support. This timely systematic review summarizes how currently available technology impacts outcomes for people living with diabetes. A systematic review of high quality review articles and meta analyses focused on utilizing technology in diabetes self-management education and support services was conducted. Articles were included if published between January 2013 and January 2017. Twenty-five studies were included for analysis. The majority evaluated the use of mobile phones and secure messaging. Most studies described healthy eating, being active and metabolic monitoring as the predominant self-care behaviors evaluated. Eighteen of 25 reviews reported significant reduction in A1c as an outcome measure. Four key elements emerged as essential for improved A1c: (1) communication, (2) patient-generated health data, (3) education, and (4) feedback. Technology-enabled diabetes self-management solutions significantly improve A1c. The most effective interventions incorporated all the components of a technology-enabled self-management feedback loop that connected people with diabetes and their health care team using 2-way communication, analyzed patient-generated health data, tailored education, and individualized feedback. The evidence from this systematic review indicates that organizations, policy makers and payers should consider integrating these solutions in the design of diabetes self-management education and support services for population health and value-based care models. With the widespread adoption of mobile phones, digital health solutions that incorporate evidence-based, behaviorally designed interventions can improve the reach and access to diabetes self-management education and ongoing support.

Using Coaching to Provide Ongoing Support and Supervision to Out-of-School Time Staff. Part 3 in a Series on Implementing Evidence-Based Practices in Out-of-School Time Programs: The Role of Frontline Staff. Research-to-Results Brief. Publication #2009-06

ERIC Educational Resources Information Center

Burkhauser, Mary; Metz, Allison J. R.

2009-01-01

Although skills needed by out-of-school time practitioners can be introduced during training, many skills can only really be learned on the job with ongoing support and supervision provided by a "coach." Research from both the education and out-of-school time fields supports the value of staff coaching as a professional development tool, and staff…

Retooling Institutional Support Infrastructure for Clinical Research

PubMed Central

Snyder, Denise C.; Brouwer, Rebecca N.; Ennis, Cory L.; Spangler, Lindsey L.; Ainsworth, Terry L.; Budinger, Susan; Mullen, Catherine; Hawley, Jeffrey; Uhlenbrauck, Gina; Stacy, Mark

2016-01-01

Clinical research activities at academic medical centers are challenging to oversee. Without effective research administration, a continually evolving set of regulatory and institutional requirements can detract investigator and study team attention away from a focus on scientific gain, study conduct, and patient safety. However, even when the need for research administration is recognized, there can be struggles over what form it should take. Central research administration may be viewed negatively, with individual groups preferring to maintain autonomy over processes. Conversely, a proliferation of individualized approaches across an institution can create inefficiencies or invite risk. This article describes experiences establishing a unified research support office at the Duke University School of Medicine based on a framework of customer support. The Duke Office of Clinical Research was formed in 2012 with a vision that research administration at academic medical centers should help clinical investigators navigate the complex research environment and operationalize research ideas. The office provides an array of services that have received high satisfaction ratings. The authors describe the ongoing culture change necessary for success of the unified research support office. Lessons learned from implementation of the Duke Office of Clinical Research may serve as a model for other institutions undergoing a transition to unified research support. PMID:27125563

Accelerating Clean Energy Commercialization. A Strategic Partnership Approach

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

Adams, Richard; Pless, Jacquelyn; Arent, Douglas J.

Technology development in the clean energy and broader clean tech space has proven to be challenging. Long-standing methods for advancing clean energy technologies from science to commercialization are best known for relatively slow, linear progression through research and development, demonstration, and deployment (RDD&D); and characterized by well-known valleys of death for financing. Investment returns expected by traditional venture capital investors have been difficult to achieve, particularly for hardware-centric innovations, and companies that are subject to project finance risks. Commercialization support from incubators and accelerators has helped address these challenges by offering more support services to start-ups; however, more effort ismore » needed to fulfill the desired clean energy future. The emergence of new strategic investors and partners in recent years has opened up innovative opportunities for clean tech entrepreneurs, and novel commercialization models are emerging that involve new alliances among clean energy companies, RDD&D, support systems, and strategic customers. For instance, Wells Fargo and Company (WFC) and the National Renewable Energy Laboratory (NREL) have launched a new technology incubator that supports faster commercialization through a focus on technology development. The incubator combines strategic financing, technology and technical assistance, strategic customer site validation, and ongoing financial support.« less

Spatio-temporal evolution of water-related ecosystem services: Taihu Basin, China.

PubMed

Chen, Junyu; Cui, Tao; Wang, Huimin; Liu, Gang; Gilfedder, Mat; Bai, Yang

2018-01-01

Water-related ecosystem services (WESs) arise from the interaction between water ecosystems and their surrounding terrestrial ecosystems. They are critical for human well-being as well as for the whole ecological circle. An urgent service-oriented reform for the utilization and supervision of WESs can assist in avoiding ecological risks and achieving a more sustainable development in the Taihu Basin, China (THB). Spatially distributed models allow the multiple impacts of land use/land cover conversion and climate variation on WESs to be estimated and visualized efficiently, and such models can form a useful component in the toolbox for integrated water ecosystem management. The Integrated Valuation of Ecosystem Services and Tradeoffs model is used here to evaluate and visualize the spatio-temporal evolution of WESs in the THB from 2000 to 2010. Results indicate that water retention service experienced a decline from 2000 to 2005 with a recovery after 2005, while there was ongoing water scarcity in urban areas. Both the water purification service and the soil retention service underwent a slight decrease over the study period. Nutrients export mainly came from developed land and cultivated land, with the hilly areas in the south of the THB forming the primary area for soil loss. The quantity and distribution of WESs were impacted significantly by the shrinkage of cultivated land and the expansion of developed land. These findings will lay a foundation for a service-oriented management of WESs in the THB and support evidence-based decision making.

Supporting international medical graduates' transition to their host-country: realist synthesis.

PubMed

Kehoe, Amelia; McLachlan, John; Metcalf, Jane; Forrest, Simon; Carter, Madeline; Illing, Jan

2016-10-01

Many health services and systems rely on the contribution of international medical graduates (IMGs) to the workforce. However, concern has grown around their regulation and professional practice. There is a need, in the absence of strong evidence and a robust theoretical base, for a deeper understanding of the efficacy of interventions used to support IMGs' transition to their host countries. This study seeks to explore and synthesise evidence relating to interventions developed for IMGs. It aims to provide educators and policy makers with an understanding of how interventions should be developed to support IMGs in their transition to the workplace, particularly looking to identify how and why they are effective. The realist synthesis involved an initial systematic search of the literature for the period January 1990 to April 2015. Secondary searches were conducted throughout the review in order to inform and test the developing programme theory. The context, mechanism and outcome data were extracted from all sources meeting the inclusion criteria. Fourteen case studies were included to further aid theory refinement. Sixty-two articles were identified, describing diverse interventions of varying intensity. A further 26 articles were identified through a secondary search. The findings illustrate that, alongside a developed programme, ongoing support and cultural awareness at organisational and training levels are crucial. Individual differences must also be taken into consideration. This will ensure that IMGs engage in transformative learning, increase their levels of self-efficacy and cultural health capital, and reduce feelings of stress and anxiety. These factors will have an impact on work, interactions and cultural adjustment. Organisational, training and individual contexts all play a role in IMGs' adjustment during the transition process. Establishing ongoing support is critical. A list of recommendations for implementation is given. © 2016 The Authors. Medical Education Published by John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Identification and initial response to children's exposure to intimate partner violence: a qualitative synthesis of the perspectives of children, mothers and professionals.

PubMed

Lewis, Natalia V; Feder, Gene S; Howarth, Emma; Szilassy, Eszter; McTavish, Jill R; MacMillan, Harriet L; Wathen, Nadine

2018-04-28

To synthesise evidence on the acceptable identification and initial response to children's exposure to intimate partner violence (IPV) from the perspectives of providers and recipients of healthcare and social services. We conducted a thematic synthesis of qualitative research, appraised the included studies with the modified Critical Appraisal Skills Programme checklist and undertook a sensitivity analysis of the studies scored above 15. We searched eight electronic databases, checked references and citations and contacted authors of the included studies. We included qualitative studies with children, parents and providers of healthcare or social services about their experiences of identification or initial responses to children's exposure to IPV. Papers that have not been peer-reviewed were excluded as well as non-English papers. Searches identified 2039 records; 11 studies met inclusion criteria. Integrated perspectives of 42 children, 212 mothers and 251 professionals showed that sufficient training and support for professionals, good patient-professional relationship and supportive environment for patient/clients need to be in place before enquiry/disclosure of children's exposure to IPV should occur. Providers and recipients of care favour a phased enquiry about IPV initiated by healthcare professionals, which focuses on 'safety at home' and is integrated into the context of the consultation or visit. Participants agreed that an acceptable initial response prioritises child safety and includes emotional support, education about IPV and signposting to IPV services. Participants had conflicting perspectives on what constitutes acceptable engagement with children and management of safety. Sensitivity analysis produced similar results. Healthcare and social service professionals should receive sufficient training and ongoing individual and system-level support to provide acceptable identification of and initial response to children's exposure to IPV. Ideal identification and responses should use a phased approach to enquiry and the WHO Listen, Inquire about needs and concerns, Validate, Enhance safety and Support principles integrated into a trauma-informed and violence-informed model of care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Use of a Smartphone Recovery Tool for Latinos with Co-Occurring Alcohol and Other Drug Disorders and Mental Disorders.

PubMed

Muroff, Jordana; Robinson, Winslow; Chassler, Deborah; López, Luz M; Gaitan, Erika; Lundgren, Lena; Guauque, Claudia; Dargon-Hart, Susan; Stewart, Emily; Dejesus, Diliana; Johnson, Kimberly; Pe-Romashko, Klaren; Gustafson, David H

2017-01-01

Addressing alcohol and other drug disorders and other mental disorders among adult Hispanics/Latinos is of critical concern, as they are one of the fastest-growing ethnic groups with a disproportionate rate of disease, mental disorders, and poverty. Although improvement in outcomes is associated with sustained participation in ongoing treatment for co-occurring alcohol and other drug disorders/mental disorders, continuing care is rare for these chronic conditions, especially for Latinos with more limited access to culturally and linguistically competent services. The evidence-based smartphone recovery application Addiction-Comprehensive Health Enhancement Support System (A-CHESS) was translated and adapted for Spanish-speaking Latinos with alcohol and other drug disorders/mental disorders, thus developing CASA-CHESS to address a high level of need for services, high rates of relapse, and lack of existing culturally competent services for Latinos. Of the 79 Latino clients who completed residential treatment and received a smartphone equipped with CASA-CHESS, 26.6% discontinued using CASA-CHESS and 73.4% remained active for four or more months. CASA-CHESS usage was sustained over the four months across all three tenets of self-determination theory (competence, relatedness, and autonomy), with the most commonly utilized services being relevant to relatedness (e.g., messaging, discussion boards). CASA-CHESS clients demonstrated a similar pattern of usage to A-CHESS clients. Findings illustrate that Spanish-speaking Latinos with alcohol and other drug disorders/mental disorders will use a smartphone application to assist with their recovery, continuing their access to resources, case management, and quality information after leaving residential treatment. Consistent with previous findings, our results also emphasize the importance of social support during the four months post-discharge. Such evidence-based, theory-driven digital interventions may extend access to culturally and linguistically competent services.

Developing a community based service model for disability: Listening to the needs of all beneficiaries and providers.

PubMed

Collins, Katrina

2017-12-11

To inform the strategic and operational development of a community based service model at the Crann Centre, Cork, Ireland for SB children, adults, their families and providers. A needs assessment was conducted by gathering the views of multiple stakeholder perspectives within the SB community in the geographical region the Centre will serve. The intention is to create project deliverables that are responsive to the needs highlighted through this research. The study used a multi method design with a participatory research approach to explore the needs of SB individuals, families and providers. This involved in depth interviews, focus groups and online surveys. One hundred and fifty-nine respondents contributed to this qualitative needs assessment. The research established a range of psychosocial, clinical, vocational and educational issues causing ongoing difficulties for SB individuals and families. Providers highlighted supports that would benefit the social and clinical wellbeing of persons with SB. Collectively participants in the study reported that there was an absence of coordinated, continuous and comprehensive service delivery for the SB community in the region. This was amplified by geographical location of services and access to relevant supports. Consensus across stakeholders in this research pointed to the necessity for an innovative model of community based provision at the Crann Centre. This was described as offering a service with family at the core of an assets based model of practice. A key finding was the lack of importance placed on the social and emotional development of SB individuals. Traditionally participants described a singular focus on physical health through clinically defined treatment models. The desire for a social model of disability that informed health and wellbeing of SB individuals and families emerged as a prominent recommendation from the research.

PPO and HMO performance factors: insurance company evaluation criteria.

PubMed

Rodin, B E

1993-01-01

A venture into managed care should be done only following the proper amount of due diligence. The goal should be to select the most effective managed care organization with the flexibility to meet long-term needs and the mission to work on an ongoing basis to improve service and managed care performance. Unfortunately, all too often purchasers do not demand critical information from managed care service providers. As a result, poor quality organizations have prospered and delivered less than satisfactory results. In fact, it is not unusual that savings from discounts are more than offset by increased use of health care services because of poor utilization management. It is important to be aware that use of the appropriate selection methods and monitoring performance on an ongoing basis are best done by dedicated professionals. They are also resource intensive and require a sophisticated systems capability. Since resources and systems involve significant investment, the most appropriate course for purchasers is to play the role of educated consumers. Detailed documentation should be demanded from all potential service providers to ensure that due diligence and ongoing management are in fact performed. The health care management staff at ITT Hartford is often told by managed care vendors that few other purchasers perform thorough review. It is imperative that managed care be scrutinized at least as closely as any important business venture.

Unidata's Vision for Transforming Geoscience by Moving Data Services and Software to the Cloud

NASA Astrophysics Data System (ADS)

Ramamurthy, Mohan; Fisher, Ward; Yoksas, Tom

2015-04-01

Universities are facing many challenges: shrinking budgets, rapidly evolving information technologies, exploding data volumes, multidisciplinary science requirements, and high expectations from students who have grown up with smartphones and tablets. These changes are upending traditional approaches to accessing and using data and software. Unidata recognizes that its products and services must evolve to support new approaches to research and education. After years of hype and ambiguity, cloud computing is maturing in usability in many areas of science and education, bringing the benefits of virtualized and elastic remote services to infrastructure, software, computation, and data. Cloud environments reduce the amount of time and money spent to procure, install, and maintain new hardware and software, and reduce costs through resource pooling and shared infrastructure. Cloud services aimed at providing any resource, at any time, from any place, using any device are increasingly being embraced by all types of organizations. Given this trend and the enormous potential of cloud-based services, Unidata is taking moving to augment its products, services, data delivery mechanisms and applications to align with the cloud-computing paradigm. Specifically, Unidata is working toward establishing a community-based development environment that supports the creation and use of software services to build end-to-end data workflows. The design encourages the creation of services that can be broken into small, independent chunks that provide simple capabilities. Chunks could be used individually to perform a task, or chained into simple or elaborate workflows. The services will also be portable in the form of downloadable Unidata-in-a-box virtual images, allowing their use in researchers' own cloud-based computing environments. In this talk, we present a vision for Unidata's future in a cloud-enabled data services and discuss our ongoing efforts to deploy a suite of Unidata data services and tools in the Amazon EC2 and Microsoft Azure cloud environments, including the transfer of real-time meteorological data into its cloud instances, product generation using those data, and the deployment of TDS, McIDAS ADDE and AWIPS II data servers and the Integrated Data Server visualization tool.

Placement, support, and retention of health professionals: national, cross-sectional findings from medical and dental community service officers in South Africa.

PubMed

Hatcher, Abigail M; Onah, Michael; Kornik, Saul; Peacocke, Julia; Reid, Stephen

2014-02-26

In South Africa, community service following medical training serves as a mechanism for equitable distribution of health professionals and their professional development. Community service officers are required to contribute a year towards serving in a public health facility while receiving supervision and remuneration. Although the South African community service programme has been in effect since 1998, little is known about how placement and practical support occur, or how community service may impact future retention of health professionals. National, cross-sectional data were collected from community service officers who served during 2009 using a structured self-report questionnaire. A Supervision Satisfaction Scale (SSS) was created by summing scores of five questions rated on a three-point Likert scale (orientation, clinical advising, ongoing mentorship, accessibility of clinic leadership, and handling of community service officers' concerns). Research endpoints were guided by community service programmatic goals and analysed as dichotomous outcomes. Bivariate and multivariate logistical regressions were conducted using Stata 12. The sample population comprised 685 doctors and dentists (response rate 44%). Rural placement was more likely among unmarried, male, and black practitioners. Rates of self-reported professional development were high (470 out of 539 responses; 87%). Participants with higher scores on the SSS were more likely to report professional development. Although few participants planned to continue work in rural, underserved communities (n = 171 out of 657 responses, 25%), those serving in a rural facility during the community service year had higher intentions of continuing rural work. Those reporting professional development during the community service year were twice as likely to report intentions to remain in rural, underserved communities. Despite challenges in equitable distribution of practitioners, participant satisfaction with the compulsory community service programme appears to be high among those who responded to a 2009 questionnaire. These data offer a starting point for designing programmes and policies that better meet the health needs of the South African population through more appropriate human resource management. An emphasis on professional development and supervision is crucial if South Africa is to build practitioner skills, equitably distribute health professionals, and retain the medical workforce in rural, underserved areas.

Understanding Geometric Ideas: Pre-Service Primary Teachers' Knowledge as a Basis for Teaching

ERIC Educational Resources Information Center

Seah, Rebecca

2015-01-01

This paper reports part of an ongoing investigation into aspects of pre-service teachers' geometric knowledge. One hundred and fifty-two Australian pre-service teachers responded to a series of questions that reflect the type of knowledge teachers are expected to know and teach. Analysis of their responses shows that teacher knowledge can be…

26th USDA interagency research forum on invasive species

Treesearch

Katherine A. McManus; Kurt W. Gottschalk

2015-01-01

This meeting was the 26th in a series of annual USDA Interagency Research Forums that are sponsored by the Forest Service, Animal and Plant Health Inspection Service, National Institute of Food and Agriculture, and Agriculture Research Service. The Group's original goal of fostering communication and providing a forum for the overview of ongoing research among the...

