20 CFR 638.514 - Residential support services.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Residential support services. 638.514 Section... support services. The center operator shall provide for residential support services structured as an... social environment, seven days a week, 24 hours a day, designed to enhance learning and personal...

20 CFR 638.514 - Residential support services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Residential support services. 638.514 Section... support services. The center operator shall provide for residential support services structured as an... social environment, seven days a week, 24 hours a day, designed to enhance learning and personal...

Surveying Community Nursing Support for Persons with an Intellectual Disability and Palliative Care Needs

ERIC Educational Resources Information Center

Bailey, Maria; Doody, Owen; Lyons, Rosemary

2016-01-01

Palliative care services have developed over the years to support all persons with life-limiting conditions. Moreover, services for people with an intellectual disability have moved from the traditional institutional setting to supporting people with an intellectual disability to live in their own community and family home. The expansion of…

Evaluation of the Self-Directed Personal Services Program Operated through Enable.

ERIC Educational Resources Information Center

Walker, Pam; And Others

This report evaluates a self-directed personal service (SDPS) program operated through the larger Enable Program for people with disabilities in Onondaga County, New York. First, it contrasts characteristics of traditional personal assistance services (such as low pay, agency-determined, limited types/levels of support, and program management…

Trafficking in persons and victim health in Australia.

PubMed

Schloenhardt, Andreas; Klug, Benjamin

2011-12-01

This article explores the health problems experienced by victims of trafficking in persons in Australia and analyses the domestic support schemes established to assist these victims. It focuses specifically on the health of adult, female victims who constitute the majority of identified victims, and who are the principal recipients of government support services. Domestic experiences and support schemes are reviewed in the light of international law and best practice guidelines. Recommendations are made to improve the health services available to victims of trafficking in persons in Australia.

Dementia service centres in Austria: A comprehensive support and early detection model for persons with dementia and their caregivers – theoretical foundations and model description

PubMed Central

Span, Edith; Reisberg, Barry

2015-01-01

Despite the highly developed social services in Austria, the County of Upper Austria, one of the nine counties of Austria had only very limited specialized services for persons with dementia and their caregivers in 2001. Support groups existed in which the desire for more specialized services was voiced. In response to this situation, funding was received to develop a new structure for early disease detection and long term support for both the person with dementia and their caregivers. This article describes the development of the model of the Dementia Service Centres (DSCs) and the successes and difficulties encountered in the process of implementing the model in six different rural regions of Upper Austria. The DSC was described in the First Austrian Dementia Report as one of the potential service models for the future. PMID:24339114

Dementia service centres in Austria: A comprehensive support and early detection model for persons with dementia and their caregivers - theoretical foundations and model description.

PubMed

Auer, Stefanie R; Span, Edith; Reisberg, Barry

2015-07-01

Despite the highly developed social services in Austria, the County of Upper Austria, one of the nine counties of Austria had only very limited specialized services for persons with dementia and their caregivers in 2001. Support groups existed in which the desire for more specialized services was voiced. In response to this situation, funding was received to develop a new structure for early disease detection and long term support for both the person with dementia and their caregivers. This article describes the development of the model of the Dementia Service Centres (DSCs) and the successes and difficulties encountered in the process of implementing the model in six different rural regions of Upper Austria. The DSC was described in the First Austrian Dementia Report as one of the potential service models for the future. © The Author(s) 2013.

Assessing Individual Support Needs to Enhance Personal Outcomes

ERIC Educational Resources Information Center

van Loon, Jos; Claes, Claudia; Vandevelde, Stijn; Van Hove, Geert; Schalock, Robert L.

2010-01-01

Education and human service organizations providing services to people with intellectual and closely related developmental disabilities are increasingly being impacted by the supports paradigm, the quality of life concept, and the evaluation of personal outcomes. In this article the authors discuss the relationship among these three areas,…

Quality of services and quality of life from service providers' perspectives: analysis with focus groups.

PubMed

Jenaro, C; Vega, V; Flores, N; Cruz, M

2013-06-01

Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this population. The current study aims to identify service providers' perceptions regarding the quality of life of their clients and the quality of services they provide. It also aims to identify similarities and differences of appraisals among professionals, and to identify associations between supports, quality of life and quality of services. Data were collected from 22 service providers who attended three focus groups (professionals, direct support staff, and managers) from whom 424 comments were analysed. Service providers were asked about the required support for users, the meaning of quality of life for those users, and about features that should characterise quality services. Thematic analysis was employed and transcripts of the sessions were coded according to the dimensions of models on supports, quality of life and quality of services. Chi-squared tests were utilised to test for potential differences among groups. Each professional group has its own priorities concerning required supports. Among the organisation different and potentially conflicting perceptions regarding the meaning of experiencing quality of life coexist. Concerning quality of services, only managers mentioned personal outcomes. Finally, institutionalisation has a negative impact on supports, quality of life and quality of services. It is necessary to move beyond a shared awareness of the negative impact of institutionalisation towards the transformation of services in search of personal quality outcomes. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

The significance of services in a psychiatric hospital for family members of persons with mental illness.

PubMed

Shor, Ron; Shalev, Anat

2015-03-01

Hospitalization of persons with mental illness may cause their family members to experience multiple stressors that stem from the hospitalization as well as from the duties of helping him or her. However, providing support services in psychiatric hospitals for family members has received only limited attention. To change this situation, mental health professionals in a psychiatric hospital in Israel developed an innovative family-centered practice model, the Family Members' Support and Consultation (FMSC) service center. We examined the significance to family members of the services they received from the FMSC service center in a study that included 20 caregivers. Ten participated in 2 focus groups of 5 participants each; 10 were interviewed personally. We implemented a thematic analysis to analyze the data. According to the participants, the staff of the FMSC service center provided support services that helped them cope with the stressors and difficulties they experienced within the context of the psychiatric hospital. The participants emphasized the significance of the immediacy and accessibility of support provided, as well as the positive effects of systemic interventions aimed at changing the relationships between family members and systems in the psychiatric hospital. Our findings show the importance of integrating a service that focuses on the needs of family members of persons with mental illness within a psychiatric hospital. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Supporting recovery by improving patient engagement in a forensic mental health hospital: results from a demonstration project.

PubMed

Livingston, James D; Nijdam-Jones, Alicia; Lapsley, Sara; Calderwood, Colleen; Brink, Johann

2013-01-01

Mental health services are shifting toward approaches that promote patients' choices and acknowledge the value of their lived experiences. To support patients' recovery and improve their experiences of care in a Canadian forensic mental health hospital, an intervention was launched to increase patient engagement by establishing a peer support program, strengthening a patient advisory committee, and creating a patient-led research team. The effect of the intervention on patient- and system-level outcomes was studied using a naturalistic, prospective, longitudinal approach. Quantitative and qualitative data were gathered from inpatients and service providers twice during the 19-month intervention. Despite succeeding in supporting patients' participation, the intervention had minimal impacts on internalized stigma, personal recovery, personal empowerment, service engagement, therapeutic milieu, and the recovery orientation of services. Peer support demonstrated positive effects on internalized stigma and personal recovery. Strengthening patient engagement contributes toward improving experiences of care in a forensic hospital, but it may have limited effects on outcomes.

Personalization of Rule-based Web Services.

PubMed

Choi, Okkyung; Han, Sang Yong

2008-04-04

Nowadays Web users have clearly expressed their wishes to receive personalized services directly. Personalization is the way to tailor services directly to the immediate requirements of the user. However, the current Web Services System does not provide any features supporting this such as consideration of personalization of services and intelligent matchmaking. In this research a flexible, personalized Rule-based Web Services System to address these problems and to enable efficient search, discovery and construction across general Web documents and Semantic Web documents in a Web Services System is proposed. This system utilizes matchmaking among service requesters', service providers' and users' preferences using a Rule-based Search Method, and subsequently ranks search results. A prototype of efficient Web Services search and construction for the suggested system is developed based on the current work.

Integrating Personalized and Community Services for Mobile Travel Planning and Management

NASA Astrophysics Data System (ADS)

Yu, Chien-Chih

Personalized and community services have been noted as keys to enhance and facilitate e-tourism as well as mobile applications. This paper aims at proposing an integrated service framework for combining personalized and community functions to support mobile travel planning and management. Major mobile tourism related planning and decision support functions specified include personalized profile management, information search and notification, evaluation and recommendation, do-it-yourself planning and design, community and collaboration management, auction and negotiation, transaction and payment, as well as trip tracking and quality control. A system implementation process with an example prototype is also presented for illustrating the feasibility and effectiveness of the proposed system framework, process model, and development methodology.

Telework for persons with disabilities in the E.U. and the U.S.A: what can we learn from each other?

PubMed

Schopp, Laura H

2004-01-01

Persons with disabilities represent a growing population in both the European Union (EU) and the United States (USA). The ability to work is a key component in achieving independence and full inclusion in society, and employability is increasingly seen as an important outcome variable for studies in health and disability. However, persons with disabilities face considerable challenges in returning to work due to barriers related to transportation, job changes after disability, lack of support services in the workplace, and related barriers. Telework, or work from a distance, may help to mitigate these obstacles, while expanding the range of work options available for persons with disabilities. The EU has made substantial policy progress to support telework, but persons with disabilities have had only limited long-term success in telework initiatives due to lack of work support services. The USA has generally strong support services but lacks telework policy infrastructure. The EU and the USA can benefit from collaborative work to enhance their complementary strengths.

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.

Supporting Diversity.

ERIC Educational Resources Information Center

Horton, Betty, Ed.; And Others

1996-01-01

This newsletter feature issue focuses on services for persons with developmental disabilities that support the whole person by acknowledging, respecting, and incorporating aspects of identity such as race, ethnicity, religion, sexual orientation, gender, age, and class. Articles include: (1) "Serving the Whole Person: The Journey to Embracing…

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

PubMed

Power, Andrew; Bartlett, Ruth; Hall, Edward

2016-06-01

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

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

PubMed

Shor, Ron; Birnbaum, Menachem

2012-08-01

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

The role of support person for Ngaanyatjarra women during pregnancy and birth.

PubMed

Simmonds, Donna M; West, Lalla; Porter, Julie; Davies, Melva; Holland, Carol; Preston-Thomas, Annie; O'Rourke, Peter K; Tangey, Annie

2012-06-01

This study took place in a remote community on the Ngaanyatjarra Lands, Western Australia. Ngaanyatjarra women's cultural practices have been subject to erosion during the past 70 years. Women are now expected to birth hundreds of kilometres from home and, due to financial barriers, without family support. Older women lament their lack of input into, and control of, contemporary birthing services. In order to provide culturally appropriate maternity services we asked: What issues would the Ngaanyatjarra women of the community like to see resolved in the area of antenatal and birthing services? Eligible participants were any Ngaanyatjarra women of the study community who had birthed at least once. We utilised a participatory research methodology. 36 women were interviewed. This paper discusses one finding related to support for child-bearing women. The role is important in many ways. Ngaanyatjarra women did not traditionally have their support persons with them during labour and birth, nor do they necessarily expect them to be present in current times. Most women do, however, wish to have a support person with them during antenatal checkups and when they travel to town to await birth. Aboriginal women from remote communities should be able to have a support person with them when they access regional birthing services, but the nature of this role must not be assumed. A culturally appropriate service has input from the community, provides options and respects choices. Copyright © 2011 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

20 CFR 222.42 - When employee is contributing to support.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false When employee is contributing to support. 222... employee is contributing to support. (a) An employee is contributing to the support of a person if the employee gives cash, goods, or services to help support such person. Support includes food, clothing...

The Architecture of Recovery: Two Kinds of Housing Assistance for Chronic Homeless Persons with Substance Use Disorders.

PubMed

Wittman, Friedner D; Polcin, Douglas L; Sheridan, Dave

2017-01-01

Roughly half a million persons in the United States are homeless on any given night and over a third of those individuals have significant alcohol/other drug (AOD) problems. Many are chronically homeless and in need of assistance for a variety of problems. However, the literature on housing services for this population has paid limited attention to comparative analyses contrasting different approaches. We examined the literature on housing models for homeless persons with AOD problems and critically analyzed how service settings and operations aligned with service goals. We found two predominant housing models that reflect different service goals: Sober Living Houses (SLHs) and Housing First (HF). SLHs are communally based living arrangements that draw on the principles of Alcoholics Anonymous. They emphasize a living environment that promotes abstinence and peer support for recovery. HF is based on the premise that many homeless persons with substance abuse problems will reject abstinence as a goal. Therefore, the HF focus is providing subsidized or free housing and optional professional services for substance abuse, psychiatric disorders and other problems. If homeless service providers are to develop comprehensive systems for homeless persons with AOD problems, they need to consider important contrasts in housing models, including definitions of "recovery," roles of peer support, facility management, roles for professional service, and the architectural designs that support the mission of each type of housing. This paper is the first to consider distinct consumer choices within homeless service systems and provide recommendations to improve each based upon an integrated analysis that considers how architecture and operations align with service goals.

Public Affairs & Strategic Communications (NGB-PA) - Personal Staff - Joint

Science.gov Websites

Guard ARNG Media ARNG Public Affairs Family Services Youth Programs Survivor Services Military Funeral General Officer Management Public Affairs Executive Support Services Legislative Liaison Special Staff : Personal Staff : Public Affairs Public Affairs & Strategic Communications (NGB-PA) Mission: Assess

Elder Abuse: Some Questions for Policymakers.

ERIC Educational Resources Information Center

Callahan, James J. Jr.

1988-01-01

Claims elder abuse is not clearly defined, affects relatively small numbers of older persons, is an under-funded area of social service and has weak political support. Recommends a broad-based service strategy for older persons. (Author/ABL)

Longitudinal associations between case management and supportive services use among black and Latina HIV-positive women in New York City.

PubMed

Halkitis, Perry N; Kupprat, Sandra A; Mukherjee, Preetika Pandey

2010-01-01

The literature analyzing the relationship between case management and supportive service use longitudinally among African American and Latina HIV-positive women is limited. This retrospective analysis of participant case management, supportive service, and medical charts sought to examine both descriptive and relational data on use of case management and supportive services over a 2-year period from 2002 to 2005 and to analyze moderating person- level or institution-level factors. The analyzed case management, supportive service, and medical charts revealed that participants interacted with their case manager four times and received 3.6 supportive services per month. Transportation, primary healthcare/medical specialists, and support groups were the services most used, with rates ranging from 70% to 80%. Using hierarchical linear modeling (HLM), the unconditional growth models showed that case management and supportive service use patterns remained constant over the 24-month period. Additionally, the multivariate unconditional model suggests a significant positive relationship between case management and supportive services. No moderation was indicated in the association between case management and supportive service use by person-level (e.g., mental illness, substance use) and institution-level (i.e., service delivery model) factors. Participants use supportive and case management services in a similar manner based on individual need. This synergistic relationship suggests that increases in either may result in retaining women in care. Implications for service delivery point to the need for skills building training for case managers, outreach workers, or system navigators to assist with short-term goals of establishing rapport and maintaining the client relationship, as this may lead to HIV-positive women accessing services. Additionally, outreach and engagement strategies need to be developed for those who typically underuse these services.

A tool to support meaningful person-centred activity for clients with dementia - a Delphi study.

PubMed

Lloyd, Barbara; Stirling, Christine

2015-01-01

This paper reports on a study to validate the concept of the 'Activity Support Tool' that aimed to assist dementia service workers to identify and act upon the support needs of people with dementia living alone, in line with the person-centred ideal. The tool was part of a two-stage exploratory qualitative study, which used interview and observational data from seven people with dementia living alone. Findings highlighted that people with dementia use objects and spaces within their homes to maintain or re-enact identities from the past. Thematic results from interviews were translated into a tool, with construct validation using the Delphi technique. Eighteen expert health professionals received round one of the questionnaire and six participants completed round three. The first round directed our focus towards operationalizing the person-centred ideal of dementia care. The tool was considered by almost all advisory panel members to be a potentially valuable resource for helping to address impediments to integrated, effective and person-centred dementia care. Specific strengths identified were simplicity, person-centeredness and applicability across service settings. Issues of concern included practicability, risk management, gender stereotyping and terminology. The results support the findings of previous research into the intuitive and ethical appeal, but problematic applicability, of person-centred dementia services. Health professionals with a range of service-related expertise found the concept of person-centred care compelling, but required tangible, enduring structures to translate the ideal into practical action. The tool now requires further research to test its usefulness in practice.

Maximizing Autonomy: Reforming Personal Support Laws in Sweden and the United States.

ERIC Educational Resources Information Center

Herr, Stanley S.

1995-01-01

Forms of guardianship for U.S. individuals with disabilities are reviewed, and Swedish legal and public policy innovations that replace guardianship with personal support services, such as mentors and personal assistants, are considered. The impact of Sweden's reforms on autonomy, independence, and integration is addressed. (Author/SW)

Participation and service access rights for people with intellectual disability: a role for law?

PubMed

Carney, Terry

2013-03-01

Supported decision-making and personal budgets for services are the new paradigms. Supported decision-making proposals from the Australian State of Victoria are analysed against international trends to determine the viability of laws reflecting new international norms of the United Nations Convention on the Rights of Persons with Disabilities 2006 (CRPD). The article concludes that it is desirable to pursue supported decision-making and allied legal reforms, but the contribution of the law is small and the new supported decision-making paradigms have similarities to old paternalist guardianship, as well as possible unintended consequences. It is suggested that realising the equality, support, protection, and socioeconomic service aspirations of the CRPD raise important practical challenges for governments, for service providers, for families, and-centrally-for people with intellectual disability (ID).This article examines the limited contribution law can make to this enterprise.

32 CFR 733.4 - Complaints of nonsupport and insufficient support of dependents.

Code of Federal Regulations, 2011 CFR

2011-07-01

... evidence may consist of— (i) U.S. Navy members. An affidavit of the service member, relative, disinterested... letters written by that spouse to the service member or other persons. However, affidavits of the service... the person with whom the spouse allegedly had sexual liaisons. Witness statements should ordinarily...

32 CFR 733.4 - Complaints of nonsupport and insufficient support of dependents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... evidence may consist of— (i) U.S. Navy members. An affidavit of the service member, relative, disinterested... letters written by that spouse to the service member or other persons. However, affidavits of the service... the person with whom the spouse allegedly had sexual liaisons. Witness statements should ordinarily...

Recovery in Scotland: Beyond service development

PubMed Central

2012-01-01

Over the last ten years there has been significant activity related to the promotion and support of recovery in Scotland, much of it linked to the work of the Scottish Recovery Network. A range of government policies have consistently identified recovery as a guiding principle of both service design and mental health improvement efforts. New learning has been developed and shared, workforce competencies reviewed and training developed, and a range of national initiatives put in place. In Scotland, as elsewhere, these efforts have tended to focus primarily on ensuring that mental health services offer environments and practices that support personal recovery. While service improvement is crucial, a wider challenge is ensuring that opportunities and support for self-directed recovery are enhanced outside statutory services. Providing examples, this paper will look at the development of recovery in Scotland – including the work of the Scottish Recovery Network – and consider the potential for building on progress made by rebalancing efforts to support personal recovery, highlighting the importance of public attitudes and community-based learning approaches. We will also touch on the role of identity in personal recovery and consider cultural issues related to the promotion of recovery in Scotland. PMID:22385428

24 CFR 585.3 - Program components.

Code of Federal Regulations, 2010 CFR

2010-04-01

... councils; (2) Counseling services to assist trainees in personal, health, housing, child care, family or legal problems and/or referral services to appropriate social service resources; (3) Support services...

Analysis model for personal eHealth solutions and services.

PubMed

Mykkänen, Juha; Tuomainen, Mika; Luukkonen, Irmeli; Itälä, Timo

2010-01-01

In this paper, we present a framework for analysing and assessing various features of personal wellbeing information management services and solutions such as personal health records and citizen-oriented eHealth services. The model is based on general functional and interoperability standards for personal health management applications and generic frameworks for different aspects of analysis. It has been developed and used in the MyWellbeing project in Finland to provide baseline for the research, development and comparison of many different personal wellbeing and health management solutions and to support the development of unified "Coper" concept for citizen empowerment.

The impact of services that offer individualised funds, shared management, person-centred relationships, and self-direction on the lived experiences of consumers with mental illness.

PubMed

Peterson, Sunila; Buchanan, Angus; Falkmer, Torbjorn

2014-01-01

Mental health service providers across Australia, including Western Australia (WA), have begun to offer individualised funds, shared management, person-centred and self-directed (SPS) services. No research exists on the impact of SPS services on the lived experiences of these particular consumers. This study explored the impact of a SPS service offered for the first time in WA to consumers with mental illness. Data on sixteen consumers' lived experiences were analysed using an abbreviated grounded theory approach. These data had been developed by the consumers, Guides (staff) and an independent evaluator, and most of it had been collected in the past prior to the commencement of the study. Three over-arching categories, and related subcategories, emerged indicating that 1) access to individualised funds enabled practical and psychological benefits to consumers; 2) consistent contact in shared management and person-centred relationships enhanced the provision of timely and meaningful staff support to consumers; and 3) high quality shared management and person-centred relationships with staff and the opportunity to self-direct enabled consumers' change and growth. SPS services enhanced consumers' lived experiences and enabled staff to provide and consumers to experience timely access to recovery resources, consistent contact, responsive and high quality support, and self-direction of services. In this, consumers changed, grew and achieved desired recovery experiences. The overall impact of the SPS service seemed to be founded on the goodness of fit between person characteristics of staff and consumers, which enabled rich support that provided for corrective emotional experiences. This enabled consumers to build meaningful and hopeful lives where they started to live with, and beyond, their mental illness.

Personalized Location-Based Recommendation Services for Tour Planning in Mobile Tourism Applications

NASA Astrophysics Data System (ADS)

Yu, Chien-Chih; Chang, Hsiao-Ping

Travel and tour planning is a process of searching, selecting, grouping and sequencing destination related products and services including attractions, accommodations, restaurants, and activities. Personalized recommendation services aim at suggesting products and services to meet users’ preferences and needs, while location-based services focus on providing information based on users’ current positions. Due to the fast growing of user needs in the mobile tourism domain, how to provide personalized location-based tour recommendation services becomes a critical research and practical issue. The objective of this paper is to propose a system architecture and design methods for facilitating the delivery of location-based recommendation services to support personalized tour planning. Based on tourists’ current location and time, as well as personal preferences and needs, various recommendations regarding sightseeing spots, hotels, restaurants, and packaged tour plans can be generated efficiently. An application prototype is also implemented to illustrate and test the system feasibility and effectiveness.

Identifying User Needs and the Participative Design Process

NASA Astrophysics Data System (ADS)

Meiland, Franka; Dröes, Rose-Marie; Sävenstedt, Stefan; Bergvall-Kåreborn, Birgitta; Andersson, Anna-Lena

As the number of persons with dementia increases and also the demands on care and support at home, additional solutions to support persons with dementia are needed. The COGKNOW project aims to develop an integrated, user-driven cognitive prosthetic device to help persons with dementia. The project focuses on support in the areas of memory, social contact, daily living activities and feelings of safety. The design process is user-participatory and consists of iterative cycles at three test sites across Europe. In the first cycle persons with dementia and their carers (n = 17) actively participated in the developmental process. Based on their priorities of needs and solutions, on their disabilities and after discussion between the team, a top four list of Information and Communication Technology (ICT) solutions was made and now serves as the basis for development: in the area of remembering - day and time orientation support, find mobile service and reminding service, in the area of social contact - telephone support by picture dialling, in the area of daily activities - media control support through a music playback and radio function, and finally, in the area of safety - a warning service to indicate when the front door is open and an emergency contact service to enhance feelings of safety. The results of this first project phase show that, in general, the people with mild dementia as well as their carers were able to express and prioritize their (unmet) needs, and the kind of technological assistance they preferred in the selected areas. In next phases it will be tested if the user-participatory design and multidisciplinary approach employed in the COGKNOW project result in a user-friendly, useful device that positively impacts the autonomy and quality of life of persons with dementia and their carers.

The Changing Environment of Personal Information Systems.

ERIC Educational Resources Information Center

Burton, Hilary D.

1985-01-01

Discusses technological developments causing changes in personal information systems: increase in commercial support services; proliferation of microcomputers; capability to download from secondary services into private files; and developing desire to utilize functions such as electronic mail and automated office functions. Appendices list 21…

Recovery-Oriented Services--The Role of Training in Transformation

ERIC Educational Resources Information Center

Nowak, Izabela; Switaj, Piotr; Anczewska, Marta

2015-01-01

Recovery oriented practice/service provision is how workers and services support people in their recovery journey. There are four identified practice domains: promoting citizenship, organizational commitment, supporting personally defined recovery, and working relationship. Professionals might be helpful if they are willing to be open, respectful…

24 CFR 964.308 - Supportive services requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... member to receive available services or to commute to his or her place of employment; (g) Personal... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Supportive services requirements... DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND...

24 CFR 964.308 - Supportive services requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... member to receive available services or to commute to his or her place of employment; (g) Personal... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Supportive services requirements... DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND...

24 CFR 964.308 - Supportive services requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... member to receive available services or to commute to his or her place of employment; (g) Personal... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Supportive services requirements... DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND...

24 CFR 964.308 - Supportive services requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... member to receive available services or to commute to his or her place of employment; (g) Personal... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Supportive services requirements... DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND...

Un/Paid Labor: Medicaid Home and Community Based Services Waivers That Pay Family as Personal Care Providers.

PubMed

Friedman, Carli; Rizzolo, Mary C

2016-08-01

The United States long-term services and supports system is built on largely unpaid (informal) labor. There are a number of benefits to allowing family caregivers to serve as paid personal care providers including better health and satisfaction outcomes, expanded workforces, and cost effectiveness. The purpose of this study was to examine how Medicaid HCBS Section 1915(c) waivers for people with intellectual and developmental disabilities allocate personal care services to pay family caregivers. Our analysis revealed about two thirds of waivers in fiscal year (FY) 2014 allowed for family caregivers to potentially be paid for personal care services. This amounted to up to $2.71 billion of projected spending, which is slightly more than half of all personal care service expenditures in FY 2014.

Ethnic minority, young onset, rare dementia type, depression: A case study of a Muslim male accessing UK dementia health and social care services.

PubMed

Regan, Jemma L

2016-07-01

A case study comprised of formal interviews, formal observations and informal discussions investigated the motivations and experiences accessing dementia care health and social care services for a Muslim, Pakistani male with dementia. Motivations derived from 'desperation' and an inability to access support from family or religious community. Experiences of accessing services were mostly negative. Dementia services were ill-informed about how to support persons with young onset dementia, with pre-existing mental health conditions, from an ethnic minority. Education and training to remove barriers to all dementia care services is required for persons with dementia, their families and within dementia services and religious communities. © The Author(s) 2014.

Predictors of Undergraduate Students' University Support Service Use during the First Year of University

ERIC Educational Resources Information Center

Julal, F. S.

2016-01-01

University support services can be a beneficial resource for students coping with personal stressors. This study investigated the predictors of service use by undergraduate students during their first year at university. Participants completed self-report measures of problem-solving effectiveness, psychological distress and perceived social…

Longitudinal Job Satisfaction of Persons in Supported Employment.

ERIC Educational Resources Information Center

Test, David W.; Carver, Tonya; Ewers, Lisa; Haddad, Jennifer; Person, Julie

2000-01-01

This longitudinal study examined satisfaction with supported employment jobs and services with 32 disabled individuals receiving services between 1992 and 1997. Analysis of interview data indicates participants were consistently satisfied with both their chosen supported employment jobs (including the work, friendships made, and money earned) and…

The Role of Faith-Based Organizations in the Education, Support, and Services for Persons Living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome.

PubMed

Stephens, Teresa M

2018-03-01

Faith-based organizations are in a unique position to provide resilience-enhancing efforts for persons living with human immunodeficiency virus/AIDS. Many persons living with human immunodeficiency virus/AIDS report having a strong faith or religious affiliation, with a large percentage attending church services on a regular basis. Faith-based organizations can use these factors to reach out to these individuals and effectively promote health, well-being, education, and support. Faith-based organizations can contribute to the reduction of stigma and isolation for persons living with human immunodeficiency virus/AIDS. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Personality Diagnosis for Personalized eHealth Services

NASA Astrophysics Data System (ADS)

Cortellese, Fabio; Nalin, Marco; Morandi, Angelica; Sanna, Alberto; Grasso, Floriana

In this paper we present two different approaches to personality diagnosis, for the provision of innovative personalized services, as used in a case study where diabetic patients were supported in the improvement of physical activity in their daily life. The first approach presented relies on a static clustering of the population, with a specific motivation strategy designed for each cluster. The second approach relies on a dynamic population clustering, making use of recommendation systems and algorithms, like Collaborative Filtering. We discuss pro and cons of each approach and a possible combination of the two, as the most promising solution for this and other personalization services in eHealth.

Personal Assistant Support for Students with Severe Physical Disabilities in Postsecondary Education

ERIC Educational Resources Information Center

Hedrick, Bradley N.; Stumbo, Norma J.; Martin, Jay K.; Martin, Liam G.; Nordstrom, David L.; Morrill, Joshua H.

2012-01-01

The purpose of this exploratory research is to document the level of personal assistance support provided to students with severe physical disabilities by disability support services in higher education institutions across the United States. A national survey was conducted of members of the Association of Higher Education And Disability (AHEAD)…

Support needs and experiences of family members of wounded, injured or sick UK service personnel.

PubMed

Verey, Anna; Keeling, M; Thandi, G; Stevelink, S; Fear, N

2017-12-01

When a service person has been wounded, injured or sick (WIS), family members may provide care during their recovery in an unpaid capacity. This may occur in diverse environments including hospitals, inpatient rehabilitation centres, in the community and at home. Thirty-seven family members of WIS personnel were interviewed regarding their support needs, family relationships and use of UK support services. Semistructured, in-depth telephone interviews were used, with data analysis undertaken using a thematic approach. 'Family member involvement' was the main theme under which four subthemes were situated: 'continuity of support', 'proactive signposting and initiating contact', 'psychoeducation and counselling' and 'higher risk groups'. Family members felt they might benefit from direct, consistent and continuous care regardless of the WIS person's injury or engagement type, and whether the WIS person was being treated in a hospital, rehabilitative centre or at home. The findings of this study suggest that family members of WIS personnel value proactive, direct and sustained communication from support service providers. We suggest that families of UK service personnel may benefit from family care coordinators, who could provide continuous and consistent care to family members of WIS personnel. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Allowing Spouses to Be Paid Personal Care Providers: Spouse Availability and Effects on Medicaid-Funded Service Use and Expenditures

ERIC Educational Resources Information Center

Newcomer, Robert J.; Kang, Taewoon; Doty, Pamela

2012-01-01

Purpose of the Study: Medicaid service use and expenditure and quality of care outcomes in California's personal care program known as In-Home Supportive Service (IHSS) are described. Analyses investigated Medicaid expenditures, hospital use, and nursing home stays, comparing recipients who have paid spouse caregivers with those having other…

The current state of personal assistance services: implications for policy and future research.

PubMed

Hagglund, Kristofer J; Clark, Mary J; Mokelke, Emily K; Stout, Brian J

2004-01-01

Personal assistant services (PAS) are designed to support persons with disabilities in their routine performance of activities of daily living (ADLs) and to provide individuals with disability the opportunity to go to school, volunteer, obtain active employment, and participate in social and recreational activities. PAS are primary and essential to the realization of societal inclusion and personal freedom among persons with severe, disabling conditions. This paper reviews the personal assistance literature for persons with spinal cord injury and other disabilities. Evidence-based recommendations are made for PAS policy initiatives and future directions in PAS research.

An exploration of person-centred concepts in human services: A thematic analysis of the literature.

PubMed

Waters, Rebecca A; Buchanan, Angus

2017-10-01

Being 'person-centred' in the delivery of health and human services has become synonymous with quality care, and it is a core feature of policy reform in Australia and other Western countries. This research aimed to identify the uses, definitions and characteristics of the term 'person-centred' in the ageing, mental health and disability literature. A thematic analysis identified seven common core themes of person-centredness: honouring the person, being in relationship, facilitating participation and engagement, social inclusion/citizenship, experiencing compassionate love, being strengths/capacity focussed, and organisational characteristics. These suggest a set of higher-order experiences for people that are translated differently in different human services. There is no common definition of what it means to be person-centred, despite being a core feature of contemporary health and human service policy, and this suggests that its inclusion facilitates further misunderstanding and misinterpretation. A common understanding and policy conceptualisation of person-centredness is likely to support quality outcomes in service delivery especially where organisations work across human service groups. Further research into the application and service expressions of being 'person-centred' in context is necessary. Copyright © 2017 Elsevier B.V. All rights reserved.

Student Support Services and Student Satisfaction in Online Education

ERIC Educational Resources Information Center

Erdil, Kutlay M.

2007-01-01

This paper investigates the relationship between quality of support services in online education and the level of satisfaction of e-learners with these services. Case study was employed to measure University of Surrey's virtual MBA students' satisfaction with course facilitator, personal tutor and help desk functions designed for online education.…

An exploration of factors associated with older persons' perceptions of the benefits of and satisfaction with a preventive home visit service.

PubMed

Tøien, Mette; Bjørk, Ida Torunn; Fagerström, Lisbeth

2017-12-18

Preventive home visits (PHVs) are healthcare services aimed at promoting the health of home-dwelling older people and to support their abilities to live independently. To enhance effectiveness, studies that explore older persons' experiences of PHVs are needed. To assess older persons' perceived benefits and opinions of a PHV service and explore associations between perceived benefits from PHV and relevant sociodemographic/health-related factors. The study was based on a comprehensive understanding of health, as including objective health/disease, subjective health/well-being and coping ability. A cross-sectional survey was administered during spring 2013 in a Norwegian municipality where nurses had offered annual PHVs to residents aged 75 years and older since 1999. We invited a stratified random sample of 393 PHV users to participate; of these, 161 volunteered. The main outcome variables in the questionnaire were perceived benefits from PHV. Logistic regression models were used to analyse the associations between each benefit and sociodemographic/health-related background variables. Approximately 39% of the respondents reported that PHVs added to their feelings of safety; 66% reported support for ability to live at home; 72% reported support for having a good life, 83% were satisfied with the service, and 90% stated that PHVs are important for older people. Each benefit was associated with different sociodemographic/health-related factors. Support for feelings of safety increased with age. More support for living at home was associated with poor physical health and not living alone. Those without children perceived more support for a good life. Satisfaction with PHV increased with increasing scores on the Life Orientation Scale. Persons with poor mental health and those not living alone more often perceived PHV as important. Annual, comprehensive PHVs to a general older population may support older persons' health and independence. Low response rate restricts the possibility to generalise the results. © 2017 Nordic College of Caring Science.

Person-Environment Congruence as a Predictor of Customer Service Performance.

ERIC Educational Resources Information Center

Fritzsche, Barbara A.; Powell, Amy B.; Hoffman, Russell

1999-01-01

Customer service representatives (n=90) completed the Position Classification Inventory (PCI), Self-Directed Search, and a cognitive ability test. PCI was similar to the Dictionary of Holland Occupational Codes in predicting performance. Cognitive ability was not significantly correlated with performance. Person/environment fit was supported as a…

Personal Assistance Services (PAS): Toward Universal Access to Support. Annotated Bibliography.