XXVII (28th) USDA interagency research forum on invasive species

Treesearch

Katherine A. McManus; Therese M. Poland

2017-01-01

This meeting was the 28th in a series of annual USDA Interagency Research Forums that are sponsored by the Forest Service, Animal and Plant Health Inspection Service, National Institute of Food and Agriculture, and Agriculture Research Service. The Group's original goal of fostering communication and providing a forum for the overview of ongoing research among the...

Publication Services at the University Library Graz: A New Venture, a New Role

ERIC Educational Resources Information Center

Ginther, Clara; Lackner, Karin; Kaier, Christian

2017-01-01

Establishing Publication Services in the library at the University of Graz did more than broaden the service portfolio of the library. A convergence of expertise at the library, needs of researchers at the university, and ongoing changes in scholarly communication also contributed to the evolution of the library's role and profile. The new…

Long Distance Relationships: Assessing the Library Service Needs of Rural Students in eLearning Courses

ERIC Educational Resources Information Center

Sterling, Lorelei; McKay, Jennifer; Ericson, Christine

2017-01-01

In states with limited road accessibility, rural students can feel isolated from library services. This article explores the creation, implementation, and results of an on-going longitudinal study assessing the library service needs of rural students in eLearning courses. To align with current practices in online pedagogies, including the…

Residential Services for Persons with Developmental Disabilities: Status and Trends through 1995. Report #49.

ERIC Educational Resources Information Center

Prouty, Robert, Ed.; Lakin, K. Charlie, Ed.

This report from the ongoing National Residential Information Systems Project on Residential Services provides statistics on persons with mental retardation and related developmental disabilities (MR/DD) receiving residential services in the U.S. for the year ending June 30,1995, as well as comparative statistics from earlier years. The report…

Preliminary Evaluation of the Validity and Reliability of the Spanish Version of the Therapeutic Alliance with Clinician (TAC) Questionnaire

ERIC Educational Resources Information Center

Bedregal, Luis E.; Paris, Manuel Jr.; Anez, Luis M.; Shahar, Golan; Davidson, Larry

2006-01-01

As part of a broader study aimed at evaluating perceived alliance with service providers and level of satisfaction with services received, 103 monolingual Spanish speaking Hispanic women were interviewed. Participants were receiving ongoing behavioral health treatment at three different community service provider sites located in the greater New…

Evaluation of a specialized oncology nursing supportive care intervention in newly diagnosed breast and colorectal cancer patients following surgery: a cluster randomized trial.

PubMed

Sussman, Jonathan; Bainbridge, Daryl; Whelan, Timothy J; Brazil, Kevin; Parpia, Sameer; Wiernikowski, Jennifer; Schiff, Susan; Rodin, Gary; Sergeant, Myles; Howell, Doris

2018-05-01

Better coordination of supportive services during the early phases of cancer care has been proposed to improve the care experience of patients. We conducted a randomized trial to test a community-based nurse-led coordination of care intervention in cancer patients. Surgical practices were cluster randomized to a control group involving usual care practices or a standardized nursing intervention consisting of an in-person supportive care assessment with ongoing support to meet identified needs, including linkage to community services. Newly diagnosed breast and colorectal cancer patients within 7 days of cancer surgery were eligible. The primary outcome was the patient-reported outcome (PRO) of continuity of care (CCCQ) measured at 3 weeks. Secondary outcomes included unmet supportive care needs (SCNS), quality of life (EORTC QLQ-C30), health resource utilization, and level of uncertainty with care trajectory (MUIS) at 3 and/or 8 weeks. A total of 121 breast and 72 colorectal patients were randomized through 28 surgical practices. There was a small improvement in the informational domain of continuity of care (difference 0.29 p = 0.05) and a trend to less emergency room use (15.8 vs 7.1%) (p = 0.07). There were no significant differences between groups on unmet need, quality of life, or uncertainty. We did not find substantial gaps in the PROs measured immediately following surgery for breast and colorectal cancer patients. The results of this study support a more targeted approach based on need and inform future research focused on improving navigation during the initial phases of cancer treatment. ClinicalTrials.gov Identifier: NCT00182234. SONICS-Effectiveness of Specialist Oncology Nursing.

Research data management and libraries: relationships, activities, drivers and influences.

PubMed

Pinfield, Stephen; Cox, Andrew M; Smith, Jen

2014-01-01

The management of research data is now a major challenge for research organisations. Vast quantities of born-digital data are being produced in a wide variety of forms at a rapid rate in universities. This paper analyses the contribution of academic libraries to research data management (RDM) in the wider institutional context. In particular it: examines the roles and relationships involved in RDM, identifies the main components of an RDM programme, evaluates the major drivers for RDM activities, and analyses the key factors influencing the shape of RDM developments. The study is written from the perspective of library professionals, analysing data from 26 semi-structured interviews of library staff from different UK institutions. This is an early qualitative contribution to the topic complementing existing quantitative and case study approaches. Results show that although libraries are playing a significant role in RDM, there is uncertainty and variation in the relationship with other stakeholders such as IT services and research support offices. Current emphases in RDM programmes are on developments of policies and guidelines, with some early work on technology infrastructures and support services. Drivers for developments include storage, security, quality, compliance, preservation, and sharing with libraries associated most closely with the last three. The paper also highlights a 'jurisdictional' driver in which libraries are claiming a role in this space. A wide range of factors, including governance, resourcing and skills, are identified as influencing ongoing developments. From the analysis, a model is constructed designed to capture the main aspects of an institutional RDM programme. This model helps to clarify the different issues involved in RDM, identifying layers of activity, multiple stakeholders and drivers, and a large number of factors influencing the implementation of any initiative. Institutions may usefully benchmark their activities against the data and model in order to inform ongoing RDM activity.

Resisting and challenging stigma in Uganda: the role of support groups of people living with HIV

PubMed Central

Mburu, Gitau; Ram, Mala; Skovdal, Morten; Bitira, David; Hodgson, Ian; Mwai, Grace W; Stegling, Christine; Seeley, Janet

2013-01-01

Introduction Global scale up of antiretroviral therapy is changing the context of HIV-related stigma. However, stigma remains an ongoing concern in many countries. Groups of people living with HIV can contribute to the reduction of stigma. However, the pathways through which they do so are not well understood. Methods This paper utilizes data from a qualitative study exploring the impact of networked groups of people living with HIV in Jinja and Mbale districts of Uganda. Participants were people living with HIV (n=40), members of their households (n=10) and their health service providers (n=15). Data were collected via interviews and focus group discussions in 2010, and analyzed inductively to extract key themes related to the approaches and outcomes of the groups’ anti-stigma activities. Results Study participants reported that HIV stigma in their communities had declined as a result of the collective activities of groups of people living with HIV. However, they believed that stigma remained an ongoing challenge. Gender, family relationships, social and economic factors emerged as important drivers of stigma. Challenging stigma collectively transcended individual experiences and united people living with HIV in a process of social renegotiation to achieve change. Groups of people living with HIV provided peer support and improved the confidence of their members, which ultimately reduced self-stigma and improved their ability to deal with external stigma when it was encountered. Conclusions Antiretroviral therapy and group-based approaches in the delivery of HIV services are opening up new avenues for the collective participation of people living with HIV to challenge HIV stigma and act as agents of social change. Interventions for reducing HIV stigma should be expanded beyond those that aim to increase the resilience and coping mechanisms of individuals, to those that build the capacity of groups to collectively cope with and challenge HIV stigma. Such interventions should be gender sensitive and should respond to contextual social, economic and structural factors that drive stigma. PMID:24242256

Resisting and challenging stigma in Uganda: the role of support groups of people living with HIV.

PubMed

Mburu, Gitau; Ram, Mala; Skovdal, Morten; Bitira, David; Hodgson, Ian; Mwai, Grace W; Stegling, Christine; Seeley, Janet

2013-11-13

Global scale up of antiretroviral therapy is changing the context of HIV-related stigma. However, stigma remains an ongoing concern in many countries. Groups of people living with HIV can contribute to the reduction of stigma. However, the pathways through which they do so are not well understood. This paper utilizes data from a qualitative study exploring the impact of networked groups of people living with HIV in Jinja and Mbale districts of Uganda. Participants were people living with HIV (n=40), members of their households (n=10) and their health service providers (n=15). Data were collected via interviews and focus group discussions in 2010, and analyzed inductively to extract key themes related to the approaches and outcomes of the groups' anti-stigma activities. Study participants reported that HIV stigma in their communities had declined as a result of the collective activities of groups of people living with HIV. However, they believed that stigma remained an ongoing challenge. Gender, family relationships, social and economic factors emerged as important drivers of stigma. Challenging stigma collectively transcended individual experiences and united people living with HIV in a process of social renegotiation to achieve change. Groups of people living with HIV provided peer support and improved the confidence of their members, which ultimately reduced self-stigma and improved their ability to deal with external stigma when it was encountered. Antiretroviral therapy and group-based approaches in the delivery of HIV services are opening up new avenues for the collective participation of people living with HIV to challenge HIV stigma and act as agents of social change. Interventions for reducing HIV stigma should be expanded beyond those that aim to increase the resilience and coping mechanisms of individuals, to those that build the capacity of groups to collectively cope with and challenge HIV stigma. Such interventions should be gender sensitive and should respond to contextual social, economic and structural factors that drive stigma.

Research Data Management and Libraries: Relationships, Activities, Drivers and Influences

PubMed Central

Pinfield, Stephen; Cox, Andrew M.; Smith, Jen

2014-01-01

The management of research data is now a major challenge for research organisations. Vast quantities of born-digital data are being produced in a wide variety of forms at a rapid rate in universities. This paper analyses the contribution of academic libraries to research data management (RDM) in the wider institutional context. In particular it: examines the roles and relationships involved in RDM, identifies the main components of an RDM programme, evaluates the major drivers for RDM activities, and analyses the key factors influencing the shape of RDM developments. The study is written from the perspective of library professionals, analysing data from 26 semi-structured interviews of library staff from different UK institutions. This is an early qualitative contribution to the topic complementing existing quantitative and case study approaches. Results show that although libraries are playing a significant role in RDM, there is uncertainty and variation in the relationship with other stakeholders such as IT services and research support offices. Current emphases in RDM programmes are on developments of policies and guidelines, with some early work on technology infrastructures and support services. Drivers for developments include storage, security, quality, compliance, preservation, and sharing with libraries associated most closely with the last three. The paper also highlights a ‘jurisdictional’ driver in which libraries are claiming a role in this space. A wide range of factors, including governance, resourcing and skills, are identified as influencing ongoing developments. From the analysis, a model is constructed designed to capture the main aspects of an institutional RDM programme. This model helps to clarify the different issues involved in RDM, identifying layers of activity, multiple stakeholders and drivers, and a large number of factors influencing the implementation of any initiative. Institutions may usefully benchmark their activities against the data and model in order to inform ongoing RDM activity. PMID:25485539

The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change

PubMed Central

2013-01-01

Background Despite growth in implementation research, limited scientific attention has focused on understanding and improving sustainability of health interventions. Models of sustainability have been evolving to reflect challenges in the fit between intervention and context. Discussion We examine the development of concepts of sustainability, and respond to two frequent assumptions —'voltage drop,’ whereby interventions are expected to yield lower benefits as they move from efficacy to effectiveness to implementation and sustainability, and 'program drift,’ whereby deviation from manualized protocols is assumed to decrease benefit. We posit that these assumptions limit opportunities to improve care, and instead argue for understanding the changing context of healthcare to continuously refine and improve interventions as they are sustained. Sustainability has evolved from being considered as the endgame of a translational research process to a suggested 'adaptation phase’ that integrates and institutionalizes interventions within local organizational and cultural contexts. These recent approaches locate sustainability in the implementation phase of knowledge transfer, but still do not address intervention improvement as a central theme. We propose a Dynamic Sustainability Framework that involves: continued learning and problem solving, ongoing adaptation of interventions with a primary focus on fit between interventions and multi-level contexts, and expectations for ongoing improvement as opposed to diminishing outcomes over time. Summary A Dynamic Sustainability Framework provides a foundation for research, policy and practice that supports development and testing of falsifiable hypotheses and continued learning to advance the implementation, transportability and impact of health services research. PMID:24088228

The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change.

PubMed

Chambers, David A; Glasgow, Russell E; Stange, Kurt C

2013-10-02

Despite growth in implementation research, limited scientific attention has focused on understanding and improving sustainability of health interventions. Models of sustainability have been evolving to reflect challenges in the fit between intervention and context. We examine the development of concepts of sustainability, and respond to two frequent assumptions -'voltage drop,' whereby interventions are expected to yield lower benefits as they move from efficacy to effectiveness to implementation and sustainability, and 'program drift,' whereby deviation from manualized protocols is assumed to decrease benefit. We posit that these assumptions limit opportunities to improve care, and instead argue for understanding the changing context of healthcare to continuously refine and improve interventions as they are sustained. Sustainability has evolved from being considered as the endgame of a translational research process to a suggested 'adaptation phase' that integrates and institutionalizes interventions within local organizational and cultural contexts. These recent approaches locate sustainability in the implementation phase of knowledge transfer, but still do not address intervention improvement as a central theme. We propose a Dynamic Sustainability Framework that involves: continued learning and problem solving, ongoing adaptation of interventions with a primary focus on fit between interventions and multi-level contexts, and expectations for ongoing improvement as opposed to diminishing outcomes over time. A Dynamic Sustainability Framework provides a foundation for research, policy and practice that supports development and testing of falsifiable hypotheses and continued learning to advance the implementation, transportability and impact of health services research.

The Cedar Project WelTel mHealth intervention for HIV prevention in young Indigenous people who use illicit drugs: study protocol for a randomized controlled trial.

PubMed

Jongbloed, Kate; Friedman, Anton J; Pearce, Margo E; Van Der Kop, Mia L; Thomas, Vicky; Demerais, Lou; Pooyak, Sherri; Schechter, Martin T; Lester, Richard T; Spittal, Patricia M

2016-03-09

Despite successes in preventing and treating HIV, Indigenous people in Canada continue to face disproportionately high rates of HIV infection. Programs that support healing from lifetime trauma, support connection to culture, and reduce drug-related harms are critical to preventing HIV among young Indigenous people who use drugs. The Cedar Project WelTel mHealth intervention proposed here is a structured mobile-phone initiative to connect young Indigenous people who use drugs with Cedar Case Managers in a community-based setting. The intervention consists of a package of supports, including a mobile phone and cellular plan, weekly two-way text messaging, and support from Cedar Case Managers. The Cedar Project WelTel mHealth study is a multi-site Zelen pre-randomized trial to measure the effect of a two-way supportive text-message intervention to reduce HIV vulnerability among young Indigenous people who use illicit drugs in two Canadian cities. The trial is nested within the Cedar Project, an ongoing cohort study addressing HIV and hepatitis C vulnerability among young Indigenous people who use drugs in Vancouver and Prince George, British Columbia. The Cedar Project Partnership, an independent body of Indigenous Elders, leaders, and health/social service experts, governs all aspects of the study. Two hundred participants will be followed over a 16-month period, with HIV propensity score at 6 months as the primary outcome. Secondary outcomes include HIV propensity at 1 year, HIV risk, resilience, psychological distress, access to drug-related services, and connection to culture measured at 6 months and 1 year. Primary analysis is by intention to treat. Culturally safe interventions that address barriers to HIV prevention while supporting the strength of young Indigenous people who use drugs are urgently needed. Despite presenting a tremendous opportunity to connect young, highly transient Indigenous people who use drugs to prevention services, supportive two-way mHealth programs have yet to be tested for HIV prevention in a community-based setting with this population. ClinicalTrials.gov NCT02437123 https://clinicaltrials.gov/show/NCT02437123 (registered 4 May 2015). Protocol version: 24 July 2015.

Public attitudes towards involuntary admission and treatment by mental health services in Norway.

PubMed

Joa, Inge; Hustoft, Kjetil; Anda, Liss Gøril; Brønnick, Kolbjørn; Nielssen, Olav; Johannessen, Jan Olav; Langeveld, Johannes H

The role of compulsory treatment of serious mental disorders has been the topic of ongoing public debate involving among others mental health professionals, service providers, service user advocates, relatives of service users, media commentators and politicians. However, relatively little is known about general public attitudes towards involuntary admission and compulsory treatment of people with various mental disorders. This article examines the attitudes in a representative sample of Norway's population towards the use of involuntary admission and treatment, and under which circumstances does the general public consider compulsory treatment to be justified in the Norwegian mental health care services. Data were collected from a representative sample of the population in Norway aged 18 and older. The sample was stratified for gender, geographical region and age distribution (n=2001). The survey was performed in the months of May 2009 (n=1000) and May 2011 (n=1001), using Computer Assisted Telephone Interviews (CATI) by an independent polling company. All respondents were provided a general definition of coercive intervention before the interview was conducted. Univariate descriptions and bivariate analyses were performed by means of cross-tabulation, analysis of variance (one-way ANOVA) and comparing of group of means. Cohen's d was used as the measure for effect size. Between 87% and 97% of those surveyed expressed strong or partial agreement with the use of involuntary admissions or compulsory treatment related to specified cases and situations. The majority of interviewees (56%) expressed the opinion that overall, current levels are acceptable. A further, 34% were of the opinion that current levels are too low, while only 9.9% of respondents supported a reduction in the level of involuntary treatment. Lower levels of education were associated with a more positive attitude towards involuntary admission and treatment. There was stronger support for admission to prevent suicide than the possibility of violence by the mentally ill. The Norwegian adult population largely supports current legislation and practices regarding involuntary admission and compulsory treatment in the mental health services. Copyright © 2017 Elsevier Ltd. All rights reserved.

Understanding the dynamics of sustainable change: A 20-year case study of integrated health and social care.