ERIC Educational Resources Information Center

Racino, Julie Ann

This annotated bibliography provides approximately 100 summaries and evaluations of documents, published from 1979 to 1995, on personal assistance services (PAS) for individuals with disabilities. Studies and articles were selected for inclusion based upon their capacity to inform the development of PAS models, including conceptual, policy, and…

Social Workers in Home Care: The Israeli Case

ERIC Educational Resources Information Center

Ayalon, Liat; Baum, Nehami

2010-01-01

In Israel, the government partially supports personal home care services (grooming, feeding, assistance with transfers) as a means to maintain frail individuals in their home environment for as long as possible. Social workers capture a prominent position in these arrangements as initiators and supervisors of personal home care services. This…

Characteristics of Transgender Women Living with HIV Receiving Medical Care in the United States.

PubMed

Mizuno, Yuko; Frazier, Emma L; Huang, Ping; Skarbinski, Jacek

2015-09-01

Little has been reported from population-based surveys on the characteristics of transgender persons living with HIV. Using Medical Monitoring Project (MMP) data, we describe the characteristics of HIV-infected transgender women and examine their care and treatment needs. We used combined data from the 2009 to 2011 cycles of MMP, an HIV surveillance system designed to produce nationally representative estimates of the characteristics of HIV-infected adults receiving medical care in the United States, to compare demographic, behavioral, and clinical characteristics, and met and unmet needs for supportive services of transgender women with those of non-transgender persons using Rao-Scott chi-square tests. An estimated 1.3% of HIV-infected persons receiving care in the United States self-identified as transgender women. Transgender women were socioeconomically more marginalized than non-transgender men and women. We found no differences between transgender women and non-transgender men and women in the percentages prescribed antiretroviral therapy (ART). However, a significantly lower percentage of transgender women compared to non-transgender men had 100% ART dose adherence (78.4% vs. 87.4%) and durable viral suppression (50.8% vs. 61.4%). Higher percentages of transgender women needed supportive services. No differences were observed in receipt of most of supportive services, but transgender women had higher unmet needs than non-transgender men for basic services such as food and housing. We found little difference between transgender women and non-transgender persons in regards to receipt of care, treatment, and most of supportive services. However, the noted disparities in durable viral suppression and unmet needs for basic services should be explored further.

Reference architecture of application services for personal wellbeing information management.

PubMed

Tuomainen, Mika; Mykkänen, Juha

2011-01-01

Personal information management has been proposed as an important enabler for individual empowerment concerning citizens' wellbeing and health information. In the MyWellbeing project in Finland, a strictly citizen-driven concept of "Coper" and related architectural and functional guidelines have been specified. We present a reference architecture and a set of identified application services to support personal wellbeing information management. In addition, the related standards and developments are discussed.

Public support for safe consumption sites and syringe services programs to combat the opioid epidemic.

PubMed

McGinty, Emma E; Barry, Colleen L; Stone, Elizabeth M; Niederdeppe, Jeff; Kennedy-Hendricks, Alene; Linden, Sarah; Sherman, Susan G

2018-06-01

We examine Americans' support for two evidence-based harm reduction strategies - safe consumption sites and syringe exchange programs - and their attitudes about individuals who use opioids. We conducted a web-based survey of a nationally representative sample of U.S. adults in July-August 2017 (N = 1004). We measured respondents' support for legalizing safe consumption sites and syringe services programs in their communities and their attitudes toward people who use opioids. We used ordered logistic regression to assess how stigmatizing attitudes toward people who use opioids, political party identification, and demographic characteristics correlated with support for the two harm reduction strategies. Twenty-nine percent of Americans supported legalizing safe consumption sites and 39% supported legalizing syringe services programs. Respondents reported high levels of stigmatizing attitudes toward people who use opioids: 16% of respondents were willing to have a person using opioids marry into their family and 28% were willing to have a person using opioids start working closely with them on a job, and 27% and 10% of respondents rated persons who use opioids as deserving (versus worthless) and strong (versus weak). Stigmatizing attitudes were associated with lower support for legalizing safe consumption sites and syringe services programs. Democrats and Independents were more likely than Republicans to support both strategies. Stigmatizing attitudes toward people who use opioids are a key modifiable barrier to garnering the public support needed to fully implement evidence-based harm reduction strategies to combat the opioid epidemic. Dissemination and evaluation of stigma reduction campaigns are a public health priority. Copyright © 2018 Elsevier Inc. All rights reserved.

Security and privacy issues of personal health.

PubMed

Blobel, Bernd; Pharow, Peter

2007-01-01

While health systems in developed countries and increasingly also in developing countries are moving from organisation-centred to person-centred health service delivery, the supporting communication and information technology is faced with new risks regarding security and privacy of stakeholders involved. The comprehensively distributed environment puts special burden on guaranteeing communication security services, but even more on guaranteeing application security services dealing with privilege management, access control and audit regarding social implication and connected sensitivity of personal information recorded, processed, communicated and stored in an even internationally distributed environment.

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.

"HausTeleDienst"--a CATV-based interactive video service for elderly people.

PubMed

Stroetmann, K A; Erkert, T

1999-01-01

Since 1991, 17 elderly persons (aged 75 to over 90) in 15 households have been connected via TV-videophones to a service centre. A standard CATV network was modified to support a reverse channel. This has been world-wide the first fully interactive broadband video communications project implemented in a real setting and operating over an extended period of time. The overall aim has been to prove the ability of frail elderly and mobility-impaired persons to live independently, and to demonstrate strategies for reducing the load on social and health care service resources. Service components include remote care; information and assistance; emergency, counselling, training and exercise services. Practical experience, both from the side of the service provider and that of the users, is discussed. Simplicity of technical design and ease of handling contributed to a feeling of being empowered by the technology. In addition, the very personal and close relationship to the staff--which was strongly supported, not inhibited by the video communications--was a major factor in acceptance of the service. It proved a highly successful activity with a great potential for the future: In different contexts with newer technology, market trials are underway to commercialize this service.

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

PubMed

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

2015-01-01

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

Unmet needs for healthcare and social support services in patients with Huntington's disease: a cross-sectional population-based study.

PubMed

van Walsem, Marleen R; Howe, Emilie I; Iversen, Kristin; Frich, Jan C; Andelic, Nada

2015-09-28

In order to plan and improve provision of comprehensive care in Huntington's disease (HD), it is critical to understand the gaps in healthcare and social support services provided to HD patients. Research has described utilization of healthcare services in HD in Europe, however, studies systematically examining needs for healthcare services and social support are lacking. This study aims to identify the level and type of met and unmet needs for health and social care services among patients with HD, and explore associated clinical and socio-demographic factors. Eighty-six patients with a clinical diagnosis of HD living in the South-Eastern region of Norway were recruited. Socio-demographic and clinical characteristics were collected. The Needs and Provision Complexity Scale (NPCS) was used to assess the patients' needs for healthcare and social services. Functional ability and disease stage was assessed using the UHDRS Functional assessment scales. In order to investigate factors determining the level of total unmet needs and the level of unmet needs for Health and personal care and Social care and support services, multivariate logistic regression models were used. A high level of unmet needs for health and personal care and social support services were found across all five disease stages, but most marked in disease stage III. The middle phase (disease stage III) and advanced phase (disease stages IV and V) of HD increased odds of having a high level of total unmet needs by 3.5 times and 1.4 times respectively, compared with the early phase (disease stages I and II). Similar results were found for level of unmet needs in the domain Health and personal care. Higher education tended to decrease odds of high level of unmet needs in this domain (OR = 0.48) and increase odds of higher level of unmet needs in the domain of Social care and support (OR = 1.3). Patients reporting needs on their own tended to decrease odds of having unmet needs in Health and personal care (OR = 0.57). Needs for healthcare and social services in patients with HD should be assessed in a systematic manner, in order to provide adequate comprehensive care during the course of disease.

A Flexible Response: Person-Centred Support and Social Inclusion for People with Learning Disabilities and Challenging Behaviour

ERIC Educational Resources Information Center

Carnaby, Steven; Roberts, Bron; Lang, Janet; Nielsen, Prue

2011-01-01

Social inclusion and citizenship form the key objective of "Valuing People Now" (2009), but achieving this meaningfully with people whose behaviour can challenge services remains elusive for many services. This article describes the philosophy, development, operationalisation and evaluation of a person-centred day opportunities and supported…

Decision Support for Personalized Cloud Service Selection through Multi-Attribute Trustworthiness Evaluation

PubMed Central

Ding, Shuai; Xia, Chen-Yi; Zhou, Kai-Le; Yang, Shan-Lin; Shang, Jennifer S.

2014-01-01

Facing a customer market with rising demands for cloud service dependability and security, trustworthiness evaluation techniques are becoming essential to cloud service selection. But these methods are out of the reach to most customers as they require considerable expertise. Additionally, since the cloud service evaluation is often a costly and time-consuming process, it is not practical to measure trustworthy attributes of all candidates for each customer. Many existing models cannot easily deal with cloud services which have very few historical records. In this paper, we propose a novel service selection approach in which the missing value prediction and the multi-attribute trustworthiness evaluation are commonly taken into account. By simply collecting limited historical records, the current approach is able to support the personalized trustworthy service selection. The experimental results also show that our approach performs much better than other competing ones with respect to the customer preference and expectation in trustworthiness assessment. PMID:24972237

Decision support for personalized cloud service selection through multi-attribute trustworthiness evaluation.

PubMed

Ding, Shuai; Xia, Cheng-Yi; Xia, Chen-Yi; Zhou, Kai-Le; Yang, Shan-Lin; Shang, Jennifer S

2014-01-01

Facing a customer market with rising demands for cloud service dependability and security, trustworthiness evaluation techniques are becoming essential to cloud service selection. But these methods are out of the reach to most customers as they require considerable expertise. Additionally, since the cloud service evaluation is often a costly and time-consuming process, it is not practical to measure trustworthy attributes of all candidates for each customer. Many existing models cannot easily deal with cloud services which have very few historical records. In this paper, we propose a novel service selection approach in which the missing value prediction and the multi-attribute trustworthiness evaluation are commonly taken into account. By simply collecting limited historical records, the current approach is able to support the personalized trustworthy service selection. The experimental results also show that our approach performs much better than other competing ones with respect to the customer preference and expectation in trustworthiness assessment.

A New Life-Style for Persons with Severe Disabilities: Supported Independence.

ERIC Educational Resources Information Center

Marlett, N. J.; MacLean, H.

The paper presents a model which has provided extensive or partial services for 147 persons with severe and complex disabilities. The model, "Supported Independence Using Individualized Dollars" (dollars allocated to a specific client), emerged when the Calgary Association for Independent Living, a small self-help group of disabled…

34 CFR 376.30 - What priorities are considered for support by the Secretary under this part?

Code of Federal Regulations, 2012 CFR

2012-07-01

... demonstrate effective Statewide approaches to transitional rehabilitation service delivery for youths with... illness, mental retardation, and learning disability. (d) Transitional rehabilitation services for institutionalized persons. This priority supports projects that demonstrate effective ways to assist youths and...

34 CFR 376.30 - What priorities are considered for support by the Secretary under this part?

Code of Federal Regulations, 2011 CFR

2011-07-01

... demonstrate effective Statewide approaches to transitional rehabilitation service delivery for youths with... illness, mental retardation, and learning disability. (d) Transitional rehabilitation services for institutionalized persons. This priority supports projects that demonstrate effective ways to assist youths and...

34 CFR 376.30 - What priorities are considered for support by the Secretary under this part?

Code of Federal Regulations, 2014 CFR

2014-07-01

... demonstrate effective Statewide approaches to transitional rehabilitation service delivery for youths with... illness, mental retardation, and learning disability. (d) Transitional rehabilitation services for institutionalized persons. This priority supports projects that demonstrate effective ways to assist youths and...

34 CFR 376.30 - What priorities are considered for support by the Secretary under this part?

Code of Federal Regulations, 2013 CFR

2013-07-01

... demonstrate effective Statewide approaches to transitional rehabilitation service delivery for youths with... illness, mental retardation, and learning disability. (d) Transitional rehabilitation services for institutionalized persons. This priority supports projects that demonstrate effective ways to assist youths and...

Childhood emotional support and borderline personality features in a sample of Canadian psychiatric outpatients.

PubMed

Kealy, David; Sierra-Hernandez, Carlos A; Ogrodniczuk, John S

2016-08-01

Despite links between early relational experiences and psychopathology, data regarding childhood emotional neglect among Canadian mental health services users are scarce. To explore the absence of emotional support experiences reported by Canadian psychiatric outpatients, and to examine the relationship between childhood emotional support and borderline personality disorder (BPD) features. A survey regarding childhood emotional support was completed by consecutively admitted adult outpatients, along with self-report assessments of symptom distress and BPD features. A substantial proportion of outpatients reported absent emotional support experiences. After controlling for the effects of age and symptom distress, childhood emotional support was found to be significantly negatively associated with BPD features. The findings add further support to the need for clinical attention to the early relational experiences of mental health service users. © The Author(s) 2016.

Providing Informal Care in Terminal Illness: An Analysis of Preferences for Support Using a Discrete Choice Experiment.

PubMed

Hall, Jane; Kenny, Patricia; Hossain, Ishrat; Street, Deborah J; Knox, Stephanie A

2014-08-01

The trend for terminally ill patients to receive much of their end-of-life care at home necessitates the design of services to facilitate this. Care at home also requires that informal care be provided by family members and friends. This study investigated informal carers' preferences for support services to aid the development of end-of-life health care services. This cross-sectional study used 2 discrete choice experiments to ascertain the preferences of carers supporting patients with different levels of care need, determined by the assistance needed with personal care and labeled High Care (HC) and Low Care (LC). The sample included 168 informal carers of people receiving palliative care at home from 2 palliative care services in Sydney, Australia. Data were collected in face-to-face interviews; carers chose between 2 hypothetical plans of support services and their current services. Data were analyzed with generalized multinomial logit models that were used to calculate the impact of each attribute on the probability of a carer choosing a service plan. Preferred support included nursing services; the probability of choosing a plan increased significantly if it included nurse home visits and phone advice (P < 0.001). HC carers also wanted doctor home visits, home respite, and help with personal care (P < 0.05), and LC carers wanted help with household tasks, transport, and a case coordinator (P < 0.001). On average, both groups of carers preferred their current services, but this varied with characteristics of the carer and the caregiving situation. The most valued services are those that support carers in their caregiving role; however, supportive care preferences vary with the different circumstances of patients and carers. © The Author(s) 2013.

Trust-based information system architecture for personal wellness.

PubMed

Ruotsalainen, Pekka; Nykänen, Pirkko; Seppälä, Antto; Blobel, Bernd

2014-01-01

Modern eHealth, ubiquitous health and personal wellness systems take place in an unsecure and ubiquitous information space where no predefined trust occurs. This paper presents novel information model and an architecture for trust based privacy management of personal health and wellness information in ubiquitous environment. The architecture enables a person to calculate a dynamic and context-aware trust value for each service provider, and using it to design personal privacy policies for trustworthy use of health and wellness services. For trust calculation a novel set of measurable context-aware and health information-sensitive attributes is developed. The architecture enables a person to manage his or her privacy in ubiquitous environment by formulating context-aware and service provider specific policies. Focus groups and information modelling was used for developing a wellness information model. System analysis method based on sequential steps that enable to combine results of analysis of privacy and trust concerns and the selection of trust and privacy services was used for development of the information system architecture. Its services (e.g. trust calculation, decision support, policy management and policy binding services) and developed attributes enable a person to define situation-aware policies that regulate the way his or her wellness and health information is processed.

"Putting Music On": Everyday Leisure Activities, Choice-Making and Person-Centred Planning in a Supported Living Scheme

ERIC Educational Resources Information Center

Hassan, Nedim

2017-01-01

Background: Person-centred planning, which commonly becomes formalised within services for people with learning disabilities through an Essential Lifestyle Plan (ELP), was intended to help place the choices of individuals at the forefront of service provision. However, beyond UK government policy rhetoric, scholars have raised issues regarding the…

Utilizing Medicaid Dollars To Finance Services to Illinois Citizens with Developmental Disabilities. A Technical Assistance Report.

ERIC Educational Resources Information Center

Gettings, Robert M.

This report examines possible steps the State of Illinois might take to expand the availability of Medicaid support for services to persons with developmental disabilties. Stressed throughout are the importance of: (1) evaluating whether any given application of Medicaid funding is consistent with the State's goals for persons with developmental…

Competing Goodness: Perceptions of Person-Centered Culture Change within Human Service Agencies

ERIC Educational Resources Information Center

Starling, Stacey Lee

2012-01-01

Front and center in the endeavor to "reform" health care is the appeal to change the culture of aging within provider organizations situated in the long-term care continuum. Person-centeredness is the latest philosophical overlay to aging care and supports and services. As a dominate paradigm guiding change, the movement intends to shift…

Differences in Professional and Informal Help Seeking among Older African Americans, Black Caribbeans and Non-Hispanic Whites

PubMed Central

Woodward, Amanda T.; Chatters, Linda M.; Taylor, Robert Joseph; Neighbors, Harold W.; Jackson, James S.

2011-01-01

This study uses a national probability sample of older adults to examine racial and ethnic differences in the use of professional services and informal support for a stressful personal problem. Using data from the National Survey of American Life, this study focuses on African Americans, Black Caribbean immigrants, and Whites aged 55 years and older who experienced a personal problem that caused them significant distress (n=862). Multinomial logistic regression is used to estimate the association of race with the use of professional services only, informal support only, both professional services and informal support, or no help at all, while controlling for demographic and socioeconomic variables, characteristics of the informal support network, the type of problem experienced, and experiences of racial discrimination. Examining the use of professional services and informal support provides a more complete picture of racial and ethnic differences of help-seeking behaviors among older adults, and the factors associated with the sources from which these adults request help. Most respondents use informal support alone or in combination with professional services. Black Caribbeans are more likely than African Americans to rely on informal support only, whereas African Americans are more likely than Whites to not receive help. However, these findings are accounted for by differences in social support and experiences of discrimination. PMID:21666782

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

ERIC Educational Resources Information Center

Power, Andrew; Bartlett, Ruth; Hall, Edward

2016-01-01

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

From Framework to Practice: Person-Directed Planning in the Real World

ERIC Educational Resources Information Center

Martin, Lynn; Grandia, Philip; Ouellette-Kuntz, Hélène; Cobigo, Virginie

2016-01-01

Background: Person-directed planning (PDP) is an approach to planning supports that aims to redistribute power from the service system to individuals with intellectual and developmental disabilities (IDD) and natural supports, improve relationships and build community. To do this, the right people with the right attitudes engaging in the right…

Reflections on Change: Supporting People with Learning Disabilities in Residential Services

ERIC Educational Resources Information Center

Salmon, Rebecca; Holmes, Nan; Dodd, Karen

2014-01-01

This study describes research that was designed to explore the reflections and perspectives of staff who had experienced the change from institutional care to person-centred care and learn what factors had supported the change to, and continued adoption of, person-centred care. In-depth, semistructured interviews were conducted with seven…

Customer Satisfaction with Air Force Civil Engineering Support

DTIC Science & Technology

1988-09-01

Regulation aS-l states, "No other base organization directly affects the living environment of every person on base as does the BCE (Base Civil Engineering...accounting, engineering, and legal firms; personal services such as housekeeping, barbering, and recreational services; and most of the nonprofit areas of...a single package via Lear jet to keep a promise to a customer" (Lele, 1987: 45). Frito Lay maintains a 10,000 person sales force in what is a

Assessing interventions available to internally displaced persons in Abia state, Nigeria.

PubMed

Enwereji, Ee

2009-03-01

Internally displaced persons are faced with several problems, such as sexual violence, and deserve appropriate intervention, especially in view of the increasing prevalence of HIV/AIDS and other infections in Nigeria. This study attempts to assess interventions offered by governmental authorities and organizations to internally displaced persons and to identify gaps in services as well as to identify what needs to be strengthened. The author reviewed relevant published and unpublished documents and collected data by interviews with semi-structured questions. Twenty-five organizations and government and police departments and 55 internally displaced persons were interviewed. None of the organizations, including governmental institutions, provided social services or assistance in prevention of HIV/AIDS to internally displaced persons. The main services provided by 17 (68%) organizations to 43 (78.2%) of internally displaced persons were provision of food, clothing and money, but these were provided on an ad hoc basis. Only 3 organizations (12%) included spiritual counseling and resolution of communal conflicts in their services. The fact that most organizations, including the government, do not have services for internally displaced persons indicates lack of support for internally displaced persons. The government should be urged to include these people in most prevention services, including HIV/AIDS prevention and treatment. This should help reduce the national prevalence of HIV/AIDS.

Developing culturally responsive approaches with Southeast Asian American families experiencing developmental disabilities.

PubMed

Baker, Dian L; Miller, Elizabeth; Dang, Michelle T; Yaangh, Chiem-Seng; Hansen, Robin L

2010-12-01

Southeast Asian American families are underrepresented among recipients of special education and social services for people with developmental disabilities. Our aims were to use a community-based participatory research approach to examine Hmong and Mien families' perceptions of developmental disabilities and understand barriers to and facilitators of service provision among families experiencing developmental disabilities. We describe here a case study of a successful attempt to engage marginalized and underserved communities to understand their needs to improve access and services for persons with developmental disabilities. We conducted 2 focus groups with 11 key informants and 1 focus group with 10 family members of persons with developmental disabilities, as well as in-depth interviews with 3 shamans. Using a thematic analysis approach, we coded notes and transcripts to assess community members' understanding of developmental disabilities, experiences negotiating educational and health care systems, and barriers to high-quality care. A predominant theme was the perception that reliance on governmental support services is not appropriate. Common barriers identified included lack of accurate information, language difficulties, lack of trust, and limited outreach. These perceptions and barriers, combined with limited access to services, interfere with community acceptance and use of available support services. Despite these barriers, participants indicated that with education, outreach, and culturally responsive support, families would likely accept services. Community-based participatory methods are effective for eliciting root causes of health inequities in marginalized communities. Outreach to community-based organizations and an inclusive research practice identified social and cultural reasons for low service uptake and provided a pathway for the community to improve services for persons with developmental disabilities.

24 CFR 91.205 - Housing and homeless needs assessment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... housing and supportive services must address the unmet needs of low-income persons with HIV/AIDS and their... public housing and Section 8 tenant-based waiting list; (H) Persons with HIV/AIDS and their families; (I... (mental, physical, developmental), persons with alcohol or other drug addiction, persons with HIV/AIDS and...

24 CFR 91.205 - Housing and homeless needs assessment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... housing and supportive services must address the unmet needs of low-income persons with HIV/AIDS and their... public housing and Section 8 tenant-based waiting list; (H) Persons with HIV/AIDS and their families; (I... (mental, physical, developmental), persons with alcohol or other drug addiction, persons with HIV/AIDS and...

24 CFR 91.205 - Housing and homeless needs assessment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... housing and supportive services must address the unmet needs of low-income persons with HIV/AIDS and their... public housing and Section 8 tenant-based waiting list; (H) Persons with HIV/AIDS and their families; (I... (mental, physical, developmental), persons with alcohol or other drug addiction, persons with HIV/AIDS and...

Personalization in the health care system: do personal health budgets have an impact on outcomes and cost?

PubMed

Jones, Karen; Forder, Julien; Caiels, James; Welch, Elizabeth; Glendinning, Caroline; Windle, Karen

2013-10-01

In England's National Health Service, personal health budgets are part of a growing trend to give patients more choice and control over how health care services are managed and delivered. The personal health budget programme was launched by the Department of Health in 2009, and a three-year independent evaluation was commissioned with the aim of identifying whether the initiative ensured better health- and care-related outcomes and at what cost when compared to conventional service delivery. The evaluation used a pragmatic controlled trial design to compare the outcomes and costs of patients selected to receive a personal health budget with those continuing with conventional support arrangements (control group). Just over 1000 individuals were recruited into the personal health budget group and 1000 into the control group in order to ensure sufficient statistical power, and followed for 12 months. The use of personal health budgets was associated with significant improvement in patients' care-related quality of life and psychological wellbeing at 12 months. Personal health budgets did not appear to have an impact on health status, mortality rates, health-related quality of life or costs over the same period. With net benefits measured in terms of care-related quality of life on the adult social care outcome toolkit measure, personal health budgets were cost-effective: that is, budget holders experienced greater benefits than people receiving conventional services, and the budgets were worth the cost. The evaluation provides support for the planned wider roll-out of personal health budgets in the English NHS after 2014 in so far as the localities in the pilot sample are representative of the whole country.

Eliciting perceptions of satisfaction with services and supports from persons with intellectual disability and developmental disabilities: a review of the literature.

PubMed

Copeland, S R; Luckasson, R; Shauger, R

2014-12-01

Assessing the perceptions of individuals with intellectual disability (ID) and developmental disabilities (DD) is an essential part of evaluating and planning services and an important component of respect for self-direction and autonomy. It can be difficult, however, to assess satisfaction in such a way that individuals with disabilities' actual perceptions of satisfaction are accurately represented because of intellectual and communication difficulties they may have, the restricted range and nature of service systems, and the limitations of strategies used by some researchers. The purpose of this literature review was to systematically examine research studies designed to solicit personal satisfaction information from individuals with ID and DD. We reviewed 29 studies that met inclusion criteria to determine (1) who were participants in the studies, (2) what processes researchers used to obtain opinions and perspectives of persons with ID and DD, and (3) how researchers ensured the credibility, accuracy and voluntariness of participants' responses. Findings revealed that most of the research participants had ID with higher IQs and limited needs for supports. Researchers utilised a variety of processes to elicit perceptions of satisfaction. Most studies employed individual interviews; researchers addressed comprehensibility of questions in a number of ways (e.g. use of visuals, adjusting wording of questions, providing clear examples). Few studies reported training interviewers or taking into account participants' primary language or cultural background. No studies reported educating participants about how to understand the satisfaction information data or how to use it in advocating for more appropriate supports. Assessing the satisfaction with supports and services of individuals with ID and DD is complex particularly for persons with extensive support needs. Continued research using varied conceptual frameworks and new technologies is needed. Also helpful will be teaching persons with disabilities about the assessment process and how to use its results. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

[The personal budget--a new system of benefits for disabled people].

PubMed

Wacker, E

2009-02-01

Instead of non-cash benefits, disabled people are to receive personal payments to help them to better manage their own support. This "tailor made support" has become a legal basis for a claim in 2008. It is aimed to pave the way for a new design of assistance: more ambulant services and a stronger position for the recipient of support. Initial results within the scope of pilot projects, evaluations from various perspectives and the discernible effects of personal budgets are reported in national and international perspectives.

Role perceptions of occupational therapists providing support and education for caregivers of persons with dementia.

PubMed

Toth-Cohen, S

2000-01-01

This pilot study explored occupational therapists' perceptions of their roles as interventionists providing education and support for caregivers of persons with dementia. The intervention was provided in caregivers' homes as part of a larger funded study. Interviews were conducted with four occupational therapists to elicit their reflections on practice and their views on occupational therapy services on the basis of their experiences providing support and education for caregivers in the funded study. Key themes consisted of the contrasts between the therapists' roles in the study and their customary practices and the professional and personal impact of their role in the study. Their recommendations for occupational therapy services emphasized the need to (a) collaborate with patients, families, and other health care staff members to solve problems; (b) acknowledge others as experts; (c) include family perspectives; and (d) fully address the needs of patients and families in their home environments. Providing support and education for caregivers in the community can be a major transition for therapists accustomed to practicing in more traditional settings. Additional research is needed to explore the ways in which specific practice contexts influence delivery of occupational therapy services.

Negative and positive effects of traumatic experiences in a group of emergency service workers --the role of personal and social resources.

PubMed

Ogińska-Bulik, Nina

2013-01-01

The purpose of the research is to investigate the role of personal (spirituality) and social (social support in the workplace) resources in both negative (post-traumatic stress disorder - PTSD symptoms) and positive (post-traumatic growth) effects of experienced trauma in a group of emergency service workers. Data of 116 workers representing emergency service (37.1% firefighters, 37.1%, police officers and 25.8% medical rescue workers) who have experienced traumatic events in their worksite were analyzed. The range of age of the participants was 21-57 years (M = 35.27; SD = 8.13). Polish versions of the Impact of Events Scale - Revised and the Post-traumatic Growth Inventory were used to assess the negative and positive effects of experienced events. Spirituality was assessed by self-report questionnaire and social support in the workplace scale was measured by the scale What support you can count on. The results revealed that support from supervisors reduces the severity of PTSD symptoms, and spirituality and support from co-workers promote the growth after trauma. Personal resources in the form of spirituality, compared with the social resources, play more important role in gaining benefits from trauma than in protecting against the harmful effects of the experienced traumatic event.

Experiences of care by Australians with a diagnosis of borderline personality disorder

PubMed Central

McMahon, J.

2015-01-01

Accessible summary Borderline personality disorder (BPD) is a complex and challenging mental health condition for the person and service providers who support them.This paper reports on the results of a survey of 153 people with a diagnosis of BPD about their experiences of attempting to receive support in managing this mental health condition. It provides their perceptions of a range of experiences not reported in the existing literature, including general practitioner roles, urban and rural differences, public and private hospital differences, and comparison of usefulness of support across multiple support types.People with a diagnosis of BPD continue to experience significant discrimination when attempting to get their needs met within both public and private health services. Further education for nurses and other health professionals is indicated to address pervasive negative attitudes towards people with a diagnosis of BPD. Abstract There is limited understanding of the experience of seeking and receiving treatment and care by people with a diagnosis of borderline personality disorder (BPD), their perceptions of barriers to care and the quality of services they receive. This study aimed to explore these experiences from the perspective of Australians with this diagnosis. An invitation to participate in an online survey was distributed across multiple consumer and carer organizations and mental health services, by the Private Mental Health Consumer Carer Network (Australia) in 2011. Responses from 153 people with a diagnosis of BPD showed that they experience significant challenges and discrimination when attempting to get their needs met within both public and private health services, including general practice. Seeking help from hospital emergency departments during crises was particularly challenging. Metropolitan and rural differences, and gender differences, were also apparent. Community supports were perceived as inadequate to meet their needs. This study provides data on a range of experiences not reported in existing literature, including general practitioner roles, urban and rural differences, public and private hospital differences, and comparison of usefulness of support across multiple support types. Its findings can help inform better training for health professionals and better care for this population. PMID:26122817

[Personal resources relevant to psychological well-being in nursing].

PubMed

Arrogante, O; Pérez-García, A M; Aparicio-Zaldívar, E G

2016-01-01

To determine differences in social support, resilience, coping, and psychological well-being (PWB) among intensive care nursing and nursing staff of other hospital services, as well as to establish a structural model in these professionals where relevant personal resources to PWB were included. Correlational and cross-sectional study. A sample of 208 nursing professionals from University Hospital of Fuenlabrada (Madrid) took part in the study. This sample consisted of nurses (n=133), nursing assistants (n=61), and midwives (n=14), of whom 44 worked in intensive care unit, 50 in other special units, and 114 in wards. Social Support Subscale, 10-Item CD-RISC (resilience), Brief-Cope (coping), Scales of PWB, and sociodemographic variables. No differences were found in any assessed psychological variables as regards hospital service worked in. A structural model was found and showed that social support, resilience, and coping determined PWB of nursing professionals. The most important personal resource was coping strategies, which determined PWB directly (β=0.68). Social support influenced PWB directly (β=0.33), and indirectly (β=0.32), whereas resilience influenced it indirectly (β=0.57). Differences in PWB, coping, social support and resilience are not determined by hospital service. Coping strategies focused on engagement (or adaptive), social support, and resilience, constitute three relevant personal resources that determine the PWB of nursing staff, which can be developed and improved by specific programs. The most important PWB dimensions are self-acceptance and environment mastery. Copyright © 2015 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

Medicaid-financed residential care for persons with mental retardation.

PubMed

Lakin, K C; Hall, M J

1990-12-01

Two sources of Medicaid support for persons with mental retardation and related conditions (MR/RC) are examined, the intermediate care facility for the mentally retarded (ICF/MR) program and the home and community-based services (HCBS) waiver. Results indicate that Medicaid support through the ICF/MR program has shown little recent growth in terms of number of persons served, although expenditures continue to increase. Medicaid's HCBS waiver is being used increasingly by States to support residential placement because of its greater flexibility and more individualized approach relative to ICF/MR care. Use of Medicaid to finance care for persons with MR/RC varies considerably across States.

Medicaid-financed residential care for persons with mental retardation

PubMed Central

Lakin, K. Charlie; Hall, Margaret Jean

1990-01-01

Two sources of Medicaid support for persons with mental retardation and related conditions (MRIRC) are examined, the intermediate care facility for the mentally retarded (ICF/MR) program and the home and community-based services (HCBS) waiver. Results indicate that Medicaid support through the ICF/MR program has shown little recent growth in terms of number of persons served, although expenditures continue to increase. Medicaid's HCBS waiver is being used increasingly by States to support residential placement because of its greater flexibility and more individualized approach relative to ICF/MR care. Use of Medicaid to finance care for persons with MR/RC varies considerably across States. PMID:10113489

Un/Paid Labor: Medicaid Home and Community Based Services Waivers That Pay Family as Personal Care Providers

ERIC Educational Resources Information Center

Friedman, Carli; Rizzolo, Mary C.

2016-01-01

The United States long-term services and supports system is built on largely unpaid (informal) labor. There are a number of benefits to allowing family caregivers to serve as paid personal care providers including better health and satisfaction outcomes, expanded workforces, and cost effectiveness. The purpose of this study was to examine how…

20 CFR 641.545 - What supportive services may grantees/subgrantees provide to participants?

Code of Federal Regulations, 2010 CFR

2010-04-01

... ADMINISTRATION, DEPARTMENT OF LABOR PROVISIONS GOVERNING THE SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM Services... transportation; health care and medical services; special job-related or personal counseling; incidentals such as work shoes, badges, uniforms, eyeglasses, and tools; child and adult care; temporary shelter; and...

The evolving role of the personal support worker in home care in Ontario, Canada.

PubMed

Saari, Margaret; Patterson, Erin; Kelly, Shawna; Tourangeau, Ann E

2018-03-01

To meet increasing demand for home care, the role of personal support workers (PSWs) is shifting from providing primarily personal and supportive care to include care activities previously provided by regulated health professionals (RHPs). Much of the research examining this shift focuses on specialty programmes, with few studies investigating the daily care being provided by PSWs, frequency of care activities being provided by PSWs, and characteristics of the population receiving more complex tasks. Between January and April 2015, a review of 517 home-care service user charts was undertaken in Ontario, Canada, to: (1) describe the range of tasks being performed by PSWs in home care, (2) identify tasks transferred by RHPs to PSWs, and (3) examine characteristics of service users receiving transferred care. Findings indicate that normally, PSWs provide personal and supportive care commensurate with their training. However, in approximately one quarter of care plans reviewed, PSWs also completed more complex care activities transferred to them by RHPs. Service users receiving transferred care were older and had higher levels of cognitive and functional impairment. Although there is potential for the expansion of home-care services through increased utilisation of PSWs, healthcare leadership must ensure that the right provider is being utilised at the right time and in the right place to ensure safe and effective quality care. Thus, several actions are recommended: PSW core competencies be clearly articulated, processes used to transfer care activities from RHPs to PSWs be standardised and a team-based approach to the delivery of home-care services be considered. Utilisation of a team-based model can help establish positive relationships among home-care providers, provide increased support for PSWs, allow for easier scheduling of initial training and ensure regular reassessments of PSW competence among PSWs providing added skills. © 2017 John Wiley & Sons Ltd.