PubMed

Klinga, Charlotte; Hasson, Henna; Andreen Sachs, Magna; Hansson, Johan

2018-06-04

Change initiatives face many challenges, and only a few lead to long-term sustainability. One area in which the challenge of achieving long-term sustainability is particularly noticeable is integrated health and social care. Service integration is crucial for a wide range of patients including people with complex mental health and social care needs. However, previous research has focused on the initiation, resistance and implementation of change, while longitudinal studies remain sparse. The objective of this study was therefore to gain insight into the dynamics of sustainable changes in integrated health and social care through an analysis of local actions that were triggered by a national policy. A retrospective and qualitative case-study research design was used, and data from the model organisation's steering-committee minutes covering 1995-2015 were gathered and analysed. The analysis generated a narrative case description, which was mirrored to the key elements of the Dynamic Sustainability Framework (DSF). The development of inter-sectoral cooperation was characterized by a participatory approach in which a shared structure was created to support cooperation and on-going quality improvement and learning based on the needs of the service user. A key management principle was cooperation, not only on all organisational levels, but also with service users, stakeholder associations and other partner organisations. It was shown that all these parts were interrelated and collectively contributed to the creation of a structure and a culture which supported the development of a dynamic sustainable health and social care. This study provides valuable insights into the dynamics of organizational sustainability and understanding of key managerial actions taken to establish, develop and support integration of health and social care for people with complex mental health needs. The service user involvement and regular reviews of service users' needs were essential in order to tailor services to the needs. Another major finding was the importance of continuously adapting the content of the change to suit its context. Hence, continuous refinement of the change content was found to be more important than designing the change at the pre-implementation stage.

7 CFR 1710.204 - Filing requirements for borrowers that must maintain an approved load forecast on an ongoing basis.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Filing requirements for borrowers that must maintain an approved load forecast on an ongoing basis. 1710.204 Section 1710.204 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE GENERAL AND PRE-LOAN POLICIES AND PROCEDURES COMMON TO...

42 CFR 438.6 - Contract requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., disability, ongoing health care needs, or catastrophic claims, using risk adjustment, risk sharing, or other... or need for health care services, discriminate against individuals eligible to enroll. (4) The MCO... for health care services. (5) Provide that enrollees have the right to disenroll from their PCCM in...

42 CFR 438.6 - Contract requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., disability, ongoing health care needs, or catastrophic claims, using risk adjustment, risk sharing, or other... or need for health care services, discriminate against individuals eligible to enroll. (4) The MCO... for health care services. (5) Provide that enrollees have the right to disenroll from their PCCM in...

Lean and the Learning Organization in Higher Education

ERIC Educational Resources Information Center

Francis, David E.

2014-01-01

Canadian post-secondary institutions are seeking enhanced efficiencies due to ongoing funding shortfalls and expanding teaching, research, and service mandates. These institutions have considered or enacted Lean methodology based on results reported by public service and healthcare organizations worldwide. Lean requires a high level of…

Building Community through Mentoring Adult Learners

ERIC Educational Resources Information Center

Plante, Jarrad; Truitt, Joshua

2016-01-01

The Volunteer UCF Community Connectors and Community Builders Program provides a connection between students and their community. The goal is to develop meaningful service opportunities for UCF students that contribute measurable results and systemic change through capacity building among adult learners. The ongoing, sustainable service experience…

42 CFR 51d.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE... basis, to address the immediate needs resulting from a mental health or substance abuse emergency. Such... the more ongoing needs resulting from a mental health or substance abuse emergency than is possible...

42 CFR 51d.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE... basis, to address the immediate needs resulting from a mental health or substance abuse emergency. Such... the more ongoing needs resulting from a mental health or substance abuse emergency than is possible...

42 CFR 51d.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE... basis, to address the immediate needs resulting from a mental health or substance abuse emergency. Such... the more ongoing needs resulting from a mental health or substance abuse emergency than is possible...

42 CFR 51d.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE... basis, to address the immediate needs resulting from a mental health or substance abuse emergency. Such... the more ongoing needs resulting from a mental health or substance abuse emergency than is possible...

Evaluating High School Libraries: Service Is Top Priority.

ERIC Educational Resources Information Center

Baldwin, Margaret

1988-01-01

Discusses the need for ongoing evaluation within high school libraries to ensure adequate library services, which, in turn, enhance the total educational program. The evaluation of library facilities, collections, and staff is discussed, and an annotated bibliography of evaluation tools is provided. (6 references) (CLB)

Transitioning a home telehealth project into a sustainable, large-scale service: a qualitative study.

PubMed

Wade, Victoria A; Taylor, Alan D; Kidd, Michael R; Carati, Colin

2016-05-16

This study was a component of the Flinders Telehealth in the Home project, which tested adding home telehealth to existing rehabilitation, palliative care and geriatric outreach services. Due to the known difficulty of transitioning telehealth projects services, a qualitative study was conducted to produce a preferred implementation approach for sustainable and large-scale operations, and a process model that offers practical advice for achieving this goal. Initially, semi-structured interviews were conducted with senior clinicians, health service managers and policy makers, and a thematic analysis of the interview transcripts was undertaken to identify the range of options for ongoing operations, plus the factors affecting sustainability. Subsequently, the interviewees and other decision makers attended a deliberative forum in which participants were asked to select a preferred model for future implementation. Finally, all data from the study was synthesised by the researchers to produce a process model. 19 interviews with senior clinicians, managers, and service development staff were conducted, finding strong support for home telehealth but a wide diversity of views on governance, models of clinical care, technical infrastructure operations, and data management. The deliberative forum worked through these options and recommended a collaborative consortium approach for large-scale implementation. The process model proposes that the key factor for large-scale implementation is leadership support, which is enabled by 1) showing solutions to the problems of service demand, budgetary pressure and the relationship between hospital and primary care, 2) demonstrating how home telehealth aligns with health service policies, and 3) achieving clinician acceptance through providing evidence of benefit and developing new models of clinical care. Two key actions to enable change were marketing telehealth to patients, clinicians and policy-makers, and building a community of practice. The implementation of home telehealth services is still in an early stage. Change agents and a community of practice can contribute by marketing telehealth, demonstrating policy alignment and providing potential solutions for difficult health services problems. This should assist health leaders to move from trials to large-scale services.

What patients think about choice in healthcare? A study on primary care services in Finland.

PubMed

Aalto, Anna-Mari; Elovainio, Marko; Tynkkynen, Liina-Kaisa; Reissell, Eeva; Vehko, Tuulikki; Chydenius, Miisa; Sinervo, Timo

2018-06-01

The ongoing Finnish health and social service reform will expand choice by opening the market for competition between public and private service providers. This study examined the attitudes of primary care patients towards choice and which patient-related factors are associated with these attitudes. A sample of attenders during one week in health centres of 12 big cities and municipal consortiums (including seven outsourced local units) and in primary care units of one private company providing outsourced services for municipalities (aged 18-95, n=8128) was used. The questionnaire included questions on choice-related attitudes, sociodemographic factors, health status, use of health services and patient satisfaction. Of the responders, 77% regarded choice to be important, 49% perceived genuine opportunities to make choices and 35% were satisfied with the choice-relevant information. Higher age, low education, having a chronic illness, frequent use of services, having a personal physician and being satisfied with the physician and with waiting times were related to assigning more importance on choice. Younger patients, those with higher education as well as those with chronic illness regarded their opportunities of choosing the service provider and availability of choice-relevant information poorer. The Finnish primary care patients value choice, but they are critical of the availability of choice-relevant information. Choices of patients with complex health care needs should be supported by developing integrated care alternatives and by increasing the availability of information on existing care alternatives to meet their needs.

Understanding why women adopt and sustain home water treatment: insights from the Malawi antenatal care program.

PubMed

Wood, Siri; Foster, Jennifer; Kols, Adrienne

2012-08-01

In many settings in Africa, social marketing has proven more successful in generating brand recognition for chlorine water treatment products than in promoting their use. To promote household use of one such product in Malawi, WaterGuard, the Ministry of Health (MOH) and Population Services International (PSI) distributed free hygiene kits that included WaterGuard to pregnant women attending antenatal clinics in 2007. Follow-up surveys documented a sustained increase in WaterGuard use three years after the initial intervention. In 2010, PATH (www.path.org) conducted qualitative research on the factors motivating women to adopt, sustain, or discontinue use. To provide context, interviews were also conducted with their friends, relatives, and husbands. Interviews revealed that sustained use of WaterGuard does not necessarily imply consistent use. Most respondents reported switching back and forth between WaterGuard and stock chlorine distributed for free by the government, and many treated water seasonally rather than year-round. Qualitative findings suggest that two program strategies strongly influenced women's decisions to adopt, purchase, and continue using WaterGuard. First, positive, ongoing contacts with health care workers, especially during home visits, raised awareness of the need to treat water, encouraged trial use, and supported continuing use. Second, an extended free trial of the product overcame initial cost barriers and allowed women and their families to experience the health benefits of WaterGuard, appreciate its value and relevance to their lives, and get used to its taste. Social support-from like-minded relatives, friends, neighbors, health care workers, husbands, and children-was also a critical factor that promoted consistent, ongoing use of WaterGuard. The findings confirm the importance of interpersonal communication in prompting adoption of household water treatment and suggest that consumers assess the perceived value of a product, not simply its cost. Further research is planned to investigate questions raised about patterns of ongoing use. Copyright © 2011 Elsevier Ltd. All rights reserved.

Prevalence Rate and Demographic and Clinical Correlates of Child Sexual Abuse Among New Psychiatric Outpatients in a City in Northern Alberta.

PubMed

Agyapong, Vincent I O; Juhás, Michal; Ritchie, Amanda; Ogunsina, Olurotimi; Ambrosano, Lorella; Corbett, Sandra

2017-01-01

The prevalence rate for child sexual abuse among new psychiatric outpatients in Fort McMurray was 20.7%. With an odds ratio for sex of 3.30, female patients are about 3 times more likely to report a history of child sexual abuse compared with male patients when controlling for other factors. Similarly, patients with at most high school education and those with previous contact with psychiatric services were about 2 times more likely to report a history of child sexual abuse compared to the patients with college or university education or no previous contact with psychiatric services, respectively. Similarly, patients with histories of substance abuse and patients with family histories of mental illness had higher likelihoods of reporting histories of child sexual abuse compared to patients without histories of substance abuse or family histories of mental illness, respectively. Our findings suggest that victims of child sexual abuse are an at-risk population in need of ongoing mental health and educational support.

It’s Just (Academic) Business: A Use Case in Improving Informatics Operations with Business Intelligence

PubMed Central

McIntosh, Leslie D.; Zabarovskaya, Connie; Uhlmansiek, Mary

2015-01-01

Academic biomedical informatics cores are beholden to funding agencies, institutional administration, collaborating researchers, and external agencies for ongoing funding and support. Services provided and translational research outcomes are increasingly important to monitor, report and analyze, to demonstrate value provided to the organization and the greater scientific community. Thus, informatics operations are also business operations. As such, adopting business intelligence practices offers an opportunity to improve the efficiency of evaluation efforts while fulfilling reporting requirements. Organizing informatics development documentation, service requests, and work performed with adaptable tools have greatly facilitated these and related business activities within our informatics center. Through the identification and measurement of key performance indicators, informatics objectives and results are now quickly and nimbly assessed using dashboards. Acceptance of the informatics operation as a business venture and the adoption of business intelligence strategies has allowed for data-driven decision making, faster corrective action, and greater transparency for interested stakeholders. PMID:26306252

KSC-2013-3067

NASA Image and Video Library

2013-07-08

LAS VEGAS, Nev. – The Boeing Company performed simulated contingency water landing scenarios with a mock-up CST-100 spacecraft at Bigelow Aerospace's headquarters near Las Vegas. The CST-100 is designed for ground landings, but could splash down on the water, if necessary. During the water tests, Department of Defense search-and-recovery personnel practiced pulling five Boeing engineers out of the capsule and to safety. The tests are part of the company’s ongoing work supporting its funded Space Act Agreement with NASA’s Commercial Crew Program, or CCP, during the Commercial Crew Integrated Capability, or CCiCap, initiative. CCP is intended to lead to the availability of commercial human spaceflight services for government and commercial customers to low-Earth orbit. Future development and certification initiatives eventually will lead to the availability of human spaceflight services for NASA to send its astronauts to the International Space Station, where critical research is taking place daily. For more information about CCP, go to http://www.nasa.gov/commercialcrew. Photo credit: Boeing

A randomized control trial of a chronic care intervention for homeless women with alcohol use problems.

PubMed

Upshur, Carole; Weinreb, Linda; Bharel, Monica; Reed, George; Frisard, Christine

2015-04-01

A clinician-randomized trial was conducted using the chronic care model for disease management for alcohol use problems among n = 82 women served in a health care for the homeless clinic. Women with problem alcohol use received either usual care or an intervention consisting of a primary care provider (PCP) brief intervention, referral to addiction services, and on-going support from a care manager (CM) for 6 months. Both groups significantly reduced their alcohol consumption, with a small effect size favoring intervention at 3 months, but there were no significant differences between groups in reductions in drinking or in housing stability, or mental or physical health. However, intervention women had significantly more frequent participation in substance use treatment services. Baseline differences and small sample size limit generalizability, although substantial reductions in drinking for both groups suggest that screening and PCP brief treatment are promising interventions for homeless women with alcohol use problems. Copyright © 2015 Elsevier Inc. All rights reserved.

Toward a national, sustained U.S. ecosystem assessment

USGS Publications Warehouse

Jackson, Stephen T.; Duke, Clifford S.; Hampton, Stephanie E.; Jacobs, Katharine L.; Joppa, Lucas N.; Kassam, Karim-Aly S. K.; Mooney, Harold A.; Ogden, Laura A.; Ruckelshaus, Mary; Shogren, Jason F.

2016-01-01

The massive investment of resources devoted to monitoring and assessment of economic and societal indicators in the United States is neither matched by nor linked to efforts to monitor and assess the ecosystem services and biodiversity that support economic and social well-being. Although national-scale assessments of biodiversity (1) and ecosystem indicators (2) have been undertaken, nearly a decade has elapsed since the last systematic assessment (2). A 2011 White House report called for a national biodiversity and ecosystem services assessment (3), but the initiative has stalled. Our aim here is to stimulate the process and outline a credible framework and pathway for an ongoing assessment of ecosystem functioning (see the photo). A national assessment should engage diverse stakeholders from multiple sectors of society and should focus on metrics and analyses of direct relevance to policy decisions, from local to national levels. Although many technical or science-focused components are in place, they need to be articulated, distilled, and organized to address policy issues.

An intergenerational reminiscence programme for older adults with early dementia and youth volunteers: values and challenges.

PubMed

Chung, Jenny C C

2009-06-01

To examine the values of a reminiscence programme, adopting an intergenerational approach, on older persons with early dementia and youth volunteers. A pre- and post- one group design was adopted. Forty-nine elderly participants with early dementia and 117 youth volunteers participated in the study. Each elderly participant was assigned to two youth participants. This dyad group participated in a 12-session reminiscence programme. The youth participants acted as facilitators to prompt the elderly participants to share and discuss past events and experiences, and to support them to fabricate a personalized life-story book. An occupational therapist provided ongoing support and monitoring. The elderly participants were evaluated by the Chinese version of Mini-mental State Examination, Quality of Life-Alzheimer's Disease (QoL-AD), and Chinese version of Geriatric Depression Scale (CGDS) before and after the programme. Dementia Quiz (DQ), Rosenberg Self-Esteem Scale and a 20-item feedback questionnaire on the programme were used to evaluate the youth participants. Significant pre- and postprogramme differences were found for QoL-AD (mean change = -1.91; 95% CI = -3.18, -0.64) and CGDS (mean change = 1.86; 95% CI = 0.92, 2.80) among the elderly participants, and for DQ (mean change = -1.14; 95% CI = -2.11, -0.17) among the youth participants. Volunteers also showed positive appreciation of older persons and opined that this community service provided them an opportunity to reflect on their relationship with elderly relatives. Some volunteers, however, commented the heavy workload of the reminiscence programme. The intergenerational reminiscence programme suggests mutually beneficial values for both groups of participants. Whilst it is feasible to involve trained volunteers in the implementation of dementia-related programmes, it is essential that they are adequately trained and that ongoing support and monitoring are provided.

School re-entry of the pediatric heart transplant recipient.

PubMed

Weil, Constance M; Rodgers, S; Rubovits, S

2006-12-01

Pediatric cardiac transplant has become increasingly frequent in the last decade and survival rates have improved remarkably. Outcome research on this population suggests that the majority of children have the capacity for healthy adaptation although 25-40% have been shown to have some type of psychiatric difficulties. As school plays a major role in these children's lives, early intervention and close liaison with schools is indicated to reduce psychological morbidity, enhance adaptation within the school environment and enhance overall adjustment. This paper proposes a model for a school re-entry program for this population. The school re-entry program is aimed at children who are undergoing cardiac transplant and will be entering or re-entering the school system. They may range in academic age from preschool to college level and have been attending private or public schools with placements in regular education programs, regular education programs with resource support, special education programs, and alternative school programs. Others may not have been attending school because of the severity of their medical condition and have been receiving in-home tutoring. Each child is offered school re-entry assistance by a multi-disciplinary team composed of members from the Cardiology Transplant Service. The re-entry program includes cognitive and psychosocial assessment, liaison with the child's school pre- and post-transplant, academic planning and provision of academic, emotional, and behavioral support before, during, and immediately after transplant, a school re-entry visit, and an ongoing school consultation. The goal is to address issues necessary for a successful school re-entry including appropriate academic placement and support, psychosocial adjustment, education of school personnel and ongoing health needs of the student. The next step is to formally evaluate the efficacy of this program in successful school re-entry.

24TH USDA interagency research forum on invasive species; 2013 Jan

Treesearch

Katherine A McManus; Kurt W. Gottschalk

2013-01-01

This meeting was the 24th in a series of annual USDA Interagency Research Forums that are sponsored by the Forest Service, Animal and Plant Health Inspection Service, National Institute of Food and Agriculture, and Agriculture Research Service. The Group's original goal of fostering communication and providing a forum for the overview of ongoing research among the...

25th U.S. Department of Agriculture interagency research forum on invasive species [proceedings

Treesearch

Katherine A. McManus; Kurt W., comps Gottschalk

2014-01-01

This meeting was the 25th in a series of annual USDA Interagency Research Forums that are sponsored by the Forest Service, Animal and Plant Health Inspection Service, National Institute of Food and Agriculture, and Agriculture Research Service. The Group's original goal of fostering communication and providing a forum for the overview of ongoing research among the...

Using Data to Assess Staffing and Services: University of Iowa Main Library

ERIC Educational Resources Information Center

Paulus, Amy R.

2014-01-01

The Main Library Service Desk is a one-stop academic help center located between a newly renovated student-focused space called the Learning Commons and the library collections. Services began with the first day of classes, August 26, 2013, and assessment has been ongoing, in part due to the availability of data. Staffing levels, staffing hours,…

27th USDA interagency research forum on Invasive species

Treesearch

Katherine A. McManus

2016-01-01

This meeting was the 27th in a series of annual USDA Interagency Research Forums that are sponsored by the Forest Service, Animal and Plant Health Inspection Service, National Institute of Food and Agriculture, and Agriculture Research Service. The Group’s original goal of fostering communication and providing a forum for the overview of ongoing research among the...

An Introduction to Education Research Methods: Exploring the Learning Journey of Pre-Service Teachers in a Transnational Programme

ERIC Educational Resources Information Center

White, Sonia; Hepple, Erika; Tangen, Donna; Comelli, Marlana; Alwi, Amyzar; Shaari, Zaira Abu Hassan

2016-01-01

Internationally there is interest in developing the research skills of pre-service teachers as a means of ongoing professional renewal with a distinct need for systematic and longitudinal investigation of student learning. The current study takes a unique perspective by exploring the research learning journey of pre-service teachers participating…

Report on Partial Findings of an Ongoing Research: Social Networking Sites (SNS) as a Platform to Support Teaching and Learning in Secondary Schools

ERIC Educational Resources Information Center

Bt. Ubaidullah, Nor Hasbiah; Samsuddin, Khairulanuar; Bt. Fabil, Norsikin; Bt. Mahadi, Norhayati

2011-01-01

This paper reports the partial findings of a survey that was carried out in the analysis phase of an ongoing research for the development of a prototype of a Social Networking Site (SNS) to support teaching and learning in secondary schools. For the initial phase of the study, a quantitative research method was used based on a survey involving 383…

Inhibition of caspases prevents ototoxic and ongoing hair cell death

NASA Technical Reports Server (NTRS)

Matsui, Jonathan I.; Ogilvie, Judith M.; Warchol, Mark E.

2002-01-01

Sensory hair cells die after acoustic trauma or ototoxic insults, but the signal transduction pathways that mediate hair cell death are not known. Here we identify several important signaling events that regulate the death of vestibular hair cells. Chick utricles were cultured in media supplemented with the ototoxic antibiotic neomycin and selected pharmacological agents that influence signaling molecules in cell death pathways. Hair cells that were treated with neomycin exhibited classically defined apoptotic morphologies such as condensed nuclei and fragmented DNA. Inhibition of protein synthesis (via treatment with cycloheximide) increased hair cell survival after treatment with neomycin, suggesting that hair cell death requires de novo protein synthesis. Finally, the inhibition of caspases promoted hair cell survival after neomycin treatment. Sensory hair cells in avian vestibular organs also undergo continual cell death and replacement throughout mature life. It is unclear whether the loss of hair cells stimulates the proliferation of supporting cells or whether the production of new cells triggers the death of hair cells. We examined the effects of caspase inhibition on spontaneous hair cell death in the chick utricle. Caspase inhibitors reduced the amount of ongoing hair cell death and ongoing supporting cell proliferation in a dose-dependent manner. In isolated sensory epithelia, however, caspase inhibitors did not affect supporting cell proliferation directly. Our data indicate that ongoing hair cell death stimulates supporting cell proliferation in the mature utricle.

Working Memory and Consciousness: The Current State of Play

PubMed Central

Persuh, Marjan; LaRock, Eric; Berger, Jacob

2018-01-01

Working memory (WM), an important posit in cognitive science, allows one to temporarily store and manipulate information in the service of ongoing tasks. WM has been traditionally classified as an explicit memory system—that is, as operating on and maintaining only consciously perceived information. Recently, however, several studies have questioned this assumption, purporting to provide evidence for unconscious WM. In this article, we focus on visual working memory (VWM) and critically examine these studies as well as studies of unconscious perception that seem to provide indirect evidence for unconscious WM. Our analysis indicates that current evidence does not support an unconscious WM store, though we offer independent reasons to think that WM may operate on unconsciously perceived information. PMID:29551967

A perspective on space robotics in Japan

NASA Technical Reports Server (NTRS)

Ohkami, Yoshiaki; Nakatani, Ichiro; Wakabayashi, Yasufumi; Iwata, Tsutomu

1994-01-01

This report summarizes the research and development status and perspective on space robotics in Japan. The R & D status emphasizes the current on-going projects at NASDA including the JEM Remote Manipulator System (JEMRMS) to be used on Space Station Freedom and the robotics experiments on Engineering Satellite 7 (ETS-7). As a future perspective, not only NASDA, but also ISAS and other government institutes have been promoting their own research in space robotics in order to support wide spread space activities in the future. Included in this future research is an autonomous satellite retrieval experiment, a dexterous robot experiment, an on-orbit servicing platform, an IVA robot, and several moon/planetary rovers proposed by NASDA or ISAS and other organizations.

Concept of Operations for RCO SPO

NASA Technical Reports Server (NTRS)

Matessa, Michael; Strybel, Thomas; Vu, Kim; Battiste, Vernol; Schnell, Thomas

2017-01-01

Reduced crew operations (RCO) refers to the reduction of crew members flying long-haul or military operations with more than one pilot onboard. Single pilot operations (SPO) refers to flying a commercial transport aircraft with only one pilot on board the aircraft, assisted by advanced onboard automation andor ground operators providing piloting support services. Properly implemented, RCO/SPO could provide operating cost savings while maintaining a level of safety no less than conventional two-pilot commercial operations. A concept of operations (ConOps) for any paradigm describes the characteristics of its various components and their integration in a multi-dimensional design space. This paper presents key options for humanautomation function allocation being considered by NASA in its ongoing development of RCO/SPO ConOps.

Application of lean manufacturing concepts to drug discovery: rapid analogue library synthesis.

PubMed

Weller, Harold N; Nirschl, David S; Petrillo, Edward W; Poss, Michael A; Andres, Charles J; Cavallaro, Cullen L; Echols, Martin M; Grant-Young, Katherine A; Houston, John G; Miller, Arthur V; Swann, R Thomas

2006-01-01

The application of parallel synthesis to lead optimization programs in drug discovery has been an ongoing challenge since the first reports of library synthesis. A number of approaches to the application of parallel array synthesis to lead optimization have been attempted over the years, ranging from widespread deployment by (and support of) individual medicinal chemists to centralization as a service by an expert core team. This manuscript describes our experience with the latter approach, which was undertaken as part of a larger initiative to optimize drug discovery. In particular, we highlight how concepts taken from the manufacturing sector can be applied to drug discovery and parallel synthesis to improve the timeliness and thus the impact of arrays on drug discovery.

Fixed Route Comprehensive Operational Analysis, 1994 Operating Year. Fourth Installment, Route 2: Berkshire Shopping Center Analysis

DOT National Transportation Integrated Search

1995-03-01

The study evaluated the performance of the service, analyzed possible alternatives, and recommended several service changes, which took effect in August of 1993. By use of ongoing data collection, HART intends to provide continual analysis of the ser...

Tenure Track Investigator | Center for Cancer Research

Cancer.gov

The Neuro-Oncology Branch (NOB), Center for Cancer Research (CCR) of the National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (HHS), Bethesda, MD, is actively recruiting for a tenure-track principal investigator to work in the area of immunology and/or immunotherapy.  The NOB Immunology/Immunotherapy Investigator will be tasked with forming and leading an independent research program.  This position will build the basic immunology program in the NOB and complement ongoing and planned translational research and clinical trials evaluating the effects of immunotherapy in patients with primary brain tumors.  This program will be able to access biospecimens generated from ongoing and planned immunotherapy protocols within the NOB, thus creating an opportunity to perform correlative studies to interrogate the complex biology of immunologic response, toxicity, and treatment resistance.  Demonstrated expertise in scientific inquiries in immunotherapy and/or immunology are essential, but prior work in brain tumors is not required.  This is an exciting opportunity to join a growing trans-institutional research team that promotes and supports collaborations across the basic, translational, and clinical research spectrum to develop novel therapeutics for individuals with primary central nervous system malignancies that will globally influence the field.

Evolving Distributed Generation Support Mechanisms: Case Studies from United States, Germany, United Kingdom, and Australia

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

Lowder, Travis; Zhou, Ella; Tian, Tian

This report expands on a previous National Renewable Energy Laboratory (NREL) technical report (Lowder et al. 2015) that focused on the United States' unique approach to distributed generation photovoltaics (DGPV) support policies and business models. While the focus of that report was largely historical (i.e., detailing the policies and market developments that led to the growth of DGPV in the United States), this report looks forward, narrating recent changes to laws and regulations as well as the ongoing dialogues over how to incorporate distributed generation (DG) resources onto the electric grid. This report also broadens the scope of Lowder etmore » al. (2015) to include additional countries and technologies. DGPV and storage are the principal technologies under consideration (owing to market readiness and deployment volumes), but the report also contemplates any generation resource that is (1) on the customer side of the meter, (2) used to, at least partly, offset a host's energy consumption, and/or (3) potentially available to provide grid support (e.g., through peak shaving and load shifting, ancillary services, and other means).« less

Who is buying bioethics research?

PubMed

Sharp, Richard R; Scott, Angela L; Landy, David C; Kicklighter, Laura A

2008-08-01

Growing ties to private industry have prompted many to question the impartiality of academic bioethicists who receive financial support from for-profit corporations in exchange for ethics-related services and research. To the extent that corporate sponsors may view bioethics as little more than a way to strengthen public relations or avoid potential controversy, close ties to industry may pose serious threats to professional independence. New sources of support from private industry may also divert bioethicists from pursuing topics of greater social importance, such as the needs of medically underserved communities. To inform ongoing debates about the financing of bioethics and its transparency to those concerned about potential sources of bias, we examined funding disclosures appearing in original research reports in major bioethics journals. Reviewing research published over a 15-year period, we found little evidence that for-profit corporations are influencing bioethics research directly. Instead, we found evidence that a great number of organizations, both public and private, support bioethics research. These findings suggest that worries about the cooption of bioethics research by a few interested stakeholders are greatly overstated and undersupported by available data.

Knowledge management: Role of the the Radiation Safety Information Computational Center (RSICC)

NASA Astrophysics Data System (ADS)

Valentine, Timothy

2017-09-01

The Radiation Safety Information Computational Center (RSICC) at Oak Ridge National Laboratory (ORNL) is an information analysis center that collects, archives, evaluates, synthesizes and distributes information, data and codes that are used in various nuclear technology applications. RSICC retains more than 2,000 software packages that have been provided by code developers from various federal and international agencies. RSICC's customers (scientists, engineers, and students from around the world) obtain access to such computing codes (source and/or executable versions) and processed nuclear data files to promote on-going research, to ensure nuclear and radiological safety, and to advance nuclear technology. The role of such information analysis centers is critical for supporting and sustaining nuclear education and training programs both domestically and internationally, as the majority of RSICC's customers are students attending U.S. universities. Additionally, RSICC operates a secure CLOUD computing system to provide access to sensitive export-controlled modeling and simulation (M&S) tools that support both domestic and international activities. This presentation will provide a general review of RSICC's activities, services, and systems that support knowledge management and education and training in the nuclear field.

In times of war, adolescents do not fall silent: Teacher-student social network communication in wartime.

PubMed

Ophir, Yaakov; Rosenberg, Hananel; Asterhan, Christa S C; Schwarz, Baruch B

2016-01-01

Exposure to war is associated with psychological disturbances, but ongoing communication between adolescents and teachers may contribute to adolescents' resilience. This study examined the extent and nature of teacher-student communication on Social Network Sites (SNS) during the 2014 Israel-Gaza war. Israeli adolescents (N = 208, 13-18 yrs) completed information about SNS communication. A subset of these (N = 145) completed questionnaires on social rejection and distress sharing on SNS. More than a half (56%) of the respondents communicated with teachers via SNS. The main content category was 'emotional support'. Adolescents' perceived benefits from SNS communication with teachers were associated with distress sharing. Social rejection was negatively associated with emotional support and perceived benefits from SNS communication. We conclude that SNS communication between teachers and students may provide students with easy access to human connections and emotional support, which is likely to contribute to adolescents' resilience in times of war. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Exploring Parents' Perceptions and How Physiotherapy Supports Transition from Rehabilitation to School for Youth with an ABI.

PubMed

Lee, Tracy; Norton, Andrea; Hayes, Sue; Adamson, Keith; Schwellnus, Heidi; Evans, Cathy

2017-11-01

To explore parents' perceptions of their youth's transition from rehabilitation to school following an Acquired Brain Injury (ABI) and how physiotherapy influenced the youth's participation and physical function during the transition. The study utilized phenomenological qualitative methodology using semi-structured interviews with 11 parents of youth 10 to 18 years of age recruited from one pediatric rehabilitation hospital in Ontario. Each interview was audiotaped, transcribed verbatim, and thematically analyzed. Parents valued physiotherapy and highlighted potential areas of improved service delivery to promote participation in an active lifestyle during this transition. In addition to being parents, they had to assume new roles and responsibilities in order to motivate their youth to continue with therapy and physical activity and had to facilitate their participation in school, recreational and social activities. For youth following an ABI, the transition back to school is complex and strategies should be supportive and responsive. Implications for physiotherapists include improved collaboration with community partners to motivate youth and promote physical activity; engage youth with their peers early in the rehabilitation process; and ongoing support for parents.

Improving the quality of perinatal mental health: a health visitor-led protocol.

PubMed

Lewis, Anne; Ilot, Irene; Lekka, Chrysanthi; Oluboyede, Yemi

2011-02-01

The mental health of mothers is of significant concern to community practitioners. This paper reports on a case study exploring the success factors of a well established, health visitor-led protocol to identify and treat women with mild to moderate depression. Data were collected through interviews with a purposive sample of 12 community practitioners, a focus group of four health visitors and observation of a multidisciplinary steering group meeting. The protocol was described as an evidence-based tool and safety net that could be used flexibly to support clinical judgments and tailored to individual needs. Success factors included frontline clinician engagement and ownership, continuity of leadership to drive development and maintain momentum, comprehensive and on-going staff training, and strategic support for the protocol as a quality indicator at a time of organisational change. Quality and clinical leadership are continuing policy priorities. The protocol enabled frontline staff to lead a service innovation, providing a standardised multiprofessional approach to women's mental health needs through effective support, advice and treatment that can be measured and quality assured.

The Brotherhood Medical Center: Collaborative Foundation of Maternity and Children's Healthcare Facility for Displaced Syrians.

PubMed

Aburas, Rahma; Najeeb, Amina; Baageel, Laila; Mackey, Tim K

2018-01-01

The United Nations has declared the Syrian conflict, with more than 50% of Syria's population currently displaced, as the worst humanitarian crisis of the twenty-first century. The Syrian conflict has led to a collapse of infrastructure, including access to critical and lifesaving healthcare services. Women and children account for approximately 75% of internally displaced Syrians and refugees. This population is also particularly vulnerable to poor health outcomes, a condition worsened by lack of access to maternal and child health services. In response to this crisis, a partnership of Saudi and Syrian physicians established a non-profit healthcare facility named the Brotherhood Medical Center (BMC) to serve women and children within a safe area near the Syrian-Turkish border. The project began in September 2014 and was implemented in three phases of establishment, phased construction and formal launch and operation. Currently, the BMC is working at about 70% of its capacity and is run in partnership with the Syrian Expatriate Medical Association. Although there was strong initial support from donors, the BMC continues to face many financial and operational challenges, including difficulties in transferring money to Syria, shortage of medical supplies, and lack of qualified medical personnel. Despite these challenges, the BMC represents a critical model and an important case study of the challenges of delivering healthcare services to underserved populations during an ongoing conflict. However, more robust support from the international community is needed to ensure it continues its important health and humanitarian mission.

Recovery and Borderline Personality Disorder: A Description of the Innovative Open Borders Program.

PubMed

Mortimer-Jones, Sheila; Morrison, Paul; Munib, Ahmed; Paolucci, Francesco; Neale, Sonia; Bostwick, Amanda; Hungerford, Catherine

2016-09-01

Although Recovery-oriented approaches to delivering mental health services are now promoted in health services across the globe, there is an ongoing need to adapt these approaches to meet the unique needs of consumers with a diagnosis of borderline personality disorder. The lived experience of borderline personality disorder includes emotional dysregulation, intense and unstable relationships, self-harming behaviours, fear of abandonment, and a limited capacity to cope with stress. These experiences present a range of challenges for those who deliver Recovery-oriented services and advocate the principles of empowerment and self-determination. This paper describes a novel crisis intervention program, "Open Borders," which has been established to meet the unique needs of people with a borderline personality disorder diagnosis. Open Borders is a Recovery-oriented model that is run at a public, state-wide residential facility for mental health consumers in Western Australia, and offers alternative pathways to achieving mental health Recovery, including self-referral and short-term admission to a residential facility. The aims of the program are to break the cycle of hospital admission, reduce rates of self-harm, and support the complex Recovery journey of consumers with a diagnosis of borderline personality disorder. Open Borders provides an exemplar for other health service organisations seeking to establish Recovery-oriented crisis intervention alternatives.

Organizational structure, leadership and readiness for change and the implementation of organizational cultural competence in addiction health services.