Design and Evaluation of a Health-Focused Personal Informatics Application with Support for Generalized Goal Management

ERIC Educational Resources Information Center

Medynskiy, Yevgeniy

2012-01-01

The practice of health self-management offers behavioral and problem-solving strategies that can effectively promote responsibility for one's own wellbeing, improve one's health outcomes, and decrease the cost of health services. Personal informatics applications support health self-management by allowing their users to easily track…

Involving mental health service users in suicide-related research: a qualitative inquiry model.

PubMed

Lees, David; Procter, Nicholas; Fassett, Denise; Handley, Christine

2016-03-01

To describe the research model developed and successfully deployed as part of a multi-method qualitative study investigating suicidal service-users' experiences of mental health nursing care. Quality mental health care is essential to limiting the occurrence and burden of suicide, however there is a lack of relevant research informing practice in this context. Research utilising first-person accounts of suicidality is of particular importance to expanding the existing evidence base. However, conducting ethical research to support this imperative is challenging. The model discussed here illustrates specific and more generally applicable principles for qualitative research regarding sensitive topics and involving potentially vulnerable service-users. Researching into mental health service users with first-person experience of suicidality requires stakeholder and institutional support, researcher competency, and participant recruitment, consent, confidentiality, support and protection. Research with service users into their experiences of sensitive issues such as suicidality can result in rich and valuable data, and may also provide positive experiences of collaboration and inclusivity. If challenges are not met, objectification and marginalisation of service-users may be reinforced, and limitations in the evidence base and service provision may be perpetuated.

A Chaperone: Using Twitter for Professional Guidance, Social Support and Personal Empowerment of Novice Teachers in Online Workshops

ERIC Educational Resources Information Center

Pieterse, Efrat; Peled, Yehuda

2014-01-01

This research examines the feasibility and benefits of using Twitter as a support tool to enhance social interaction among teachers in their first year of service, as they participate in an online induction workshop, and as a tool to aid the workshop's moderator in monitoring the group and enhancing and supporting the early-service teachers'…

Utilization of legal and financial services of partners in dementia care study.

PubMed

Shrestha, Srijana; Judge, Katherine S; Wilson, Nancy L; Moye, Jennifer A; Snow, A Lynn; Kunik, Mark E

2011-03-01

Financial and legal services are unique needs of persons with dementia and their caregivers. This study examines their need for legal and financial assistance and the kinds of legal and financial services provided within Partners in Dementia Care, a telephone-based, care coordination and support service intervention delivered through a partnership between Veterans Affairs (VA) medical centers and local Alzheimer's Association chapters. Based on comprehensive assessment, and needs prioritization, care coordinators collaboratively planned action steps (specific behavioral tasks) with each caregiver/person with dementia to address the dyad's identified unmet needs. Results show that 51 (54.8%) of 93 dyads reported a need for legal and financial services. Action steps related to legal and financial need included education or assistance with legal services (27.27%), nonhealth-related financial benefits (32.32%), health-related financial benefits (21.21%), financial management/planning (9.09%), and financial support (10.1%). Comparable numbers of action steps were directed to VA (41.4%) and non-VA (58.6%) services.

Participation and Service Access Rights for People with Intellectual Disability: A Role for Law?

ERIC Educational Resources Information Center

Carney, Terry

2013-01-01

Background: Supported decision-making and personal budgets for services are the new paradigms. Method: Supported decision-making proposals from the Australian State of Victoria are analysed against international trends to determine the viability of laws reflecting new international norms of the United Nations Convention on the Rights of Persons…

Overview on Deaf-Blindness

MedlinePlus

... Inclusion IDEA (Individuals with Disabilities Education Act) Assistive Technology History of Deaf-Blind Education Transition to Adulthood > Transition Self Determination Person Centered Planning Postsecondary Education Independent Living ... > Intervener Services Support Service Provider Personnel Development & ...

An intelligent tele-healthcare environment offering person-centric and wellness-maintenance services.

PubMed

Abidi, S S

2001-06-01

Worldwide healthcare delivery trends are undergoing a subtle paradigm shift--patient centered services as opposed to provider centered services and wellness maintenance as opposed to illness management. In this paper we present a Tele-Healthcare project TIDE--Tele-Healthcare Information and Diagnostic Environment. TIDE manifests an 'intelligent' healthcare environment that aims to ensure lifelong coverage of person-specific health maintenance decision-support services--i.e., both wellness maintenance and illness management services--ubiquitously available via the Internet/WWW. Taking on an all-encompassing health maintenance role--spanning from wellness to illness issues--the functionality of TIDE involves the generation and delivery of (a) Personalized, Pro-active, Persistent, Perpetual, and Present wellness maintenance services, and (b) remote diagnostic services for managing noncritical illnesses. Technically, TIDE is an amalgamation of diverse computer technologies--Artificial Intelligence, Internet, Multimedia, Databases, and Medical Informatics--to implement a sophisticated healthcare delivery infostructure.

A Web-based home welfare and care services support system using a pen type image sensor.

PubMed

Ogawa, Hidekuni; Yonezawa, Yoshiharu; Maki, Hiromichi; Sato, Haruhiko; Hahn, Allen W; Caldwell, W Morton

2003-01-01

A long-term care insurance law for elderly persons was put in force two years ago in Japan. The Home Helpers, who are employed by hospitals, care companies or the welfare office, provide home welfare and care services for the elderly, such as cooking, bathing, washing, cleaning, shopping, etc. We developed a web-based home welfare and care services support system using wireless Internet mobile phones and Internet client computers, which employs a pen type image sensor. The pen type image sensor is used by the elderly people as the entry device for their care requests. The client computer sends the requests to the server computer in the Home Helper central office, and then the server computer automatically transfers them to the Home Helper's mobile phone. This newly-developed home welfare and care services support system is easily operated by elderly persons and enables Homes Helpers to save a significant amount of time and extra travel.

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

PubMed

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

2000-01-01

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

20 CFR 61.1 - Statutory provisions

Code of Federal Regulations, 2010 CFR

2010-04-01

... Instrumentalities Act (5 U.S.C. 8171 et seq.); (4) Any person engaged for personal services outside the continental... department or agency of the United States, may waive the application of the Act; or (5) Any person engaged... under circumstances supporting a reasonable inference that the absence is due to the belligerent action...

20 CFR 61.1 - Statutory provisions

Code of Federal Regulations, 2011 CFR

2011-04-01

... Instrumentalities Act (5 U.S.C. 8171 et seq.); (4) Any person engaged for personal services outside the continental... department or agency of the United States, may waive the application of the Act; or (5) Any person engaged... under circumstances supporting a reasonable inference that the absence is due to the belligerent action...

Activities of Intellectual Disability Clinical Nurse Specialists in Ireland.

PubMed

Doody, Owen; Slevin, Eamonn; Taggart, Laurence

The aim of this study was to identify the contribution of Irish intellectual disability clinical nurse specialists (ID CNSs) to service delivery. A nonexperimental descriptive design was selected to survey ID CNSs presently working in Ireland. The questionnaire was developed based on focus group interviews, available literature, and expert panel views. Ethical approval and access were granted to all ID CNSs in Ireland. Thirty-two responded (33.68% response rate) from all work areas (voluntary organizations or health service executive) practicing within residential, community, or school services. Respondents were surveyed across a range of areas (demographic details and support to client, staff, family, organization, community, other agencies, and professional development). Findings identify that ID CNSs are active in all aspects of their roles as clinical specialist, educator, communicator, researcher, change agent, and leader, thus supporting person-centered care and improving service delivery. To meet changing healthcare demands, promote person-centered care, and improve service delivery, the CNS role in ID should be developed and supported. The findings merit a further study on ID CNS role activity, possible variables influencing role activity, and team members' views.

Supporting Families to Support Students

ERIC Educational Resources Information Center

Kelly, John; Rossen, Eric; Cowan, Katherine C.

2018-01-01

Collaboration between students' families and the school is an essential component to promoting student mental and behavioral health. Many schools structure their mental health services using a Multi-Tiered System of Supports that offers three different tiers of support from universal supports to personalized help for students with serious…

Assessing interventions available to internally displaced persons in Abia state, Nigeria

PubMed Central

Enwereji, EE

2009-01-01

Internally displaced persons are faced with several problems, such as sexual violence, and deserve appropriate intervention, especially in view of the increasing prevalence of HIV/AIDS and other infections in Nigeria. This study attempts to assess interventions offered by governmental authorities and organizations to internally displaced persons and to identify gaps in services as well as to identify what needs to be strengthened. Method: The author reviewed relevant published and unpublished documents and collected data by interviews with semi-structured questions. Twenty-five organizations and government and police departments and 55 internally displaced persons were interviewed. Results: None of the organizations, including governmental institutions, provided social services or assistance in prevention of HIV/AIDS to internally displaced persons. The main services provided by 17 (68%) organizations to 43 (78.2%) of internally displaced persons were provision of food, clothing and money, but these were provided on an ad hoc basis. Only 3 organizations (12%) included spiritual counseling and resolution of communal conflicts in their services. Conclusion: The fact that most organizations, including the government, do not have services for internally displaced persons indicates lack of support for internally displaced persons. The government should be urged to include these people in most prevention services, including HIV/AIDS prevention and treatment. This should help reduce the national prevalence of HIV/AIDS PMID:21483498

Designing personal exercise monitoring employing multiple modes of delivery: implications from a qualitative study on heart rate monitoring.

PubMed

Segerståhl, Katarina; Oinas-Kukkonen, Harri

2011-12-01

Various personal monitoring technologies have been introduced for supporting regular physical activity, which is of critical importance in reducing the risks of several chronic diseases. Recent studies suggest that combining multiple modes of delivery, such as text messages and mobile monitoring devices with web applications, holds potential for effectively supporting physical exercise. Of particular interest is how the functionality and content of these systems should be distributed across the different modes for successful outcomes. The aim of this study was to: (a) investigate how users incorporate a system employing two modes of delivery - a wearable heart rate monitor and a web service - into their training and (b) to analyze benefits and limitations in personal exercise monitoring and how they relate to the different modes in use. A qualitative field study employing diaries and semi-structured interviews was carried out with 30 participants who used a heart rate monitoring system comprising a wearable heart rate monitor, Polar FT60 and a web service, Polar Personal Trainer for a period of 21 days. The data were systematically analyzed to identify specific benefits and limitations associated with the system characteristics and modes as perceived by the end-users. The benefits include supporting exploratory learning, controlling target behavior, rectifying behaviors, motivation and logging support. The limitations are associated with information for validating the system, virtual coaching, task-technology fit, data integrity and privacy concerns. Mobile interfaces enable exploratory learning and controlling of target behaviors in situ, while web services can effectively support users' need for cognition within the early stages of adoption and long-term training with intelligent coaching functionality. This study explains several benefits and limitations in personal exercise monitoring. These can be addressed with crossmedial design, i.e., strategic distribution of functionality and content across modes within the system. Our findings suggest that personal exercise monitoring systems may be improved by more systematically combining mobile and web-based functionality. 2011 Elsevier Ireland Ltd. All rights reserved.

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.

Quality of Services and Quality of Life from Service Providers' Perspectives: Analysis with Focus Groups

ERIC Educational Resources Information Center

Jenaro, C.; Vega, V.; Flores, N.; Cruz, M.

2013-01-01

Background: Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this…

The relationship between older Americans act in-home services and low-care residents in nursing homes.

PubMed

Thomas, Kali S

2014-03-01

The aim of the study was to investigate the relationship between supportive services provided under Title III-B of the Older Americans Act (OAA) and the prevalence of low-care residents in nursing homes (NHs). State Program Reports (state-level expenditure and utilization data for each OAA service) and NH facility-level data were analyzed using a two-way fixed effects model. Results suggest that every additional 1% of the population age 65+ that receives personal care services is associated with a 0.8% decrease in the proportion of low-care residents in NHs. Despite efforts to rebalance long-term care, there are still many NH residents who have the functional capacity to live in a less restrictive environment. This is among the first studies to suggest that states that have invested in their in-home supportive services, particularly personal care services provided through the OAA, have proportionally fewer of these people.

Transparent data service with multiple wireless access

NASA Technical Reports Server (NTRS)

Dean, Richard A.; Levesque, Allen H.

1993-01-01

The rapid introduction of digital wireless networks is an important part of the emerging digital communications scene. The introduction of Digital Cellular, LEO and GEO Satellites, and Personal Communications Services poses both a challenge and an opportunity for the data user. On the one hand wireless access will introduce significant new portable data services such as personal notebooks, paging, E-mail, and fax that will put the information age in the user's pocket. On the other hand the challenge of creating a seamless and transparent environment for the user in multiple access environments and across multiple network connections is formidable. A summary of the issues associated with developing techniques and standards that can support transparent and seamless data services is presented. The introduction of data services into the radio world represents a unique mix of RF channel problems, data protocol issues, and network issues. These problems require that experts from each of these disciplines fuse the individual technologies to support these services.

A Profile of Respite Service Providers in New South Wales

ERIC Educational Resources Information Center

Chan, Jeffrey B.

2008-01-01

Respite is one of the critical support systems for families and carers who support and care for a person with a life-long disability. This study examined the profile of respite services in the Australian state of New South Wales and explored respite providers' views of the factors influencing respite use, and their expectations of respite…

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

ERIC Educational Resources Information Center

McGrew, Lee

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

Person-Centered and Collaborative Supports for College Success

ERIC Educational Resources Information Center

Weir, Cate

2004-01-01

Recent studies of innovative supports and services in postsecondary education reveal more effective and cooperative mechanisms with which to provide supports to individuals with disabilities (Stodden, Jones, & Chang, 2003; Whelley, Hart, & Zafft, 2003). Colleges and universities can design supports that permit consumer choice while…

Family functioning, health and social support assessed by aged home care clients and their family members.

PubMed

Hautsalo, Katja; Rantanen, Anja; Astedt-Kurki, Päivi

2013-10-01

The aim of this study was to describe aged home care clients' and their family members' experiences of their family functioning, family health and social support received. An additional purpose was to determine which factors are connected with social support. Increasing life expectancy and ageing of the population require consideration of the adequacy of home care services and the role of family members as care providers. The older population is a very heterogeneous group because of their variable needs and several disabilities. To ensure the quality of home care, experimental information is needed from clients and their family members. A survey design with convenience sampling. The home care client and a family member of his/her answered a questionnaire together, including background questions, the Family Functioning, Health and Social Support instrument and an open question about support received from home care. Statistical methods were used to describe quantitative data, and content analysis was used in analysing the replies to the open question. Family health was noted as good, and family functioning and overall social support fairly good. An older person's higher basic education, higher age of the family member, better family health and male gender were connected with better social support received. The relationship of the older person and the family member as well as the duration of home care service use had an effect on social support received. The content analysis raised expectations related to time, planning of service, organisational factors and caring practise. Home care clients' and families' needs for support vary, and therefore, the assessment of needs, care planning and updating are important. The variable support needs of older people and their family members require flexible and adaptable home services. Cooperation between all participants involved in care would promote the well-being of the older person and the entire family. © 2012 Blackwell Publishing Ltd.

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

PubMed

Song, Li-Yu

2017-04-01

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

Financial management services in consumer-directed programs.

PubMed

Scherzer, Teresa; Wong, Alice; Newcomer, Robert

2007-01-01

Shifting from an agency-based model of personal assistance services to consumer direction has important consequences for both recipients and workers. In consumer direction, recipients assume the responsibilities of employing their attendants--for both self-directing their supportive services and being responsible for numerous fiscal responsibilities. Many states have eased these fiscal responsibilities among recipients in publicly financed personal care programs by using Financial Management Services (also known as fiscal intermediaries). This article introduces the major types of Financial Management Services organizations used by Medicaid consumer-directed personal care programs, and examines the extent to which the varied approaches can and do serve the needs of both recipients and workers. Despite the expansion of consumer-directed programs and the accompanying emergence of Financial Management Services, these organizations have not been extensively studied or evaluated. The paper concludes with a discussion of the challenges, opportunities, and policy implications of the current practice; and suggests directions for future research.

75 FR 54898 - Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

... Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services... Part C funds under The Ryan White HIV/AIDS Program to support comprehensive primary care services for persons living with HIV/AIDS, including primary medical care, laboratory testing, oral health care...

Early Interactions with Children Who Are Deaf-Blind

MedlinePlus

... Inclusion IDEA (Individuals with Disabilities Education Act) Assistive Technology History of Deaf-Blind Education Transition to Adulthood > Transition Self Determination Person Centered Planning Postsecondary Education Independent Living ... > Intervener Services Support Service Provider Personnel Development & ...

Long-Term Supportive Housing is Associated with Decreased Risk for New HIV Diagnoses Among a Large Cohort of Homeless Persons in New York City.

PubMed

Lee, Christopher T; Winquist, Andrea; Wiewel, Ellen W; Braunstein, Sarah; Jordan, Hannah T; Gould, L Hannah; Gwynn, R Charon; Lim, Sungwoo

2018-05-08

It is unknown whether providing housing to persons experiencing homelessness decreases HIV risk. Housing, including access to preventive services and counseling, might provide a period of transition for persons with HIV risk factors. We assessed whether the new HIV diagnosis rate was associated with duration of supportive housing. We linked data from a cohort of 21,689 persons without a previous HIV diagnosis who applied to a supportive housing program in New York City (NYC) during 2007-2013 to the NYC HIV surveillance registry. We used time-dependent Cox modeling to compare new HIV diagnoses among recipients of supportive housing (defined a priori, for program evaluation purposes, as persons who spent > 7 days in supportive housing; n = 6447) and unplaced applicants (remainder of cohort), after balancing the groups on baseline characteristics with propensity score weights. Compared with unplaced applicants, persons who received ≥ 3 continuous years of supportive housing had decreased risk for new HIV diagnosis (HR 0.10; CI 0.01-0.99). Risk of new HIV diagnosis decreased with longer duration placement in supportive housing. Supportive housing might aid in primary HIV prevention.

47 CFR 78.22 - Objections to applications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICE Applications and Licenses § 78.22 Objections to applications. (a) Any party in interest may file a... which official notice may be taken, be supported by affidavit of a person or persons with personal knowledge thereof. (b) The applicant may file an opposition to any petition to deny, and the petitioner may...

47 CFR 78.22 - Objections to applications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICE Applications and Licenses § 78.22 Objections to applications. (a) Any party in interest may file a... which official notice may be taken, be supported by affidavit of a person or persons with personal knowledge thereof. (b) The applicant may file an opposition to any petition to deny, and the petitioner may...

24 CFR 91.205 - Housing and homeless needs assessment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... housing and supportive services must address the unmet needs of low-income persons with HIV/AIDS and their... housing and section 8 tenant-based waiting lists, for persons with HIV/AIDS and their families, for... other drug addiction, persons with HIV/AIDS and their families, public housing residents, and any other...

24 CFR 91.205 - Housing and homeless needs assessment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... housing and supportive services must address the unmet needs of low-income persons with HIV/AIDS and their... housing and section 8 tenant-based waiting list, for persons with HIV/AIDS and their families, for victims... other drug addiction, persons with HIV/AIDS and their families, public housing residents, and any other...

77 FR 76295 - Proposed Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-27

... child support programs, assisting child support agencies in locating parents, and enforcing child... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Proposed... maintained by the Federal Office of Child Support Enforcement, was established pursuant to the Personal...

42 CFR 441.482 - Permissible purchases.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Permissible purchases. 441.482 Section 441.482... Optional Self-Directed Personal Assistance Services Program § 441.482 Permissible purchases. (a... assistance. (b) The services, supports and items that are purchased with a service budget must be linked to...

Spinal Cord Injury Community Survey: Understanding the Needs of Canadians with SCI.

PubMed

Noreau, Luc; Noonan, Vanessa K; Cobb, John; Leblond, Jean; Dumont, Frédéric S

2014-01-01

There is a lack of literature regarding service needs of people with SCI living in the community. Better assessment of expressed and met and unmet needs would help in the development of effective service delivery. From a national SCI Community Survey in Canada, the aim was to identify the most critical service needs of people living in the community at least 1 year post discharge from rehabilitation and the support they received to meet their needs. Data were collected mainly through a secure Web site and encompassed demographics, personal and household income, an SCI severity measure, and an SCI community needs measure containing information on 13 SCI-related needs. A total of 1,549 persons with SCI (traumatic lesion, n = 1,137; nontraumatic lesion, n = 412) across Canada completed the survey. Most critical needs for community integration were expressed by a substantial proportion of survey participants, but significantly more expressed and met needs were reported by persons with a traumatic than a nontraumatic lesion. Personal and environmental characteristics influenced the probability of expressing and meeting needs (eg, severity of injury and household income). Help and support to meet expressed needs were received from government agencies, community organizations, and friends or family. Better assessment of expressed and met or unmet needs for services remains a challenge but will serve as a tool to optimize service delivery in the community. Environmental barriers to services, particularly the process of getting needs met and associated costs, remain an issue that requires a reconsideration of some aspects of access to services.

Coping support factors among Australians affected by terrorism: 2002 Bali bombing survivors speak.

PubMed

Stevens, Garry J; Dunsmore, Julie C; Agho, Kingsley E; Taylor, Melanie R; Jones, Alison L; Raphael, Beverley

2013-12-16

To examine terrorism survivors' perceptions of factors likely to promote coping and recovery, and to determine whether coping supports vary according to demographic, physical and mental health, incident-exposure and bereavement variables. Individuals directly exposed to and/or bereaved by the 2002 Bali bombings and who had participated in a New South Wales Health therapeutic support program completed cross-sectional telephone interviews during July-November 2010. Spoken passages were categorised into coping support themes. Advocated supports were then examined by demographic, physical and mental health, incident-exposure and bereavement variables. Based on their experiences, respondents identified personal, social and service-related factors that they believed would optimally support future survivors of terrorism. Of the 81 people contacted, 55 (68%) participated, providing a total of 114 comments. Thirty-two respondents were women, and 54 had lost relatives or friends in the bombing. Mean age was 50 years (range, 20-73 years). Four meaningful coping support themes emerged, with excellent inter-rater reliability: professional help and counselling; social support; proactive government response and policy; and personal coping strategies. Women were significantly more likely to advocate the need for proactive government response (P = 0.03). Men were more likely to endorse the use of personal coping strategies (P < 0.01). Respondents diagnosed with a mental health condition since the bombings were significantly less likely to advocate social support processes (P = 0.04). Our findings highlight the perceived value of counselling-related services for terrorism-affected groups. Male survivors may benefit more from mental health interventions that initially build on problem-focused forms of coping, including brief education about reactions and periodic check-ups. Proactive government health and support services that allow simplified and longer-term access were consistently identified as priority areas.

Developing Substance Use Programming for Person-Oriented Recovery and Treatment (SUPPORT): protocol for a pilot randomized controlled trial.

PubMed

Watson, Dennis P; Ray, Bradley; Robison, Lisa; Xu, Huiping; Edwards, Rhiannon; Salyers, Michelle P; Hill, James; Shue, Sarah

2017-01-01

There is a lack of evidence-based substance use disorder treatment and services targeting returning inmates. Substance Use Programming for Person-Oriented Recovery and Treatment (SUPPORT) is a community-driven, recovery-oriented approach to substance abuse care which has the potential to address this service gap. SUPPORT is modeled after Indiana's Access to Recovery program, which was closed due to lack of federal support despite positive improvements in clients' recovery outcomes. SUPPORT builds on noted limitations of Indiana's Access to Recovery program. The ultimate goal of this project is to establish SUPPORT as an effective and scalable recovery-oriented system of care. A necessary step we must take before launching a large clinical trial is pilot testing the SUPPORT intervention. The pilot will take place at Public Advocates in Community Re-Entry (PACE), nonprofit serving individuals with felony convictions who are located in Marion County, Indiana (Indianapolis). The pilot will follow a basic parallel randomized design to compare clients receiving SUPPORT with clients receiving standard services. A total of 80 clients within 3 months of prison release will be recruited to participate and randomly assigned to one of the two intervention arms. Quantitative measures will be collected at multiple time points to understand SUPPORT's impact on recovery capital and outcomes. We will also collect qualitative data from SUPPORT clients to better understand their program and post-discharge experiences. Successful completion of this pilot will prepare us to conduct a multi-site clinical trial. The ultimate goal of this future work is to develop an evidence-based and scalable approach to treating substance use disorder among persons returning to society after incarceration. ClinicalTrials.gov (Clinical Trials ID: NCT03132753 and Protocol Number: 1511731907). Registered 28 April 2017.

Identifying profiles of service users in housing services and exploring their quality of life and care needs.

PubMed

Bitter, Neis A; Roeg, Diana P K; van Nieuwenhuizen, Chijs; van Weeghel, Jaap

2016-11-23

Housing services aim to support people with mental illness in their daily life and recovery. As the level of recovery differs between service users, the quality of life and care needs also might vary. However, the type and amount of care and support that service users receive do not always match their recovery. In order to improve the quality of care, this study aims to explore whether subgroups of service users exist based on three dimensions of recovery and to examine and compare the quality of life and care needs of the persons in these subgroups. Latent class analysis was performed with data from 263 service users of housing services in the Netherlands. Classes were based on three variables: personal recovery (Mental Health Recovery Measure), social recovery (Social Functioning Scale), and clinical recovery (Brief Symptom Inventory). Subsequently, the quality of life (MANSA) and care needs (CANSAS) of the different classes were analysed by the use of descriptive and inferential statistics. Three classes could be distinguished. Class 1 (45%) comprised of people who score the highest of the three classes in terms of personal and social recovery and who experience the least number of symptoms. People in class 2 (44%) and class 3 (11%) score significantly lower on personal and social recovery, and they experience significantly more symptoms compared to class 1. The distinction between class 2 and 3 can be made on the significantly higher number of symptoms in class 3. All three classes differ significantly on quality of life and unmet needs. The quality of life of service users of housing services needs improvement, as even persons in the best-recovered subgroup have a lower quality of life than the average population. Workers of housing services need to be aware of the recovery of a client and what his or her individual needs and goals are. Furthermore, better care (allocation) concerning mental and physical health and rehabilitation is needed. Care should be provided on all dimensions of recovery at the same time, therefore mental health care organisations should work together and integrate their services. ISRCTN registry ISRCTN77355880 retrospectively registered 05/07/2013.

Personalized Outreach to University Students with a History of Reading Difficulties: Early Screening and Outreach to Support Academically At-Risk Students

ERIC Educational Resources Information Center

Deacon, S. Hélène; Tucker, Rebecca; Bergey, Bradley W.; Laroche, Annie; Parrila, Rauno

2017-01-01

We examined whether identification of and personalized outreach to a group of students with a history of reading difficulties would impact their use of support services and academic outcomes. Using a brief self-report questionnaire, we identified students with a history of reading difficulties (n = 175) and a comparison group of university…

Association of Emotional Labor, Self-efficacy, and Type A Personality with Burnout in Korean Dental Hygienists

PubMed Central

2017-01-01

The purpose of this study was to examine the relationship between emotional labor and burnout, and whether the levels of self-efficacy and type A personality characteristics increase the risk of burnout in a sample of Korean female dental hygienists. Participants were 807 female dental hygienists with experience in performing customer service for one year or more in dental clinics, dental hospitals, or general hospitals in Korea. Data were collected using a structured self-administered questionnaire. A hierarchical multiple linear regression analysis was used to examine the effects of emotional labor on burnout, and to elucidate the additive effects of self-efficacy and type A personality on burnout. The results showed that “overload and conflict in customer service,” “emotional disharmony and hurt,” and “lack of a supportive and protective system in the organization” were positively associated with burnout. With reference to the relationship between personality traits and burnout, we found that personal traits such as self-efficacy and type A personality were significantly related to burnout, which confirmed the additive effects of self-efficacy and type A personality on burnout. These results indicate that engaging in excessive and prolonged emotional work in customer service roles is more likely to increase burnout. Additionally, an insufficient organizational supportive and protective system toward the negative consequences of emotional labor was found to accelerate burnout. The present findings also revealed that personality traits such as self-efficacy and type A personality are also important in understanding the relationship between emotional labor and burnout. PMID:28776336

Association of Emotional Labor, Self-efficacy, and Type A Personality with Burnout in Korean Dental Hygienists.

PubMed

Jeung, Da Yee; Lee, Hyun Ok; Chung, Won Gyun; Yoon, Jin Ha; Koh, Sang Baek; Back, Chi Yun; Hyun, Dae Sung; Chang, Sei Jin

2017-09-01

The purpose of this study was to examine the relationship between emotional labor and burnout, and whether the levels of self-efficacy and type A personality characteristics increase the risk of burnout in a sample of Korean female dental hygienists. Participants were 807 female dental hygienists with experience in performing customer service for one year or more in dental clinics, dental hospitals, or general hospitals in Korea. Data were collected using a structured self-administered questionnaire. A hierarchical multiple linear regression analysis was used to examine the effects of emotional labor on burnout, and to elucidate the additive effects of self-efficacy and type A personality on burnout. The results showed that "overload and conflict in customer service," "emotional disharmony and hurt," and "lack of a supportive and protective system in the organization" were positively associated with burnout. With reference to the relationship between personality traits and burnout, we found that personal traits such as self-efficacy and type A personality were significantly related to burnout, which confirmed the additive effects of self-efficacy and type A personality on burnout. These results indicate that engaging in excessive and prolonged emotional work in customer service roles is more likely to increase burnout. Additionally, an insufficient organizational supportive and protective system toward the negative consequences of emotional labor was found to accelerate burnout. The present findings also revealed that personality traits such as self-efficacy and type A personality are also important in understanding the relationship between emotional labor and burnout. © 2017 The Korean Academy of Medical Sciences.

Neuro-Oncology Branch patient emotional support services | Center for Cancer Research

Cancer.gov

Emotional Support Services The diagnosis of a brain tumor elicits many different and sometimes difficult emotions, not only for the patient, but also for their family members. Patients may encounter changes in cognitive functioning and language, a diminished ability to focus or make decisions, or short-term memory loss, all of which can greatly affect their personal and

The individual and beyond: a socio-rational choice model of service participation among homeless adults with substance abuse problems.

PubMed

Sosin, Michael R; Grossman, Susan F

2003-01-01

While substance user service programs can help homeless adults solve their substance use and housing problems, relatively few needy individuals use and complete these programs. The lack of participation is poorly explained by typical empirical studies, most of which consider the role in service participation of various personal traits and client problems. The current article instead seeks to explain service participation through the application of an alternative, "socio-rational choice" model. This model has three premises: Clients weigh the costs and benefits of participating in services against alternative uses of their time and resources. The clients' weighing procedures reflect their personal situations and perceptions of the treatment environment. The perceptions of their personal situations and perceptions of the treatment environment are affected by the manner in which clients react to representatives of service systems, members of their social network including both housed and homeless persons, and other individuals. Secondary evidence supports many of the model's hypotheses and generally suggests that homeless clients may be heavily affected by their experiences with individuals and systems with which they come into contact.

Jordanian Pre-Service Teachers' Perceptions of the Portfolio as a Reflective Learning Tool

ERIC Educational Resources Information Center

Bataineh, Ruba Fahmi; Al-Karasneh, Samih Mahmoud; Al-Barakat, Ali Ahmad; Bataineh, Rula Fahmi

2007-01-01

This study investigates how portfolios support pre-service teachers' learning to teach. The findings revealed that the portfolio provides pre-service teachers with productive learning experiences which help them develop their "library use, knowledge, skills, attitudes, personal traits, motivation to learn, interpersonal relationships"…

Recommendations for peer-to-peer support for NICU parents

PubMed Central

Hall, S L; Ryan, D J; Beatty, J; Grubbs, L

2015-01-01

Peer-to-peer support provided by ‘veteran' neonatal intensive care unit (NICU) parents to those with current NICU babies is a legitimate and unique form of support that can complement or supplement, but not replace, services provided by professional NICU staff. Peer support can be delivered through hospital- or community-based programs that offer one-to-one in-person or telephone matches, or support groups that meet in-person or via the Internet. Issues in program development, volunteer training and program operation are discussed. Recommendations for offering peer support to all NICU parents as an integral component of family-centered care and comprehensive family support are presented. PMID:26597805

The Market for Community Services for Older People.

ERIC Educational Resources Information Center

Hereford, Russell W.

The Supportive Services Program for Older Persons is designed to demonstrate that a private market for home and community-based health related services can be developed in response to the demand expressed by older people and their families. The objective of the program is to expand the service options available to older people by letting market…

Health conditions and support needs of persons living in residential facilities for adults with intellectual disability in Western Cape Province.

PubMed

McKenzie, J; McConkey, R; Adnams, C

2013-04-17

Intellectual disability (ID) is a relatively high-incidence disability, with an increased risk of poor physical and mental health. Persons with ID also have lifelong support needs that must be met if they are to achieve an acceptable quality of life. Little is known about these health conditions and support needs in the African context. This study examines persons over the age of 18 years with ID in residential facilities in Western Cape Province. To analyse the health conditions and support needs of persons with ID in Western Cape Province. A survey of residents' health conditions and support needs was conducted in face-to-face interviews with the managers of 37 out of 41 identified facilities. The survey comprised 2 098 residents (54% of them female), representing less than 2% of the estimated population of persons with ID in the province. The survey suggests that such persons experience a wide range of health conditions (notably mental health and behavioural issues) but have limited access to general health care and rehabilitation services. Furthermore, the daily living supports required for an acceptable quality of life are limited. The findings highlight the need for better health and support provision to persons with ID.

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

PubMed

Putnam, Michelle; Tang, Fengyan

2008-01-01

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

The Meaning of Social Support for Persons with Serious Mental Illness

PubMed Central

Chronister, Julie; Chou, Chih-Chin; Kwan, Kwong-Liem Karl; Lawton, Melissa; Silver, Kurt

2015-01-01

Aim This study sought to better understand the population-specific types of social support relevant to adults living with serious mental illness (SMI). Our study was exploratory and used a qualitative approach that centered on uncovering the types of social support meaningful and relevant to persons with SMI. Method The sample comprised of 52 adults receiving county mental health services in the San Francisco Bay Area. Data was gathered from six focus groups and analyzed using NVivo10 and Consensual Qualitative Research (CQR; Hill et al., 2005; Hill et al., 1997). Results Six qualitative domains were identified: a) Supportive Conditions, b) Day-to-Day Living, c) Illness Management, d) Resources and Information, e) Guidance and Advice, and f) Community Participation Support. Discussion While the six support domains share some broad-based conceptual underpinnings with traditional models of emotional and instrumental support, the domains emerging from our study represent supports uniquely tied to the stressors associated with living with an SMI, and therefore hold conceptual distinction from traditional types of support. Conclusions/Implications Findings from this study offer a conceptual framework for understanding social support for persons living with SMI and lay the groundwork for the development of a SMI-specific measure of social support. In addition, our research permits future researchers to investigate the conditions under which social support buffers the impact of SMI stressors, assisting service providers in more effective identification of individual support needs for clinical intervention. PMID:26009778

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.

Qualitative Analysis of Resources and Barriers for Borderline Personality Disorder in the U.S.

PubMed Central

Lohman, Matthew C.; Whiteman, Karen L.; Yeomans, Frank E.; Cherico, Sheila A.; Christ, Winifred R.