PubMed

Guerrero, Erick G; Kim, Ahraemi

2013-10-01

Increasing representation of racial and ethnic minorities in the health care system and on-going concerns about existing health disparities have pressured addiction health services programs to enhance their cultural competence. This study examines the extent to which organizational factors, such as structure, leadership and readiness for change contribute to the implementation of community, policy and staffing domains representing organizational cultural competence. Analysis of a randomly selected sample of 122 organizations located in primarily Latino and African American communities showed that programs with public funding and Medicaid reimbursement were positively associated with implementing policies and procedures, while leadership was associated with staff having greater knowledge of minority communities and developing a diverse workforce. Moreover, program climate was positively associated with staff knowledge of communities and having supportive policies and procedures, while programs with graduate staff and parent organizations were negatively associated with knowledge of and involvement in these communities. By investing in funding, leadership skills and a strategic climate, addiction health services programs may develop greater understanding and responsiveness of the service needs of minority communities. Implications for future research and program planning in an era of health care reform in the United States are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Epidemiology of Modern Battlefield Colorectal Trauma: A Review of 977 Coalition Casualties

DTIC Science & Technology

2012-01-01

records, the ongoing Joint Surgical Transcolonic Injury or Ostomy Multi-theater Assessment project quantifies epidemiologic trends in colon injury...Transcolonic Injury or Ostomy Multi-theater Assessment (J-STOMA) project is an ongoing initiative to examine outcomes from OIF/OEF specific to co... ostomy reversal; (4) quality of life in injured US Service members who require fecal diversion (temporary or permanent); and (5) incidence and outcomes

International Space Station Sustaining Engineering: A Ground-Based Test Bed for Evaluating Integrated Environmental Control and Life Support System and Internal Thermal Control System Flight Performance

NASA Technical Reports Server (NTRS)

Ray, Charles D.; Perry, Jay L.; Callahan, David M.

2000-01-01

As the International Space Station's (ISS) various habitable modules are placed in service on orbit, the need to provide for sustaining engineering becomes increasingly important to ensure the proper function of critical onboard systems. Chief among these are the Environmental Control and Life Support System (ECLSS) and the Internal Thermal Control System (ITCS). Without either, life onboard the ISS would prove difficult or nearly impossible. For this reason, a ground-based ECLSS/ITCS hardware performance simulation capability has been developed at NASA's Marshall Space Flight Center. The ECLSS/ITCS Sustaining Engineering Test Bed will be used to assist the ISS Program in resolving hardware anomalies and performing periodic performance assessments. The ISS flight configuration being simulated by the test bed is described as well as ongoing activities related to its preparation for supporting ISS Mission 5A. Growth options for the test facility are presented whereby the current facility may be upgraded to enhance its capability for supporting future station operation well beyond Mission 5A. Test bed capabilities for demonstrating technology improvements of ECLSS hardware are also described.

Aviation Weather Information Communications Study (AWIN). Phase 1 and 2

NASA Technical Reports Server (NTRS)

Ball, J. W.; Herron, R. G.; Nozawa, E. T.; Thomas, E. A.; Witchey, R. D.

2000-01-01

This two part study examines the communication requirements to provide weather information in the cockpit as well as public and private communication systems available to address the requirements. Ongoing research projects combined with user needs for weather related information are used to identify and describe potential weather products that address decision support in three time frames: Far-Term Strategic, Near-Term Strategic and Tactical. Data requirements of these future products are identified and quantified. Communications systems and technologies available in the public as well as private sector are analyzed to identify potential solutions. Recommendations for further research identify cost, performance, and safety benefits to justify the investment. The study concludes that not all weather information has the same level of urgency to safety-of-flight and some information is more critical to one category of flight than another. Specific weather products need to be matched with communication systems with appropriate levels of reliability to support the criticality of the information. Available bandwidth for highly critical information should be preserved and dedicated to safety. Meanwhile, systems designed for in-flight-entertainment and other passenger/crew services could be used to support less critical information that is used only for planning and economic decision support.

Enhancement of Mutual Discovery, Search, and Access of Data for Users of NASA and GEOSS-Cataloged Data Systems

NASA Astrophysics Data System (ADS)

Teng, W. L.; Maidment, D. R.; Rodell, M.; Strub, R. F.; Arctur, D. K.; Ames, D. P.; Vollmer, B.; Seiler, E.

2014-12-01

An ongoing NASA-funded project has removed a longstanding barrier to accessing NASA data (i.e., accessing archived time-step array data as point-time series) for selected variables of the North American and Global Land Data Assimilation Systems (NLDAS and GLDAS, respectively) and other EOSDIS (Earth Observing System Data Information System) data sets. These time series ("data rods") are pre-generated or generated on-the-fly (OTF), leveraging the NASA Simple Subset Wizard (SSW), a gateway to NASA data centers. Data rods Web services are accessible through the CUAHSI Hydrologic Information System (HIS) and the Goddard Earth Sciences Data and Information Services Center (GES DISC) but are not easily discoverable by users of other non-NASA data systems. The Global Earth Observation System of Systems (GEOSS) is a logical mechanism for providing access to the data rods, both pre-generated and OTF. There is an ongoing series of multi-organizational GEOSS Architecture Implementation Pilots, now in Phase-7 (AIP-7) and with a strong water sub-theme, that is aimed at the GEOSS Water Strategic Target "to produce [by 2015] comprehensive sets of data and information products to support decision-making for efficient management of the world's water resources, based on coordinated, sustained observations of the water cycle on multiple scales." The aim of this "GEOSS Water Services" project is to develop a distributed, global registry of water data, map, and modeling services catalogued using the standards and procedures of the Open Geospatial Consortium and the World Meteorological Organization. This project has already demonstrated that the GEOSS infrastructure can be leveraged to help provide access to time series of model grid information (e.g., NLDAS, GLDAS) or grids of information over a geographical domain for a particular time interval. A new NASA-funded project was begun, to expand on these early efforts to enhance the discovery, search, and access of NASA data by non-NASA users, comprising the following key aspects: 1. Leverage SSW API and EOS Clearing House (ECHO) 2. Register data rods services in GEOSS 3. Develop Web Feature Services (WFS) for data rods 4. Enhance metadata in WFS 5. Make non-NASA data visible to NASA users by leveraging SSW 6. Develop hydrological use cases to guide project deployment and serve as metrics

Enhancing Discovery, Search, and Access of NASA Hydrological Data by Leveraging GEOSS

NASA Technical Reports Server (NTRS)

Teng, William L.

2015-01-01

An ongoing NASA-funded project has removed a longstanding barrier to accessing NASA data (i.e., accessing archived time-step array data as point-time series) for selected variables of the North American and Global Land Data Assimilation Systems (NLDAS and GLDAS, respectively) and other EOSDIS (Earth Observing System Data Information System) data sets (e.g., precipitation, soil moisture). These time series (data rods) are pre-generated. Data rods Web services are accessible through the CUAHSI Hydrologic Information System (HIS) and the Goddard Earth Sciences Data and Information Services Center (GES DISC) but are not easily discoverable by users of other non-NASA data systems. The Global Earth Observation System of Systems (GEOSS) is a logical mechanism for providing access to the data rods. An ongoing GEOSS Water Services project aims to develop a distributed, global registry of water data, map, and modeling services cataloged using the standards and procedures of the Open Geospatial Consortium and the World Meteorological Organization. The ongoing data rods project has demonstrated the feasibility of leveraging the GEOSS infrastructure to help provide access to time series of model grid information or grids of information over a geographical domain for a particular time interval. A recently-begun, related NASA-funded ACCESS-GEOSS project expands on these prior efforts. Current work is focused on both improving the performance of the generation of on-the-fly (OTF) data rods and the Web interfaces from which users can easily discover, search, and access NASA data.

Visual impairment, coping strategies and impact on daily life: a qualitative study among working-age UK ex-service personnel.

PubMed

Stevelink, Sharon A M; Malcolm, Estelle M; Fear, Nicola T

2015-11-12

Sustaining a visual impairment may have a substantial impact on various life domains such as work, interpersonal relations, mobility and social and mental well-being. How to adjust to the loss of vision and its consequences might be a challenge for the visually impaired person. The purpose of the current study was to explore how younger male ex-Service personnel cope with becoming visually impaired and how this affects their daily life. Semi-structured interviews with 30 visually impaired male ex-Service personnel, all under the age of 55, were conducted. All participants are members of the charity organisation Blind Veterans UK. Interviews were analysed thematically. Younger ex-Service personnel applied a number of different strategies to overcome their loss of vision and its associated consequences. Coping strategies varied from learning new skills, goal setting, integrating the use of low vision aids in their daily routine, to social withdrawal and substance misuse. Vision loss affected on all aspects of daily life and ex-Service personnel experienced an on-going struggle to accept and adjust to becoming visually impaired. Health care professionals, family and friends of the person with the visual impairment need to be aware that coping with a visual impairment is a continuous struggle; even after a considerable amount of time has passed, needs for emotional, social, practical and physical support may still be present.

Communicating about Mental Illness and Violence: Balancing Increased Support for Services and Stigma

PubMed Central

Goldman, Howard H.; Pescosolido, Bernice A.; Barry, Colleen L.

2017-01-01

In the ongoing national policy debate about how to best address serious mental illness (SMI), a major controversy among mental health advocates is whether drawing public attention to an apparent link between SMI and violence, shown to elevate stigma, is the optimal strategy for increasing public support for investing in mental health services or whether non-stigmatizing messages can be equally effective. We conducted a randomized experiment to examine this question. Participants in a nationally representative online panel (N=1,326) were randomized to read one of three brief narratives about SMI emphasizing violence, systemic barriers to treatment, or successful treatment and recovery or to a control arm. Narratives, or stories about individuals, are a common communication strategy used by policymakers, advocates, and the news media. Study results showed that narratives emphasizing violence and barriers to treatment were equally effective in increasing the public’s willingness to pay additional taxes to improve the mental health system (55% and 52% versus 42% in the control arm). Only the narrative emphasizing the link between SMI and violence increased stigma. For the mental health advocates dedicated to improving the public mental health system, findings offer an alternative to stigmatizing messages linking mental illness and violence. PMID:29630706

Communicating about Mental Illness and Violence: Balancing Stigma and Increased Support for Services.

PubMed

McGinty, Emma E; Goldman, Howard H; Pescosolido, Bernice A; Barry, Colleen L

2018-04-01

In the ongoing national policy debate about how to best address serious mental illness (SMI), a major controversy among mental health advocates is whether drawing public attention to an apparent link between SMI and violence, shown to elevate stigma, is the optimal strategy for increasing public support for investing in mental health services or whether nonstigmatizing messages can be equally effective. We conducted a randomized experiment to examine this question. Participants in a nationally representative online panel (N = 1,326) were randomized to a control arm or to read one of three brief narratives about SMI emphasizing violence, systemic barriers to treatment, or successful treatment and recovery. Narratives, or stories about individuals, are a common communication strategy used by policy makers, advocates, and the news media. Study results showed that narratives emphasizing violence or barriers to treatment were equally effective in increasing the public's willingness to pay additional taxes to improve the mental health system (55 percent and 52 percent, vs. 42 percent in the control arm). Only the narrative emphasizing the link between SMI and violence increased stigma. For mental health advocates dedicated to improving the public mental health system, these findings offer an alternative to stigmatizing messages linking mental illness and violence. Copyright © 2018 by Duke University Press.

Challenges in managing elderly people with diabetes in primary care settings in Norway

PubMed Central

2013-01-01

Abstract Objective To explore the experiences and clinical challenges that nurses and nursing assistants face when providing high-quality diabetes-specific management and care for elderly people with diabetes in primary care settings. Design Focus-group interviews. Subjects and setting Sixteen health care professionals: 12 registered nurses and four nursing assistants from nursing homes (10), district nursing service (5), and a service unit (1) were recruited by municipal managers who had local knowledge and knew the workforce. All the participants were women aged 32–59 years with clinical experience ranging from 1.5 to 38 years. Results Content analysis revealed a discrepancy between the level of expertise which the participants described as important to delivering high-quality care and their capacity to deliver such care. The discrepancy was due to lack of availability and access to current information, limited ongoing support, lack of cohesion among health care professionals, and limited confidence and autonomy. Challenges to delivering high-quality care included complex, difficult patient situations and lack of confidence to make decisions founded on evidence-based guidelines. Conclusion Participants lacked confidence and autonomy to manage elderly people with diabetes in municipal care settings. Lack of information, support, and professional cohesion made the role challenging. PMID:24205973

"Five hundred years of medicine gone to waste"? Negotiating the implementation of an intercultural health policy in the Ecuadorian Andes.

PubMed

Llamas, Ana; Mayhew, Susannah

2018-06-04

In Ecuador, indigenous women have poorer maternal health outcomes and access to maternity services. This is partly due to cultural barriers. A hospital in Ecuador implemented the Vertical Birth (VB) policy to address such inequities by adapting services to the local culture. This included conducting upright deliveries, introducing Traditional Birth Attendants (TBAs) and making physical adaptations to hospital facilities. Using qualitative methods, we studied the VB policy implementation in an Ecuadorian hospital to analyse the factors that affect effective implementation of intercultural health policies at the local level. We collected data through observation, in-depth interviews, a focus group discussion, and documentation review. We conducted 46 interviews with healthcare workers, managers, TBAs, key informants and policy-makers involved in maternal health. Data analysis was guided by grounded theory and drew heavily on concepts of "street-level bureaucracy" to interpret policy implementation. The VB policy was highly controversial; actors' values (including concerns over patient safety) motivated their support or opposition to the Vertical Birth policy. For those who supported the policy, managers, policy-makers, indigenous actors and a minority of healthcare workers supported the policy, it was critical to address ethnic discrimination to improve indigenous women's access to the health service. Most healthcare workers initially resisted the policy because they believed vertical births led to poorer clinical outcomes and because they resented working alongside TBAs. Healthcare workers developed coping strategies and effectively modified the policy. Managers accepted these as a compromise to enable implementation. Although contentious, intercultural health policies such as the VB policy have the potential to improve maternity services and access for indigenous women. Evidence-base medicine should be used as a lever to facilitate the dialogue between healthcare workers and TBAs and to promote best practice and patient safety. Actors' values influenced policy implementation; policy implementation resulted from an ongoing negotiation between healthcare workers and managers.

Cultivating Data Expertise and Roles at a National Research Center

NASA Astrophysics Data System (ADS)

Thompson, C. A.

2015-12-01

As research becomes more computation and data-intensive, it brings new demands for staff that can manage complex data, design user services, and facilitate open access. Responding to these new demands, universities and research institutions are developing data services to support their scientists and scholarly communities. As more organizations extend their operations to research data, a better understanding of the staff roles and expertise required to support data-intensive research services is needed. What is data expertise - knowledge, skills, and roles? This study addresses this question through a case study of an exemplar research center, the National Center for Atmospheric Research (NCAR) in Boulder, CO. The NCAR case study results were supplemented and validated with a set of interviews of managers at additional geoscience data centers. To date, 11 interviews with NCAR staff and 19 interviews with managers at supplementary data centers have been completed. Selected preliminary results from the qualitative analysis will be reported in the poster: Data professionals have cultivated expertise in areas such as managing scientific data and products, understanding use and users, harnessing technology for data solutions, and standardizing metadata and data sets. Staff roles and responsibilities have evolved over the years to create new roles for data scientists, data managers/curators, data engineers, and senior managers of data teams, embedding data expertise into each NCAR lab. Explicit career paths and ladders for data professionals are limited but starting to emerge. NCAR has supported organization-wide efforts for data management, leveraging knowledge and best practices across all the labs and their staff. Based on preliminary results, NCAR provides a model for how organizations can build expertise and roles into their data service models. Data collection for this study is ongoing. The author anticipates that the results will help answer questions on what are the knowledge and skills required for data professionals and how organizations can develop data expertise.

Analysis of educational research at a medical faculty in Germany and suggestions for strategic development – a case study

PubMed Central

Prediger, Sarah; Harendza, Sigrid

2016-01-01

Background: Evidence-based medical education is playing an increasingly important role in the choice of didactic methods and the development of medical curricula and assessments. In Germany, a growing number of educational research projects has accompanied an ongoing change in the medical education process. The aim of this project was to assess medical education research activities at one medical faculty to develop procedural recommendations for the support and development of best evidence medical education. Methods: Using a newly developed online questionnaire, the 65 institutes and departments of the medical faculty of Hamburg University at Hamburg University Medical-Center (UKE) were asked to report their medical education research and service projects, medical education publications, medical education theses, financial support for educational projects, and supportive structures that they would consider helpful in the future. The data were grouped, and a SWOT analysis was performed. Results: In total, 60 scientists who were involved in 112 medical education research publications between 1998 and 2014 were identified at the UKE. Twenty-five of them had published at least one manuscript as first or last author. Thirty-three UKE institutions were involved in educational service or research projects at the time of the study, and 75.8% of them received internal or external funding. Regular educational research meetings and the acquisition of co-operation partners were mentioned most frequently as beneficial supportive structures for the future. Conclusion: An analysis to define the status quo of medical education research at a medical faculty seems to be a helpful first step for the development of a strategy and structure to further support researchers in medical education. PMID:27990467

Analysis of educational research at a medical faculty in Germany and suggestions for strategic development - a case study.

PubMed

Prediger, Sarah; Harendza, Sigrid

2016-01-01

Background: Evidence-based medical education is playing an increasingly important role in the choice of didactic methods and the development of medical curricula and assessments. In Germany, a growing number of educational research projects has accompanied an ongoing change in the medical education process. The aim of this project was to assess medical education research activities at one medical faculty to develop procedural recommendations for the support and development of best evidence medical education. Methods: Using a newly developed online questionnaire, the 65 institutes and departments of the medical faculty of Hamburg University at Hamburg University Medical-Center (UKE) were asked to report their medical education research and service projects, medical education publications, medical education theses, financial support for educational projects, and supportive structures that they would consider helpful in the future. The data were grouped, and a SWOT analysis was performed. Results: In total, 60 scientists who were involved in 112 medical education research publications between 1998 and 2014 were identified at the UKE. Twenty-five of them had published at least one manuscript as first or last author. Thirty-three UKE institutions were involved in educational service or research projects at the time of the study, and 75.8% of them received internal or external funding. Regular educational research meetings and the acquisition of co-operation partners were mentioned most frequently as beneficial supportive structures for the future. Conclusion: An analysis to define the status quo of medical education research at a medical faculty seems to be a helpful first step for the development of a strategy and structure to further support researchers in medical education.