2016-01-01

Objective Resources and treatment for individuals with borderline personality disorder (BPD) are limited and often difficult to obtain. Experiences and preferences of individuals seeking care are seldom examined but important elements in determining challenges to obtaining appropriate care. This article aimed to identify key resources for and barriers to obtaining supportive and treatment services for BPD, from the perspective of individuals seeking care. Methods Data came from transcripts of resource requests made to the Borderline Personality Disorder Resource Center from January 2008 to December 2015 (N=6,253). Basic statistics regarding requested BPD service types, demographic information, and national distribution of requests were generated for all eligible transcripts. Qualitative analysis was used to identify themes, challenges, and common experiences reported among a random subset of those seeking services (N=500). Results Primary services or resources requested were outpatient services (51%), informational materials (13%), and daycare programs (9%). Care-seekers identified family services, crisis intervention, and mental health literacy as areas where available resources did not meet current demand and which could be improved and/or expanded. Factors identified as potential barriers to finding and obtaining appropriate treatment for BPD included stigmatization and marginalization within mental healthcare systems, financial concerns, and comorbidity with psychiatric or medical disorders. Conclusions Individuals seeking supportive services and treatment for BPD face numerous barriers to obtaining appropriate care. Expanded services and resources to connect individuals with treatment are needed to meet the current demands and preferences of those seeking care. PMID:27691382

Recovery practice in community mental health teams: national survey

PubMed Central

Leamy, M.; Clarke, E.; Le Boutillier, C.; Bird, V.; Choudhury, R.; MacPherson, R.; Pesola, F.; Sabas, K.; Williams, J.; Williams, P.; Slade, M.

2016-01-01

Background There is consensus about the importance of ‘recovery’ in mental health services, but the link between recovery orientation of mental health teams and personal recovery of individuals has been underresearched. Aims To investigate differences in team leader, clinician and service user perspectives of recovery orientation of community adult mental health teams in England. Method In six English mental health National Health Service (NHS) trusts, randomly chosen community adult mental health teams were surveyed. A random sample of ten patients, one team leader and a convenience sample of five clinicians were surveyed from each team. All respondents rated the recovery orientation of their team using parallel versions of the Recovery Self Assessment (RSA). In addition, service users also rated their own personal recovery using the Questionnaire about Processes of Recovery (QPR). Results Team leaders (n = 22) rated recovery orientation higher than clinicians (n = 109) or patients (n = 120) (Wald(2) = 7.0, P = 0.03), and both NHS trust and team type influenced RSA ratings. Patient-rated recovery orientation was a predictor of personal recovery (b = 0.58, 95% CI 0.31–0.85, P<0.001). Team leaders and clinicians with experience of mental illness (39%) or supporting a family member or friend with mental illness (76%) did not differ in their RSA ratings from other team leaders or clinicians. Conclusions Compared with team leaders, frontline clinicians and service users have less positive views on recovery orientation. Increasing recovery orientation may support personal recovery. PMID:27340113

The public's priorities in health services.

PubMed

Kaplan, Giora; Baron-Epel, Orna

2015-10-01

Rationing in health services cannot be solved only by cost-effective analysis because social values play a central role in the difficult trade-off dilemma of prioritizing some service over others. To examine the relative importance ascribed by the public to selected components of health services, in the national allocation of resources as well as in their personal insurance. A telephone survey of a representative sample of the Israeli adult population (N = 1225). Two versions of the questionnaire were used. At the national level, interviewees were asked to assume they were the Minister of Health. At the personal level, interviewees were asked to choose items to be included in their personal complementary health insurance. Check-ups for early disease detection and nursing care for the frail elderly got the highest support for extra budget as well as to be included in personal insurance. Other items presented were fertility treatments, cardiac rehabilitation, mental health, dental health, programmes for preventive medicine and health promotion, subsidizing supplemental insurance for the poor, additional staff for primary clinics and building a new hospital. The lowest support was for alternative medicine and for cosmetic surgery. No subgroup in the Israeli society presented a different first priority. The Israeli public does not give high priority to 'nice to have' services but their selections are 'mature' and responsible. Rationing in health care requires listening to the public even if there are still many methodological limitations on how to reflect the public's opinion. © 2013 Blackwell Publishing Ltd.

A community-based peer support service for persons with severe mental illness in China.

PubMed

Fan, Yunge; Ma, Ning; Ma, Liang; Xu, Wei; Steven Lamberti, J; Caine, Eric D

2018-06-04

Peer support services for patients with severe mental illness (SMI) originated from Western countries and have become increasingly popular during the past twenty years. The aim of this paper is to describe a peer service model and its implementation in China, including the model's feasibility and sustainability. A peer support service was developed in four Chinese communities. Implementation, feasibility and sustainability were assessed across five domains: Service process, service contents, peer training and supervision, service satisfaction, and service perceived benefit. Service process: 214 peer support activities were held between July 2013 and June 2016. No adverse events occurred during three years. Each activity ranged from 40 to 120 min; most were conducted in a community rehabilitation center or community health care center. Service content: Activities focused on eight primary topics-daily life skills, social skills, knowledge of mental disorders, entertainment, fine motor skill practice, personal perceptions, healthy life style support, emotional support. Peer training and supervision: Intensive training was provided for all peers before they started to provide services. Regular supervision and continued training were provided thereafter; online supervision supplemented face to face meetings. Service satisfaction: Nineteen consumers (79.2%) (χ 2 (1) = 12.76, p < 0.001) were satisfied with the peers and 17 consumers (70.8%) (χ 2 (1) = 8.05, p = 0.005) expressed a strong desire to continue to participate in the service. Fourteen caregivers (93.3%) (χ 2 (1) = 11.27, p = 0.001) wanted the patients to continue to organize or participate in the service. Service perceived benefit: Six peers (85.7%) (χ 2 (1) = 3.57, p = 0.059) reported an improvement of working skills. Ten consumers (41.7%) (χ 2 (1) = 0.05, p = 0.827) reported better social communication skills. Six caregivers (40%) (χ 2 (1) = 1.67, p = 0.197) observed patients' increase in social communication skills, five (33.3%) (χ 2 (1) = 1.67, p = 0.197) found their own mood had been improved. Peer support services for patients with SMI can be sustainably implemented within Chinese communities without adverse events that jeopardize safety and patient stability. Suggestions for future service development include having professionals give increased levels of support to peers at the beginning of a new program. A culturally consistent peer service manual, including peer role definition, peer training curriculum, and supervision methods, should be developed to help implement the service smoothly.

Integrated prevention services for HIV infection, viral hepatitis, sexually transmitted diseases, and tuberculosis for persons who use drugs illicitly: summary guidance from CDC and the U.S. Department of Health and Human Services.

PubMed

2012-11-09

This report summarizes current (as of 2011) guidelines or recommendations published by multiple agencies of the U.S. Department of Health and Human Services (DHHS) for prevention and control of human immunodeficiency virus (HIV) infection, viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB) for persons who use drugs illicitly. It also summarizes existing evidence of effectiveness for practices to support delivery of integrated prevention services. Implementing integrated services for prevention of HIV infection, viral hepatitis, STDs, and TB is intended to provide persons who use drugs illicitly with increased access to services, to improve timeliness of service delivery, and to increase effectiveness of efforts to prevent infectious diseases that share common risk factors, behaviors, and social determinants. This guidance is intended for use by decision makers (e.g., local and federal agencies and leaders and managers of prevention and treatment services), health-care providers, social service providers, and prevention and treatment support groups. Consolidated guidance can strengthen efforts of health-care providers and public health providers to prevent and treat infectious diseases and substance use and mental disorders, use resources efficiently, and improve health-care services and outcomes in persons who use drugs illicitly. An integrated approach to service delivery for persons who use drugs incorporates recommended science-based public health strategies, including 1) prevention and treatment of substance use and mental disorders; 2) outreach programs; 3) risk assessment for illicit use of drugs; 4) risk assessment for infectious diseases; 5) screening, diagnosis, and counseling for infectious diseases; 6) vaccination; 7) prevention of mother-to-child transmission of infectious diseases; 8) interventions for reduction of risk behaviors; 9) partner services and contact follow-up; 10) referrals and linkage to care; 11) medical treatment for infectious diseases; and 12) delivery of integrated prevention services. These strategies are science-based, public health strategies to prevent and treat infectious diseases, substance use disorders, and mental disorders. Treatment of infectious diseases and treatment of substance use and mental disorders contribute to prevention of transmission of infectious diseases. Integrating prevention services can increase access to and timeliness of prevention and treatment.

32 CFR 77.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... services. (1) Elementary, secondary, or post secondary school teaching or administration. (2) Support of teachers or school administrators. (3) Law enforcement. (4) Public health care. (5) Social services. (6... reduction in force. (g) Transition assistance program counselor. A person charged with the responsibility of...

32 CFR 77.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... services. (1) Elementary, secondary, or post secondary school teaching or administration. (2) Support of teachers or school administrators. (3) Law enforcement. (4) Public health care. (5) Social services. (6... reduction in force. (g) Transition assistance program counselor. A person charged with the responsibility of...

Personal assistance services in the workplace: A literature review.

PubMed

Dowler, Denetta L; Solovieva, Tatiana I; Walls, Richard T

2011-10-01

Personal assistance services (PAS) can be valuable adjuncts to the complement of accommodations that support workers with disabilities. This literature review explored the professional literature on the use of PAS in the workplace. Bibliographic sources were used to locate relevant research studies on the use of PAS in the workplace. The studies in this review used both qualitative and quantitative methods to identify current definitions of work-related and personal care-related PAS, agency-directed versus consumer-directed PAS, long-term and short-term funding issues, development of PAS policy, and barriers to successful implementation of PAS. The studies uncovered issues related to (a) recruiting, training, and retaining personal assistants, (b) employer concerns, (c) costs and benefits of workplace PAS, (d) wages and incentives for personal assistants, and (e) sources for financing PAS as a workplace accommodation. The findings reveal the value and benefits of effective PAS on the job. PAS can lead to successful employment of people with disabilities when other accommodations cannot provide adequate workplace support. Additionally, the evolution of workplace PAS is dependent on development of realistic PAS policy and funding options. Published by Elsevier Inc.

"The more you know, the more you realise it is really challenging to do": Tensions and uncertainties in person-centred support for people with long-term conditions.

PubMed

Entwistle, Vikki A; Cribb, Alan; Watt, Ian S; Skea, Zoë C; Owens, John; Morgan, Heather M; Christmas, Simon

2018-03-30

To identify and examine tensions and uncertainties in person-centred approaches to self-management support - approaches that take patients seriously as moral agents and orient support to enable them to live (and die) well on their own terms. Interviews with 26 UK clinicians about working with people with diabetes or Parkinson's disease, conducted within a broader interdisciplinary project on self-management support. The analysis reported here was informed by philosophical reasoning and discussions with stakeholders. Person-centred approaches require clinicians to balance tensions between the many things that can matter in life, and their own and each patient's perspectives on these. Clinicians must ensure that their supportive efforts do not inadvertently disempower people. When attending to someone's particular circumstances and perspectives, they sometimes face intractable uncertainties, including about what is most important to the person and what, realistically, the person can or could do and achieve. The kinds of professional judgement that person-centred working necessitates are not always acknowledged and supported. Practical and ethical tensions are inherent in person-centred support and need to be better understood and addressed. Professional development and service improvement initiatives should recognise these tensions and uncertainties and support clinicians to navigate them well. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Can't get it out of my mind: employee rumination after customer mistreatment and negative mood in the next morning.

PubMed

Wang, Mo; Liu, Songqi; Liao, Hui; Gong, Yaping; Kammeyer-Mueller, John; Shi, Junqi

2013-11-01

Drawing on cognitive rumination theories and conceptualizing customer service interaction as a goal attainment situation for service employees, the current study examined employee rumination about negative service encounters as an intermediate cognitive process that explains the within-person fluctuations in negative emotional reactions resulting from customer mistreatment. Multilevel analyses of 149 call-center employees' 1,189 daily surveys revealed that on days that a service employee received more (vs. less) customer mistreatment, he or she ruminated more (vs. less) at night about negative encounters with customers, which in turn led to higher (vs. lower) levels of negative mood experienced in the next morning. In addition, service rule commitment and perceived organizational support moderated the within-person effect of customer mistreatment on rumination, such that this effect was stronger among those who had higher (vs. lower) levels of service rule commitment but weaker among those who had higher (vs. lower) levels of perceived organizational support. Theoretical and practical implications of these findings are discussed. (c) 2013 APA, all rights reserved.

Long-Term Experiences in Cash and Counseling for Young Adults with Intellectual Disabilities: Familial Programme Representative Descriptions.

PubMed

Harry, Melissa L; MacDonald, Lynn; McLuckie, Althea; Battista, Christina; Mahoney, Ellen K; Mahoney, Kevin J

2017-07-01

Our aim was to explore previously unknown long-term outcomes of self-directed personal care services for young adults with intellectual disabilities and limitations in activities of daily living. The present authors utilized participatory action research and qualitative content analysis in interviewing 11 unpaid familial programme representatives of young adults with intellectual disabilities, ages 23-34, who were eligible for income-based Medicaid and enrolled five or more years in a Cash and Counseling-based programme of self-direction in the United States. Young adults are represented as receiving services and supports in a supportive and stable environment, with previously identified short-term programme benefits evident over the long-term. Young adults are also transitioning to adulthood at home with their families as primary social support and caregivers, bridging a service gap. Our results show that self-direction helps meet these young adults' personal care and community engagement needs over time. © 2016 John Wiley & Sons Ltd.

Open access support groups for people experiencing personality disorders: do group members' experiences reflect the theoretical foundations of the SUN project?

PubMed

Gillard, Steve; White, Rachel; Miller, Steve; Turner, Kati

2015-03-01

The SUN Project is an innovative, open access support group, based in the community, for people experiencing personality disorders, developed in response to UK Department of Health policy advocating improvements in personality disorders services. The aim of this article is to critically explore where and how the theoretically informed model underpinning the SUN Project is reflected in the view and experiences of people attending the project. This article reports an in-depth, qualitative interview-based study employing a critical realist approach. As part of a larger study about self-care and mental health, in-depth qualitative interviews were held with 38 people new to the SUN Project, and again 9 months later. Data were extracted that were relevant to core components of the project model and were subjected to thematic analysis. The critical realist approach was used to move back and forth between empirical data and theory underpinning the SUN project, providing critical insight into the model. Participant accounts were broadly concordant with core components of the SUN Project's underlying model: Open access and self-referral; group therapeutic processes; community-based support; service users as staff. There were some tensions between interviewee accounts and theoretical aspects of the model, notably around the challenges that group processes presented for some individuals. The model underlying the SUN Project is useful in informing good practice in therapeutic, community-based peer support groups for people experiencing personality disorders. Careful consideration should be given to a limited multi-modal approach, providing focused one-to-one support for vulnerable individuals who find it hard to engage in group processes. Facilitated peer support groups based in the community may act as a powerful therapeutic resource for people experiencing personality disorders. Promoting open access and self-referral to support groups may increase feelings of empowerment and engagement for people experiencing personality disorders. Some individuals experiencing personality disorders who could potentially benefit from therapeutic groups may need focused one-to-one support to do so. © 2014 The British Psychological Society.

Design and technical evaluation of an enhanced location-awareness service enabler for spatial disorientation management of elderly with mild cognitive impairment.

PubMed

Moreno, Pedro A; Hernando, M Elena; Gómez, Enrique J

2015-01-01

The progressive ageing of population has turned the mild cognitive impairment (MCI) into a prevalent disease suffered by elderly. Consequently, the spatial disorientation has become a significant problem for older people and their caregivers. The ambient-assisted living applications are offering location-based services for empowering elderly to go outside and encouraging a greater independence. Therefore, this paper describes the design and technical evaluation of a location-awareness service enabler aimed at supporting and managing probable wandering situations of a person with MCI. Through the presence capabilities of the IP multimedia subsystem (IMS) architecture, the service will alert patient's contacts if a hazardous situation is detected depending on his location. Furthermore, information about the older person's security areas has been included in the user profile managed by IMS. In doing so, the service enabler introduced contribute to "context-awareness" paradigm allowing the adaptation and personalization of services depending on user's context and specific conditions or preferences.

Have they done what they should? Moral reasoning in the context of translating older persons' everyday problems into eligible needs for home modification services.

PubMed

Johansson, Karin

2013-09-01

This study explores how moral reasoning is expressed in matching health care with the problems older persons experience in their everyday life. Narrative data were collected from older persons who had applied for home modification services and from professionals involved in these services in Sweden. A theoretical framework, based on theories on the anthropology of morals, was applied to explore how the participants made conclusions about "what should be done." Moral reasoning was found to be guided by ideologies related to the historical and cultural context of the Swedish welfare state. Different interpretations of how these values should be expressed in specific situations led to different conclusions about what should be done. The study highlights the importance of understanding how values are enacted rather than what values different social agents have in order to understand how health care services can be designed and provided to support older persons' everyday life. © 2013 by the American Anthropological Association.

Interfacing the VAX 11/780 Using Berkeley Unix 4.2.BSD and Ethernet Based Xerox Network Systems. Volume 1.

DTIC Science & Technology

1984-12-01

3Com Corporation ....... A-18 Ethernet Controller Support . . . . . . A-19 Host Systems Support . . . . . . . . . A-20 Personal Computers Support...A-23 VAX EtherSeries Software 0 * A-23 Network Research Corporation . o o o . o A-24 File Transfer Service . . . . o A-25 Virtual Terminal Service 0...Control office is planning to acquire a Digital Equipment Corporation VAX 11/780 mainframe computer with the Unix Berkeley 4.2BSD operating system. They

Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study.

PubMed

Heslehurst, Nicola; Dinsdale, Sarah; Brandon, Helene; Johnston, Camilla; Summerbell, Carolyn; Rankin, Judith

2017-06-01

to understand the lived experiences and views of being referred to an antenatal dietetic service from the perspective of pregnant women with obesity. a qualitative, interpretive approach using one-to-one in-depth interviews to explore the lived experience of pregnant women with obesity following referral to an antenatal dietetics service. Thematic content analysis was carried out by two researchers independently to develop data-driven themes. one NHS Trust maternity and dietetic services, North East England, UK. fifteen pregnant women with a booking body mass index ≥30kg/m 2 attending an obesity-specific antenatal dietetic service. All women were White, parity between 0 and 2, and BMI range 30-51kg/m 2 . four themes were identified. (1) Women's overall experience of the service: experiences were predominately positive with only two negative cases identified. (2) Process of referral: women placed importance on informative and in-person communication about the service, with health professionals, at the point of referral. (3) Delivery of the service: dietitians were considered to be the experts and women wanted more frequent contact. (4) Content of the service: tailored advice enabled behaviour change, and women desired increased physical activity support and weight monitoring. women reported an overall positive experience and thought that dietitians were the expert health professionals to support them. Women in this study felt that tailoring advice specific to their personal circumstances helped them implement changes, and had a strong interest in the nutritional benefits for fetal development. Women considered weight monitoring to be a positive element of the service; however, further research is required given the limited and conflicting evidence-base. it is important to incorporate women's experiences in the development and delivery of antenatal weight management services to facilitate person-centred care. Communication by health professionals at the point of referral is particularly important to provide accurate expectations of services and to reduce anxieties. Dietitians are considered to be appropriate experts to deliver these services, although they may need additional support to address women's physical activity needs in pregnancy. Copyright © 2016 Elsevier Ltd. All rights reserved.

Discussing Poverty as a Student Issue: Making a Case for Student Human Services

ERIC Educational Resources Information Center

Cady, Clare

2012-01-01

Student poverty is an issue with which far too many students are confronted. Student affairs professionals must increase their awareness of this human dynamic and develop programs, services, and personal knowledge to support students faced with this challenge.

Serving Gifted and Talented Students: A Resource for School Personnel.

ERIC Educational Resources Information Center

Genshaft, Judy L., Ed.; And Others

This collection considers the personal and educational needs of the student who is gifted, with emphasis on the roles of support staff. It covers developmental perspectives; assessment, identification, and evaluation issues; educational services; personal, interpersonal, and cultural issues; intervention strategies; and gifted education issues.…

Health care access and support for disabled women in Canada: falling short of the UN Convention on the Rights of Persons with Disabilities: a qualitative study.

PubMed

Gibson, Barbara E; Mykitiuk, Roxanne

2012-01-01

The United Nations Convention on the Rights of Persons with Disabilities and other international human rights conventions guarantee the fundamental human rights to physical, social, and psychological health. The purpose of this study was to examine whether these rights are being upheld in Canada for disabled women. An interpretive, qualitative, focus group design was employed. Participants were women 18 to 67 years of age with a self-identified physical, sensory, cognitive, and/or psychiatric impairment. Eleven focus groups were conducted with 74 disabled women from urban and rural settings in Northern Ontario, Manitoba, and Nova Scotia. The data were analyzed for themes using a flexible coding system derived from and consistent with the research objectives and the study's human rights framework. Participants described multiple intersecting factors that impeded or facilitated access to health care. Services included both generic health services and impairment-specific services. Participants experienced a number of barriers accessing professionals, support programs, and services. These are described under three broad themes: 1) Labyrinthine health service 'systems,' 2) assumptions, attitudes, and discriminatory practices, and 3) inadequate sexual health or reproductive services and supports. The results suggest that Canada falls significantly short of guaranteeing disabled women's human rights to access health care supports and services. Access barriers resulted from the inefficiencies and complexities of the multiple agencies and programs that disabled women had to navigate, difficulties accessing information on available services, and negative attitudes of some health and social service providers. Copyright © 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Professional discipline and support recommendations for family caregivers of persons with dementia.

PubMed

Gaugler, Joseph E; Westra, Bonnie L; Kane, Robert L

2016-06-01

Family caregivers of persons with dementia often require support services to help ease the challenges of providing care. Although the efficacy of some dementia caregiver interventions seems apparent, evidence indicating which types of protocols can best meet the diverse needs of individual families is not yet available. Because of this gap, families must often turn to professionals for such guidance, but it remains unknown whether professionals from different disciplines are more inclined to recommend particular types of services than others. This study assessed whether recommendations of supportive interventions to hypothetical dementia family caregivers differed by professional discipline. In a cross-sectional survey design, a convenience sample of 422 dementia care professionals across the USA viewed up to 24 randomly selected, hypothetical scenarios that systematically varied characteristics of persons with dementia and their caregivers. For each scenario, 7 possible intervention recommendations were rated. A total of 6,890 scenarios were rated and served as the unit of analysis. General linear models revealed that discipline was often a stronger predictor of how likely professionals were to recommend dementia caregiver interventions than caregiver, care recipient, or other professional characteristics. Psychotherapists tended to recommend psychoeducation more than other professionals, while those in medicine were more likely to recommend training of the person with dementia and psychotherapy. The heterogeneity in recommendations suggests that the professional source of information influences the types of support families are directed toward. Empirical evidence should inform these professional judgments to better achieve person-centered care for families.

A comparison of consumer-directed and agency-directed personal assistance services programmes.

PubMed

Hagglund, Kristofer; Clark, Mary; Farmer, Janet; Sherman, Ashley

2004-05-06

To compare a consumer-directed personal assistance services (PAS) programme with an agency-directed PAS programme. A convenience sample was used for this cross-sectional study with one data collection point. Outcomes were compared for consumer-directed and agency-directed PAS. Hierarchical regressions were also used to determine the predictors of outcomes across PAS programmes. In-home interviews were conducted by a trained data collector from April 2000 to December 2001. Participants in the consumer-directed programme reported more choices over PAS and satisfaction with PAS. Self-reported outcomes were primarily predicted by the following variables: service arrangement, type of provider, importance of directing PAS, health status, number of personal assistants used in past 12 months, sufficient PAS hours received, and social support. Consumer-directed PAS enhances outcomes for many persons with disabilities. Self-reported outcomes are affected by many factors that could be addressed in PAS programme development.

From Framework to Practice: Person-Directed Planning in the Real World.

PubMed

Martin, Lynn; Grandia, Philip; Ouellette-Kuntz, Hélène; Cobigo, Virginie

2016-11-01

Person-directed planning (PDP) is an approach to planning supports that aims to redistribute power from the service system to individuals with intellectual and developmental disabilities (IDD) and natural supports, improve relationships and build community. To do this, the right people with the right attitudes engaging in the right actions are needed. This paper examines how key elements in PDP contribute to successes in planning. Researchers worked with three planning teams from different community service agencies using participatory action research techniques (i.e. free list and pile sort, Socratic wheel, whys/hows exercise). Most key elements of PDP were relevant to each team. Perceptions of which had most contributed to planning successes differed. The various elements of PDP are used by and useful to planning teams, although some may be more relevant to some successes than others because of specific goals, or the person's strengths and needs. © 2015 John Wiley & Sons Ltd.

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.

Telephone Support During Overseas Deployment for Military Spouses

DTIC Science & Technology

2017-12-01

other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a...negotiating roles and relationships; changes during deployment; strategies to support the spouse and the service member; and cues to alert spouses when to...14 o Table 4. Decision Making When Service Member (SM) Home and Deployed ............. 15 • Spouse Deployed Contents – Elearning modules

Carer and service providers' experiences of individual funding models for children with a disability in rural and remote areas.

PubMed

Dew, Angela; Bulkeley, Kim; Veitch, Craig; Bundy, Anita; Lincoln, Michelle; Brentnall, Jennie; Gallego, Gisselle; Griffiths, Scott

2013-07-01

There is a global movement for people with a disability towards person-centred practices with opportunities for self-determination and choice. Person-centred approaches may involve individual funding (IF) for the purchase of required support. A shift to a person-centred model and IF should allow people with a disability and their carers greater choice in therapy access. However, individuals who live in rural and remote areas have less choice and access to therapy services than their metropolitan counterparts. Drawing on data from a larger study into therapy service delivery in a rural and remote area of New South Wales, Australia, this study describes some benefits and barriers to using IF to access therapy services in rural areas. Ten carers and 60 service providers participated in audio-recorded focus groups and individual interviews during which IF was discussed. Transcribed data were analysed using thematic analysis and constant comparison. Greater access to and choice of therapy providers were identified as benefits of IF. Four barriers were identified: (i) lack of information and advice; (ii) limited local service options and capacity; (iii) higher costs and fewer services and (iv) complexity of self-managing packages. A range of strategies is required to address the barriers to using IF in rural and remote areas. Carers indicated a need for: accessible information; a local contact person for support and guidance; adequate financial compensation to offset additional travel expenses and coordinated eligibility and accountability systems. Service providers required: coordinated cross-sector approaches; local workforce planning to address therapist shortages; certainty around service viability and growth; clear policies and procedures around implementation of IF. This study highlights the need for further discussion and research about how to overcome the barriers to the optimal use of an IF model for those living in rural and remote areas. © 2013 John Wiley & Sons Ltd.

Personality Development during Teacher Preparation.

PubMed

Corcoran, Roisin P; O'Flaherty, Joanne

2016-01-01

Objective: The purpose of this 3-year longitudinal study was to examine pre-service teachers' personality trajectories as measured by the IPIP Big-Five factor markers during teacher preparation. The relationship between students' personality traits, social desirability, and prior academic attainment was also examined. Method: This 3-year longitudinal study invited participants from the first year of a 4-year undergraduate (UG) pre-service teacher education program, the class of 2017. The sample consisted of 305 students. Results: The results suggest that extraversion, agreeableness, conscientiousness, emotional stability, and openness to experience were best represented by a non-significant longitudinal change in means. Results also suggest that social desirability predicts agreeableness and emotional stability with small to moderate effect sizes. Conclusion: The study concludes that no value is added to pre-service teachers' personality traits during 3 years of tertiary education. Furthermore, the data presented does not support the view that academic attainment is a good predictor of personality traits. Implications for educational research, theory, and practice are considered.

Personality Development during Teacher Preparation

PubMed Central

Corcoran, Roisin P.; O’Flaherty, Joanne

2016-01-01

Objective: The purpose of this 3-year longitudinal study was to examine pre-service teachers’ personality trajectories as measured by the IPIP Big-Five factor markers during teacher preparation. The relationship between students’ personality traits, social desirability, and prior academic attainment was also examined. Method: This 3-year longitudinal study invited participants from the first year of a 4-year undergraduate (UG) pre-service teacher education program, the class of 2017. The sample consisted of 305 students. Results: The results suggest that extraversion, agreeableness, conscientiousness, emotional stability, and openness to experience were best represented by a non-significant longitudinal change in means. Results also suggest that social desirability predicts agreeableness and emotional stability with small to moderate effect sizes. Conclusion: The study concludes that no value is added to pre-service teachers’ personality traits during 3 years of tertiary education. Furthermore, the data presented does not support the view that academic attainment is a good predictor of personality traits. Implications for educational research, theory, and practice are considered. PMID:27877143

PERSONAL HEALTH BUDGETS IN ENGLAND: MOOD MUSIC OR DEATH KNELL FOR THE NATIONAL HEALTH SERVICE?

PubMed

Scott-Samuel, Alex

2015-01-01

Personal health budgets in England are National Health Service (NHS) funds that can be allocated to certain groups of patients to allow them, together with their NHS support staff, to purchase services or equipment that they believe will enhance their health and well-being. Some see this as a welcome personalization of health care that increases people's control over their health. However, personal health budgets are being introduced at a time when rapid privatization of the English NHS is taking place and when restrictions are being placed on people's access to health care. As a result, many view their introduction as a diversionary gimmick designed to help pave the way for the conversion of the NHS into the insurance-based system, which many believe is the intention of the U.K. government. This article describes the research and policy context in which this controversial intervention is being introduced and presents recent expert debate between proponents and opponents of personal health budgets, from e-mail discussion lists.

Payment rates for personal care assistants and the use of long-term services and supports among those dually eligible for Medicare and Medicaid.

PubMed

Ko, Michelle; Newcomer, Robert; Kang, Taewoon; Hulett, Denis; Chu, Philip; Bindman, Andrew B

2014-12-01

To examine the association between payment rates for personal care assistants and use of long-term services and supports (LTSS) following hospital discharge among dual eligible Medicare and Medicaid beneficiaries. State hospital discharge, Medicaid and Medicare claims, and assessment data on California Medicaid LTSS users from 2006 to 2008. Cross-sectional study. We used multinomial logistic regression to analyze county personal care assistant payment rates and postdischarge LTSS use, and estimate marginal probabilities of each outcome across the range of rates paid in California. We identified dual eligible Medicare and Medicaid adult beneficiaries discharged from an acute care hospital with no hospitalizations or LTSS use in the preceding 12 months. Personal care assistant payment rates were modestly associated with home and community-based services (HCBS) use versus nursing facility entry following hospital discharge (RRR 1.2, 95 percent CI: 1.0-1.4). For a rate of $6.75 per hour, the probability of HCBS use was 5.6 percent (95 percent CI: 4.2-7.1); at $11.75 per hour, 18.0 percent (95 percent CI: 12.5-23.4). Payment rate was not associated with the probability of nursing facility entry. Higher payment rates for personal care assistants may increase utilization of HCBS, but with limited substitution for nursing facility care. © Health Research and Educational Trust.

The Usage of Homebound Instruction: Training, Preparation, and Perceptions of Service Providers

ERIC Educational Resources Information Center

Petit, Constance C.

2013-01-01

This study presents the findings related to the use of homebound instruction as a special education service model and to the practices and perceptions of service providers in the areas of personal effectiveness, model effectiveness, and administrator support. A self-administered survey was distributed to a national sample of 484 educators from two…

Social Adaptation of Refugees. A Guide for Service Providers.

ERIC Educational Resources Information Center

Center for Applied Linguistics, Washington, DC. Language and Orientation Resource Center.

This guide is intended for persons who are concerned with the social adjustment of refugees in the United States. Its objectives are threefold: (1) to help the service providers better understand the refugee as an individual; (2) to add to the knowledge of how to provide culturally-appropriate services and support for the needs of newly arrived…

National Guard Bureau Joint Staff

Science.gov Websites

, Publications Management, Administrative Services, Joint Staff Information Data Systems, Property Book -7 J-8 Personal Staff Inspector General Judge Advocate General Officer Management Public Affairs Executive Support Services Legislative Liaison Special Staff Directorate of Management Office of the Provost

31 CFR 542.516 - Certain services in support of nongovernmental organizations' activities authorized.

Code of Federal Regulations, 2014 CFR

2014-07-01

... limited to, preventing infectious disease and promoting maternal/child health, sustainable agriculture..., or through the Government of Syria or any other person whose property and interests in property are... other transactions involving, the Government of Syria or any other person whose property and interests...

Enhancing Personal Outcomes: Organizational Strategies, Guidelines, and Examples

ERIC Educational Resources Information Center

Schalock, Robert L.; Verdugo, Miquel A.; Bonham, Gordon S.; Fantova, Fernando; Van Loon, Jos

2008-01-01

Education and rehabilitation programs in the field of intellectual disabilities are developing specific strategies related to demonstrated personal outcomes, quality of life (QOL)-related services and supports, evidence-based practices, and quality improvement. The purpose of this article is to summarize key aspects of these strategies within a…

An Implemented Strategy for Campus Connectivity and Cooperative Computing.

ERIC Educational Resources Information Center

Halaris, Antony S.; Sloan, Lynda W.

1989-01-01

ConnectPac, a software package developed at Iona College to allow a computer user to access all services from a single personal computer, is described. ConnectPac uses mainframe computing to support a campus computing network, integrating personal and centralized computing into a menu-driven user environment. (Author/MLW)

Postsecondary Education and Persons with Intellectual Disabilities: An Introduction

ERIC Educational Resources Information Center

Stodden, Robert A.; Whelley, Teresa

2004-01-01

Legislation in recent years, including the ADA , IDEA, and the Olmstead Act, has vastly affected the accessibility of postsecondary education for persons with disabilities. This paper presents an overview of that legislation and considers how the resultant supports and services have become more flexible and increasingly tailored to the…

[Voluntary help in dementia - predictors for utilisation and expected quality from a family caregiver's point of view].

PubMed

Grässel, E; Luttenberger, K; Römer, H; Donath, C

2010-09-01

Although support services are considered cost-effective in the relief of care-giving family members of dementia patients, there has been little research to date on the predictors of use and quality expectations. These two questions are examined for the first time based on cross-sectional data of 404 care-giving family members, users and non-users of voluntary help services. Quantitative data are evaluated using binary logistical regression analysis, qualitative data using content analysis. The rating of how helpful the use of a voluntary help service is in the personal situation was found to be the only significant predictor of use. With respect to quality, it is most important that the persons giving support be punctual and well-trained. To increase the rate of use, care-giving family members must be convinced of the relevant benefits of using a voluntary help service. In addition, attention must be paid to the professional organization and training of voluntary helpers. Georg Thieme Verlag KG Stuttgart, New York.

Virtual working systems to support R&D groups

NASA Astrophysics Data System (ADS)

Dew, Peter M.; Leigh, Christine; Drew, Richard S.; Morris, David; Curson, Jayne

1995-03-01

The paper reports on the progress at Leeds University to build a Virtual Science Park (VSP) to enhance the University's ability to interact with industry, grow its applied research and workplace learning activities. The VSP exploits the advances in real time collaborative computing and networking to provide an environment that meets the objectives of physically based science parks without the need for the organizations to relocate. It provides an integrated set of services (e.g. virtual consultancy, workbased learning) built around a structured person- centered information model. This model supports the integration of tools for: (a) navigating around the information space; (b) browsing information stored within the VSP database; (c) communicating through a variety of Person-to-Person collaborative tools; and (d) the ability to the information stored in the VSP including the relationships to other information that support the underlying model. The paper gives an overview of a generic virtual working system based on X.500 directory services and the World-Wide Web that can be used to support the Virtual Science Park. Finally the paper discusses some of the research issues that need to be addressed to fully realize a Virtual Science Park.

Developing a uniformed assessment tool to evaluate care service needs for disabled persons in Japan.

PubMed

Takei, Teiji; Takahashi, Hiroshi; Nakatani, Hiroki

2008-05-01

Until recently, the care services for disabled persons have been under rigid control by public sectors in terms of provision and funding in Japan. A reform was introduced in 2003 that brought a rapid increase of utilization of services and serious shortage of financial resources. Under these circumstances, the "Services and Supports for Persons with Disabilities Act" was enacted in 2005, requiring that the care service provision process should be transparent, fair and standardized. The purpose of this study is to develop an objective tool for assessing the need for disability care. In the present study we evaluate 1423 cases of patients receiving care services in 60 municipalities, including all three categories of disabilities (physical, intellectual and mental). Using the data of the total 106 items, we conducted factor analysis and regression analysis to develop an assessment tool for people with disabilities. The data revealed that instrumental activities of daily living (IADL) played an essential role in assessing disability levels. We have developed the uniformed assessment tool that has been utilized to guide the types and quantity of care services throughout Japan.

Death of a Special Person: The Grieving Process. Symposium (University of Central Texas, Killean, Texas, November 13, 1991).

ERIC Educational Resources Information Center

Dean, Diana; And Others

This document is the transcript of a symposium that presented information to persons employed or anticipating employment in the human services field in order to assist them in providing support for survivors attempting to cope with the death of a special person. The symposium included the following topics: models of responses to bereavement (those…

23 CFR 230.204 - Implementation of supportive services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... majority and minority contractors, contractors' associations, minority groups, and other persons or..., such as technical assistance, managerial assistance, counseling, certification assistance, and follow...

Risk behavior and access to HIV/AIDS prevention services in a community sample of homeless persons entering permanent supportive housing.

PubMed

Wenzel, Suzanne L; Rhoades, Harmony; Harris, Taylor; Winetrobe, Hailey; Rice, Eric; Henwood, Ben

2017-05-01

Homeless persons suffer disproportionately high rates of HIV infection, and moving into permanent supportive housing (PSH) can provide a stable base from which to access needed prevention services. However, little is known about HIV risk or prevention behavior during this critical time of transition. The current study investigated STI and HIV risk and prevention behavior and recent use of prevention and treatment services (i.e., education, testing, medication) among homeless persons preparing to move into PSH. Data come from interviews with 421 homeless adults before they moved into PSH. Thirty-seven percent of the respondents were sexually active; of those, 75.7% reported unprotected sex. Nearly two-thirds (64%) reported past year HIV testing and 40% reported testing for another STI. Fewer than one-third (31%) of respondents reported receiving posttest counseling at their last HIV test. HIV seropositivity was self-reported by 10%. Among those persons who were HIV-positive, 57.1% reported less than 100% antiretroviral (ARV) adherence. Among HIV-negative respondents, less than 1% had been prescribed preexposure prophylaxis (PrEP). Less than half (46.4%) of the sample reported any HIV prevention education in the past year. This population of homeless adults about to move into PSH report high rates of HIV risk behavior, but low rates of HIV prevention education and very little PrEP utilization. Further, low rates of ARV adherence among HIV-positive respondents indicate significant risk for HIV transmission and acquisition. Entering PSH is a period of transition for homeless persons when integrated care is critically important to ensure positive health outcomes, but these data suggest that PrEP and other HIV prevention services are poorly accessed among this population. As such, multipronged services that integrate PrEP and other HIV prevention services are needed to prevent transmission and acquisition of HIV in this high-risk, vulnerable population and ensure the health and wellbeing of PSH residents.

How Do Persons with Mild Acquired Cognitive Impairment Use Information and Communication Technology and E-Services? Results from a Swedish National Survey.

PubMed

Eghdam, Aboozar; Bartfai, Aniko; Oldenburg, Christian; Koch, Sabine

2016-01-01

Mild acquired cognitive impairment is a term used to describe a sub-group of persons with mild cognitive impairment who are expected to reach a stable cognitive level over time. One tactic that can be considered for further developing treatment for this group is the use of information and communication technology and e-services. The purpose of this study was to investigate the current use of regular e-services and social media by this group as well as their user experiences. Data were collected through a self-administered survey and analyzed using quantitative methods. The questionnaire included questions regarding the participants' use of and experience with e-services. Categorization of e-services was based on and cross-validated with the International Classification of Functioning, Disability and Health (ICF). To estimate participants' degree and type of impairment, the Cognitive Failure Questionnaire (CFQ), measuring cognitive difficulties in performing everyday tasks, was added. In total, 282 persons with acquired brain injury participated in the survey. The participants' CFQ scores showed that they were suffering from mild to moderate cognitive impairments, most often acquired from traumatic brain injuries (40%). The majority (89%) used e-services in different categories whereof the most popular and essential ones were communication services (59%) and banking (39%) services. Participants with higher total CFQ scores (>58) used more e-services in most of the categories compared to participants with lower scores (<31). Although participants were interested in social media, they were annoyed by advertisements and the Internet speed in general. Some participants reported privacy concerns and addictive behavior. However, they mostly considered e-services to be trustworthy and supportive in different contexts. The usage of electronic devices decreased by age with the exception of electronic tablets that were used by older participants approximately as frequently as by other age groups. Although persons with mild to moderate acquired brain injury used various e-services that are not customized for them, very few participants used self-care health services (apps) and readers (e-readers). Further studies are needed on utilizing these identified aspects for this group to support them with their chronic condition.

Implementing a multi-modal support service model for the family caregivers of persons with age-related macular degeneration: a study protocol for a randomised controlled trial.

PubMed

Gopinath, Bamini; Craig, Ashley; Kifley, Annette; Liew, Gerald; Bloffwitch, Jaye; Vu, Kim Van; Joachim, Nichole; Cummins, Rob; Heraghty, Julie; Broady, Timothy; Hayes, Alison; Mitchell, Paul

2017-08-04

Age-related macular degeneration (AMD) is a leading cause of blindness and low vision among older adults. Previous research shows a high prevalence of distress and disruption to the lifestyle of family caregivers of persons with late AMD. This supports existing evidence that caregivers are 'hidden patients' at risk of poor health outcomes. There is ample scope for improving the support available to caregivers, and further research should be undertaken into developing services that are tailored to the requirements of family caregivers of persons with AMD. This study aims to implement and evaluate an innovative, multi-modal support service programme that aims to empower family caregivers by improving their coping strategies, enhancing hopeful feelings such as self-efficacy and helping them make the most of available sources of social and financial support. A randomised controlled trial consisting of 360 caregiver-patient pairs (180 in each of the intervention and wait-list control groups). The intervention group will receive the following: (1) mail-delivered cognitive behavioural therapy designed to improve psychological adjustment and adaptive coping skills; (2) telephone-delivered group counselling sessions allowing caregivers to explore the impacts of caring and share their experiences; and (3) education on available community services/resources, financial benefits and respite services. The cognitive behavioural therapy embedded in this programme is the best evaluated and widely used psychosocial intervention. The primary outcome is a reduction in caregiver burden. Secondary outcomes include improvements in caregiver mental well-being, quality of life, fatigue and self-efficacy. Economic analysis will inform whether this intervention is cost-effective and if it is feasible to roll out this service on a larger scale. The study was approved by the University of Sydney human research ethics committee. Study findings will be disseminated via presentations at national/international conferences and peer-reviewed journal articles. The trial registration number is ACTRN12616001461482; pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Differences in social support of caregivers living with partners suffering from COPD or dementia.

PubMed

Nordtug, Bente; Krokstad, Steinar; Sletvold, Olav; Holen, Are

2013-05-01

Future patients with chronic diseases will probably remain longer in their homes. To enable family caregivers to meet these challenges, public services and informal support are essential. This study compared social support between home-dwelling caregivers of partners with chronic obstructive pulmonary disease or dementia. A cross-sectional study of 206 caregivers. Professional aid was quantified by the services utilised. Informal support from family and friends was rated by the number of helping persons and the degree of social withdrawal. The Medical Outcomes Study Social Support Survey Form captured perceived social support. For both diseases, increased severity correlated with more utilisation of professional aid. The chronic obstructive pulmonary disease group perceived more social support, reported less social withdrawal and higher numbers of helping persons. Ill partners' aggressive behaviour reduced perceived support. The use of professional aid was negatively associated with the ill partner's level of self-care, and positively correlated with social withdrawal. Professional aid was more utilised by the dementia group and by men. Differences in caregivers' needs for social support were related to their partner's disease. Counteracting social withdrawal, considering type of illness and gender differences may increase the quality of informal care. © 2011 Blackwell Publishing Ltd.

Trust Model for Protection of Personal Health Data in a Global Environment.

PubMed

Ruotsalainen, Pekka; Blobel, Bernd

2017-01-01

Successful health care, eHealth, digital health, and personal health systems increasingly take place in cross-jurisdictional, dynamic and risk-encumbered information space. They require rich amount of personal health information (PHI). Trust is and will be the cornerstone and prerequisite for successful health services. In global environments, trust cannot be expected as granted. In this paper, health service in the global environment is perceived as a meta-system, and a trust management model is developed to support it. The predefined trusting belief currently used in health care is not transferable to global environments. In the authors' model, the level of trust is dynamically calculated from measurable attributes. These attributes describe trust features of the service provider and its environment. The calculated trust value or profile can be used in defining the risk service user has to accept when disclosing PHI, and in definition of additional privacy and security safeguards before disclosing PHI and/or using services.

Knowledge into action - supporting the implementation of evidence into practice in Scotland.

PubMed

Davies, Sandra; Herbert, Paul; Wales, Ann; Ritchie, Karen; Wilson, Suzanne; Dobie, Laura; Thain, Annette

2017-03-01

The knowledge into action model for NHS Scotland provides a framework for librarians and health care staff to support getting evidence into practice. Central to this model is the development of a network of knowledge brokers to facilitate identification, use, creation and sharing of knowledge. To translate the concepts described in the model into tangible activities with the intention of supporting better use of evidence in health care and subsequently improving patient outcomes. Four areas of activity were addressed by small working groups comprising knowledge services staff in local and national boards. The areas of activity were as follows: defining existing and required capabilities and developing learning opportunities for the knowledge broker network; establishing national search and summarising services; developing actionable knowledge tools; and supporting person-to-person knowledge sharing. This work presents the development of practical tools and support to translate a conceptual model for getting knowledge into action into a series of activities and outputs to support better use of evidence in health care and subsequently improved patient outcomes. © 2017 Health Libraries Group.

Introducing Technology for Thriving in Residential Long-Term Care.

PubMed

Østensen, Elisabeth; Gjevjon, Edith Roth; Øderud, Tone; Moen, Anne

2017-01-01

To present an emerging innovative care model that supports participation and thriving by older adults in residential care, by introduction to new technology and mobilizing volunteer services. Qualitative, exploratory study, introducing tablet computers to 15 older adults in two municipalities. The intervention encompassed weekly workshops over the course of 1 year with volunteer adolescents as personal tutors. Observations of workshops, interviews with nurses, and repeated semistructured interviews with older adult participants eliciting their perspective on use, experiences, perceived usefulness, and overall evaluation of the intervention. A model of four components is suggested to support participation and thriving by older adults in residential care: (a) simplified tools: iPad-technology relatively easy to use; (b) person-centered process: one-to-one tutoring following each individual's own pace; (c) young volunteers to teach technology, establishing an intergenerational arena; and (d) being mindful of driving forces that encourage use and learning. We found that all kinds of use and all levels of mastery generated a sense of pride that supported thriving and enjoyment. These findings support the use of new technology and use of volunteer services for sustaining thriving in older adults. The person-centered approach stimulates use of the tablet, and participants showed enjoyment, more social participation, and reported subjective experiences of thriving. Innovative models of care that prevent (or postpone) functional decline and support thriving in older adults are highly sought after in health care. A model that systematically involves volunteer services comes with potentials to alleviate nurses' workload, and then the intervention is seen as a manageable and low-cost initiative in residential care. © 2016 Sigma Theta Tau International.

IAServ: an intelligent home care web services platform in a cloud for aging-in-place.

PubMed

Su, Chuan-Jun; Chiang, Chang-Yu

2013-11-12

As the elderly population has been rapidly expanding and the core tax-paying population has been shrinking, the need for adequate elderly health and housing services continues to grow while the resources to provide such services are becoming increasingly scarce. Thus, increasing the efficiency of the delivery of healthcare services through the use of modern technology is a pressing issue. The seamless integration of such enabling technologies as ontology, intelligent agents, web services, and cloud computing is transforming healthcare from hospital-based treatments to home-based self-care and preventive care. A ubiquitous healthcare platform based on this technological integration, which synergizes service providers with patients' needs to be developed to provide personalized healthcare services at the right time, in the right place, and the right manner. This paper presents the development and overall architecture of IAServ (the Intelligent Aging-in-place Home care Web Services Platform) to provide personalized healthcare service ubiquitously in a cloud computing setting to support the most desirable and cost-efficient method of care for the aged-aging in place. The IAServ is expected to offer intelligent, pervasive, accurate and contextually-aware personal care services. Architecturally the implemented IAServ leverages web services and cloud computing to provide economic, scalable, and robust healthcare services over the Internet.

IAServ: An Intelligent Home Care Web Services Platform in a Cloud for Aging-in-Place

PubMed Central

Su, Chuan-Jun; Chiang, Chang-Yu

2013-01-01

As the elderly population has been rapidly expanding and the core tax-paying population has been shrinking, the need for adequate elderly health and housing services continues to grow while the resources to provide such services are becoming increasingly scarce. Thus, increasing the efficiency of the delivery of healthcare services through the use of modern technology is a pressing issue. The seamless integration of such enabling technologies as ontology, intelligent agents, web services, and cloud computing is transforming healthcare from hospital-based treatments to home-based self-care and preventive care. A ubiquitous healthcare platform based on this technological integration, which synergizes service providers with patients’ needs to be developed to provide personalized healthcare services at the right time, in the right place, and the right manner. This paper presents the development and overall architecture of IAServ (the Intelligent Aging-in-place Home care Web Services Platform) to provide personalized healthcare service ubiquitously in a cloud computing setting to support the most desirable and cost-efficient method of care for the aged-aging in place. The IAServ is expected to offer intelligent, pervasive, accurate and contextually-aware personal care services. Architecturally the implemented IAServ leverages web services and cloud computing to provide economic, scalable, and robust healthcare services over the Internet. PMID:24225647

Towards A Self Adaptive System for Social Wellness.

PubMed

Khattak, Asad Masood; Khan, Wajahat Ali; Pervez, Zeeshan; Iqbal, Farkhund; Lee, Sungyoung

2016-04-13

Advancements in science and technology have highlighted the importance of robust healthcare services, lifestyle services and personalized recommendations. For this purpose patient daily life activity recognition, profile information, and patient personal experience are required. In this research work we focus on the improvement in general health and life status of the elderly through the use of an innovative services to align dietary intake with daily life and health activity information. Dynamic provisioning of personalized healthcare and life-care services are based on the patient daily life activities recognized using smart phone. To achieve this, an ontology-based approach is proposed, where all the daily life activities and patient profile information are modeled in ontology. Then the semantic context is exploited with an inference mechanism that enables fine-grained situation analysis for personalized service recommendations. A generic system architecture is proposed that facilitates context information storage and exchange, profile information, and the newly recognized activities. The system exploits the patient's situation using semantic inference and provides recommendations for appropriate nutrition and activity related services. The proposed system is extensively evaluated for the claims and for its dynamic nature. The experimental results are very encouraging and have shown better accuracy than the existing system. The proposed system has also performed better in terms of the system support for a dynamic knowledge-base and the personalized recommendations.

EMPOWER--pathways for supporting the self-management of diabetes patients.

PubMed

Plößnig, Manuela; Kabak, Yildiray; Lamprinos, Ilias; Pabst, Alexander; Hildebrand, Claudia; Mantwill, Sarah

2015-01-01

Diabetes is a serious world-wide medical challenge and there is a recognised need for improved diabetes care outcomes. This paper describes results of the EMPOWER project, to foster the self-management of diabetes patients by integration of existing and new services offered to patients after having been diagnosed with diabetes. The Self-Management Pathway described in this paper helps patients in the specification of personalized activities based on medical recommendations and personal goals, as well as self-monitoring of the results. The whole process is supported by innovative ICT services that motivate patients to change their lifestyle and adhere to defined medication and activity plans. We describe the approach and present the findings of the validation phase in Germany and Turkey.

Time utilisation trends of supported employment services by persons with mental disability in South Africa.

PubMed

Van Niekerk, Lana; Coetzee, Zelda; Engelbrecht, Madri; Hajwani, Zerina; Terreblanche, Santie

2015-01-01

This paper reports on the second phase of a two-phased study that was undertaken to determine the feasibility of supported employment (SE) as a strategy with which to facilitate the employment of persons with disability in competitive work contexts. The study population comprised people with mental disabilities receiving SE in the Western Cape Province, South Africa. To describe the components of SE utilised by persons with mental disability (i.e. psychiatric or intellectual disability) in terms of type and time utilisation patterns over 12 months. Criterion sampling, a form of purposive sampling, was used to identify 29 study participants - 19 with intellectual disability and 10 with psychiatric disability. Data collection commenced for each participant when a work placement had been identified and preparation for such ensued. Data was collected prospectively for a period of 12 months. SE service components utilised by participants were captured using a data capture sheet that was developed for this purpose. Time utilisation indicated a steep downwards trend for both cohorts. The decrease in utilisation of SE service components over a period of one year was more pronounced in the psychiatric disability (PD) cohort, who utilized almost half the total SE services in the first month. SE services can be considered as a viable option for return to work in resource-constrained environments. Providers of SE services will need to modify approaches in order to meet contextual realities.

Trust Information and Privacy Policies - Enablers for pHealth and Ubiquitous Health.

PubMed

Ruotsalainen, Pekka; Blobel, Bernd

2014-01-01

pHealth occurs in uncontrolled and unsecure environment where predefined organizational trust does not exist. To be accepted by users, pHealth requires a privacy model where privacy is a personal property, i.e., a person can perform own will and define policies which regulate how personal health information (PHI) is used. Privacy and trust are interconnected concepts. Therefore, before beginning to use pHealth services, the person needs practical and reliable information that enables her or him to determine the trustworthiness level of services. To avoid the use of blind trust, organizations, researchers, policymakers, and standardization organizations have proposed the use of dynamic context-aware policies for privacy management in pHealth. To make meaningful privacy decision, a person should understand the impact of selected policy rules on the processing of PHI in different situations. In this paper, the use of computational trust information for defining privacy polies and reducing their number is proposed. A trust value and understandable trust attributes enable a person to tailor privacy policies requested for trustworthy use of pHealth services. Trust attributes proposed are derived from privacy concerns existing in open ubiquitous environment. These attributes also force pHealth services providers to publish information needed for trust calculation and in this way to support openness and transparency.

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.

The role of family carers in the use of personal budgets by people with mental health problems.

PubMed

Hamilton, Sarah; Szymczynska, Paulina; Clewett, Naomi; Manthorpe, Jill; Tew, Jerry; Larsen, John; Pinfold, Vanessa

2017-01-01

Personal budgets aim to increase choice and independence for people with social care needs but they remain underused by people with mental health problems compared to other disability groups. The use of personal budgets may impact on families in a variety of ways, both positive and negative. This paper draws on interviews, undertaken in 2012-2013 with 18 family carers and 12 mental health service users, that explored experiences of family involvement in accessing and managing personal budgets for a person with mental health-related social care needs. The sample was drawn from three sites across England, with additional carers being recruited via voluntary sector networks. Our findings show that for many people with severe mental health needs who lack motivation and confidence to negotiate access to personal budgets, carers may provide the necessary support to enable them to benefit from this form of social care support. We illustrate the role carers may play in initiating, pursuing and maximising the level of support available through personal budgets. However, some carers interviewed considered that personal budget funding was reduced because of practitioners' assumptions about carers' willingness and ability to provide support. We also report perceived tensions between family carers and practitioners around appropriate involvement in decision-making. The study findings have implications for local authorities, practitioners and family carers in supporting the involvement of family carers in support for people with severe mental health problems. © 2015 John Wiley & Sons Ltd.

Disability Policy Evaluation: Combining Logic Models and Systems Thinking

ERIC Educational Resources Information Center

Claes, Claudia; Ferket, Neelke; Vandevelde, Stijn; Verlet, Dries; De Maeyer, Jessica

2017-01-01

Policy evaluation focuses on the assessment of policy-related personal, family, and societal changes or benefits that follow as a result of the interventions, services, and supports provided to those persons to whom the policy is directed. This article describes a systematic approach to policy evaluation based on an evaluation framework and an…

[Personal Futures Planning: Building a Foundation for Individualized Transition Services.

ERIC Educational Resources Information Center

Carr, Theresa, Ed.

1993-01-01

These two newsletter special issues focus on personal futures planning (PFP) for people with deaf blindness, with emphasis on technical assistance activities involved in implementing a PFP program. PFP guides a team through three phases of activities: (1) developing a "circle of support" for an individual with deaf blindness; (2)…

Medicaid--It's Not Just about Income!

ERIC Educational Resources Information Center

Mercado, Denise

2007-01-01

Medicaid Waivers are crucial to the community life of individuals with significant disabilities and their families. In a nutshell, Medicaid Waivers prevent institutionalization by providing the support individuals with significant disabilities need to live in the communities of their choice. These supports include Personal Care services and…

77 FR 50083 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-20

... Intellectual Property with Foreign Persons. OMB Control Number: 0608-0067. Form Number(s): BE-125. Type of...: The data are needed to monitor U.S. international trade in selected services and intellectual property... accounts, support U.S. commercial policy on trade in selected services and intellectual property, conduct...

77 FR 23228 - Submission for OMB Review; Evaluation of State Vocational Rehabilitation Agency Administration of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... Agency Administration of Supported Employment Programs SUMMARY: The Vocational Rehabilitation (VR... results in a substantial impediment to employment, who can benefit from VR services for employment, and who require VR services. DATES: Interested persons are invited to submit comments on or before May 18...

MR78, Mental Retardation: The Leading Edge. Service Programs That Work.

ERIC Educational Resources Information Center

Perske, Robert

The book highlights 30 effective service programs for mentally retarded persons. The first section presents information on eight family oriented programs serving high risk, Down's syndrome, urban poor, and profoundly handicapped children. Included are descriptions of parent education, support, and advocacy programs. Among seven public school…

The Logic of Relations and the Logic of Management

ERIC Educational Resources Information Center

Buntinx, Wil

2008-01-01

Background: Increasing emphasis on financial and administrative control processes is affecting service culture in support organisations for persons with intellectual disability. This phenomenon is currently obvious in Dutch service organisations that find themselves in transition towards more community care and at the same time under pressure from…

77 FR 61416 - Announcement of the Award of Single-Source Expansion Supplement Grants to Nine Personal...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-09

... Philadelphia Health Management Philadelphia PA 61,068.00 Corporation. Teen Outreach Pregnancy Services... Pregnancy Prevention Program, Division of Adolescent Development and Support, Family and Youth Services.... Outcome data will determine the effectiveness of the implemented pregnancy prevention models used in the...

28 CFR 804.4 - Submission and approval.

Code of Federal Regulations, 2010 CFR

2010-07-01

... vocational training services. (1) Any person or organization wishing to donate as a gift in-kind contributions of space or hospitality to support offender programs, or equipment or vocational training services...) There is a conflict of interest in accepting the gift; (ii) Acceptance of the gift is otherwise unlawful...

The role of support staff in promoting the social inclusion of persons with an intellectual disability.

PubMed

McConkey, R; Collins, S

2010-08-01

Past studies have found that people supported in more individualised housing options tend to have levels of community participation and wider social networks than those in other accommodation options. Yet, the contribution of support staff in facilitating social inclusion has received relatively scant attention. In all 245 staff working in either supported living schemes, or shared residential and group homes, or in day centres completed a written questionnaire in which they rated in terms of priority to their job, 16 tasks that were supportive of social inclusion and a further 16 tasks that related to the care of the person they supported. In addition staff identified those tasks that they considered were not appropriate to their job. Across all three service settings, staff rated more care tasks as having higher priority than they did the social inclusion tasks. However, staff in supported living schemes rated more social inclusion tasks as having high priority than did staff in the other two service settings. Equally the staff who were most inclined to rate social inclusion tasks as not being applicable to their job were those working day centres; female rather than male staff, those in front-line staff rather than senior staff, and those in part-time or relief positions rather than full-time posts. However, within each service settings, there were wide variations in how staff rated the social inclusion tasks. Staff working in more individualised support arrangements tend to give greater priority to promoting social inclusion although this can vary widely both across and within staff teams. Nonetheless, staff gave greater priority to care tasks especially in congregated service settings. Service managers may need to give more emphasis to social inclusion tasks and provide the leadership, training and resources to facilitate support staff to re-assess their priorities.

Consumer Health Informatics Aspects of Direct-to-Consumer Personal Genomic Testing.

PubMed

Gray, Kathleen; Stephen, Remya; Terrill, Bronwyn; Wilson, Brenda; Middleton, Anna; Tytherleigh, Rigan; Turbitt, Erin; Gaff, Clara; Savard, Jacqueline; Hickerton, Chriselle; Newson, Ainsley; Metcalfe, Sylvia

2017-01-01

This paper uses consumer health informatics as a framework to explore whether and how direct-to-consumer personal genomic testing can be regarded as a form of information which assists consumers to manage their health. It presents findings from qualitative content analysis of web sites that offer testing services, and of transcripts from focus groups conducted as part a study of the Australian public's expectations of personal genomics. Content analysis showed that service offerings have some features of consumer health information but lack consistency. Focus group participants were mostly unfamiliar with the specifics of test reports and related information services. Some of their ideas about aids to knowledge were in line with the benefits described on provider web sites, but some expectations were inflated. People were ambivalent about whether these services would address consumers' health needs, interests and contexts and whether they would support consumers' health self-management decisions and outcomes. There is scope for consumer health informatics approaches to refine the usage and the utility of direct-to-consumer personal genomic testing. Further research may focus on how uptake is affected by consumers' health literacy or by services' engagement with consumers about what they really want.

[The head of the medical service must be the person...(To the 70th anniversary of N.G. Ryzhman)].

PubMed

Val'skiĭ, V V; Butikov, V P; Rybakov, S M; Chernikov, O G

2014-09-01

The article is devoted to contribution of major general (rear Admiral. - navy) of medical service Nikolay Grigoryevich Ryzhman (1944-2005), the chief of the medical service of the Northern fleet (1991-1999), to development of naval medicine, who would have turn 70 years this September. The constant analysis, and experience generalization of the medical services of the fleet connections and associations and aspiration to provide fighting capacity for the fleet crew - were a keynote of Ryzhman's activity concerned development and deployment of the new forms and methods of medical support and searching of ways to increase crew efficiency. The implemented methods and forms of organization of the medical support and scientific development of the medical support are used even now in the practical activities of the medical service of the Northern fleet.

Impact of hearing loss in the workplace: raising questions about partnerships with professionals.

PubMed

Jennings, Mary Beth; Shaw, Lynn

2008-01-01

The number of adults with hearing loss who continue to work later in life is growing. Persons with hearing loss are generally unaware of the role that audiologists, occupational therapists, and vocational rehabilitation counsellors might play in the assessment of the workplace environment and appropriate accommodations. Three narratives of adults with hearing loss are used to demonstrate the gaps in accessing information, technology and services needed to maintain optimal work performance and productivity. The lack of recognition of the multidimensional needs of older workers with hearing loss and the lack of timely coordination of services led to all three persons acting alone in trying to access services and supports. In two of the three cases the impact of the hearing loss resulted in further unexpected losses such as the loss of employment and the loss of a worker-identity. There is an urgent need for partnering with persons who are hard of hearing to develop new strategies for knowledge exchange, more thorough assessment of hearing demands and modifications in the workplace, and interdisciplinary approaches to service specific to the needs of hard of hearing persons.

Supporting pre-service science teachers in developing culturally relevant pedagogy

NASA Astrophysics Data System (ADS)

Krajeski, Stephen

This study employed a case study methodology to investigate a near-authentic intervention program designed to support the development of culturally relevant pedagogy and its impact on pre-service science teachers' notions of culturally relevant pedagogy. The unit of analysis for this study was the discourse of pre-service science teachers enrolled in a second semester science methods course, which was the site of the intervention program. Data for this study was collected from videos of classroom observations, audio recordings of personal interviews, and artifacts created by the pre-service science teachers during the class. To determine how effective science teacher certification programs are at supporting the development of culturally relevant pedagogy without an immersion aspect, two research questions were investigated: 1) How do pre-service science teachers view and design pedagogy while participating in an intervention designed to support the development of culturally relevant pedagogy? 2) How do pre-service science teachers view the importance of culturally relevant pedagogy for supporting student learning? How do their practices in the field change these initial views?

End-to-end security for personal telehealth.

PubMed

Koster, Paul; Asim, Muhammad; Petkovic, Milan

2011-01-01

Personal telehealth is in rapid development with innovative emerging applications like disease management. With personal telehealth people participate in their own care supported by an open distributed system with health services. This poses new end-to-end security and privacy challenges. In this paper we introduce new end-to-end security requirements and present a design for consent management in the context of the Continua Health Alliance architecture. Thus, we empower patients to control how their health information is shared and used in a personal telehealth eco-system.

Experiences of support in working toward personal recovery goals: a collaborative, qualitative study.

PubMed

Biringer, Eva; Davidson, Larry; Sundfør, Bengt; Ruud, Torleif; Borg, Marit

2016-11-25

Recovery can be understood as a subjective process guided by personal expectations, goals and hopes. The aim of the study was to explore how persons using a Community Mental Health Centre (CMHC) experienced that their expectations for treatment, and goals and hopes for recovery were supported by the health professionals during treatment. Employing a hermeneutic-phenomenological approach, eight service users were interviewed about their expectations for treatment and their goals and hopes for recovery at the start of their contact with health professionals at a CMHC. Two years later, they were re-interviewed about their experiences of treatment and support from the health professionals in their work towards these goals and hopes. A collaborative approach was adopted. A co-researcher with lived experience took part in all stages of the study. Data were analysed by means of a data-driven stepwise approach in line with thematic analysis. Five themes reflecting how participants experienced support from health professionals at the CMHC in their work towards their recovery goals were elicited, as follows: developing an understanding of oneself and one's mental health problems; learning how to change feelings and behaviours; being 'pushed' into social arenas; finding helpful medication; and counselling in family, practical and financial issues. The participants' expectations about counselling with regard to longer-term family, practical, and financial challenges were insufficiently met by the CMHC. In the experience of the service users, recovery occurred within the context of their everyday life with or without the support of their professional helpers. To facilitate recovery, health professionals should acknowledge the service user's personal goals and hopes and take a more comprehensive and longer-term approach to his or her needs and desires. Acknowledging and facilitating recovery goals by offering counselling with regard to family, practical and financial issues seems particularly important.

'These are not luxuries, it is essential for access to life': Disability related out-of-pocket costs as a driver of economic vulnerability in South Africa.

PubMed

Hanass-Hancock, Jill; Nene, Siphumelele; Deghaye, Nicola; Pillay, Simmi

2017-01-01

With the dawn of the new sustainable development goals, we face not only a world that has seen great successes in alleviating poverty but also a world that has left some groups, such as persons with disabilities, behind. Middle-income countries (MICs) are home to a growing number of persons with disabilities. As these countries strive to achieve the new goals, we have ample opportunity to include persons with disabilities in the emerging poverty alleviation strategies. However, a lack of data and research on the linkages between economic vulnerability and disability in MICs hampers our understanding of the factors increasing economic vulnerability in people with disabilities. This article aims to present data related to elements of this vulnerability in one MIC, South Africa. Focusing on out-of-pocket costs, it uses focus group discussions with 73 persons with disabilities and conventional content analysis to describe these costs. A complex and nuanced picture of disability-driven costs evolved on three different areas: care and support for survival and safety, accessibility of services and participation in community. Costs varied depending on care and support needs, accessibility (physical and financial), availability, and knowledge of services and assistive devices. The development of poverty alleviation and social protection mechanisms in MICs like South Africa needs to better consider diverse disability-related care and support needs not only to improve access to services such as education and health (National Health Insurance schemes, accessible clinics) but also to increase the effect of disability-specific benefits and employment equity policies.

Payment Rates for Personal Care Assistants and the Use of Long-Term Services and Supports among Those Dually Eligible for Medicare and Medicaid

PubMed Central

Ko, Michelle; Newcomer, Robert; Kang, Taewoon; Hulett, Denis; Chu, Philip; Bindman, Andrew B

2014-01-01

Objective To examine the association between payment rates for personal care assistants and use of long-term services and supports (LTSS) following hospital discharge among dual eligible Medicare and Medicaid beneficiaries. Data Sources State hospital discharge, Medicaid and Medicare claims, and assessment data on California Medicaid LTSS users from 2006 to 2008. Study Design Cross-sectional study. We used multinomial logistic regression to analyze county personal care assistant payment rates and postdischarge LTSS use, and estimate marginal probabilities of each outcome across the range of rates paid in California. Data Extraction Methods We identified dual eligible Medicare and Medicaid adult beneficiaries discharged from an acute care hospital with no hospitalizations or LTSS use in the preceding 12 months. Principal Findings Personal care assistant payment rates were modestly associated with home and community-based services (HCBS) use versus nursing facility entry following hospital discharge (RRR 1.2, 95 percent CI: 1.0–1.4). For a rate of $6.75 per hour, the probability of HCBS use was 5.6 percent (95 percent CI: 4.2–7.1); at $11.75 per hour, 18.0 percent (95 percent CI: 12.5–23.4). Payment rate was not associated with the probability of nursing facility entry. Conclusions Higher payment rates for personal care assistants may increase utilization of HCBS, but with limited substitution for nursing facility care. PMID:25327166

Monitoring game-based motor rehabilitation of patients at home for better plans of care and quality of life.

PubMed

Ponte, S; Gabrielli, S; Jonsdottir, J; Morando, M; Dellepiane, S

2015-01-01

This paper describes the biomedical, remote monitoring infrastructure developed and currently tested in the EU REHAB@HOME project to support home rehabilitation of the upper extremity of persons post-stroke and in persons with other neurological disorders, such as Multiple Sclerosis patients, in order to track their progress over therapy and improve their Quality of Life. The paper will specifically focus on describing the initial testing of the tele-rehabilitation system's components for patients' biomedical monitoring over therapy, which support the delivery and monitoring of more personalized, engaging plans of care by rehabilitation centers and services.

Does anyone understand HMO advertising?

PubMed

Bisinger, J M

1986-12-01

Much HMO advertising is executed with technical proficiency, but a high level of technical skill cannot compensate for poor objectives, an inadequate analysis of the business situation, or a lack of advertising effectiveness. Industrial marketing techniques often involve person-to-person selling via a sales staff, sales reps, on-site technical assistance and informational meetings, team selling, etc. Some HMOs also employ these techniques. In general, the promotional focus in these situations is not on mass media; communication tends to be in support of personal sales activities. These personal techniques are used because of the difficulty of selling complicated products or services. Is an HMO a simple product/service? If it is not, consumer promotional tactics will probably be ineffective. If used, these promotional tactics probably will be unintelligible because "consumers" do not select HMOs; their employers do.