Advancing Collaboration through Hydrologic Data and Model Sharing

NASA Astrophysics Data System (ADS)

Tarboton, D. G.; Idaszak, R.; Horsburgh, J. S.; Ames, D. P.; Goodall, J. L.; Band, L. E.; Merwade, V.; Couch, A.; Hooper, R. P.; Maidment, D. R.; Dash, P. K.; Stealey, M.; Yi, H.; Gan, T.; Castronova, A. M.; Miles, B.; Li, Z.; Morsy, M. M.

2015-12-01

HydroShare is an online, collaborative system for open sharing of hydrologic data, analytical tools, and models. It supports the sharing of and collaboration around "resources" which are defined primarily by standardized metadata, content data models for each resource type, and an overarching resource data model based on the Open Archives Initiative's Object Reuse and Exchange (OAI-ORE) standard and a hierarchical file packaging system called "BagIt". HydroShare expands the data sharing capability of the CUAHSI Hydrologic Information System by broadening the classes of data accommodated to include geospatial and multidimensional space-time datasets commonly used in hydrology. HydroShare also includes new capability for sharing models, model components, and analytical tools and will take advantage of emerging social media functionality to enhance information about and collaboration around hydrologic data and models. It also supports web services and server/cloud based computation operating on resources for the execution of hydrologic models and analysis and visualization of hydrologic data. HydroShare uses iRODS as a network file system for underlying storage of datasets and models. Collaboration is enabled by casting datasets and models as "social objects". Social functions include both private and public sharing, formation of collaborative groups of users, and value-added annotation of shared datasets and models. The HydroShare web interface and social media functions were developed using the Django web application framework coupled to iRODS. Data visualization and analysis is supported through the Tethys Platform web GIS software stack. Links to external systems are supported by RESTful web service interfaces to HydroShare's content. This presentation will introduce the HydroShare functionality developed to date and describe ongoing development of functionality to support collaboration and integration of data and models.

45 CFR 2516.810 - What types of evaluations are grantees and subgrantees required to perform?

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE SCHOOL-BASED SERVICE-LEARNING PROGRAMS...? All grantees and subgrantees are required to perform internal evaluations which are ongoing efforts to assess performance and improve quality. Grantees and subgrantees may, but are not required to, arrange...

36 CFR 72.17 - Preliminary Action Program-commitments to be included.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Preliminary Action Program-commitments to be included. 72.17 Section 72.17 Parks, Forests, and Public Property NATIONAL PARK SERVICE... commitment to park and recreation systems by establishing ongoing planning, rehabilitation, service...

36 CFR 72.17 - Preliminary Action Program-commitments to be included.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Preliminary Action Program-commitments to be included. 72.17 Section 72.17 Parks, Forests, and Public Property NATIONAL PARK SERVICE... commitment to park and recreation systems by establishing ongoing planning, rehabilitation, service...

20 CFR 404.429 - Earnings; defined.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the purpose of maintaining good will when such contact has a minimal effect on the ongoing operation... agricultural labor excluded under § 404.1055; (4) Remuneration, cash and non-cash, for service as a home worker... calendar year; (5) Services performed outside the United States in the Armed Forces of the United States...

20 CFR 404.429 - Earnings; defined.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the purpose of maintaining good will when such contact has a minimal effect on the ongoing operation... agricultural labor excluded under § 404.1055; (4) Remuneration, cash and non-cash, for service as a home worker... calendar year; (5) Services performed outside the United States in the Armed Forces of the United States...

20 CFR 404.429 - Earnings; defined.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the purpose of maintaining good will when such contact has a minimal effect on the ongoing operation... agricultural labor excluded under § 404.1055; (4) Remuneration, cash and non-cash, for service as a home worker... calendar year; (5) Services performed outside the United States in the Armed Forces of the United States...

20 CFR 404.429 - Earnings; defined.

Code of Federal Regulations, 2012 CFR

2012-04-01

... the purpose of maintaining good will when such contact has a minimal effect on the ongoing operation... agricultural labor excluded under § 404.1055; (4) Remuneration, cash and non-cash, for service as a home worker... calendar year; (5) Services performed outside the United States in the Armed Forces of the United States...

The Offshore Model for Universities

ERIC Educational Resources Information Center

Ross, Andrew

2008-01-01

This article discusses the ongoing effort of the World Trade Organization (WTO) to bring higher education services within the purview of the General Agreement on Trade and Services (GATS). One result of the anticipated liberalization of trade in education, the author explains, is the headlong rush of Anglophone universities into the global market…

The future for follow-up of gynaecological cancer in Europe. Summary of available data and overview of ongoing trials.

PubMed

Leeson, S C; Beaver, K; Ezendam, N P M; Mačuks, R; Martin-Hirsch, P L; Miles, T; Jeppesen, M M; Jensen, P T; Zola, P

2017-03-01

After completing treatment, most patients follow a pre-determined schedule of regular hospital outpatient appointments, which includes clinical examinations, consultations and routine tests. After several years of surveillance, patients are transferred back to primary care. However, there is limited evidence to support the effectiveness and efficiency of this approach. This paper examines the current rationale and evidence base for hospital-based follow-up after treatment for gynaecological cancer. We investigate what alternative models of care have been formally evaluated and what research is currently in progress in Europe, in order to make tentative recommendations for a model of follow-up. The evidence base for traditional hospital based follow-up is limited. Alternative models have been reported for other cancer types but there are few evaluations of alternative approaches for gynaecological cancers. We identified five ongoing European studies; four were focused on endometrial cancer patients and one feasibility study included all gynaecological cancers. Only one study had reached the reporting stage. Alternative models included nurse-led telephone follow-up and comparisons of more intensive versus less intensive regimes. Outcomes included survival, quality of life, psychological morbidity, patient satisfaction and cost effectiveness of service. More work is needed on alternative strategies for all gynaecological cancer types. New models will be likely to include risk stratification with early discharge from secondary care for early stage disease with fast track access to specialist services for suspected cancer recurrence or other problems. Copyright © 2017 Elsevier B.V. All rights reserved.

NASA CEV Reference Entry GN&C System and Analysis

NASA Technical Reports Server (NTRS)

Munday, S.; Madsen, C.; Broome, J.; Gay, R.; Tigges, M.; Strahan, A.

2007-01-01

As part of its overall objectives, the Orion spacecraft will be required to perform entry and Earth landing functions for Low Earth Orbit (LEO) and Lunar missions. Both of these entry scenarios will begin with separation of the Service Module (SM), making them unique from other Orion mission phases in that only the Command Module (CM) portion of the Crew Exploration Vehicle (CEV) will be involved, requiring a CM specific Guidance, Navigation and Control (GN&C) system. Also common to these mission scenarios will be the need for GN&C to safely return crew (or cargo) to earth within the dynamic thermal and structural constraints of entry and within acceptable accelerations on the crew, utilizing the limited aerodynamic performance of the CM capsule. The lunar return mission could additionally require an initial atmospheric entry designed to support a precision skip and second entry, all to maximize downrange performance and ensure landing in the United States. This paper describes the Entry GN&C reference design, developed by the NASA-led team, that supports these entry scenarios and that was used to validate the Orion System requirements. Description of the reference design will include an overview of the GN&C functions, avionics, and effectors and will relate these to the specific design drivers of the entry scenarios, as well as the desire for commonality in vehicle systems to support the different missions. The discussion will also include the requirement for an Emergency Entry capability beyond that of the nominal performance of the multi-string GNC system, intended to return the crew to the earth in a survivable but unguided manner. Finally, various analyses will be discussed, including those completed to support validation efforts of the current CEV requirements, along with those on-going and planned with the intention to further refine the requirements and to support design development work in conjunction with the prime contractor. Some of these ongoing analyses will include work to size effectors (jets) and fuel budgets, to refine skip entry concepts, to characterize navigation performance and uncertainties, to provide for SM disposal offshore and to identify requirements to support target site selection.

Salutogenic service user involvement in nursing research: a case study.

PubMed

Mjøsund, Nina Helen; Vinje, Hege Forbech; Eriksson, Monica; Haaland-Øverby, Mette; Jensen, Sven Liang; Kjus, Solveig; Norheim, Irene; Portaasen, Inger-Lill; Espnes, Geir Arild

2018-05-12

The aim was to explore the process of involving mental healthcare service users in a mental health promotion research project as research advisors and to articulate features of the collaboration which encouraged and empowered the advisors to make significant contributions to the research process and outcome. There is an increasing interest in evaluating aspects of service user involvement in nursing research. Few descriptions exist of features that enable meaningful service user involvement. We draw on experiences from conducting research which used the methodology interpretative phenomenological analysis to explore how persons with mental disorders perceived mental health. Aside from the participants in the project, five research advisors with service user experience were involved in the entire research process. We applied a case study design to explore the ongoing processes of service user involvement. Documents and texts produced while conducting the project (2012-2016), as well as transcripts from multistage focus group discussions with the research advisors, were analysed. The level of involvement was dynamic and varied throughout the different stages of the research process. Six features: leadership, meeting structure, role clarification, being members of a team, a focus on possibilities and being seen and treated as holistic individuals, were guiding principles for a salutogenic service user involvement. These features strengthened the advisors' perception of themselves as valuable and competent contributors. Significant contributions from research advisors were promoted by facilitating the process of involvement. A supporting structure and atmosphere were consistent with a salutogenic service user involvement. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Improving the provision of language services at an academic medical center: ensuring high-quality health communication for limited-English-proficient patients.

PubMed

Standiford, Connie J; Nolan, Elizabeth; Harris, Michelle; Bernstein, Steven J

2009-12-01

To evaluate and improve the provision of language services at an academic medicine center caring for a diverse population including many limited-English-proficient (LEP) patients. The authors performed a prospective observational study between November 2006 and December 2008 evaluating the provision of language services at the University of Michigan Health System. The primary performance measures were (1) screening patients for their preferred language for health care, (2) assessing the proportion of LEP patients receiving language services from a qualified language services provider, and (3) assessing whether there were any disparities in diabetes care for LEP patients compared with English-speaking patients. The proportion of patients screened for preferred language increased from 59% to 96% with targeted inventions, such as training staff to capture preferred language for health care and correcting prior inaccurate primary language data entry. The proportion of LEP outpatients with a qualified language services provider increased from 19% to 83% through the use of staff and contract interpreters, over-the-phone interpreting and bilingual providers. There were no systematic differences in diabetes quality performance measures between LEP and English-proficient patients. Academic medical centers should measure their provision of language services and compare quality and safety data (e.g., performance measures and adverse events) between LEP and English-speaking patients to identify disparities in care. Leadership support and ongoing training are needed to ensure language-specific services are embedded into clinical care to meet the needs of our diverse patient populations.

Aging: GAO Activities in Fiscal Year 1985.

DTIC Science & Technology

1985-12-01

Fee Schedule for Laboratory Services * Survey of HCFA’s Ongoing Efforts to Assure the Appropriateness of Medicare DRG Payment Rates * Review of New...unnecessary expenditures for prosthetic lenses and related Reduce Medicare professional services used after the removal of cataracts and inequitable Payments...Requirements for Evaluating the Impacts of Medicare Pro- spective Payment on Post-Hospital Long-Term-Care Services : Prelimi- nary Report (GAO/PEMD-85

Meeting the Complex Needs of Urban Youth and Their Families through the 4Rs 2Ss Family Strengthening Program: The "Real World" Meets Evidence-Informed Care

ERIC Educational Resources Information Center

Small, Latoya A.; Jackson, Jerrold; Gopalan, Geetha; McKay, Mary McKernan

2015-01-01

Background: Youth living in poverty face compounding familial and environmental was challenges in utilizing effective community mental health services. Ongoing stressors increase their drop-out rate in mental health service use. Difficulties also exist in staying engaged in services when involved with the child welfare system. This study examines…

Funding for teratology information services: up, down, and all around.

PubMed

Quinn, Dee

2012-08-01

Funding for Teratology Information Services has been an ongoing struggle over the 25 years of its existence. Traditional and novel funding mechanisms have been explored with varying success. The importance of providing teratology risk assessment and counseling to all women of reproductive age is now an established health care objective. Sufficient and stable funding for these services is essential. Copyright © 2012 Wiley Periodicals, Inc.

Qualitative exploration of the views of healthy living champions from pharmacies in England.

PubMed

Rutter, Paul; Vryaparj, Gursharan

2015-02-01

In England, the 'Healthy Living Pharmacy (HLP)' initiative has been trialed; positive outcomes led to national roll-out across England to 20 pathfinder sites. A HLP provides health promotion/prevention services through a structured framework to meet local population need. Non-pharmacist staff receive additional training so that they can provide these services, and are known as Healthy Living Champions (HLCs). To explore HLCs views on their role and to identify any barriers or facilitators in performing the role. Fourteen semi-structured face-to-face interviews were conducted during February and March 2013 in NHS Dudley, and analysed using the principles of content analysis. Three themes emerged from the interviews; HLC job role; training; and public awareness. HLC staff showed high levels of motivation, a strong desire to help people and felt a sense of personal reward, resulting in increased levels of job satisfaction. Training had improved their confidence but they still had reservations in offering services such as alcohol intervention and weight management. All believed that public awareness was low despite advertising. HLCs were positive toward their new role and derived job satisfaction from helping people to improve their health, although on-going training and support was perceived as important.

20171015 - Generating Exposure-Relevant Measurement Data for Potential Use in Support of TSCA Requirements (ISES)

EPA Science Inventory

The EPA Office of Research and Development (ORD) has a number of ongoing projects which generate exposure measurements. These data may inform ongoing implementation of the amended Toxic Substances Control Act (TSCA). Exposure measurements include physical-chemical property inform...

Development and evaluation of a Smartphone-enabled, caregiver-supported educational intervention for management of physical disabilities following stroke in India: protocol for a formative research study

PubMed Central

Sureshkumar, K; Murthy, G V S; Kinra, Sanjay; Goenka, Shifalika; Kuper, Hannah

2015-01-01

The incidence and prevalence of stroke in India has reached epidemic proportions. The growing magnitude of disability in patients with stroke in India poses a major public health challenge. Given the nature of the condition, affected individuals often become disabled with profound effects on their quality of life. The availability of rehabilitation services for people with disabilities is inadequate in India. Rehabilitation services are usually offered by private hospitals located in urban areas and many stroke survivors, especially those who are poor or live in rural areas, cannot afford to pay for, or do not have access to, such services. Thus, identification of cost-effective ways to rehabilitate people with stroke-related disability is an important challenge. Educational interventions in stroke rehabilitation can assist stroke survivors to make informed decisions regarding their on-going treatment and to self-manage their condition with support from their caregivers. Although educational interventions have been shown to improve patient knowledge for self-management of stroke, an optimal format for the intervention has not as yet been established, particularly in low- and middle-income countries. This formative research study aims to systematically develop an educational intervention for management of post-stroke disability for stroke survivors in India, and evaluate the feasibility and acceptability of delivering the intervention using Smartphones and with caregiver support. The research study will be conducted in Chennai, India, and will be organised in three different phases. Phase 1: Development of the intervention. Phase 2: Field testing and finalising the intervention. Phase 3: Piloting of the intervention and assessment of feasibility and acceptability. A mixed-methods approach will be used to develop and evaluate the intervention. If successful, it will help realise the potential of using Smartphone-enabled, carer-supported educational intervention to bridge the gaps in service access for rehabilitation of individuals with stroke-related disability in India. The proposed research will also provide valuable information for clinicians and policymakers. PMID:26751379

Sexual Health Help-Seeking Behavior among Migrants from Sub-Saharan Africa and South East Asia living in High Income Countries: A Systematic Review.

PubMed

Rade, Donna Angelina; Crawford, Gemma; Lobo, Roanna; Gray, Corie; Brown, Graham

2018-06-22

The number of migrants has increased globally. This phenomenon has contributed to increasing health problems amongst migrants in high-income countries, including vulnerability for HIV acquisition and other sexual health issues. Adaptation processes in destination countries can present difficulties for migrants to seek help from and gain access to health services. This study examined migrants’ from sub-Saharan Africa (SSA) and South East Asia (SEA) sexual health help-seeking behavior in high-income countries with universal health coverage. The systematic review followed PRISMA guidelines and was registered with PROSPERO. Several databases were searched from 2000 to 2017. Of 2824 studies, 15 met the inclusion criteria. These consisted of 12 qualitative and three quantitative studies conducted in Australia, Spain, the United Kingdom, Belgium, Scotland, Ireland, and Sweden. Migrants experienced a range of difficulties accessing health services, specifically those related to sexual health, in high-income countries. Few studies described sources of sexual health help-seeking or facilitators to help-seeking. Barriers to access were numerous, including: stigma, direct and indirect costs, difficulty navigating health systems in destination countries and lack of cultural competency within health services. More culturally secure health services, increased health service literacy and policy support to mitigate costs, will improve health service access for migrants from SSA and SEA. Addressing the structural drivers for stigma and discrimination remains an ongoing and critical challenge.

Ensuring the effectiveness of community-wide emergency cardiac care.