Personal genome testing in medical education: student experiences with genotyping in the classroom

PubMed Central

2013-01-01

Background Direct-to-consumer (DTC) personal genotyping services are beginning to be adopted by educational institutions as pedagogical tools for learning about human genetics. However, there is little known about student reactions to such testing. This study investigated student experiences and attitudes towards DTC personal genome testing. Methods Individual interviews were conducted with students who chose to undergo personal genotyping in the context of an elective genetics course. Ten medical and graduate students were interviewed before genotyping occurred, and at 2 weeks and 6 months after receiving their genotype results. Qualitative analysis of interview transcripts assessed the expectations and experiences of students who underwent personal genotyping, how they interpreted and applied their results; how the testing affected the quality of their learning during the course, and what were their perceived needs for support. Results Students stated that personal genotyping enhanced their engagement with the course content. Although students expressed skepticism over the clinical utility of some test results, they expressed significant enthusiasm immediately after receiving their personal genetic analysis, and were particularly interested in results such as drug response and carrier testing. However, few reported making behavioral changes or following up on specific results through a healthcare provider. Students did not report utilizing genetic counseling, despite feeling strongly that the 'general public' would need these services. In follow-up interviews, students exhibited poor recall on details of the consent and biobanking agreements, but expressed little regret over their decision to undergo genotyping. Students reported mining their raw genetic data, and conveyed a need for further consultation support in their exploration of genetic variants. Conclusions Personal genotyping may improve students' self-reported motivation and engagement with course material. However, consultative support that is different from traditional genetic counseling will be necessary to support students. Before incorporating personal genotyping into coursework, institutions should lead multi-disciplinary discussion to anticipate issues and incorporate teaching mechanisms that engage the ethical, legal, and social implications of personal genotyping, including addressing those found in this study, to go beyond what is offered by commercial providers. PMID:23510111

Personal genome testing in medical education: student experiences with genotyping in the classroom.

PubMed

Vernez, Simone Lucia; Salari, Keyan; Ormond, Kelly E; Lee, Sandra Soo-Jin

2013-01-01

Direct-to-consumer (DTC) personal genotyping services are beginning to be adopted by educational institutions as pedagogical tools for learning about human genetics. However, there is little known about student reactions to such testing. This study investigated student experiences and attitudes towards DTC personal genome testing. Individual interviews were conducted with students who chose to undergo personal genotyping in the context of an elective genetics course. Ten medical and graduate students were interviewed before genotyping occurred, and at 2 weeks and 6 months after receiving their genotype results. Qualitative analysis of interview transcripts assessed the expectations and experiences of students who underwent personal genotyping, how they interpreted and applied their results; how the testing affected the quality of their learning during the course, and what were their perceived needs for support. Students stated that personal genotyping enhanced their engagement with the course content. Although students expressed skepticism over the clinical utility of some test results, they expressed significant enthusiasm immediately after receiving their personal genetic analysis, and were particularly interested in results such as drug response and carrier testing. However, few reported making behavioral changes or following up on specific results through a healthcare provider. Students did not report utilizing genetic counseling, despite feeling strongly that the 'general public' would need these services. In follow-up interviews, students exhibited poor recall on details of the consent and biobanking agreements, but expressed little regret over their decision to undergo genotyping. Students reported mining their raw genetic data, and conveyed a need for further consultation support in their exploration of genetic variants. Personal genotyping may improve students' self-reported motivation and engagement with course material. However, consultative support that is different from traditional genetic counseling will be necessary to support students. Before incorporating personal genotyping into coursework, institutions should lead multi-disciplinary discussion to anticipate issues and incorporate teaching mechanisms that engage the ethical, legal, and social implications of personal genotyping, including addressing those found in this study, to go beyond what is offered by commercial providers.

Americans with Developmental Disabilities: Policy Directions for the States.

ERIC Educational Resources Information Center

Wright, Barbara; King, Martha P.

This Task Force report offers recommendations to state legislatures in the following policy areas: early intervention, family support, transition services, community living, supported employment, and funding for persons with developmental disabilities. Stressed is a consumer orientation which focuses on individual and family strengths and needs.…

Service user experiences of specialist mental health supported accommodation: A systematic review of qualitative studies and narrative synthesis.

PubMed

Krotofil, Joanna; McPherson, Peter; Killaspy, Helen

2018-04-02

Specialist supported accommodation services have become a key component of most community-based mental healthcare systems. While mental health policies highlight the importance of service user involvement in service development and care planning, there are no comprehensive literature reviews synthesising services users' perspectives on, or experiences of, supported accommodation services. This systematic review was undertaken to fill this gap. We searched electronic databases (January 2015, updated June 2017), conducted hand searches and used forward-backward snowballing to identify 13,678 papers. We inspected the full-text of 110 papers and included 50 of these in the final review. Data extraction and quality assessments were conducted. We used narrative synthesis to develop a conceptual model of service users' experiences that included structural, process, relational and contextual factors, such as the characteristics of the service, relationships with staff and other service users, the intensity and nature of support, the physical environment, and social and community integration. The review highlights the complex interplay of individual, service-level and community factors in shaping the lived experience of service users and their impact on personal identity and recovery. Our approach addressed some of the widely reported limitations of the quantitative research in this field, providing a conceptual model relevant to service user experiences across supported accommodation service types, population groups and countries. © 2018 John Wiley & Sons Ltd.

Recovery-oriented service provision and clinical outcomes in assertive community treatment.

PubMed

Kidd, Sean A; George, Lindsey; O'Connell, Maria; Sylvestre, John; Kirkpatrick, Helen; Browne, Gina; Odueyungbo, Adefowope O; Davidson, Larry

2011-01-01

While the term "recovery" is routinely referenced in clinical services and health policy, few studies have examined the relationship between recovery-oriented service provision and client outcomes. The present study was designed to examine the relationship between recovery-orientation of service provision for persons with severe mental illnesses and outcomes in Assertive Community Treatment (ACT). Client, family, staff, and manager ratings of service recovery-orientation and outcomes across a range of service utilization and community functioning indicators were examined among 67 ACT teams in Ontario, Canada. Significant associations were found between ratings of recovery-oriented service provision and better outcomes in the domains of legal involvement, hospitalization days, education involvement, and employment. Results were not uniformly positive or consistent, however, across stakeholder Recovery Self-Assessment (RSA) ratings or outcomes. These findings provide some preliminary support for an association between recovery-oriented service delivery for persons with severe mental illnesses and better outcomes. In line with the current practice commentary, this association would suggest the importance of evaluating and cultivating recovery-oriented values and practices in ACT contexts. This is a particularly salient point given that ACT standards minimally address key domains of recovery-oriented service provision. Further study is required, however, to determine if these findings apply to the implementation of ACT in other jurisdictions or generalize to other community support programs.

Immigrants and borderline personality disorder at a psychiatric emergency service.

PubMed

Pascual, J C; Malagón, A; Córcoles, D; Ginés, J M; Soler, J; García-Ribera, C; Pérez, V; Bulbena, A

2008-12-01

Several studies have suggested that immigrants have higher rates of psychiatric emergency service use and a higher risk of mental disorders such as schizophrenia than indigenous populations. To compare the likelihood that immigrants (immigrant group) v. indigenous population (indigenous group) will be diagnosed with borderline personality disorder in a psychiatric emergency service and to determine differences according to area of origin. A total of 11 578 consecutive admissions over a 4-year period at a tertiary psychiatric emergency service were reviewed. The collected data included socio-demographic and clinical variables and the Severity of Psychiatric Illness rating score. Psychiatric diagnosis was limited to information available in the emergency room given that a structured interview is not usually feasible in this setting. The diagnosis of borderline personality disorder was based on DSM-IV criteria. Immigrants were divided into five groups according to region of origin: North Africa, sub-Saharan Africa, South America, Asia and Western countries. Multivariate statistical logistic regression analysis showed that all subgroups of immigrants had a lower likelihood of being diagnosed with borderline personality disorder than the indigenous population independently of age and gender. Furthermore, the rates of borderline personality disorder diagnosis were considerably lower in Asian and sub-Saharan subgroups than in South American, North African, Western or native subgroups. Our results showed that in the psychiatric emergency service borderline personality disorder was diagnosed less frequently in the immigrant group v. the indigenous group. Our results do not support the concept of migration as a risk factor for borderline personality disorder.

An Organization Model to Assist Individual Physicians, Scientists, and Senior Health Care Administrators With Personal and Professional Needs.

PubMed

Shanafelt, Tait D; Lightner, Deborah J; Conley, Christopher R; Petrou, Steven P; Richardson, Jarrett W; Schroeder, Pamela J; Brown, William A

2017-11-01

Working as a physician, scientist, or senior health care administrator is a demanding career. Studies have demonstrated that burnout and other forms of distress are common among individuals in these professions, with potentially substantive personal and professional consequences. In addition to system-level interventions to promote well-being globally, health care organizations must provide robust support systems to assist individuals in distress. Here, we describe the 15-year experience of the Mayo Clinic Office of Staff Services (OSS) providing peer support to physicians, scientists, and senior administrators at one center. Resources for financial planning (retirement, tax services, college savings for children) and peer support to assist those experiencing distress are intentionally combined in the OSS to normalize the use of the Office and reduce the stigma associated with accessing peer support. The Office is heavily used, with approximately 75% of physicians, scientists, and senior administrators accessing the financial counseling and 5% to 7% accessing the peer support resources annually. Several critical structural characteristics of the OSS are specifically designed to minimize potential stigma and reduce barriers to seeking help. These aspects are described here with the hope that they may be informative to other medical practices considering how to create low-barrier access to help individuals deal with personal and professional challenges. We also detail the results of a recent pilot study designed to extend the activity of the OSS beyond the reactive provision of peer support to those seeking help by including regular, proactive check-ups for staff covering a range of topics intended to promote personal and professional well-being. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Engagement in adolescent career preparation: social support, personality and the development of choice decidedness and congruence.

PubMed

Hirschi, Andreas; Niles, Spencer G; Akos, Patrick

2011-02-01

This longitudinal panel study investigated predictors and outcomes of active engagement in career preparation among 349 Swiss adolescents from the beginning to the end of eighth grade. Latent variable structural equation modeling was applied. The results showed that engagement in terms of self- and environmental-exploration and active career planning related positively to interindividual increases in career decidedness and choice congruence. More perceived social support, early goal decidedness, and particular personality traits predicted more engagement. Support and personality impacted outcomes only mediated through engagement. Early decidedness and congruence were significant predictors of their respective later levels. Implications for practice are presented. Copyright © 2009 The Association for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Medicaid Home Care Services and Survival in New York City

ERIC Educational Resources Information Center

Albert, Steven M.; Simone, Bridget; Brassard, Andrea; Stern, Yaakov; Mayeux, Richard

2005-01-01

Purpose: New York City's Medicaid Home Care Services Program provides an integrated program of housekeeping and personal assistance care along with regular nursing assessments. We sought to determine if this program of supportive care offers a survival benefit to older adults. Design and Methods: Administrative data from New York City's Medicaid…

Directorate of Management - Special Staff - Joint Staff - Leadership - The

Science.gov Websites

Space Management, Publications Management, Administrative Services, Joint Staff Information Data Systems J-4 J-5 J-6 J-7 J-8 Personal Staff Inspector General Judge Advocate General Officer Management Public Affairs Executive Support Services Legislative Liaison Special Staff Directorate of Management

Family Quality of Life Empowered by Family-Oriented Support

ERIC Educational Resources Information Center

Schippers, Alice; van Boheemen, Marleen

2009-01-01

Professional services for persons with intellectual disabilities (ID) have begun to attach more importance to their environment. The concept of (family-related) quality of life proved to link very well with this idea and lent itself to constructing and evaluating services. One outcome was the emergence of equal partnerships between families,…

Using Goal Analysis to Drive Improvements in Performance and Outcomes

ERIC Educational Resources Information Center

Lawlor, David; Spitz, Romy; York, Michaela; Harvey, Brenda

2013-01-01

Economic pressures for public health and human services systems to control budgets are increasing the need for demonstrating value of support services provided to persons with intellectual disabilities. In this article, we build from earlier work that presented a method for assessing goal attainment to expand the study of goal characteristics as a…

48 CFR 3037.104-91 - Personal services contracts with individuals under the authority of 10 U.S.C. 1091 (USCG).

Code of Federal Regulations, 2010 CFR

2010-10-01

... rates, fees, or other costs. (e) In the event only one individual responds to an advertised requirement... only for travel outside the local area in support of the statement of work. (i) Coordinate benefits... statement of work for health care services. ...

Making space for belonging: critical reflections on the implementation of personalised adult social care under the veil of meaningful inclusion.

PubMed

Power, Andrew

2013-07-01

This paper critically reflects on the way in which recent adult social care reform has been evolving beneath the alleged policy goal of prioritising the cultivation of meaningful inclusion and 'belonging' in the community. With this goal, there has been a focus away from 'services' for persons with intellectual disabilities, to supporting natural connections within the community. This paper draws on a grounded theory study of the perspectives of those responsible for overseeing community living arrangements for persons with disabilities, drawing on interviews and focus groups with service providers and relevant government officials. It examines the socio-spatial implications of the gradual shift towards 'belonging' as a disability policy goal, as it has evolved in two discrete settings - British Columbia, Canada and Ireland. The findings identify the complexities involved in facilitating active community connection for persons with intellectual disabilities and reveal important cautionary lessons for other jurisdictions where community living policy has arguably been moving away from communal services towards self-managed supports in 'real' communities through personal budgets in an effort to remove barriers to participation. The paper thus critically reflects on the rapid pursuit for transformation in personalised adult social care in government policy, arguing that the process of fostering meaningful community inclusion will and should take time. Copyright © 2013 Elsevier Ltd. All rights reserved.

Supported Employment for Youth with Disabilities: A Successful Community-Referenced Employment Training Program.

ERIC Educational Resources Information Center

McCabe, Patrick P.; Smergut, Peter C.

1994-01-01

The Manhattan Transition Center provides supported employment for youth with mild to severe disabilities. Local enclave worksites staffed by teacher/paraprofessional teams place participants in jobs. Under the zero-reject policy, employers and service providers are responsible for participants' personal and work-related growth. (SK)

78 FR 28700 - Unblocking of Specially Designated Nationals and Blocked Persons Pursuant to the Foreign...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-15

... Secretary of Homeland Security when designating and blocking the property or interests in property, subject... financial or technological support for or to, or providing goods or services in support of, the..., Colombia; citizen Colombia; Cedula No. 79263544 (Colombia) (individual) [SDNTK]. 2. MORENO BERNAL, Luz...

How the 'warped' relationships between nurses' emotions, attitudes, social support and perceived organizational conditions impact customer orientation.

PubMed

Gountas, Sandra; Gountas, John

2016-02-01

Much research focuses on organizational culture and its impact on customer orientation or emotional states and their impact on job satisfaction and well-being. This study aims to combine the complex roles of nurses' emotion states and job satisfaction in a model that identifies the effects of standards for service delivery (organizational culture), supervisor and co-worker support and the development of customer orientation. A previous study examined the relationships between nurses' personal resources, job satisfaction and customer orientation. This study examines how these variables relate to organizational standards and social support. A cross-sectional survey using a self-completion questionnaire with validated, existing scales to measure standards for service delivery, supervisor and co-worker support, job satisfaction, empathic concern, emotional exhaustion and customer orientation. Nurses (159) completed the questionnaire in 2010. The data were analysed using WarpPLS, a structural equation modelling software package. The results indicate that the final model fits the data well and explains 84% of the variance in customer orientation. The findings show the importance of standard for service delivery (organizational culture), supervisor and co-worker support on customer orientation. Nurses' personal resources interact with these, particularly supervisor and co-worker support, to develop staff job satisfaction and empathy. The need for support mechanisms in stressful times is discussed. We propose that training in compassion and empathy would help leaders to model desirable attributes that contribute towards customer orientation. © 2015 John Wiley & Sons Ltd.

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

PubMed Central

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

2016-01-01

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

Tax subsidization of personal assistance services.

PubMed

Mendelsohn, Steven; Myhill, William N; Morris, Michael

2012-04-01

Personal assistance services (PAS) is the term used to describe the range of assistance, services, and supports many people with disabilities and older Americans need to remain in their homes and communities. The Americans with Disabilities Act requires that people with disabilities receive essential services in the communities of their choice rather than in institutional settings. PAS availability often determines whether persons with disabilities become institutionalized or remain in their communities. PAS, however, are not inexpensive or broadly available. Strategies are needed to improve their availability to people with disabilities and the elderly. We sought to analyze 8 provisions of the Internal Revenue Code for their utility to make PAS more affordable and available. The authors conducted a legal analysis of 8 statutory provisions, as interpreted by regulations, court decisions, and other authoritative sources. Each of the tax provisions analyzed covers some PAS expenses incurred by an individual or family. Favorable tax treatment is impacted by the nature and amount of expenses and by the location and conditions of services. The current limitations and complexities of legal interpretations and the fact that many individuals with disabilities are uninformed about these tax provisions present challenges and opportunities. As the need for PAS grows, reform of tax policy is an important complement to health care and long-term services and supports for people with disabilities. To increase utilization of current beneficial tax provisions that subsidize the cost of PAS, individuals with disabilities and tax preparers must become better informed about using these provisions. Copyright © 2012 Elsevier Inc. All rights reserved.

"They're homeless in a home": Retaining homeless-experienced consumers in supported housing.

PubMed

Gabrielian, Sonya; Hamilton, Alison B; Alexandrino, Adrian; Hellemann, Gerhard; Young, Alexander S

2017-05-01

Permanent, community-based housing with supportive services ("supported housing") has numerous favorable outcomes for homeless-experienced consumers. Little is known, however, about consumers who attain but subsequently lose their supported housing. Using mixed methods, we compared persons who retained their supported housing for at least 1 year ("stayers") with those who lost their supported housing within 1 year of move-in ("exiters"). Among persons housed through the VA Supported Housing (VASH) program at the VA Greater Los Angeles between 2011 and 2012, we queried VA homeless registry data to identify stayers (n = 1,558) and exiters (n = 85). We reviewed the medical records of 85 randomly selected stayers and all 85 exiters to compare demographics, homelessness chronicity, era of service, income, presence or absence of a serious mental illness, and health service utilization. From this subsample, we purposively selected 20 stayers and 20 exiters for semistructured, qualitative interviews, and more detailed medical record review. We also performed qualitative interviews and focus groups with VASH staff/leadership (n = 15). Recursive partitioning identified quantitative variables that best-differentiated stayers from exiters. Thematic analyses were performed on qualitative data. Interrelated factors were associated with exiting supported housing: chronic homelessness; low intrinsic motivation; unmet needs for mental health care, substance abuse treatment, and independent living skills; poor primary care engagement; frequent emergency department use; and recent mental health hospitalizations. These findings suggest the value of clinical interventions that address these factors-for example, motivational interviewing or social skills training-adapted to the setting and context of supported housing. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

About Genetic Counselors

MedlinePlus

... While most genetic counseling is provided in-person, access to genetic counselors is expanding, and many now provide consultation services by telephone, videoconferencing , and the internet, or offer education and support in group settings. ...

Neuro-Oncology Branch patient emotional support services | Center for Cancer Research

Cancer.gov

Emotional Support Services The diagnosis of a brain tumor elicits many different and sometimes difficult emotions, not only for the patient, but also for their family members. Patients may encounter changes in cognitive functioning and language, a diminished ability to focus or make decisions, or short-term memory loss, all of which can greatly affect their personal and professional lives. We are dedicated to helping patients and their families deal with the physical and emotional facets of this disease.

The MyHealthService approach for chronic disease management based on free open source software and low cost components.

PubMed

Vognild, Lars K; Burkow, Tatjana M; Luque, Luis Fernandez

2009-01-01

In this paper we present an approach to building personal health services, supporting following-up, physical exercising, health education, and psychosocial support for the chronically ill, based on free open source software and low-cost computers, mobile devices, and consumer health and fitness devices. We argue that this will lower the cost of the systems, which is important given the increasing number of people with chronicle diseases and limited healthcare budgets.

From Exhaustion to Disengagement via Self-Efficacy Change: Findings from Two Longitudinal Studies among Human Services Workers

PubMed Central

Rogala, Anna; Shoji, Kotaro; Luszczynska, Aleksandra; Kuna, Anna; Yeager, Carolyn; Benight, Charles C.; Cieslak, Roman

2016-01-01

This longitudinal research examined the relationship direction between burnout components (exhaustion and disengagement) within the context of personal resources measured by self-efficacy and social support. In line with the conservation of resources theory we hypothesized that exhaustion may trigger a spiral loss of personal resources where self-efficacy declines and subsequently, social support also declines and in turn predict disengagement. Participants in Study 1 were mental healthcare providers (N = 135) working with U.S. military personnel suffering from trauma. Participants in Study 2 were healthcare providers, social workers, and other human services professionals (N = 193) providing various types of services for civilian trauma survivors in Poland. Baseline and 6-month follow-up measurements included burnout components, burnout self-efficacy and perceived social support. The path analysis showed consistent results for both longitudinal studies; exhaustion measured at Time 1 led to disengagement at Time 2, after controlling for baseline disengagement levels. Across Study 1 and Study 2 these associations were mediated by self-efficacy change: Higher exhaustion led to greater decline in self-efficacy which in turn explained higher disengagement at the follow-up. Social support, however, did not mediate between self-efficacy and disengagement. These mediating effects were invariant across Studies 1 and 2, although the mean levels of burnout and personal resources differed significantly. The results contribute to a discussion on the internal structure of job burnout and a broader understanding of the associations between exhaustion and disengagement that may be explained by the underlying mechanism of change in self-efficacy. PMID:26779114

Personal assistance for adults (19-64) with both physical and intellectual impairments.

PubMed

Mayo-Wilson, E; Montgomery, P; Dennis, J

2008-04-16

There is a high incidence of impairments among working age adults, and their prevalence is increasing in the West. Many countries offer personal assistance in the form of individualised support for people living in the community by a paid assistant other than a healthcare professional for at least 20 hours per week. To assess the effectiveness of personal assistance for adults with physical and intellectual impairments, and the impacts of personal assistance on others, compared to other interventions. Electronic databases including CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Dissertation Abstracts International and a variety of specialist Swedish databases were searched from 1980 to June 2005; reference lists were checked; 345 experts, organisations, government bodies and charities were contacted in an attempt to locate relevant research. Adults (19-64) with permanent physical and intellectual impairments living in the community who require assistance to perform tasks of daily living (e.g., bathing and eating) and participate in normal activities. Controlled studies of personal assistance in which participants were prospectively assigned to study groups and in which control group outcomes were measured concurrently with intervention group outcomes were included. Titles and abstracts were examined by two reviewers. Outcome data were extracted. Because no two studies made the same comparison, studies were not combined for meta-analyses. Studies were assessed for bias. Results and potential sources of bias are presented for included studies. Two studies involving 1002 participants compared personal assistance versus usual care. Whilst personal assistance was generally preferred over other services, some people prefer other services. Personal assistance may have some benefits for some recipients and may benefit caregivers. Paid assistance probably substitutes for informal care and may cost government more than alternatives; however, some evidence suggests it may reduce costs. The total costs to recipients and society are unknown. Research in this field is limited. Personal assistance is expensive and difficult to organise, especially in places that do not already have services in place, but its total cost relative to other services is unknown. When implementing new programmes, recipients could be randomly assigned to different forms of assistance (e.g. organised by individual users versus organised through a cooperative). While advocates may support personal assistance for myriad reasons, this review demonstrates that further studies are required to determine which models of assistance are most effective and efficient for particular people.

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.

How Do Persons with Mild Acquired Cognitive Impairment Use Information and Communication Technology and E-Services? Results from a Swedish National Survey

PubMed Central

Bartfai, Aniko; Oldenburg, Christian; Koch, Sabine

2016-01-01

Introduction Mild acquired cognitive impairment is a term used to describe a sub-group of persons with mild cognitive impairment who are expected to reach a stable cognitive level over time. One tactic that can be considered for further developing treatment for this group is the use of information and communication technology and e-services. The purpose of this study was to investigate the current use of regular e-services and social media by this group as well as their user experiences. Methods and Materials Data were collected through a self-administered survey and analyzed using quantitative methods. The questionnaire included questions regarding the participants’ use of and experience with e-services. Categorization of e-services was based on and cross-validated with the International Classification of Functioning, Disability and Health (ICF). To estimate participants’ degree and type of impairment, the Cognitive Failure Questionnaire (CFQ), measuring cognitive difficulties in performing everyday tasks, was added. Results In total, 282 persons with acquired brain injury participated in the survey. The participants’ CFQ scores showed that they were suffering from mild to moderate cognitive impairments, most often acquired from traumatic brain injuries (40%). The majority (89%) used e-services in different categories whereof the most popular and essential ones were communication services (59%) and banking (39%) services. Participants with higher total CFQ scores (>58) used more e-services in most of the categories compared to participants with lower scores (<31). Although participants were interested in social media, they were annoyed by advertisements and the Internet speed in general. Some participants reported privacy concerns and addictive behavior. However, they mostly considered e-services to be trustworthy and supportive in different contexts. The usage of electronic devices decreased by age with the exception of electronic tablets that were used by older participants approximately as frequently as by other age groups. Conclusions Although persons with mild to moderate acquired brain injury used various e-services that are not customized for them, very few participants used self-care health services (apps) and readers (e-readers). Further studies are needed on utilizing these identified aspects for this group to support them with their chronic condition. PMID:27427947

Usability evaluation of a web-based support system for people with a schizophrenia diagnosis.

PubMed

van der Krieke, Lian; Emerencia, Ando C; Aiello, Marco; Sytema, Sjoerd

2012-02-06

Routine Outcome Monitoring (ROM) is a systematic way of assessing service users' health conditions for the purpose of better aiding their care. ROM consists of various measures used to assess a service user's physical, psychological, and social condition. While ROM is becoming increasingly important in the mental health care sector, one of its weaknesses is that ROM is not always sufficiently service user-oriented. First, clinicians tend to concentrate on those ROM results that provide information about clinical symptoms and functioning, whereas it has been suggested that a service user-oriented approach needs to focus on personal recovery. Second, service users have limited access to ROM results and they are often not equipped to interpret them. These problems need to be addressed, as access to resources and the opportunity to share decision making has been indicated as a prerequisite for service users to become a more equal partner in communication with their clinicians. Furthermore, shared decision making has been shown to improve the therapeutic alliance and to lead to better care. Our aim is to build a web-based support system which makes ROM results more accessible to service users and to provide them with more concrete and personalized information about their functioning (ie, symptoms, housing, social contacts) that they can use to discuss treatment options with their clinician. In this study, we will report on the usability of the web-based support system for service users with schizophrenia. First, we developed a prototype of a web-based support system in a multidisciplinary project team, including end-users. We then conducted a usability study of the support system consisting of (1) a heuristic evaluation, (2) a qualitative evaluation and (3) a quantitative evaluation. Fifteen service users with a schizophrenia diagnosis and four information and communication technology (ICT) experts participated in the study. The results show that people with a schizophrenia diagnosis were able to use the support system easily. Furthermore, the content of the advice generated by the support system was considered meaningful and supportive. This study shows that the support system prototype has valuable potential to improve the ROM practice and it is worthwhile to further develop it into a more mature system. Furthermore, the results add to prior research into web applications for people with psychotic disorders, in that it shows that this group of end users can work with web-based and computer-based systems, despite the cognitive problems they experience.

Smoking Cessation

MedlinePlus

... SR (Zyban ® ), 6 varenicline tartrate (Chantix ® ) 6,13 Counseling and medication are both effective for treating tobacco ... services. These may include: Free support, advice, and counseling from experienced quitline coaches A personalized quit plan ...

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.

Barriers to integrating information technology in Saudi Arabia science education

NASA Astrophysics Data System (ADS)

Al-Alwani, Abdulkareem Eid Salamah

This study examined current level of information technology integration in science education in the Yanbu school district in Saudi Arabia, and barriers to use. Sub-domains investigated included: infrastructure and resources, policy and support, science teachers' personal beliefs, and staff development. Survey determined demographic data and level of technology implementation, personal computer use, and current instructional practice. Mean frequency of information technology use was 1--2 times during a semester. Science teachers rated barriers limiting use of technology in teaching with a scale ranging from 0 (does not limit) to 3 (greatly limits). Results found all four factors were significant barriers: infrastructure and resources (M = 2.06; p < .001), staff development (M = 2.02; p <.001), policy and support (M = 1.84; p < .041) and science teachers' personal beliefs regarding technology (M = 1.15; p < .001). Regression analysis found that locations, level of training, teaching experience, and gender predicted frequency of use (F(3,168) = 3.63, R2 = .10, p < .014). Teachers who received in-service training programs used IT significantly more frequently than those who did not receive any training (t = 2.41, p = 0.017). Teachers who received both pre-service and in-service training used IT significantly more frequently than those who did not receive any training (t = 2.61, p = 0.01). Low technology users perceived that there was no support or incentives for using technology, while high technology users did not perceive these barriers (r = -0.18, p = .01). High technology users had positive personal beliefs about how information technology benefits learning, while low technology users held negative beliefs about technology use (r = -0.20, p = .003). The more barriers science teachers experienced, the less likely they were to be information technology users (r = -0.16, p = .02). There is a need for more computers in school, more teacher training, more time for teachers to learn to use technology, and more readily-available, technical support staff. Further studies are needed to represent all science teachers in Saudi Arabia, assess technology capacity of all schools, and assess in-service staff development strategies.

Establishing pediatric surgical services in emerging countries: What the first world can learn from Vanuatu.

PubMed

Leodoro, Basil M; Beasley, Spencer W; Maoate, Kiki

2015-05-01

Conventional surgical aid to emerging countries often does little to build capacity or infrastructure. An evolving model in the South Pacific has been designed to promote local expertise by training local surgeons to a high standard and helping establish sustainable pediatric surgical services in those regions. This review identifies the key elements required to improve and expand local specialist pediatric surgical capacity in Vanuatu. It highlights some of the challenges that face external agencies in helping to create sufficient local infrastructure to achieve these goals and describes how the impediments can be overcome. We conducted a review of the program that provides a sustainable pediatric surgical service to the small and poor Pacific nation of Vanuatu through the involvement and support of the Pacific Island Project administered by the Royal Australasian College of Surgeons. A needs assessment must be done from the recipient's perspective and can be achieved by collaboration between an external agency and existing local surgeons. The key to a sustainable service is identifying and training high quality young indigenous doctors early and providing mentorship and support, including after their return. A sustainable and viable service requires an adequately resourced position for the new surgeons(s) within a framework of a long term strategic plan for the specialty and adequate infrastructure in place on their return. Development of rapport with government and influencing strategic health priorities is a prerequisite of a new national specialty service. (1) Establishing long term viable pediatric surgical capability can only be achieved through the local health system with local leadership and ownership. (2) Internal capability includes governance, alignment with ministry of health priorities and policies, and effective clinical leadership. (3) Selection of person(s) to be trained is best done early, and he/she must be supported throughout training and afterwards. (4) Long term dependence on a single person makes the service vulnerable. (5) Ultimately, a service configuration that ensures children have timely access to quality specialist advice and which reflects the needs of the population is the main determinant of clinical outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Intentions and experiences of effective practice in mental health specific supported accommodation services: a qualitative interview study.

PubMed

Sandhu, Sima; Priebe, Stefan; Leavey, Gerard; Harrison, Isobel; Krotofil, Joanna; McPherson, Peter; Dowling, Sarah; Arbuthnott, Maurice; Curtis, Sarah; King, Michael; Shepherd, Geoff; Killaspy, Helen

2017-07-11

Deinstitutionalisation in Europe has led to the development of community-based accommodation for people with mental health problems. The type, setting, and intensity of support provided vary and the costs are substantial. Yet, despite the large investment in these services, there is little clarity on their aims and outcomes or how they are regarded by staff and the clients. We interviewed 30 staff and 30 clients from the three main types of supported accommodation in England (residential care, supported housing, floating outreach) to explore their perspectives on the purpose of these services, and the components of care considered most helpful. The interviews were coded and analysed using thematic analysis. There were generally consistent understandings amongst clients and staff across service types on the goals and purposes of supported accommodation services as: building independence and confidence; supporting people with their mental health; and providing safety and stability. We also noted a competing theme of anxiety about the continuity of support when clients move on from a service. Themes on the experience of what aided effective practice centred on: the supportive presence of others; incremental steps to progress; working together to avoid deskilling and dependency; feeling known and personally understood; tailoring support for social and community engagement; and building confidence through encouragement. The findings provide an understanding of the commonalities in service approach, and goals of clients in these services, as well as the facilitators of goal attainment. However, they also highlight a common tension between providing safe and supportive living environments, whilst also promoting independence and facilitating rehabilitative change.

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.

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

PubMed

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

2013-06-01

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

"I'm still me - I'm still here!" Understanding the person's sense of self in the provision of self-management support for people with progressive neurological long-term conditions.

PubMed

Kulnik, Stefan Tino; Hollinshead, Lucinda; Jones, Fiona

2018-01-11

There is increasing interest in tailoring self-management support, but little detail is available on the relevance and impact of such approaches for people with progressive neurological conditions. The aim of this study was to draw on individuals' experiences to inform the practice of self-management support for these groups. Community rehabilitation service users were purposively recruited and took part in in-depth qualitative interviews. Interviews were audio-recorded and transcribed. Data analysis was iterative and interpretative, taking a phenomenological approach. Strategies to enhance rigor were auditability, peer review, and researcher reflexivity. The sample consisted of 10 adults (age 20-79 years) who were living with a range of progressive neurological conditions. Individuals demonstrated resourcefulness in developing practice-based self-management strategies. Beyond practical strategies, interviewees' experiences were signified by reflecting on and upholding a sense of identity and a desire for purpose against the background of losses and gains over time. Linking with this overarching theme of "Sense of self" were aspects of "My body and mind", "Time", "Space", "Relationships", and "What I do". Self-management approaches for individuals with progressive neurological conditions will benefit from incorporating ways of recognizing, articulating, and supporting the person's sense of identity and purpose. Implications for rehabilitation Self-management approaches for people with progressive neurological conditions need to take account of individuals' wishes to contribute, connect with others, and be valued as a person. Person-centred self-management support can be realized through a broader approach than solely managing disease progression. The experiences and words of people with progressive neurological conditions can be used to inform meaningful evaluation of self-management support to drive service delivery by measuring what really matters. Rehabilitation practitioners need to adapt their conceptualisations of goal setting to account for how people with progressive neurological conditions themselves interpret "progress" and "improvement". Person-centred conversation that values who the person is can be an effective starting point for self-management interventions in people with progressive neurological conditions.

Early detection of psychosis - establishing a service for persons at risk.

PubMed

Schultze-Lutter, Frauke; Ruhrmann, Stephan; Klosterkötter, Joachim

2009-01-01

The establishment phase of an early detection centre for prodromal psychosis is introduced and characterised, along with its detaining and promoting factors within a universal multi-payer health care system. Across the first six years (1998-2003), users' characteristics are compared between different diagnostic groups and to the local population statistics; and, for an exemplary 12-months period (3-1-2002 to 2-28-2003), the characteristics of telephone contacts with the service are studied. Rising steadily in number across the first three years, 872 persons, predominantly of German citizenship and higher education, consulted the service until 2003, 326 with first-episode psychosis and 144 not fulfilling criteria for a current or beginning psychosis. Of the 402 putatively prodromal patients, 94% reported predictive basic symptoms, 68.9% attenuated and 20.6% transient psychotic symptoms. Most contacts by persons meeting any prodromal criterion were initiated by mental health professionals (psychiatrists or psychologists) and counselling services. Supported by public awareness campaigns, an early detection service is well received by its users and private practitioners as reflected by the large proportion of referrals from the latter. However, persons of non-German background as well as of lower education were underrepresented indicating that these sub-groups should be approached by tailored programmes.

Trans people's experiences with assisted reproduction services: a qualitative study.

PubMed

James-Abra, S; Tarasoff, L A; Green, D; Epstein, R; Anderson, S; Marvel, S; Steele, L S; Ross, L E

2015-06-01

What are the experiences of trans persons (i.e. those whose gender identity does not match the gender assigned to them at birth) who sought or accessed assisted reproduction (AR) services in Ontario, Canada, between 2007 and 2010? The majority of trans persons report negative experiences with AR service providers. Apart from research examining desire to have children among trans people, most of the literature on this topic has debated the ethics of assisting trans persons to become parents. To-date, all of the published research concerning trans persons' experiences with AR services is solely from the perspective of service providers; no studies have examined the experiences of trans people themselves. Secondary qualitative research study of data from nine trans-identified people and their partners (total n = 11) collected as part of a community-based study of access to AR services for sexual and gender minority people between 2010 and 2012. Trans-identified volunteers (and their partners, when applicable) who had used or attempted to access AR services since 2007 from across Ontario, Canada, participated in a 60-90 minute, semi-structured qualitative interview. Qualitative analysis was performed using a descriptive phenomenological approach. Emerging themes were continually checked against the data as part of an iterative process. The data highlight barriers to accessing AR services for trans people. Participant recommendations for improving AR service provision to better meet the needs of this population are presented. These recommendations address the following areas: (i) AR service provider education and training; (ii) service provider and clinic practices and (iii) clinic environment. The majority of study participants were trans people who identified as men and who resided in major urban areas; those living in smaller communities may have different experiences that were not adequately captured in this analysis. While existing literature debates the ethics of assisting trans people to become parents through the use of AR, our study demonstrates that they are already accessing or attempting to access these services. This reality necessitates a shift toward exploring the ways in which AR services can be improved to better meet the needs of this population, from the perspectives of both service users and service providers. This project was supported by the Canadian Institutes of Health Research-Institute of Gender and Health, in partnership with the Assisted Human Reproduction Canada: Catalyst Grant: Psychosocial Issues Associated with Assisted Human Reproduction (FRN-103595). S.M. was supported by a Canada Graduate Scholarship from the Social Science and Humanities Research Council, as well as research funding from Osgoode Hall Law School, York University. S.J.-A. was supported by an Ontario Graduate Scholarship funded by the Province of Ontario and the University of Toronto. N/A. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

‘These are not luxuries, it is essential for access to life’: Disability related out-of-pocket costs as a driver of economic vulnerability in South Africa

PubMed Central

Nene, Siphumelele; Deghaye, Nicola; Pillay, Simmi

2017-01-01

Background With the dawn of the new sustainable development goals, we face not only a world that has seen great successes in alleviating poverty but also a world that has left some groups, such as persons with disabilities, behind. Middle-income countries (MICs) are home to a growing number of persons with disabilities. As these countries strive to achieve the new goals, we have ample opportunity to include persons with disabilities in the emerging poverty alleviation strategies. However, a lack of data and research on the linkages between economic vulnerability and disability in MICs hampers our understanding of the factors increasing economic vulnerability in people with disabilities. Methods This article aims to present data related to elements of this vulnerability in one MIC, South Africa. Focusing on out-of-pocket costs, it uses focus group discussions with 73 persons with disabilities and conventional content analysis to describe these costs. Results A complex and nuanced picture of disability-driven costs evolved on three different areas: care and support for survival and safety, accessibility of services and participation in community. Costs varied depending on care and support needs, accessibility (physical and financial), availability, and knowledge of services and assistive devices. Conclusions The development of poverty alleviation and social protection mechanisms in MICs like South Africa needs to better consider diverse disability-related care and support needs not only to improve access to services such as education and health (National Health Insurance schemes, accessible clinics) but also to increase the effect of disability-specific benefits and employment equity policies. PMID:28730066

Obfuscatable multi-recipient re-encryption for secure privacy-preserving personal health record services.

PubMed

Shi, Yang; Fan, Hongfei; Xiong, Guoyue

2015-01-01

With the rapid development of cloud computing techniques, it is attractive for personal health record (PHR) service providers to deploy their PHR applications and store the personal health data in the cloud. However, there could be a serious privacy leakage if the cloud-based system is intruded by attackers, which makes it necessary for the PHR service provider to encrypt all patients' health data on cloud servers. Existing techniques are insufficiently secure under circumstances where advanced threats are considered, or being inefficient when many recipients are involved. Therefore, the objectives of our solution are (1) providing a secure implementation of re-encryption in white-box attack contexts and (2) assuring the efficiency of the implementation even in multi-recipient cases. We designed the multi-recipient re-encryption functionality by randomness-reusing and protecting the implementation by obfuscation. The proposed solution is secure even in white-box attack contexts. Furthermore, a comparison with other related work shows that the computational cost of the proposed solution is lower. The proposed technique can serve as a building block for supporting secure, efficient and privacy-preserving personal health record service systems.

Implementing personalisation for people with mental health problems: a comparative case study of four local authorities in England.

PubMed

Larsen, John; Ainsworth, Emily; Harrop, Clare; Patterson, Sue; Hamilton, Sarah; Szymczynska, Paulina; Tew, Jerry; Manthorpe, Jill; Pinfold, Vanessa

2013-04-01

Enhancing choice and control for people using services is a mental health and social-care service priority in England. Personalisation is a new policy and practice for delivery of social-care services where eligible adults are allocated a personal budget to spend to meet their agreed support needs. To describe approaches to introducing personal budgets to people with severe and enduring mental health needs, and to identify facilitators or barriers encountered. Within four English local authority (LA) areas, purposively selected to provide maximum variation, semi-structured interviews were undertaken with 58 participants from LAs, NHS trusts and third-sector organisations. An Interpretive Framework analysis considered within- and across-site insights. Issues arising from the implementation of personalisation for people with mental health needs are presented under two general themes: "responsibility and power" and "vision and leadership". Key challenges identified were complexities of working across NHS and LAs, the importance of effective leadership and engagement with service user representatives. Implementing personal budgets in mental health requires effective engagement of health and social-care systems. Change processes need strong leadership, clear vision and personal commitment, with ownership by all key stakeholders, including front-line practitioners.

Trauma-Informed Response in the Age of Title IX: Considerations for College Counselors Working with Survivors of Power-Based Personal Violence

ERIC Educational Resources Information Center

Conley, Abigail H.; Griffith, Catherine

2016-01-01

Intimate partner violence, sexual violence, and stalking are pervasive in the United States, and college women are disproportionately affected by this power-based personal violence (PBPV). Title IX mandates that colleges and universities offer support services to trauma survivors, and college counselors should be prepared to meet this need.…

The Council on Quality and Leadership in Supports for People with Disabilities: Personal Outcomes Chart Book.

ERIC Educational Resources Information Center

National Center on Outcomes Research, Council on Quality and Leadership, Towson, MD.

This report describes the genesis, definition and use of the Personal Outcomes database, a database designed to assess whether programs and services are being effective in helping individuals with disabilities. The database is based on 25 outcome measures in seven domains, including: (1) identity, which is designed to provide a sense of how people…

A Comparative Needs Analysis of Supportive Services for Non-Handicapped and Handicapped Persons Seeking Post-Secondary Education from the Community College System.

ERIC Educational Resources Information Center

Graham, Gary L.; And Others

This study was concerned with identifying the specific information needs and personal needs of handicapped students and comparing the selected needs with needs of general students. The study hypothesis was that there is no significant difference between identified needs of handicapped students and those of general students. The significance…

Concept and design philosophy of a person-accompanying robot

NASA Astrophysics Data System (ADS)

Mizoguchi, Hiroshi; Shigehara, Takaomi; Goto, Yoshiyasu; Hidai, Ken-ichi; Mishima, Taketoshi

1999-01-01

This paper proposes a person accompanying robot as a novel human collaborative robot. The person accompanying robot is such legged mobile robot that is possible to follow the person utilizing its vision. towards future aging society, human collaboration and human support are required as novel applications of robots. Such human collaborative robots share the same space with humans. But conventional robots are isolated from humans and lack the capability to observe humans. Study on human observing function of robot is crucial to realize novel robot such as service and pet robot. To collaborate and support humans properly human collaborative robot must have capability to observe and recognize humans. Study on human observing function of robot is crucial to realize novel robot such as service and pet robot. The authors are currently implementing a prototype of the proposed accompanying robot.As a base for the human observing function of the prototype robot, we have realized face tracking utilizing skin color extraction and correlation based tracking. We also develop a method for the robot to pick up human voice clearly and remotely by utilizing microphone arrays. Results of these preliminary study suggest feasibility of the proposed robot.

Supported employment for persons with mental illness: systematic review of the effectiveness of individual placement and support in the UK.

PubMed

Heffernan, John; Pilkington, Paul

2011-08-01

High levels of unemployment among persons with mental illness are a significant social disability. The individual placement and support (IPS) model of vocational support has been shown to be effective in establishing persons with mental health problems back into competitive employment in North America. Evidence outside North America is more limited. To examine the evidence for the effectiveness of the IPS model of supported employment within the United Kingdom. Systematic review of studies of the effectiveness of IPS conducted principally in the United Kingdom. The evidence base was small. Overall quality of evidence was fair. There is evidence that interventions with high fidelity to the IPS model increase the proportion of patients engaged in work or education/training over the short- to medium-term (6-18 months follow-up). More research is needed to improve the evidence base in relation to IPS within a UK context. Evaluation should focus on both the nature and quality of the employment gained, patient and service factors.

Experience of primary care among homeless individuals with mental health conditions.

PubMed

Chrystal, Joya G; Glover, Dawn L; Young, Alexander S; Whelan, Fiona; Austin, Erika L; Johnson, Nancy K; Pollio, David E; Holt, Cheryl L; Stringfellow, Erin; Gordon, Adam J; Kim, Theresa A; Daigle, Shanette G; Steward, Jocelyn L; Kertesz, Stefan G

2015-01-01

The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA), one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366) were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005), with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H) questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score). Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons' needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers.

The Art of Helpful Relationships with Professionals: A Meta-ethnography of the Perspective of Persons with Severe Mental Illness.

PubMed

Ljungberg, Amanda; Denhov, Anne; Topor, Alain

2015-12-01

Relationships with professionals have been shown to be helpful to persons with severe mental illness (SMI) in relation to a variety of services. In this article, we aimed to synthesize the available qualitative research to acquire a deepened understanding of what helpful relationships with professionals consists of, from the perspective of persons with SMI. To do this, we created a meta-ethnography of 21 studies, through which ten themes and an overarching interpretation were created. The findings show that helpful relationships with professionals are relationships where the persons with SMI get to spend time with professionals that they know and trust, who gives them access to resources, support, collaboration and valued interpersonal processes, which are allowed to transgress the boundaries of the professional relationship. The overarching interpretation shows that the relationship that persons with SMI form with professionals is a professional relationship as well as an interpersonal relationship. Both these dimensions entail actions and processes that can be helpful to persons with SMI. Therefore, it is important to recognize and acknowledge both the functional roles of service user and service provider, as well as the roles of two persons interacting with each other, in a manner that may go beyond the purview of the traditional professionalism. Furthermore, the helpful components of this relationship are determined by the individual preferences, needs and wishes of persons with SMI.

[Hyperfrequent consultations: is there a relationship with the mother's personality?].

PubMed

Igual Rosado, R; Castro Nicolau, E; Alonso Martínez, I; Terradas Corominas, M; de Frutos Gallego, E; Cebrià Andreu, J

2003-01-01

To study the psychological profile of mothers who overuse pediatric services and associated social and demographic characteristics, as well as to evaluate the association between maternal personality profile and greater use of pediatric services. Cross-sectional descriptive study, at the Basic Health Areas of Granollers Sud and Granollers Oest-Canovelles in Barcelona (Spain). Forty-four mothers, representing 21.5 % of the population meeting the inclusion criteria were studied. The population consisted of mothers of children who visited the center on an equal or higher number of occasions as two standard deviations. One-hour interviews were conducted. A data sheet to assess social and demographic variables, Milton's Multiaxial Inventory II, and Goldberg's Anxiety and Depression Scale to detect symptoms of depression and anxiety were administered. Forty-four mothers (21.5 %) attended the interviews. The mean age was 36.6 years. Most of the mothers (90.9 %) were married, 73 % had completed primary studies, 5 % were housewives, and 75 % had no family support. Fifty percent of the children were the youngest in their family, and 30 % were only children. Concerning personality disorders, 55.8 % of overusing mothers showed compulsive personality, 30.23 % schizoid personality, and 14 % dependent personality while 47.7 % of mothers presented significant symptoms of anxiety. Sociodemographic profile, anxiety, and maternal personality profile are related to overuse of pediatric services. Compulsive, schizoid and dependent personality disorders seem to be associated with overuse.

Promoting good policy for leadership and governance of health related rehabilitation: a realist synthesis.

PubMed

McVeigh, Joanne; MacLachlan, Malcolm; Gilmore, Brynne; McClean, Chiedza; Eide, Arne H; Mannan, Hasheem; Geiser, Priscille; Duttine, Antony; Mji, Gubela; McAuliffe, Eilish; Sprunt, Beth; Amin, Mutamad; Normand, Charles

2016-08-24

Good governance may result in strengthened performance of a health system. Coherent policies are essential for good health system governance. The overall aim of this research is to provide the best available scientific evidence on principles of good policy related leadership and governance of health related rehabilitation services in less resourced settings. This research was also conducted to support development of the World Health Organization's (WHO) Guidelines on health related rehabilitation. An innovative study design was used, comprising two methods: a systematic search and realist synthesis of literature, and a Delphi survey of expert stakeholders to refine and triangulate findings from the realist synthesis. In accordance with Pawson and Tilley's approach to realist synthesis, we identified context mechanism outcome pattern configurations (CMOCs) from the literature. Subsequently, these CMOCs were developed into statements for the Delphi survey, whereby 18 expert stakeholders refined these statements to achieve consensus on recommendations for policy related governance of health related rehabilitation. Several broad principles emerged throughout formulation of recommendations: participation of persons with disabilities in policy processes to improve programme responsiveness, efficiency, effectiveness, and sustainability, and to strengthen service-user self-determination and satisfaction; collection of disaggregated disability statistics to support political momentum, decision-making of policymakers, evaluation, accountability, and equitable allocation of resources; explicit promotion in policies of access to services for all subgroups of persons with disabilities and service-users to support equitable and accessible services; robust inter-sectoral coordination to cultivate coherent mandates across governmental departments regarding service provision; and 'institutionalizing' programmes by aligning them with preexisting Ministerial models of healthcare to support programme sustainability. Alongside national policymakers, our policy recommendations are relevant for several stakeholders, including service providers and service-users. This research aims to provide broad policy recommendations, rather than a strict formula, in acknowledgement of contextual diversity and complexity. Accordingly, our study proposes general principles regarding optimal policy related governance of health related rehabilitation in less resourced settings, which may be valuable across diverse health systems and contexts.

Mathematical Investigations for Supporting Pre-Service Primary Teachers Repeating a Mathematics Education Course

ERIC Educational Resources Information Center

Bailey, Judy

2014-01-01

Preparing to become an effective primary school mathematics teacher is a challenging and complex task; and is influenced by one's past experiences, personal knowledge of, and beliefs and attitudes towards mathematics. This paper examines the experiences of a small group of pre-service teachers who did not pass their first year mathematics…

A Structural Equation Model of Burnout and Job Exit among Child Protective Services Workers.

ERIC Educational Resources Information Center

Drake, Brett; Yadama, Gautam N.

1996-01-01

Uses a structural equation model to examine the three elements of the Maslach Burnout Inventory (MBI)--emotional exhaustion, depersonalization, and personal accomplishment--in relation to job exit among child protective services workers over a 15-month period. The model was supported, showing the relevance of all three MBI elements of job exit.…

75 FR 39264 - CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-08

... Resources and Services Administration CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment In... and control of HIV/AIDS and other STDs, the support of health care services to persons living with HIV/AIDS, and education of health professionals and the public about HIV/AIDS and other STDs. Matters To Be...

78 FR 32392 - CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-30

... Resources and Services Administration CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention.../AIDS, Viral Hepatitis and other STDs, the support of health care services to persons living with HIV/AIDS, and education of health professionals and the public about HIV/AIDS, Viral Hepatitis and other...

Stakeholder Perspectives on Policies to Support Family Caregivers of Older Adults with Dementia

ERIC Educational Resources Information Center

Putnam, Michelle; Pickard, Joseph G.; Rodriguez, Carroll; Shear, Erin

2010-01-01

Persons with dementia are often excluded from consumer-directed home- and community-based service programs because they cannot direct their own care. Surrogates are permitted in some states, thereby allowing program participation. This study explored family caregiver perspectives on policies that support family needs related to providing care to…

Setting new standards for customer advocacy.

PubMed

McDonald, L

1993-01-01

Dell Computer Corporation pioneered the direct marketing of personal computers in 1984 and became the first company in the PC industry to offer manufacturer-direct technical support. According to surveys of corporate buyers, the company provides the best after-sale service and support of any computer maker. Here's how Dell has institutionalized the delivery of customer satisfaction.

Family Policy

DTIC Science & Technology

1988-12-30

comander in coordination with installation residents, activities, and family support program managers . Unresourced requirements are forwarded through...members and their families in keeping their personal financial affairs in order. The program provides basic money management and consumer education...Directive 1342.16 (references (d) through (f)). 7. Deployment Support. Helps single and married Military Service members and their families to manage

Smart information system for gachon university gil hospital.

PubMed

Park, Dong Kyun; Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

2012-03-01

In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future.

Smart Information System for Gachon University Gil Hospital

PubMed Central

Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

2012-01-01

Objectives In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. Methods This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. Results The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Conclusions Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future. PMID:22509476

Characteristics of U.S. Substance Abuse Treatment Facilities Offering HIV Services: Results From a National Survey.

PubMed

Cohn, Amy; Stanton, Cassandra; Elmasry, Hoda; Ehlke, Sarah; Niaura, Ray

2016-06-01

Substance use disorders are common among persons with HIV/AIDS. This study examined the prevalence and correlates of the provision of four HIV services in a national sample of substance abuse treatment facilities. Data were from the 2011 National Survey of Substance Abuse Treatment Services. Prevalence estimates indicated that 28% of facilities offered HIV testing, 26% early intervention, 58% HIV/AIDS education, and 8% special programs for HIV/AIDS. Facilities offering inpatient substance abuse care were more than six times as likely to offer HIV testing but not more likely to offer any other type of HIV service. Facilities offering methadone treatment were 2.5 times more likely to offer HIV services. Given the high rates of substance use among persons with HIV, the prevalence of facilities offering HIV services was low in most domains, with different barriers identified in multivariable models. Integrating comprehensive HIV prevention, testing, and support services into programs that address substance abuse is needed.

Social inclusion and mental health.

PubMed

Cobigo, Virginie; Stuart, Heather

2010-09-01

Recent research on approaches to improving social inclusion for people with mental disabilities is reviewed. We describe four approaches (or tools) that can be used to improve social inclusion for people with mental disabilities: legislation, community-based supports and services, antistigma/antidiscrimination initiatives, and system monitoring and evaluation. While legislative solutions are the most prevalent, and provide an important framework to support social inclusion, research shows that their full implementation remains problematic. Community-based supports and services that are person-centered and recovery-oriented hold considerable promise, but they are not widely available nor have they been widely evaluated. Antistigma and antidiscrimination strategies are gaining in popularity and offer important avenues for eliminating social barriers and promoting adequate and equitable access to care. Finally, in the context of the current human rights and evidence-based health paradigms, systematic evidence will be needed to support efforts to promote social inclusion for people with mental disabilities, highlight social inequities, and develop best practice approaches. Tools that promote social inclusion of persons with mental disabilities are available, though not yet implemented in a way to fully realize the goals of current disability discourse.

Using intensive case management to reduce violence by mentally ill persons in the community.

PubMed

Dvoskin, J A; Steadman, H J

1994-07-01

Aggressive and intensive case management and a comprehensive array of community support services are the keys to reducing the risk of violence by people with serious mental illness in the community. The authors describe the elements of intensive case management for potentially violent clients, including use of individual case managers responsible for small caseloads, 24-hour availability of case managers, and strong linkages to agencies providing mental health services, substance abuse treatment, and social services as well as to the criminal justice system. They summarize the results of three recent studies of intensive case management programs suggesting that this intervention is effective in reducing clients' dangerousness in the community. They discuss cultural and human resource issues that affect planning of intensive case management services. Intensive case managers need to be "boundary spanners" with the training, experience, and personality to bridge the often-broad gap between human service and criminal justice systems.

"The Church of Online Support": Examining the Use of Blogs Among Family Caregivers of Persons With Dementia.

PubMed

Anderson, Joel G; Hundt, Elizabeth; Dean, Morgan; Keim-Malpass, Jessica; Lopez, Ruth Palan

2017-02-01

Many individuals, including dementia caregivers, use blogs to share their experiences. These blogs contain rich narratives representing an untapped resource for understanding the psychosocial impact of caring for a person with dementia at the family level. The present study used blogs written by caregivers of persons with dementia to explore how these individuals leveraged this medium as part of the caregiving experience. Blogs written by self-identified informal caregivers of persons with dementia were identified using a systematic search method, and data were analyzed using a qualitative thematic analysis. Four themes emerged from the narratives: social support through communication and engagement, information gathering and seeking, reminiscing and legacy building, and altruism. By understanding the ways in which individuals providing care for persons with dementia use social media as part of the caregiving experience, family nurses can develop interventions and services aimed at improving caregiver burden and quality of life.

Using benchmarking to assist the improvement of service quality in home support services for older people-IN TOUCH (Integrated Networks Towards Optimising Understanding of Community Health).

PubMed

Jacobs, Stephen P; Parsons, Matthew; Rouse, Paul; Parsons, John; Gunderson-Reid, Michelle

2018-04-01

Service providers and funders need ways to work together to improve services. Identifying critical performance variables provides a mechanism by which funders can understand what they are purchasing without getting caught up in restrictive service specifications that restrict the ability of service providers to meet the needs of the clients. An implementation pathway and benchmarking programme called IN TOUCH provided contracted providers of home support and funders with a consistent methodology to follow when developing and implementing new restorative approaches for service delivery. Data from performance measurement was used to triangulate the personal and social worlds of the stakeholders enabling them to develop a shared understanding of what is working and what is not. The initial implementation of IN TOUCH involved five District Health Boards. The recursive dialogue encouraged by the IN TOUCH programme supports better and more sustainable service development because performance management is anchored to agreed data that has meaning to all stakeholders. Copyright © 2017 Elsevier Ltd. All rights reserved.

Integrating personal medicine into service delivery: empowering people in recovery.

PubMed

MacDonald-Wilson, Kim L; Deegan, Patricia E; Hutchison, Shari L; Parrotta, Nancy; Schuster, James M

2013-12-01

Illness management and recovery strategies are considered evidence-based practices. The article describes how a web-based application, CommonGround, has been used to support implementation of such strategies in outpatient mental health services and assess its impact. The specific focus of this article is Personal Medicine, self-management strategies that are a salient component of the CommonGround intervention. With support from counties and a not-for-profit managed care organization, CommonGround has been introduced in 10 medication clinics, one Assertive Community Treatment (ACT) team, and one peer support center across Pennsylvania. Methods include analysis of data from the application's database and evaluation of health functioning, symptoms, and progress toward recovery. Health functioning improved over time and use of self-management strategies was associated with fewer concerns about medication side effects, fewer concerns about the impact of mental health medicine on physical health, more reports that mental health medicines were helping, and greater progress in individuals' recovery. Using Personal Medicine empowers individuals to work with their prescribers to find a "right balance" between what they do to be well and what they take to be well. This program helps individuals and their service team focus on individual strengths and resilient self-care strategies. More research is needed to assess factors that may predict changes in outcomes and how a web-based tool focused on self-management strategies may moderate those factors. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Spending by California’s Department of Developmental Services for Persons with Autism across Demographic and Expenditure Categories

PubMed Central

Leigh, J. Paul; Grosse, Scott D.; Cassady, Diana; Melnikow, Joy; Hertz-Picciotto, Irva

2016-01-01

Background Few autism spectrum disorder (ASD) studies have estimated non-medical costs for treatment or addressed possible differences in provision of services across gender, race-ethnic, age or demographic or expenditure categories, especially among adults. Methods The California Department of Developmental Services (CDDS) provides services to residents with developmental disabilities. CDDS provided aggregate data on primarily non-medical spending for fiscal year 2012–2013 for persons with ASD with or without intellectual disability (ID) (main sample, n = 42,274), and two sub-samples: ASD only (n = 30,164), and ASD+ID (n = 12,110). Demographic variables included sex, age and race-ethnicity. Spending categories included Employment Support, Community Care Facilities, Day Care, Transportation, and in-home and out-of-home Respite. Results Per-person spending for males and females were approximately the same: $10,488 and $10,791 for males and females for ages 3–17 and $26,491 and $26,627 for ages 18+. Among race/ethnicity categories, the ranking from highest to lowest among ages 3–17 was white non-Hispanics ($11,480), Asian non-Hispanics ($11,036), “Others” ($11,031), Hispanics ($9,571), and African-American non-Hispanics ($9,482). For ages 18+, the ranking was whites ($31,008), African-Americans ($26,831), “Others” ($25,395), Asians ($22,993), and Hispanics ($18,083). The ASD+ID sub-sample exerted disproportionate influence on findings from the main sample for persons 18+. Combining all ages, the top two expenditure categories for per-person spending were Community Care Facilities ($43,867) and Day Care ($11,244). For most adult age groups, the percentage of recipients participating were highest for Day Care (44.9% - 62.4%) and Transportation (38.6% - 50.9%). Per-person spending for Day Care, Transportation, and Employment Support was relatively low for children but relatively high for adults. Conclusion White non-Hispanics received the highest per-person spending and Hispanics among the least. Amounts within spending categories varied considerably across age groups. Our estimates may be useful as baseline measures for stakeholders preparing for increasing ASD prevalence, especially among adults. PMID:27015098

Service users' perspectives in the design of an online tool for assisted self-help in mental health: a case study of implications.

PubMed

Gammon, Deede; Strand, Monica; Eng, Lillian Sofie

2014-01-09

The involvement of persons with lived experiences of mental illness and service use is increasingly viewed as key to improving the relevance and utility of mental health research and service innovation. Guided by the principles of Community-Based Participatory Research we developed an online tool for assisted self-help in mental health. The resulting tool, PsyConnect, is ready for testing in two communities starting 2014. This case study reports from the design phase which entailed clarifying very basic questions: Who is the primary target group? What are the aims? What functions are priorities? Roles and responsibilities? What types of evidence can legitimize tool design decisions? Here we highlight the views of service users as a basis for discussing implications of user involvement for service design and research. PsyConnect has become a tool for those who expect to need assistance over long periods of time regardless of their specific condition(s). The aim is to support service users in gaining greater overview and control, legitimacy, and sense of continuity in relationships. It has a personalized "my control panel" which depicts status → process → goals. Functionality includes support for: mapping life domains; medication overview; crisis management; coping exercises; secure messaging; and social support. While the types of evidence that can legitimize design decisions are scattered and indirectly relevant, recent trends in recovery research will be used to guide further refinements. PsyConnect has undoubtedly become something other than it would have been without careful attention to the views of service users. The tool invites a proactive approach that is likely to challenge treatment cultures that are reactive, disorder-focused and consultation-based. Service user representatives will need to play central roles in training peers and clinicians in order to increase the likelihood of tool usage in line with intentions. Similarly, their influence on tool design has implications for choice of methods for evaluation. Starting down the path of service user involvement in intervention design fosters commitment to follow through in the remaining implementation and research phases. While this can be time-consuming and less meriting for researchers, it is probably vital to increasing the likelihood of success of person-centered service innovations.

Motivations of persons with psychiatric disabilities to work in mental health peer services: a qualitative study using self-determination theory.

PubMed

Moran, Galia Sharon; Russinova, Zlatka; Yim, Jung Yeon; Sprague, Catherine

2014-03-01

Individuals with psychiatric disabilities have low rates of employment and occupational rehabilitation success. Mental health peer services are a new occupational modality that opened a promising occupational path: persons with serious mental illnesses employed to provide support to others with psychiatric conditions. However challenges to successful peer work exist. Work motivation is central to understanding and supporting peer workers, yet little is known about sources of motivation to work as mental health peer providers. The aim of this study was to identify what drives individuals to mental health peer work using self determination theory (SDT). Motivations of 31 mental health peer workers were explored as part of a larger study. A theory driven approach was employed to emerging qualitative data using SDT concepts: external motivation and internally regulated motivations derived from basic needs (autonomy, competence, relatedness). External motivations included generic occupational goals and getting away from negative work experiences. Internal motivations corresponded with SDT basic needs: autonomy met-needs was reflected in having freedom to disclose and finding that work accords with personal values; competence met-needs was reflected in using personal experience as a resource to help others; and relatedness met-needs were reflected in having opportunity to connect intimately and reciprocate with consumers. This study identified external and internal motivations of persons with psychiatric disabilities to work as peer providers-a novel occupation in mental health. Employing personal experience and enabling peer contact emerge as major motivational tenets of mental health peer work. According to SDT instrumental occupational goals are considered more external than satisfaction of basic psychological needs. The study demonstrates the applicability of SDT in the design of autonomy supported environments to promote work engagement and sustenance of mental health peer providers.

"Recovery" in bipolar disorder: how can service users be supported through a self-management intervention? A qualitative focus group study.

PubMed

Todd, Nicholas J; Jones, Steven H; Lobban, Fiona A

2012-04-01

Bipolar disorder (BD) is a chronic and recurrent affective disorder. Recovery is defined as the process by which people can live fulfilling lives despite experiencing symptoms. To explore how an opportunistically recruited group of service users with BD experience recovery and self-management to understand more about how a service users' recovery may be supported. Twelve service users with BD took part in a series of focus groups. Service users' responses to questions about their personal experiences of self-management and recovery were analysed. Focus groups were transcribed verbatim and thematic analysis ([ Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101]) was employed to identify common themes in the data. Four key themes were identified: (1) Recovery is not about being symptom free; (2) Recovery requires taking responsibility for your own wellness; (3) Self-management: building on existing techniques; (4) Overcoming barriers to recovery: negativity, stigma and taboo. Service users with BD have provided further support for the concept of recovery and have suggested a number of ways recovery can be supported. A self-management approach informed by the recovery literature has been proposed as a way to support service users' recovery.

Experience and Consequences on the Deployments of the Medical Services of the German Army in Foreign Countries - Surgical Aspects

DTIC Science & Technology

2004-09-01

RTO-MP-HFM-109 41 - 1 Experience and Consequences on the Deployments of the Medical Services of the German Army in Foreign Countries...army medical services lead to new experiences concerning personal, training, preparation, support, equipment and standardisation. The consequences...are not only important for the surgical work but also for anaesthesiology , intensive care, internal medicine and neurology and psychiatry. The

An Analysis of Personal Technology Use by Service Members and Military Behavioral Health Providers.

PubMed

Edwards-Stewart, Amanda; Smolenski, Derek J; Reger, Greg M; Bush, Nigel; Workman, Don E

2016-07-01

Personal technology use is ubiquitous in the United States today and technology, in general, continues to change the face of health care. However, little is known about the personal technology use of military service members and the behavioral health care providers that treat them. This study reports the technology use of 1,101 active duty service members and 45 behavioral health care providers at a large military installation. Participants reported Internet usage; ownership of smartphones, tablets, and e-readers; usage of mobile applications (apps); and basic demographic information. Compared with providers, service members reported higher rates of smartphone ownership, were more likely to own Android smartphones than iPhones, and spent more time gaming. Both groups spent a comparable amount of time using social media. With the exception of gaming, however, differences between service members and providers were not statistically significant when demographics were matched and controlled. Among service members, younger respondents (18-34) were statistically more likely than older respondents (35-58) to own smartphones, spend time gaming, and engage in social media. Our findings can help inform provider's technology-based education and intervention of their patients and guide the development of new technologies to support the psychological health of service members. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Service patterns related to successful employment outcomes of persons with traumatic brain injury in vocational rehabilitation.

PubMed

Catalano, Denise; Pereira, Ana Paula; Wu, Ming-Yi; Ho, Hanson; Chan, Fong

2006-01-01

This study analyzed the Rehabilitation Services Administration (RSA) case service report (RSA-911) data for fiscal year 2004 to examine effects of demographic characteristics, work disincentives, and vocational rehabilitation services patterns on employment outcomes of persons with traumatic brain injuries (TBI). The results indicated that European Americans (53%) had appreciably higher competitive employment rates than Native American (50%), Asian Americans (44%), African Americans (42%), and Hispanic/Latino Americans (41%). Clients without co-occurring psychiatric disabilities had a higher employment rate (51%) than those with psychiatric disabilities (45%). Clients without work disincentives showed better employment outcomes (58%) than those with disincentives (45%). An important finding from this analysis was the central role of job search assistance, job placement assistance, and on-the-job support services for persons with TBI in predicting employment outcomes. A data mining technique, the exhaustive CHAID analysis, was used to examine the interaction effects of race, gender, work disincentives and service variables on employment outcomes. The results indicated that the TBI clients in this study could be segmented into 29 homogeneous subgroups with employment rates ranging from a low of 11% to a high of 82%, and these differences can be explained by differences in work disincentives, race, and rehabilitation service patterns.

Are consumer-directed home care beneficiaries satisfied? Evidence from Washington state.

PubMed

Wiener, Joshua M; Anderson, Wayne L; Khatutsky, Galina

2007-12-01

This study analyzed the effect of consumer-directed versus agency-directed home care on satisfaction with paid personal assistance services among Medicaid beneficiaries in Washington State. The study analyzed a survey of 513 Medicaid beneficiaries receiving home- and community-based services. As part of a larger study, we developed an 8-item Satisfaction With Paid Personal Assistance Scale as the measure of satisfaction. In predicting satisfaction with personal assistance services, we estimated an ordinary least squares regression model that was right-censored to account for the large percentage of respondents who were highly satisfied with their care. Among the older population, but not younger people with disabilities, beneficiaries receiving consumer-directed services were more satisfied than individuals receiving agency-directed care. There was no evidence that quality of care was less with consumer-directed services. In addition, overall satisfaction levels with paid home care were very high. This study supports the premise that consumer satisfaction, an important measure of quality, in consumer-directed home care is not inferior to that in agency-directed care. The positive effect of consumer direction for older people underlines the fact that this service option is relevant for this population. In addition, this research provides evidence that home- and community-based services are of high quality, at least on one dimension.

Consumption value theory and the marketing of public health: an effective formative research tool.