PubMed

Becker, L B; Pepe, P E

1993-02-01

To improve emergency cardiac care (ECC) on the national or international level, we must translate to the rest of our communities the successes found in cities with high survival rates. In recent years, important developments have evolved in our understanding of the treatment and evaluation of cardiac arrest. Some of the most important of these developments include 1) recognition of the chain of survival, which is necessary to achieve high survival rates; 2) widespread acceptance that survival rates must be assessed routinely to ensure continuous quality improvements in the emergency medical services (EMS) system; and 3) development of improved methods for performing survival rate studies that will maximize the effectiveness of information gathering and analysis. While each community should determine how to optimize their own ECC services, some general guidelines are useful. Successful treatment of cardiac arrest starts in the community with prevention and education, including early recognition of the signs and symptoms of cardiovascular ischemia. Obtaining 911 service (and preferably enhanced 911) should be a top priority for all communities. EMS dispatchers should dispatch the unit to the scene in less than one minute, provide critical information to the responders regarding the type of emergency, and offer the caller telephone-assisted CPR instructions. The EMS first-responders should strive to arrive at the patient's side in less than four minutes, be able to immediately defibrillate if necessary, and begin basic CPR. An excellent strategy to accomplish this is to equip and train all fire-fighting units in the operation of automatic external defibrillators and dispatch them as a first-responder team. To manage the cardiac arrest patient, a minimum of two rescuers trained in advanced cardiac life support plus two or more rescuers trained in basic life support are needed. Furthermore, an EMS system is not complete without on-going evaluation. Therefore, the 1992 National Conference on CPR and ECC strongly endorses the position that all ECC systems assess their survival rates through an ongoing quality improvement process and that all members of the chain of providers should be represented in the outcome assessment team. We still have much to discover regarding optimal techniques of CPR, methods for data collection, and optimal structure of an EMS system. Research in these areas will provide the foundation for future changes in EMS systems development.

Suicidal Ideation, Resilience, and Healthcare Implications for Newly Diagnosed HIV-Positive Men Who Have Sex with Men in China: A Qualitative Study.

PubMed

Li, Haochu; Tucker, Joseph; Holroyd, Eleanor; Zhang, Jie; Jiang, Baofa

2017-05-01

Globally, suicidal ideation and behavior have been widely reported among people living with human immunodeficiency virus (HIV). Knowledge gaps exist regarding the longer life and resilience-related experiences of people living with HIV (PLWH). Specifically, there is a dearth of data about the interaction of perceived risk and resilient factors resulting in a wide spectrum of intentional suicidal ideation outcomes in a Chinese cultural context. This qualitative research drew from a larger ethnographic study of newly diagnosed HIV-positive men who have sex with men (MSM) in Mainland China. Interviews were conducted with 31 MSM within 6 months of diagnosis of HIV infection. Initial suicidal ideation was commonly reported with participants subsequently feeling more resilient to these thoughts through gaining a greater understanding of their prognosis and treatment. Post-HIV diagnosis, some participants reported forming new relationships and receiving increased support from their partners, friends, peers, families, and community-based organizations. At follow-up, these participants generally reported suicidal ideation had declined. However, participants who continued to express suicidal ideation perceived extended pressure from their families' expectations for them to engage in heterosexual marriages and parenthood. Furthermore, these men reported ongoing hardships in their daily life, unemployment, lack of social support, and isolation. Among this Mainland Chinese cohort of HIV-positive MSM, suicidal ideation may be a transient phenomenon experienced initially following HIV diagnosis that resolves with increased and specific familial, social, and service-based support. It is crucial to identify the causes of stress and social suffering associated with HIV diagnosis in order to reduce suicidal ideation. In China, action is needed to develop routine mental health screening and to increase services that support PLWH. Important services mechanism to accomplish this are promoting resilience through intentional activities as well as continued public health campaigns to reduce stigma toward HIV-positive MSM.

Growing a professional network to over 3000 members in less than 4 years: evaluation of InspireNet, British Columbia's virtual nursing health services research network.

PubMed

Frisch, Noreen; Atherton, Pat; Borycki, Elizabeth; Mickelson, Grace; Cordeiro, Jennifer; Novak Lauscher, Helen; Black, Agnes

2014-02-21

Use of Web 2.0 and social media technologies has become a new area of research among health professionals. Much of this work has focused on the use of technologies for health self-management and the ways technologies support communication between care providers and consumers. This paper addresses a new use of technology in providing a platform for health professionals to support professional development, increase knowledge utilization, and promote formal/informal professional communication. Specifically, we report on factors necessary to attract and sustain health professionals' use of a network designed to increase nurses' interest in and use of health services research and to support knowledge utilization activities in British Columbia, Canada. "InspireNet", a virtual professional network for health professionals, is a living laboratory permitting documentation of when and how professionals take up Web 2.0 and social media. Ongoing evaluation documents our experiences in establishing, operating, and evaluating this network. Overall evaluation methods included (1) tracking website use, (2) conducting two member surveys, and (3) soliciting member feedback through focus groups and interviews with those who participated in electronic communities of practice (eCoPs) and other stakeholders. These data have been used to learn about the types of support that seem relevant to network growth. Network growth exceeded all expectations. Members engaged with varying aspects of the network's virtual technologies, such as teams of professionals sharing a common interest, research teams conducting their work, and instructional webinars open to network members. Members used wikis, blogs, and discussion groups to support professional work, as well as a members' database with contact information and areas of interest. The database is accessed approximately 10 times per day. InspireNet public blog posts are accessed roughly 500 times each. At the time of writing, 21 research teams conduct their work virtually using the InspireNet platform; 10 topic-based Action Teams meet to address issues of mutual concern. Nursing and other health professionals, even those who rated themselves as computer literate, required significant mentoring and support in their efforts to adopt their practice to a virtual environment. There was a steep learning curve for professionals to learn to work in a virtual environment and to benefit from the available technologies. Virtual professional networks can be positioned to make a significant contribution to ongoing professional practice and to creating environments supportive of information sharing, mentoring, and learning across geographical boundaries. Nonetheless, creation of a Web 2.0 and social media platform is not sufficient, in and of itself, to attract or sustain a vibrant community of professionals interested in improving their practice. Essential support includes instruction in the use of Web-based activities and time management, a biweekly e-Newsletter, regular communication from leaders, and an annual face-to-face conference.

Partnership, inclusion and innovation in occupational therapy: Essential or optional ingredients to flourish in a changing environment?

PubMed

Gilbert Hunt, Susan

2017-12-01

Historically occupational therapy has evidenced a tenacity to adjust and adapt to societal changes. Currently in Australia we are in the midst of significant change in health, disability and aged care service delivery alongside increasing numbers of new graduates seeking employment. Both of these changes create challenges and opportunities for the profession. How the profession adjusts to new service delivery models and supports new graduates in this changing work environment will influence our future. Using examples from practice the paper explores ways in which partnership, inclusion and innovation can be effective in a changing environment. Doing effective partnership takes time, energy and a shared commitment of all involved and often requires negotiations and compromise. Inclusion can be tricky and requires vigilance and ongoing reflection on actions to determine if the outcomes are what was intended. Innovation can play two roles; it can be used to conserve current practice in new ways or it can offer agency to disrupt and redefine practice. The way in which the profession chooses to enact partnerships and inclusion will play a vital role in shaping the future. Similarly the space and support made for conservative or disruptive innovation will determine how we choose to define ourselves going forward. Moreover, these choices and actions will govern how effective we are in navigating the changing environment and supporting new graduates transitioning into the profession. © 2017 Occupational Therapy Australia.

Protocol for a randomised controlled trial of chronic disease self-management support for older Australians with multiple chronic diseases.

PubMed

Reed, Richard L; Battersby, Malcolm; Osborne, Richard H; Bond, Malcolm J; Howard, Sara L; Roeger, Leigh

2011-11-01

The prevalence of older Australians with multiple chronic diseases is increasing and now accounts for a large proportion of total health care utilisation. Chronic disease self-management support (CDSMS) has become a core service component of many community based health programs because it is considered a useful tool in improving population health outcomes and reducing the financial burden of chronic disease care. However, the evidence base to justify these support programs is limited, particularly for older people with multiple chronic diseases. We describe an ongoing trial examining the effectiveness of a particular CDSMS approach called the Flinders Program. The Flinders Program is a clinician-led generic self-management intervention that provides a set of tools and a structured process that enables health workers and patients to collaboratively assess self-management behaviours, identify problems, set goals, and develop individual care plans covering key self-care, medical, psychosocial and carer issues. A sample of 252 older Australians that have two or more chronic conditions will be randomly assigned to receive either CDSMS or an attention control intervention (health information only) for 6 months. Outcomes will be assessed using self-reported health measures taken at baseline and post-intervention. This project will be the first comprehensive evaluation of CDSMS in this population. Findings are expected to guide consumers, clinicians and policymakers in the use of CDSMS, as well as facilitate prioritisation of public monies towards evidence-based services. Copyright © 2011 Elsevier Inc. All rights reserved.

The contribution of case study design to supporting research on Clubhouse psychosocial rehabilitation.

PubMed

Raeburn, Toby; Schmied, Virginia; Hungerford, Catherine; Cleary, Michelle

2015-10-01

Psychosocial Clubhouses provide recovery-focused psychosocial rehabilitation to people with serious mental illness at over 300 sites in more than 30 countries worldwide. To deliver the services involved, Clubhouses employ a complex mix of theory, programs and relationships, with this complexity presenting a number of challenges to those undertaking Clubhouse research. This paper provides an overview of the usefulness of case study designs for Clubhouse researchers; and suggests ways in which the evaluation of Clubhouse models can be facilitated. The paper begins by providing a brief explanation of the Clubhouse model of psychosocial rehabilitation, and the need for ongoing evaluation of the services delivered. This explanation is followed by an introduction to case study design, with consideration given to the way in which case studies have been used in past Clubhouse research. It is posited that case study design provides a methodological framework that supports the analysis of either quantitative, qualitative or a mixture of both types of data to investigate complex phenomena in their everyday contexts, and thereby support the development of theory. As such, case study approaches to research are well suited to the Clubhouse environment. The paper concludes with recommendations for future Clubhouse researchers who choose to employ a case study design. While the quality of case study research that explores Clubhouses has been variable in the past, if applied in a diligent manner, case study design has a valuable contribution to make in future Clubhouse research.

Towards a virtual health record for mobile home care of elderly citizens.

PubMed

Koch, Sabine; Hägglund, Maria; Scandurra, Isabella; Moström, Dennis

2004-01-01

Mobile work situations within home care of the elderly require immediate and ubiquitous access to patient-oriented data. The ongoing Swedish research project "Technical support for Mobile CloseCare" focuses on the development and evaluation of work-scenario oriented ICT support for enhanced home care of elderly citizens. The aim of the project is to provide a seamless and consistent information flow between different health care providers and to give intuitive access to information services for the elderly and their relatives. For that purpose, different independent software components are connected through a mobile communication platform. Flexible access to prioritized information for different users in different work situations will be given through a virtual health record. In order to obtain both usable and clinically relevant results, a user centered system development approach is followed. Evaluation of the project results will be based on usability tests and quasi-experimental studies on how system implementation influences quality of care and job- and life satisfaction for care providers, patients and relatives.

A cognitive mobile BTS solution with software-defined radioelectric sensing.

PubMed

Muñoz, Jorge; Alonso, Javier Vales; García, Francisco Quiñoy; Costas, Sergio; Pillado, Marcos; Castaño, Francisco Javier González; Sánchez, Manuel García; Valcarce, Roberto López; Bravo, Cristina López

2013-02-05

Private communications inside large vehicles such as ships may be effectively provided using standard cellular systems. In this paper we propose a new solution based on software-defined radio with electromagnetic sensing support. Software-defined radio allows low-cost developments and, potentially, added-value services not available in commercial cellular networks. The platform of reference, OpenBTS, only supports single-channel cells. Our proposal, however, has the ability of changing BTS channel frequency without disrupting ongoing communications. This ability should be mandatory in vehicular environments, where neighbouring cell configurations may change rapidly, so a moving cell must be reconfigured in real-time to avoid interferences. Full details about frequency occupancy sensing and the channel reselection procedure are provided in this paper. Moreover, a procedure for fast terminal detection is proposed. This may be decisive in emergency situations, e.g., if someone falls overboard. Different tests confirm the feasibility of our proposal and its compatibility with commercial GSM terminals.

A Cognitive Mobile BTS Solution with Software-Defined Radioelectric Sensing

PubMed Central

Muñoz, Jorge; Alonso, Javier Vales; García, Francisco Quiñoy; Costas, Secundino; Pillado, Marcos; Castaño, Francisco Javier González; Sánchez, Manuel Garćia; Valcarce, Roberto López; Bravo, Cristina López

2013-01-01

Private communications inside large vehicles such as ships may be effectively provided using standard cellular systems. In this paper we propose a new solution based on software-defined radio with electromagnetic sensing support. Software-defined radio allows low-cost developments and, potentially, added-value services not available in commercial cellular networks. The platform of reference, OpenBTS, only supports single-channel cells. Our proposal, however, has the ability of changing BTS channel frequency without disrupting ongoing communications. This ability should be mandatory in vehicular environments, where neighbouring cell configurations may change rapidly, so a moving cell must be reconfigured in real-time to avoid interferences. Full details about frequency occupancy sensing and the channel reselection procedure are provided in this paper. Moreover, a procedure for fast terminal detection is proposed. This may be decisive in emergency situations, e.g., if someone falls overboard. Different tests confirm the feasibility of our proposal and its compatibility with commercial GSM terminals. PMID:23385417

Human Trafficking and Health: A Survey of Male and Female Survivors in England

PubMed Central

Oram, Siân; Abas, Melanie; Bick, Debra; Boyle, Adrian; French, Rebecca; Jakobowitz, Sharon; Khondoker, Mizanur; Stanley, Nicky; Trevillion, Kylee; Howard, Louise

2016-01-01

Objectives. To investigate physical and mental health and experiences of violence among male and female trafficking survivors in a high-income country. Methods. Our data were derived from a cross-sectional survey of 150 men and women in England who were in contact with posttrafficking support services. Interviews took place over 18 months, from June 2013 to December 2014. Results. Participants had been trafficked for sexual exploitation (29%), domestic servitude (29.3%), and labor exploitation (40.4%). Sixty-six percent of women reported forced sex during trafficking, including 95% of those trafficked for sexual exploitation and 54% of those trafficked for domestic servitude. Twenty-one percent of men and 24% of women reported ongoing injuries, and 8% of men and 23% of women reported diagnosed sexually transmitted infections. Finally, 78% of women and 40% of men reported high levels of depression, anxiety, or posttraumatic stress disorder symptoms. Conclusions. Psychological interventions to support the recovery of this highly vulnerable population are urgently needed. PMID:27077341

Audit of annual medical appraisal and revalidation activity across the UK Defence Medical Services 2013-2014.

PubMed

Morris, Louisa E; Withnall, Rdj

2017-02-01

To provide the first annual audit of Defence Medical Services (DMS) medical appraisal and revalidation activity. A questionnaire-based survey of appraisal and revalidation activity within the 2013-2014 appraisal year (1 April 2013 - 1 March 2014) across the Royal Navy (RN), Army, Royal Air Force (RAF) and Ministry of Defence (MOD) and Defence Postgraduate Medical Deanery (DPMD) Designated Bodies (DBs). Mandatory annual medical appraisal of all DMS doctors was introduced in 2002. The General Medical Council (GMC) introduced licences to practise in November 2011. Revalidation went live in December 2012. In the 2013-2014 appraisal year, there were 1379 DMS doctors. The Responsible Officers (ROs) of the RN, Army, RAF, MOD and Defence Postgraduate Medical Deanery (DPMD) provide appraisal and revalidation services for doctors within their DBs. In the 2013-2014 appraisal year, 82% of DMS doctors completed an annual appraisal. ROs provided positive revalidation recommendations for 90% of DMS doctors without the need for additional supporting information. Additional supporting evidence was required for 10% of DMS trained doctors, but ultimately 100% of DMS doctors due revalidation in the 2013-2014 appraisal year received a positive recommendation. To assist DMS compliance with GMC quality assurance requirements, HQ Surgeon General now maintains a central database of appraisal and revalidation data across the five DMS DBs. Appropriately targeted appraiser training and 'revalidation ready top-up' training should be provided to ensure the demand for military appraisers is met, and that DMS appraisers appropriately maintain their skills. MOD now maintains a central live database for ongoing appraisal and revalidation monitoring. 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/.

Understanding the relationship between couple dynamics and engagement with HIV care services: insights from a qualitative study in Eastern and Southern Africa

PubMed Central

Wamoyi, Joyce; Renju, Jenny; Moshabela, Mosa; McLean, Estelle; Nyato, Daniel; Mbata, Doris; Bonnington, Oliver; Seeley, Janet; Church, Kathryn; Zaba, Basia; Wringe, Alison

2017-01-01

Objective To explore the interplay between couple dynamics and the engagement of people living with HIV (PLHIV) with HIV care and treatment services in three health and demographic surveillance sites in Tanzania, Malawi and South Africa. Methods A qualitative study was conducted involving 107 in-depth interviews with PLHIV with a range of HIV care and treatment histories, including current users of HIV clinics, and people not enrolled in HIV care. Interviews explored experiences of living with HIV and how and why they chose to engage or not with HIV services. Thematic analysis was conducted with the aid of NVivo 10. Results We found an interplay between couple dynamics and HIV care and treatment-seeking behaviour in Tanzania, Malawi and South Africa. Being in a relationship impacted on the level and type of engagement with HIV services in multiple ways. In some instances, couples living with HIV supported each other which improved their engagement with care and strengthened their relationships. The desire to fulfil societal expectations and attract a new partner, or have a baby with a new partner, or to receive emotional or financial support, strengthened on-going engagement with HIV care and treatment. However, fear of blame, abandonment or abuse resulted in unwillingness to disclose and often led to disputes or discord between couples. There was little evidence of intracouple understanding of each other’s lived experiences with HIV, and we found that couples rarely interacted with the formal health system together. Conclusions Couple dynamics influenced engagement with HIV testing, care and treatment for both partners through a myriad of pathways. Couple-friendly approaches to HIV care and treatment are needed that move beyond individualised care and which recognise partner roles in HIV care engagement. PMID:28736395

EXPANSION of diabetes education in a United States-Mexico border community (Expanding Services for Patients to Acquire New Skills, Set Goals, and Improve Overall Knowledge).

PubMed

Carrillo, Melissa; Sias, Jeri; Navarrete, Jacquelyn P; Aboud, Sam; Valenzuela, Enrique

To describe the process used by a pharmacy team at a community health center to coordinate and expand diabetes education services (English and Spanish) for a predominantly Hispanic, Spanish-speaking population. The project was implemented at 2 clinics in a federally qualified community health center system based in a low-income southwest U.S.-Mexico border community. This project enhanced accessibility to diabetes education to improve knowledge, skills, and goal setting through existing pharmacy services at the primary clinic and 1 rural satellite clinic. The success of the project was evaluated quantitatively. Metrics used to evaluate enhancement of existing practices included enrollment and completion rates, number of sessions, and diabetes leadership meetings. Over the 5-month project period assessed, 7 interdisciplinary professionals were certified as Diabetes Empowerment Education Program educators. Four sessions were conducted at both clinics. A total of 31 participants completed the diabetes classes. An educational attainment of 8th grade or less was reported in 91% of the rural participants compared with 50% of the urban participants. Ten interdisciplinary leadership meetings centered on recruitment, progress toward goals, and action items to ensure quality of classes. A nurse practitioner and pharmacist piloted a shared-visit model with 5 patients during a 45-minute time period. Successful diabetes education services occurred by implementing an evidence-based curriculum, identifying provider champions, increasing patient enrollment through provider referrals, and generating reports. Patient accountability was facilitated by setting patient-centered goals for knowledge and skills. Last, support groups provided ongoing support once patients graduated from a structured diabetes program. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Report says Gulf of Mexico oil spill assessment should include ecosystem services approach

NASA Astrophysics Data System (ADS)

Showstack, Randy

2011-11-01

The oil spill in the Gulf of Mexico that resulted from the 20 April 2010 explosion of the Deepwater Horizon (DWH) platform drilling the Macondo well was so massive and affected such a large and deep region of the gulf that the process of determining environmental damage in the region should be more encompassing than a typical habitat and resource equivalency approach, according to a 9 November report by the U.S. National Research Council (NRC). The congressionally requested report calls for an ecosystem services approach to complement ongoing approaches to the damage evaluation for the spill that is being conducted through the ongoing Natural Resources Damage Assessment (NRDA) process triggered by the U.S. Oil Pollution Act (OPA) of 1990.

Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

PubMed Central

2009-01-01

Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC). Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH) indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH) of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC) and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC) and family planning (FP). Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive). Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1) providing necessary equipment and renovations to health facilities; 2) improving supply management systems; 3) providing comprehensive competency-based training for health providers in RH and infection prevention; 4) improving referral systems to the hospitals; 5) advocating for changes in national RH policies and protocols; and 6) providing technical assistance for monitoring and evaluation of key RH indicators. Together, these initiatives will improve the quality and accessibility of RH services in the DRC - services which are urgently needed and to which Congolese women are entitled by international human rights law. PMID:20025757

Stormtime Magnetosphere-Ionosphere-Thermosphere Interactions and Dynamics

DTIC Science & Technology

2013-03-13

1 2. BACKGROUND ... BACKGROUND The studies described in this report were performed in support of ongoing and planned space weather programs in the areas of Space Situational...Ionosphere The purpose of this effort was to initiate on-going analysis of COSMIC -GPS measurements of total electron content (TEC) in the dayside

Exposure Modeling Tools and Databases for Consideration for Relevance to the Amended TSCA (ISES)

EPA Science Inventory

The Agency’s Office of Research and Development (ORD) has a number of ongoing exposure modeling tools and databases. These efforts are anticipated to be useful in supporting ongoing implementation of the amended Toxic Substances Control Act (TSCA). Under ORD’s Chemic...

The effect of semantic context on prospective memory performance.

PubMed

Thomas, Brandon J; McBride, Dawn M

2016-01-01

The current study provides evidence for spontaneous processing in prospective memory (PM) or memory for intentions. Discrepancy-plus-search is the spontaneous processing of PM cues via disruptions in processing fluency of ongoing task items. We tested whether this mechanism can be demonstrated in an ongoing rating task with a dominant semantic context. Ongoing task items were manipulated such that the PM cues were members of a semantic category (i.e., Body Parts) that was congruent or discrepant with the dominant semantic category in the ongoing task. Results showed that participants correctly responded to more PM cues when there was a category discrepancy between the PM cues and ongoing task items. Moreover, participants' identification of PM cues was accompanied by faster ongoing task reaction times when PM cues were discrepant with ongoing task items than when they were congruent. These results suggest that a discrepancy-plus-search process supports PM retrieval in certain contexts, and that some discrepancy-plus-search mechanisms may result from the violation of processing expectations within a semantic context.

Mental health nurses' views about antipsychotic medication side effects.

PubMed

Stomski, N J; Morrison, P; Meehan, T

2016-08-01

WHAT IS KNOWN ON THE SUBJECT?: The only previous quantitative study that examined nurses' use of assessment tools to identify antipsychotic medication side effects found that about 25% of mental health nurses were using assessment tools. No previous studies have examined factors that influence the manner in which mental health nurses assess antipsychotic medication side effects. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: One-third of the respondents were not aware of any antipsychotic medication side-effect assessment tool, and only one-quarter were currently using an assessment tool. 'Service responsibility' was significantly associated with ongoing use of antipsychotic medication assessment tools, indicating that respondents with more positive attitudes to their service were more likely to continue using antipsychotic medication assessment tools. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The low level of awareness and use of antipsychotic medication side-effect assessment tools indicates that nursing educational institutions should incorporate more detail about these tools in course content, and emphasize in particular the benefits that result from the use of these tools in clinical practice. Service processes contributed significantly to the use of antipsychotic medication assessment tools, which indicates that managers need to foster workplace cultures that promote routine use of these tools. Introduction Limited evidence suggests that only a minority of mental health nurses regularly use standardized assessment tools to assess antipsychotic medication side effects, but the factors that contribute to the non-routine use of these tools remain unknown. Aim To examine Australian mental health nurses' awareness of, and attitudes towards, side-effect assessment tools, and also identify factors the influence the use of these tools. Methods A cross-sectional survey was undertaken through distributing an online questionnaire via email to members of the Australian College of Mental Health Nurses. Completed questionnaires were received from 171 respondents. Linear regression was used to examine the relationship between the 'service responsibility' and 'personal confidence' scale scores, and awareness, previous use and ongoing use of antipsychotic medication assessment tools. Results Only one-quarter of the respondents (26.5%) were currently using an assessment tool. 'Service responsibility' was significantly associated with ongoing use of antipsychotic medication assessment tools (Β = 3.26; 95% CI 0.83-5.69). 'Personal confidence' did not influence the ongoing use of assessment tools (Β = -0.05; 95% CI -1.06-1.50). Implications for clinical practice Stakeholders can incorporate 'service responsibility' processes to foster increased use of assessment tools, which may enhance the identification antipsychotic medication side effects and improve the quality of care for service users. © 2016 John Wiley & Sons Ltd.

Partnerships and volunteers in the U.S. Forest Service

Treesearch

James D. Absher

2009-01-01

The U.S. Forest Service often relies on volunteers and partnerships to help accomplish agency goals, particularly in its recreation and heritage programs. Data from agency records and a staff survey suggest that volunteer involvement is a developing area. Ongoing efforts to improve the agency's volunteer management capacity (VMC) would benefit from more attention...

Raising Standards through INQUIRE in Pre-Service Teacher Education

ERIC Educational Resources Information Center

Elster, D.; Barendziak, T.; Haskamp, F.; Kastenholz, L.

2014-01-01

Raising standards through inquiry-based science education (IBSE)--what are the challenges for pre-service teacher education? What do ongoing teachers and active teachers learn from each other when planning, conducting and evaluating minds-on and hands-on IBSE activities in the classroom? What do they learn "beyond" IBSE? The Bremen…

Quality and Utility of the Multi-Tiered Instruction Self-Efficacy Scale

ERIC Educational Resources Information Center

Barnes, Susan K.; Burchard, Melinda S.

2011-01-01

Response to Intervention (RTI) is an educational approach that integrates ongoing assessment of individual student progress with targeted instruction. Administrators and teachers in P-12 schools expressed a need for colleagues in higher education to provide training to general education pre-service and in-service teachers in selecting appropriate…

Public Service Professionalism among State Administrators: A Multiple State Study. A Working Paper.

ERIC Educational Resources Information Center

Rose, Bruce J.; And Others

This working paper, part of an ongoing national study, presents preliminary analysis of public service professionalism among state public administrators in many states on the basis of data already produced by a continuing survey research project. Information about the data source and sample profiles are provided. Additionally, the research…

Developing Inclusive Schools: A Systemic Approach

ERIC Educational Resources Information Center

Kinsella, William; Senior, Joyce

2008-01-01

This paper emerges from an ongoing study which involved, firstly, key informant interviews with strategic personnel within the Irish education system, such personnel representing both service providers and service users. The first part of this paper provides a brief summary of the findings of that aspect of the study in relation to the key…

Promoting Student Mental Health, Learning & Welfare: 1995-96 School Psychology Services Accountability Studies.

ERIC Educational Resources Information Center

McDaid, Janet L.; Reifman, Arthur

As part of an ongoing project to determine how effectively school psychological services promote student mental health, learning, and welfare in San Diego City Schools (California), accountability studies were conducted. A previously developed planning model guided the process. During the 1995-96 school year, school psychologists gathered data…

American Red Cross Disaster Mental Health Services: Implementation and Recent Developments.

ERIC Educational Resources Information Center

Morgan, Jane

1995-01-01

The American Red Cross (ARC) Disaster Mental Health Services program uses a multidisciplinary approach to deliver crisis intervention to disaster workers and victims after hurricanes. Discusses the impetus for the ARC's development of the program, its early implementation, and ongoing challenges in the further development of this approach to…

Residential Services for Persons with Developmental Disabilities: Status and Trends through 1994. Report #46.

ERIC Educational Resources Information Center

Prouty, Robert, Ed.; Lakin, K. Charlie, Ed.

This report from the ongoing National Residential Information Systems Project provides statistics on persons with mental retardation and related developmental disabilities (MR/DD) receiving residential services in the United States for the year ending June 30, 1994, as well as comparative statistics from earlier years. An executive summary…

Residential Services for Persons with Developmental Disabilities: Status and Trends through 1996. Report #49.

ERIC Educational Resources Information Center

Prouty, Robert, Ed.; Lakin, K. Charlie, Ed.

This report from the ongoing National Residential Information Systems Project provides statistics on persons with mental retardation and related developmental disabilities (MR/DD) receiving residential services in the United States for the year ending June 30, 1996, as well as comparative statistics from earlier years. Section 1 contains chapters…

Evaluating Parent Satisfaction of School Nursing Services

ERIC Educational Resources Information Center

Read, Mary; Small, Patricia; Donaher, Kathleen; Gilsanz, Paola; Sheetz, Anne

2009-01-01

The Conceptual Model of Nursing Health Policy (CMNHP) was used to guide this study of client satisfaction as one component of an ongoing assessment of the Essential School Health Service (ESHS) Programs conducted by the Massachusetts Department of Public Health. Random samples of parents/guardians of students who use the school nursing services…

A Qualitative Study of Facilitators and Barriers Related to Comprehensive and Integrated School Psychological Services

ERIC Educational Resources Information Center

Castillo, Jose M.; Wolgemuth, Jennifer R.; Barclay, Chris; Mattison, Amira; Tan, Sim Yin; Sabnis, Sujay; Brundage, Amber; Marshall, Leslie

2016-01-01

Recent studies indicate that the majority of school psychologists' time continues to be dedicated to SPED related activities. Despite ongoing calls for school psychologists to expand their roles, why many practitioners do not deliver more comprehensive services is not well understood. This qualitative study investigated facilitators of and…

Study Abroad as Professional Development: Voices of In-Service Spanish Teachers

ERIC Educational Resources Information Center

Jochum, Christopher J.; Rawlings, Jared R.; Tejada, Ana María

2015-01-01

The purpose of this qualitative inquiry was to understand how four in-service Spanish teachers interpreted their participation in a summer study abroad program and how the experience contributed to their ongoing professional development and language proficiency. Using a multiple case design (Simons, 2009; Stake, 2005; Yin, 2009), the researchers…

77 FR 75681 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-21

... operational. Among other things, the telephone services provided by third-party carriers to the Exchange were... internet service. Specifically, the wired telephone lines and internet connections for Floor brokers... temporary suspension of those aspects of Rules 36.20 and 36.21 because of ongoing telephone and internet...

78 FR 5848 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-28

.... Among other things, the telephone services provided by third-party carriers to the Exchange were still... Internet service. Specifically, the wired telephone lines and Internet connections for Floor brokers... aspects of Rules 36.20 and 36.21 because of ongoing telephone and Internet issues. \\5\\ See Securities...

78 FR 5851 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-28

... not yet fully operational. Among other things, the telephone services provided by third-party carriers... the temporary suspension was needed because of the ongoing intermittent phone and internet service. Specifically, the wired telephone lines and internet connections for Floor brokers continued to not be...

Generalized Method for the User Evaluation of Purchased Information Services. Report Number Three; Monthly Report (October 1 to November 30, 1975).

ERIC Educational Resources Information Center

Hall, Homer J.

Four case histories were studied in an on-going project to develop a method for user selection of purchased scientific and technical information services. The issues involved were: (1) the value of computer search services to a small branch of a company technical library; (2) the special decision-making factors used for selecting items of very…

Enhancement of Mutual Discovery, Search, and Access of Data for Users of NASA and GEOSS-Cataloged Data Systems

NASA Technical Reports Server (NTRS)

Teng, William; Maidment, David; Rodell, Matthew; Strub, Richard; Arctur, David; Ames, Daniel; Rui, Hualan; Vollmer, Bruce; Seiler, Edward

2014-01-01

An ongoing NASA-funded Data Rods (time series) project has demonstrated the removal of a longstanding barrier to accessing NASA data (i.e., accessing archived time-step array data as point-time series) for selected variables of the North American and Global Land Data Assimilation Systems (NLDAS and GLDAS, respectively) and other NASA data sets. Data rods are pre-generated or generated on-the-fly (OTF), leveraging the NASA Simple Subset Wizard (SSW), a gateway to NASA data centers. Data rods Web services are accessible through the CUAHSI Hydrologic Information System (HIS) and the Goddard Earth Sciences Data and Information Services Center (GES DISC) but are not easily discoverable by users of other non-NASA data systems. An ongoing GEOSS Water Services project aims to develop a distributed, global registry of water data, map, and modeling services cataloged using the standards and procedures of the Open Geospatial Consortium and the World Meteorological Organization. Preliminary work has shown GEOSS can be leveraged to help provide access to data rods. A new NASA-funded project is extending this early work.

Implementing a fax referral program for quitline smoking cessation services in urban health centers: a qualitative study.

PubMed

Cantrell, Jennifer; Shelley, Donna

2009-12-17

Fax referral services that connect smokers to state quitlines have been implemented in 49 U.S. states and territories and promoted as a simple solution to improving smoker assistance in medical practice. This study is an in-depth examination of the systems-level changes needed to implement and sustain a fax referral program in primary care. The study involved implementation of a fax referral system paired with a chart stamp prompting providers to identify smoking patients, provide advice to quit and refer interested smokers to a state-based fax quitline. Three focus groups (n = 26) and eight key informant interviews were conducted with staff and physicians at two clinics after the intervention. We used the Chronic Care Model as a framework to analyze the data, examining how well the systems changes were implemented and the impact of these changes on care processes, and to develop recommendations for improvement. Physicians and staff described numerous benefits of the fax referral program for providers and patients but pointed out significant barriers to full implementation, including the time-consuming process of referring patients to the Quitline, substantial patient resistance, and limitations in information and care delivery systems for referring and tracking smokers. Respondents identified several strategies for improving integration, including simplification of the referral form, enhanced teamwork, formal assignment of responsibility for referrals, ongoing staff training and patient education. Improvements in Quitline feedback were needed to compensate for clinics' limited internal information systems for tracking smokers. Establishing sustainable linkages to quitline services in clinical sites requires knowledge of existing patterns of care and tailored organizational changes to ensure new systems are prioritized, easily integrated into current office routines, formally assigned to specific staff members, and supported by internal systems that ensure adequate tracking and follow up of smokers. Ongoing staff training and patient self-management techniques are also needed to ease the introduction of new programs and increase their acceptability to smokers.

Exploring the potential offered by legacy soil databases for ecosystem services mapping of Central African soils

NASA Astrophysics Data System (ADS)

Verdoodt, Ann; Baert, Geert; Van Ranst, Eric

2014-05-01

Central African soil resources are characterised by a large variability, ranging from stony, shallow or sandy soils with poor life-sustaining capabilities to highly weathered soils that recycle and support large amounts of biomass. Socio-economic drivers within this largely rural region foster inappropriate land use and management, threaten soil quality and finally culminate into a declining soil productivity and increasing food insecurity. For the development of sustainable land use strategies targeting development planning and natural hazard mitigation, decision makers often rely on legacy soil maps and soil profile databases. Recent development cooperation financed projects led to the design of soil information systems for Rwanda, D.R. Congo, and (ongoing) Burundi. A major challenge is to exploit these existing soil databases and convert them into soil inference systems through an optimal combination of digital soil mapping techniques, land evaluation tools, and biogeochemical models. This presentation aims at (1) highlighting some key characteristics of typical Central African soils, (2) assessing the positional, geographic and semantic quality of the soil information systems, and (3) revealing its potential impacts on the use of these datasets for thematic mapping of soil ecosystem services (e.g. organic carbon storage, pH buffering capacity). Soil map quality is assessed considering positional and semantic quality, as well as geographic completeness. Descriptive statistics, decision tree classification and linear regression techniques are used to mine the soil profile databases. Geo-matching as well as class-matching approaches are considered when developing thematic maps. Variability in inherent as well as dynamic soil properties within the soil taxonomic units is highlighted. It is hypothesized that within-unit variation in soil properties highly affects the use and interpretation of thematic maps for ecosystem services mapping. Results will mainly be based on analyses done in Rwanda, but can be complemented with ongoing research results or prospects for Burundi.