PubMed

Nelson, Douglas G; Byus, Kent

2002-01-01

Contemporary public health requires the support and participation of its constituency. This study assesses the capacity of consumption value theory to identify the basis of this support. A telephone survey design used simple random sampling of adult residents of Cherokee County, Oklahoma. Factor analysis and stepwise discriminant analysis was used to identify and classify personal and societal level support variables. Most residents base societal level support on epistemic values. Direct services clientele base their support on positive emotional values derived from personal contact and attractive programs. Residents are curious about public health and want to know more about the health department. Where marketing the effectiveness of public health programs would yield relatively little support, marketing health promotion activities may attract public opposition. This formative research tool suggests a marketing strategy for public health practitioners.

Important components to create personal working alliances with clients in the mental health sector to support the recovery process.

PubMed

Klockmo, Carolina; Marnetoft, Sven-Uno; Selander, John; Nordenmark, Mikael

2014-03-01

Personligt ombud (PO) is a Swedish version of case management that aims to support individuals with psychiatric disabilities. Guidelines to the PO service emphasize the different role that the PO plays with respect to the relationship with clients. The aim of this study was to investigate the components that POs found to be important in the relationship with clients. Telephone interviews with 22 POs across Sweden were carried out. The interviews were recorded, transcribed, and analyzed using qualitative content analysis. The relationship with each client was described as the foundation of the POs' work; it was the only 'tool' they had. The findings were reflected in a main theme, which showed the importance of creating personal working alliances with each client where POs put the client at the center of the work and adjusted their support according to the client's needs at the time. Important components were that the PO and the client trusted each other, that the power between the PO and the client was balanced, and to be a personal support. Many of the components that POs found to be important are shown as essential in recovery-oriented services. POs followed the client in the process and remained as long as necessary and this is one way of bringing hope to the client's recovery process. However, the personal tone can be fraught with difficulties and to maintain professionalism, it is necessary to reflect, through discussions with colleagues, with the leader and in supervision.

ROBIN, a Telepresence Robot to Support Older Users Monitoring and Social Inclusion: Development and Evaluation.

PubMed

Cortellessa, Gabriella; Fracasso, Francesca; Sorrentino, Alessandra; Orlandini, Andrea; Bernardi, Giulio; Coraci, Luca; De Benedictis, Riccardo; Cesta, Amedeo

2018-02-01

This article describes an enhanced telepresence robot named ROBIN, part of a telecare system derived from the GIRAFFPLUS project for supporting and monitoring older adults at home. ROBIN is integrated in a sensor-rich environment that aims to continuously monitor physical and psychological wellbeing of older persons living alone. The caregivers (formal/informal) can communicate through it with their assisted persons. Long-term trials in real houses highlighted several user requirements that inspired improvements on the robotic platform. The enhanced telepresence robot was assessed by users to test its suitability to support social interaction and provide motivational feedback on health-related aspects. Twenty-five users (n = 25) assessed the new multimodal interaction capabilities and new communication services. A psychophysiological approach was adopted to investigate aspects like engagement, usability, and affective impact, as well as the possible role of individual differences on the quality of human-robot interaction. ROBIN was overall judged usable, the interaction with/through it resulted pleasant and the required workload was limited, thus supporting the idea of using it as a central component for remote assistance and social participation. Open-minded users tended to have a more positive interaction with it. This work describes an enabling technology for remote assistance and social communication. It highlights the importance of being compliant with users' needs to develop solutions easy to use and able to foster their social connections. The role of personality appeared to be relevant for the interaction, underscoring a clear role of the service personalization.

Legal Provisions, Educational Services and Health Care Across the Lifespan for Autism Spectrum Disorders in India.

PubMed

Barua, Merry; Kaushik, Jaya Shankar; Gulati, Sheffali

2017-01-01

India is estimated to have over 10 million persons with autism. Rising awareness of autism in India over last decade with ready access to information has led to an increase in prevalence and earlier diagnosis, the creation of services and some policy initiatives. However, there remains a gaping chasm between policy and implementation. The reach and quality of services continues sketchy and uneven, especially in the area of education. The present review discusses existing legal provisions for children and adults with autism in India. It also discusses Governmental efforts and lacunae in existing health care facilities and education services in India. While there are examples of good practice and stories of hope, strong policy initiatives have to support grassroots action to improve the condition of persons with autism in India.

Are satisfaction with and self-management of personal assistance services associated with the life satisfaction of persons with physical disabilities?

PubMed

Fleming-Castaldy, Rita P

2011-01-01

To examine the relationships between satisfaction with and self-management of personal assistance services (PAS) and the quality of life (QoL) of persons with disabilities. To test the postulate that consumer-directed PAS can fulfil the human need for control and contribute to a satisfactory life. A survey compared the perspectives of persons using consumer-directed PAS versus those using agency-directed. A Personal Data Form obtained demographics and PAS characteristics. The Quality of Life Inventory measured life satisfaction. A PAS questionnaire measured perceptions about the management of, desire for control of, and satisfaction with PAS. Data were analysed using SPSS®- 14. Significant relationships were found between QoL and satisfaction with PAS (p < 0.001) and between perceived control of PAS and satisfaction with PAS (p < 0.001). Significant group differences were also found. Consumer-directed participants reported higher satisfaction with their PAS (p < 0.01), greater control over services (p < 0.001) and greater QoL than agency-directed participants, (p = 0.001). The relationships found between self-management, PAS satisfaction, and QoL support the value of consumer-directed programmes. Rehabilitation professionals can use this knowledge to develop, implement and research practises that enable self-management.

Work Engagement, Burnout and Personal Accomplishments Among Social Workers: A Comparison Between Those Working in Children and Adults' Services in England.

PubMed

Hussein, Shereen

2018-04-26

Social workers (SWs) provide emotional and practical support to vulnerable service users who are likely to suffer from emotional trauma and mental health conditions. Stress and burnout levels are reported to be high among SWs, however, little is known about their relationships with different characteristics. The current article utilises unique and large dataset (n = 3786) on SWs working in adults and children's services to examine factors associated with burnout. Employing job-demand/resources model and structural equations modelling, we highlight the varying significant impact of work-engagement, administrative support and work experience as moderating factors to burnout across adult and children service specialism in this sample.

Design and implementation of the standards-based personal intelligent self-management system (PICS).

PubMed

von Bargen, Tobias; Gietzelt, Matthias; Britten, Matthias; Song, Bianying; Wolf, Klaus-Hendrik; Kohlmann, Martin; Marschollek, Michael; Haux, Reinhold

2013-01-01

Against the background of demographic change and a diminishing care workforce there is a growing need for personalized decision support. The aim of this paper is to describe the design and implementation of the standards-based personal intelligent care systems (PICS). PICS makes consistent use of internationally accepted standards such as the Health Level 7 (HL7) Arden syntax for the representation of the decision logic, HL7 Clinical Document Architecture for information representation and is based on a open-source service-oriented architecture framework and a business process management system. Its functionality is exemplified for the application scenario of a patient suffering from congestive heart failure. Several vital signs sensors provide data for the decision support system, and a number of flexible communication channels are available for interaction with patient or caregiver. PICS is a standards-based, open and flexible system enabling personalized decision support. Further development will include the implementation of components on small computers and sensor nodes.

Intervention Costs From Communities Putting Prevention to Work.

PubMed

Honeycutt, Amanda A; Khavjou, Olga A; Bradley, Christina; Neuwahl, Simon; Hoerger, Thomas J; Bellard, David; Cash, Amanda J

2016-07-28

In 2010, the Centers for Disease Control and Prevention funded 50 communities to participate in the Communities Putting Prevention to Work (CPPW) program. CPPW supported community-based approaches to prevent or delay chronic disease and promote wellness by reducing tobacco use and obesity. We collected the direct costs of CPPW for the 44 communities funded through the American Recovery and Reinvestment Act (ARRA) and analyzed costs per person reached for all CPPW interventions and by intervention category. From 2011 through 2013, we collected quarterly data on costs from the 44 CPPW ARRA-funded communities. We estimated CPPW program costs as spending on labor; consultants; materials, travel, and services; overhead activities; and partners plus the value of in-kind donations. We estimated communities' costs per person reached for each intervention implemented and compared cost allocations across communities that focused on reducing tobacco use, or obesity, or both. Analyses were conducted in 2014; costs are reported in 2012 dollars. The largest share of CPPW total costs of $363 million supported interventions in communities that focused on obesity ($228 million). Average costs per person reached were less than $5 for 84% of tobacco-related interventions, 88% of nutrition interventions, and 89% of physical activity interventions. Costs per person reached were highest for social support and services interventions, almost $3 for tobacco‑use interventions and $1 for obesity prevention interventions. CPPW cost estimates are useful for comparing intervention cost per person reached with health outcomes and for addressing how community health intervention costs vary by type of intervention and by community size.

Intervention Costs From Communities Putting Prevention to Work

PubMed Central

Khavjou, Olga A.; Bradley, Christina; Neuwahl, Simon; Hoerger, Thomas J.; Bellard, David; Cash, Amanda J.

2016-01-01

Introduction In 2010, the Centers for Disease Control and Prevention funded 50 communities to participate in the Communities Putting Prevention to Work (CPPW) program. CPPW supported community-based approaches to prevent or delay chronic disease and promote wellness by reducing tobacco use and obesity. We collected the direct costs of CPPW for the 44 communities funded through the American Recovery and Reinvestment Act (ARRA) and analyzed costs per person reached for all CPPW interventions and by intervention category. Methods From 2011 through 2013, we collected quarterly data on costs from the 44 CPPW ARRA-funded communities. We estimated CPPW program costs as spending on labor; consultants; materials, travel, and services; overhead activities; and partners plus the value of in-kind donations. We estimated communities’ costs per person reached for each intervention implemented and compared cost allocations across communities that focused on reducing tobacco use, or obesity, or both. Analyses were conducted in 2014; costs are reported in 2012 dollars. Results The largest share of CPPW total costs of $363 million supported interventions in communities that focused on obesity ($228 million). Average costs per person reached were less than $5 for 84% of tobacco-related interventions, 88% of nutrition interventions, and 89% of physical activity interventions. Costs per person reached were highest for social support and services interventions, almost $3 for tobacco‑use interventions and $1 for obesity prevention interventions. Conclusions CPPW cost estimates are useful for comparing intervention cost per person reached with health outcomes and for addressing how community health intervention costs vary by type of intervention and by community size. PMID:27468157

Relationships between Personal Traits, Emotional Intelligence, Internal Marketing, Service Management, and Customer Orientation in Korean Outpatient Department Nurses.

PubMed

Kim, Bogyun; Lee, Jia

2016-03-01

Current increase and complexity of medical tests and surgical procedures at outpatient department (OPD) require OPD nurses to have customer orientation focusing on various customers' interests and needs. The purpose of this study was to identify the factors associated with customer orientation in nurses working at OPD of hospitals. The study used a descriptive correlational design with cross-sectional survey. The study settings were four general hospitals in Seoul and its metropolitan area. Data were collected from 138 OPD nurses from general hospitals. Study variables were personal traits, emotional intelligence, internal marketing, service management and customer orientation. Factors associated with customer orientation were identified as conscientiousness from personal traits (β = .37, p < .001), emotional intelligence from individual characteristics (β = .21, p = .032), and internal marketing from environmental characteristics (β = .21, p = .001). Hospital administrators should support OPD nurses to cultivate sincere and sociable personal traits and emotional intelligence, and to consider employees as internal customers to improve patient-oriented services and satisfaction. Copyright © 2015. Published by Elsevier B.V.

42 CFR 403.256 - Loss ratio supporting data.

Code of Federal Regulations, 2012 CFR

2012-10-01

... service. (vi) Interest. (vii) Expected distribution, by age and sex, of persons who will purchase the... insuring organization must submit the following to CMS— (1) A description of all changes in the loss ratio...

42 CFR 403.256 - Loss ratio supporting data.

Code of Federal Regulations, 2014 CFR

2014-10-01

... service. (vi) Interest. (vii) Expected distribution, by age and sex, of persons who will purchase the... insuring organization must submit the following to CMS— (1) A description of all changes in the loss ratio...

42 CFR 441.725 - Person-centered service plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... which the individual elects to self-direct, meeting the requirements of § 441.740. (12) Prevent the... individual; and (viii) Include an assurance that the interventions and supports will cause no harm to the...

Community participation of persons with disabilities: volunteering, donations and involvement in groups and organisations.

PubMed

Rak, Eniko C; Spencer, Lauren

2016-08-01

This study examined similarities and differences between persons with and without disabilities on volunteering, donations and group participation. A sample of 1548 individuals participated and 60% of the sample were persons with disabilities. Data for this research was drawn from a major statewide survey in a Midwestern state in the United States. Community participation was measured through involvement with civic, religious and other community-based groups, volunteering activities and donations. Logistic regression was pursued to test the effect of disability on community participation. Findings support different trends in participation between persons with and without disabilities. Individuals without disabilities are more likely to volunteer, donate money and participate in civic organisations (e.g. clubs) and other groups. Employment and household income have a significant contribution in explaining these differences. This study found significant differences in community participation between persons with disabilities and persons without disabilities. Regression analysis outcomes underscore the importance of employment and income in eliminating disparities in community involvement between persons with and without disabilities. Implications for Rehabilitation Policy change in rehabilitation agencies to fund supported volunteering services. Improve the representation of persons with disabilities in volunteering pursuits by making volunteering positions accessible to them (educate persons with disabilities to be more aware of these opportunities, provide reasonable accommodations at work sites, etc.). Educate stakeholders about the benefits of volunteering and being part of civic, and other community based groups in improving the quality of life of persons with disabilities. Identification of barriers for persons with disabilities in these pursuits (physical and attitudinal barriers, lack of resources). Identifying and utilising natural supports in the work site for persons with disabilities to receive peer support on the job from full-time employees.

A Follow-Up Study of Graduates with Learning Disabilities from a College of Education: Impact of the Disability on Personal and Professional Life

ERIC Educational Resources Information Center

Russak, Susie; Daniel Hellwing, Ariella

2015-01-01

The present study examined three issues connected to the experiences of graduates with learning disabilities (LD) from a college of education (N = 45): support services that had been most beneficial during studies, positive and negative effects of the disability on personal, and professional life. Additionally, demographic data were collected. A…

Integrating into the Mental Health System from the Criminal Justice System: Jail Aftercare Services for Persons with a Severe Mental Illness

ERIC Educational Resources Information Center

Davis, Kristin; Fallon, John; Vogel, Sue; Teachout, Alexandra

2008-01-01

This article describes a mental health evidence based practice, Assertive Community Treatment (ACT). While ACT has scientific support, it has not been rigorously tested for persons with a severe mental illness and repeated forensic involvement. This article provides preliminary evidence that ACT is best suited for reentry into the mental health…

Comparing Person-Centered Communication Education in Long-Term Care Using Onsite and Online Formats.

PubMed

Coleman, Carissa K; Fanning, Kim; Williams, Kristine N

2015-11-01

Educating nursing home (NH) staff to provide person-centered care is complicated by scheduling, costs, and other feasibility issues. The current study compared outcomes for an in-service program focused on person-centered communication provided in onsite and online formats. The Changing Talk program was provided onsite in seven NHs (n = 327 staff). The online program included eight NHs (n = 211 staff). Analysis of variance revealed an interaction between format type and pre-/post-test scores with improved recognition of person-centered communication in the onsite group only. Group program evaluations based on the modified Diffusion of Innovation in Long-Term Care Battery indicated no significant differences between training formats. Staff perception of the program was similar. Although statistically significant gains were noted in posttest scores indicating awareness of person-centered communication for the onsite group, gains were of limited clinical significance. Feasibility and effectiveness are important considerations for in-service education supporting NH culture change. Copyright 2015, SLACK Incorporated.

Understanding consumer evaluations of personalised nutrition services in terms of the privacy calculus: a qualitative study.

PubMed

Berezowska, Aleksandra; Fischer, Arnout R H; Ronteltap, Amber; Kuznesof, Sharron; Macready, Anna; Fallaize, Rosalind; van Trijp, Hans C M

2014-01-01

Personalised nutrition (PN) may provide major health benefits to consumers. A potential barrier to the uptake of PN is consumers' reluctance to disclose sensitive information upon which PN is based. This study adopts the privacy calculus to explore how PN service attributes contribute to consumers' privacy risk and personalisation benefit perceptions. Sixteen focus groups (n = 124) were held in 8 EU countries and discussed 9 PN services that differed in terms of personal information, communication channel, service provider, advice justification, scope, frequency, and customer lock-in. Transcripts were content analysed. The personal information that underpinned PN contributed to both privacy risk perception and personalisation benefit perception. Disclosing information face-to-face mitigated the perception of privacy risk and amplified the perception of personalisation benefit. PN provided by a qualified expert and justified by scientific evidence increased participants' value perception. Enhancing convenience, offering regular face-to face support, and employing customer lock-in strategies were perceived as beneficial. This study suggests that to encourage consumer adoption, PN has to account for face-to-face communication, expert advice providers, support, a lifestyle-change focus, and customised offers. The results provide an initial insight into service attributes that influence consumer adoption of PN. © 2014 S. Karger AG, Basel.

Effect of a Consumer-Directed Voucher and a Disease-Management-Health-Promotion Nurse Intervention on Home Care Use

ERIC Educational Resources Information Center

Meng, Hongdao; Friedman, Bruce; Wamsley, Brenda R.; Mukamel, Dana; Eggert, Gerald M.

2005-01-01

Purpose: We describe the impact of two interventions, a consumer-directed voucher for in-home supportive services and a chronic disease self-management-health-promotion nurse intervention, on the probability of use of two types of home care-skilled home health care and personal assistance services-received by functionally impaired Medicare…

[Who exactly are these "persons with limitations in daily living skills"? : Survey of insured persons based on health insurance data].

PubMed

Runte, Rebecca; Müller, Rolf

2016-12-01

In recent years German long-term care insurance coverage has gradually been extended to include services for people with limitations in daily living skills. Until now, however, it was unclear who exactly people with limited daily living skills are. The study aimed to characterize people with limited daily living skills who use additional support services as defined by § 45b of the Social Services Code XI (SGB XI). This study was based on a survey of 1284 people with limited daily living skills who used additional support services (§ 45b SGB XI). The data were analyzed descriptively. The average recipient was 81 years old, mainly in care level I and the majority of them were exclusively cared for by relatives. Of these recipients 61 % were diagnosed with dementia, 73.4 % had medium cognitive impairments while more than half could no longer carry out the instrumental activities of daily living (IADL). Statistics on people with limited daily living skills should be included in publications and reports so that the need for care and assistance can be estimated more precisely.

How Can Mobile SMS Communication Support and Enhance a First Year Undergraduate Learning Environment?

ERIC Educational Resources Information Center

Jones, Geraldine; Edwards, Gabriele; Reid, Alan

2009-01-01

In this paper we discuss a case study investigating how the academic and personal development of first year students on an undergraduate sports education degree can be supported and enhanced with mobile SMS (Short Message Service) communication. SMS-based technologies were introduced in response to students' particular needs (in transition to…

The Learning Credit Card: A Tool for Managing Personal Development

ERIC Educational Resources Information Center

Rushby, Nick; Twining, John; Twining, Nick; Devitt, Thomas

2008-01-01

This is the report of a five month study, undertaken by Sundridge Park Training Technologies in association with Guildford Educational Services to assess the potential of smart card technology to support learning and the management of learning. The study had two strands--the state of the art of the technology and its potential for supporting,…

Newcomers

Science.gov Websites

commands are located on Peterson Air Force Base. The Base Guide describes some of the services available on our base to include information on the Joint Personal Property Shipping Office (the office in charge Base and in the local area, log into the 21st Force Support Squadron's web site. The 21st Force Support

Self-Directed Support: Impact of Hiring Practices on Adults with Intellectual and Developmental Disabilities and Families

ERIC Educational Resources Information Center

Heller, Tamar; Arnold, Catherine K.; van Heumen, Lieke; McBride, Elizabeth L.; Factor, Alan

2012-01-01

The study examined the differential experiences and outcomes for people with intellectual and developmental disabilities and their families receiving self-directed services based on the type of personal support worker hired (parents, siblings, other relatives, friends, and agency staff). The sample consisted of 372 participants in a self-directed…

31 CFR 256.12 - What supporting documentation must agencies submit to FMS when requesting a payment from the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false What supporting documentation must... Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE... Judgment Fund. A claimant's threshold can be satisfied by combining amounts awarded for personal and...

Physical activity, social support, and depression: possible independent and indirect associations in persons with multiple sclerosis.

PubMed

Suh, Yoojin; Weikert, Madeline; Dlugonski, Deirdre; Sandroff, Brian; Motl, Robert W

2012-01-01

The present study examined the pattern of associations among physical activity, social support, mobility disability, perceived stress, and depressive symptoms in relapsing-remitting MS (RRMS). Persons (N = 218) with RRMS completed a battery of questionnaires that was sent and returned through the United States Postal Service (USPS). Bivariate correlation analysis indicated that physical activity and social support were both inversely associated with depressive symptoms (r's = -0.288 and -0.386, p ≤ 0.05, respectively). Multiple linear regression analysis indicated that physical activity (β = -0.21, p = 0.002) and social support (β = -0.37, p = 0.0001) were independently associated with depressive symptoms. Path analysis confirmed that the associations between physical activity and social support with depressive symptoms were indirect via mobility disability and perceived stress. Collectively, the evidence indicates that physical activity and social support are independently and indirectly associated with depression via mobility disability and perceived stress in relapsing-remitting MS. This supports the design of interventions and programs that target physical activity and social support for reducing depressive symptoms among persons with MS.

Feasibility of a rural palliative supportive service.

PubMed

Pesut, B; Hooper, B P; Robinson, C A; Bottorff, J L; Sawatzky, R; Dalhuisen, M

2015-01-01

Healthcare models for the delivery of palliative care to rural populations encounter common challenges: service gaps, the cost of the service in relation to the population, sustainability, and difficulty in demonstrating improvements in outcomes. Although it is widely agreed that a community capacity-building approach to rural palliative care is essential, how that approach can be achieved, evaluated and sustained remains in question. The purpose of this community-based research project is to test the feasibility and identify potential outcomes of implementing a rural palliative supportive service (RPaSS) for older adults living with life-limiting chronic illness and their family caregiver in the community. This paper reports on the feasibility aspects of the study. RPaSS is being conducted in two co-located rural communities with populations of approximately 10 000 and no specialized palliative services. Participants living with life-limiting chronic illness and their family caregivers are visited bi-weekly in the home by a nurse coordinator who facilitates symptom management, teaching, referrals, psychosocial and spiritual support, advance care planning, community support for practical tasks, and telephone-based support for individuals who must commute outside of the rural community for care. Mixed-method collection strategies are used to collect data on visit patterns; healthcare utilization; family caregiver needs; and participant needs, functional performance and quality of life. A community-based advisory committee worked with the investigative team over a 1-year period to plan RPaSS, negotiating the best fit between research methods and the needs of the community. Recruitment took longer than anticipated with service capacity being reached at 8 months. Estimated service capacity of one nurse coordinator, based on bi-weekly visits, is 25 participants and their family caregivers. A total of 393 in-person visits and 53 telephone visits were conducted between January 2013 and May 2014. Scheduled in-person visit duration showed a mean of 67 minutes. During this same time period only 19 scheduled visits were declined, and there was no study attrition except through death, indicating a high degree of acceptability of the intervention. The primary needs that were addressed during these visits have been related to chronic disease management, and the attending physical symptoms were addressed through teaching and support. The use of structured quality of life and family caregiver needs assessments has been useful in facilitating communication, although some participants experienced the nature of the questions as too personal in the early stages of the relationship with the nurse coordinator. Findings from this study illustrate the feasibility of providing home-based services for rural older adults living with life-limiting chronic illness. The RPaSS model has the potential to smooth transitions and enhance quality of life along the disease trajectory and across locations of care by providing a consistent source of support and education. This type of continuity has the potential to foster the patient- and family-centered approach to care that is the ideal of a palliative approach. Further, the use of a rural community capacity-building approach may contribute to sustainability, which is a particularly important part of rural health service delivery.

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

PubMed

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

2015-10-01

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

Perspectives of self-direction: a systematic review of key areas contributing to service users' engagement and choice-making in self-directed disability services and supports.

PubMed

Lakhani, Ali; McDonald, Donna; Zeeman, Heidi

2018-05-01

Self-directed disability support policies aim to encourage greater choice and control for service users in terms of the health and social care they receive. The proliferation of self-directed disability support policies throughout the developed world has resulted in a growing amount of research exploring the outcomes for service users, and their families and carers. Our understanding of the issues faced by people with disabilities, particularly how they make health and social care decisions and the key areas that determine their engagement with service providers within a self-directed environment is limited. A synthesis of research is timely and can provide knowledge for service users and health and social care support providers to ensure their successful participation. A systematic review guided by the PRISMA approach explored (i) the key areas determining service users' engagement with self-directed disability services and supports, and (ii) how service users make informed decisions about providers. In October 2014 and April 2016, three databases - MEDLINE, CINAHL and Web of Science - were searched for research and review articles. Eighteen sources met the search criteria. Findings were mapped into either: key areas determining service user engagement, or service users' informed decision-making. Findings concerning key areas determining engagement fell into three themes - personal responsibility for budgeting, personalised approaches, and a cultural shift in practice and delivery among service providers. Findings about decision-making yielded two themes - supporting informed decision-making and inhibiting informed decision-making. Literature suggests that self-directed models of care may provide service users with increased control over the services that they receive. Increased control for some service users and their families requires independent external decision-making support, particularly around the domains of budgeting, planning and hiring. Future research must continue to investigate the perspectives of service users pertaining to their engagement, as their participation is central to the effectiveness of the approach. © 2016 John Wiley & Sons 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.

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

PubMed

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

2016-04-01

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

Exploring Stigma by Association among Front-Line Care Providers Serving Sex Workers

PubMed Central

Phillips, Rachel; Benoit, Cecilia

2013-01-01

Stigma by association, also referred to as “courtesy stigma,” involves public disapproval evoked as a consequence of associating with stigmatized persons. While a small number of sociological studies have shown how stigma by association limits the social support and social opportunities available to family members, there is a paucity of research examining this phenomenon among the large network of persons who provide health and social services to stigmatized groups. This paper presents results from a primarily qualitative study of the work-place experiences of a purposive sample of staff from an organization providing services to sex workers. The findings suggest that stigma by association has an impact on staff health because it shapes both the workplace environment as well as staff perceptions of others' support. At the same time, it is evident that some staff, owing to their more advantaged social location, are better able to manage courtesy stigma than others. PMID:24289946

Attitudes Toward Mental Health Services Among American Indians by Two Age Groups.

PubMed

Roh, Soonhee; Brown-Rice, Kathleen A; Lee, Kyoung Hag; Lee, Yeon-Shim; Yee-Melichar, Darlene; Talbot, Elizabeth P

2015-11-01

This study examined determinants of attitudes toward mental health services with a sample of American Indian younger-old-adults (aged 50-64, n = 158) and American Indian older-old adults (aged 65 and older, n = 69). Adapting Andersen's behavioral model of healthcare utilization, predisposing factors, mental health needs, and enabling factors were considered as potential predictors. Female and those with higher levels of social support tend to report more positive attitudes toward mental health services. Culture-influenced personal belief was associated with negative attitudes toward mental health services among American Indian younger-old -adults. Age and higher chronic medical conditions were significantly related to negative attitudes toward mental health services. Health insurance was positively associated with positive attitudes toward mental health services in the American Indian older-old adults. Findings indicate that practitioners should engage how culture, social support, and chronic conditions influence the response to mental health needs when working with older American Indians.

The effects of integrating service learning into computer science: an inter-institutional longitudinal study

NASA Astrophysics Data System (ADS)

Payton, Jamie; Barnes, Tiffany; Buch, Kim; Rorrer, Audrey; Zuo, Huifang

2015-07-01

This study is a follow-up to one published in computer science education in 2010 that reported preliminary results showing a positive impact of service learning on student attitudes associated with success and retention in computer science. That paper described how service learning was incorporated into a computer science course in the context of the Students & Technology in Academia, Research, and Service (STARS) Alliance, an NSF-supported broadening participation in computing initiative that aims to diversify the computer science pipeline through innovative pedagogy and inter-institutional partnerships. The current paper describes how the STARS Alliance has expanded to diverse institutions, all using service learning as a vehicle for broadening participation in computing and enhancing attitudes and behaviors associated with student success. Results supported the STARS model of service learning for enhancing computing efficacy and computing commitment and for providing diverse students with many personal and professional development benefits.

Social workers' experiences as the family support person during cardiopulmonary resuscitation attempts.

PubMed

Firn, Janice; DeVries, Keli; Morano, Dawnielle; Spano-English, Toni

2017-07-01

During inhospital cardiopulmonary resuscitation attempts, a designated family support person (FSP) may provide guidance and support to family members. Research on nurses and chaplains in this role has been published. Social workers also regularly fulfill this service, however, little is known about how they perceive and enact this role. To explore their experiences, qualitative interviews (n = 10) were conducted with FSP social workers. Critical realist thematic analysis identified five themes: walking in cold, promoting family presence, responding to the whole spectrum of grief, going beyond the family support role, and repercussions of bearing witness. Social workers perform a variety of tasks to promote family presence during resuscitation attempts and provide psychosocial support over the continuum of care. The FSP role impacts social workers emotionally and professionally. Implications for hospital policy, staffing, and clinical practice are discussed.

Do prominent quality measurement surveys capture the concerns of persons with disability?

PubMed

Iezzoni, Lisa I; Marsella, Sarah A; Lopinsky, Tiffany; Heaphy, Dennis; Warsett, Kimberley S

2017-04-01

Demonstration programs nationwide aim to control costs and improve care for people dually-eligible for Medicare and Medicaid, including many persons with disability. Ensuring these initiatives maintain or improve care quality requires comprehensive evaluation of quality of care. To examine whether the common quality measures being used to evaluate the Massachusetts One Care duals demonstration program comprehensively address the concerns of persons with disability. Drawing upon existing conceptual frameworks, we developed a model of interrelationships of personal, health care, and environmental factors for achieving wellness for persons with disability. Based on this model, we specified a scheme to code individual quality measurement items and coded the items contained in 12 measures being used to assess Massachusetts One Care, which exclusively enrolls non-elderly adults with disability. Across these 12 measures, we assigned 376 codes to 302 items; some items received two codes. Taken together, the 12 measures contain items addressing most factors in our conceptual model that affect health care quality for persons with disability, including long-term services and supports. Some important gaps exist. No items examine sexual or reproductive health care, peer support, housing security, disability stigmatization, and specific services obtained outside the home like adult day care. Certain key concepts are covered only by a single or several of the 12 quality measures. Common quality metrics cover most - although not all-health care quality concerns of persons with disability. However, multiple different quality measures are required for this comprehensive coverage, raising questions about respondent burden. Copyright © 2017 Elsevier Inc. All rights reserved.

The Role of the Mental Health Worker in a Housing and Accommodation Support Initiative for Indigenous Australians.

PubMed

Sayers, Jan Maree; Cleary, Michelle; Hunt, Glenn E; Burmeister, Oliver K

2017-10-01

To explore the experiences of mental health workers and perceptions of their role and the scope of their work. Qualitative design. Twenty interviews were conducted with mental health workers. Interviews were analyzed using thematic analysis. Three overarching themes were identified. In this paper the overarching theme of "dimensions of my role" is discussed. Subthemes were (a) information and education, (b) person-centered care, and (c) networking and partnerships. Professional development, networking, and partnerships underpin the provision of coordinated services and ultimately person-centered care. Enhancing staff capacity building may also enable sustainability of appropriate quality services. © 2016 Wiley Periodicals, Inc.

Families living with parental mental illness and their experiences of family interventions.

PubMed

Afzelius, M; Plantin, L; Östman, M

2018-03-01

WHAT IS KNOWN ON THE SUBJECT?: Coping with parental mental illness in families can be challenging for both children and parents. Providing evidence-based family interventions to families where a parent has a mental illness can enhance the relationships in the family. Although psychiatric research has shown that evidence-based family interventions may improve the communication and understanding of parental mental illness, there is a lack in this area of research from an everyday clinical context. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: Our study reinforces the fact that parents with mental illnesses are searching for support from psychiatric services in order to talk to their children about their illness. The finding that under-age children comply when they are told by their parents to join an intervention in psychiatric services supporting the family is something not observed earlier in research. This study once more illuminates the fact that partners of a person with parental mental illness are seldom, in an obvious way, included in family support interventions. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Psychiatric services, and especially mental health nurses, have an important task in providing families with parental mental illness with support concerning communication with their children and in including the "healthy" partner in family support interventions. Introduction Although research has shown that evidence-based family interventions in research settings improve the communication and understanding of parental mental illness, there is a lack of knowledge about interventions in an everyday clinical context. Aim This study explores how families with parental mental illness experience family interventions in a natural clinical context in psychiatric services. Method Five families with children aged 10-12 were recruited from psychiatric services in southern Sweden and interviewed in a manner inspired by naturalistic inquiry and content analysis. Both family and individual interviews were performed. Results In striving to lead an ordinary life while coping with the parental mental illness, these families sought the support of the psychiatric services, especially in order to inform their children about the mental illness. Despite different family interventions, the family members felt supported and reported that the number of conflicts in the family had decreased. The parents were appreciative of help with child-rearing questions, and the children experienced a calmer family atmosphere. However, the partner of the person with mental illness experienced being left without support. Implications for practice Our study shows that psychiatric services, and especially mental health nurses, are in a position to more regularly offer family interventions in supporting the children and the healthy partners. © 2017 John Wiley & Sons Ltd.

Responding to the World Health Organization Global Disability Action Plan in Egypt: A Technical Consultancy to develop a National Disability, Health and Rehabilitation Plan.

PubMed

Gutenbrunner, Christoph; Nugraha, Boya

2018-04-18

A technical consultation to develop a National Disability, Health and Rehabilitation Plan (NDHRP) for Egypt was carried out in 2015. Its overall goal was to improve health, functioning, well-being, quality of life, and participation of persons with disability in Egypt by supporting the Ministry of Health and Population and other stakeholders to improve access to health services and strengthen health-related rehabilitation services for all persons in need. The methodological steps of the technical consultation were as follows: collecting and reviewing accessible documents and data; site visits to state institutions, health and rehabilitation services; discussions with relevant stakeholders in rehabilitation, including persons with disability; drafting recommendations based on the principles of the World Report on Disability and the World Health Organization Global Disability Action Plan and the information collected; discussion with stakeholders in a workshop; and preparation of a final report. The development of a NDHRP was successful and led to recommendations with a good level of consensus among stakeholders in Egypt. The authors hope that the NDHRP will lead to improved rehabilitation service provision, and health and quality of life of persons with disability and chronic health conditions living in Egypt.

Best practices for basic and advanced skills in health care service recovery: a case study of a re-admitted patient.

PubMed

Hayden, Anna C; Pichert, James W; Fawcett, Jodi; Moore, Ilene N; Hickson, Gerald B

2010-07-01

Service recovery refers to an organizations entire process for facilitating resolution of dissatisfactions, whether or not visible to patients and families. Patients are an important resource for reporting miscommunications, provider inattention, rudeness, or delays, especially if they perceive a connection to misdiagnosis or failed treatment. Health systems that encourage patients to be "the eyes and ears" of individual and team performance capitalize on a rich source of data for quality improvement and risk prevention. Effective service recovery requires organizations (1) to learn about negative perceptions and experiences and (2) to create an infrastructure that supports staff's ability to respond. Service recovery requires the exercise of both basic and advanced skills. We term certain skills as advanced because of the significant variation in their use or endorsement among 30 health care organizations in the United States. On the basis of our work with the 30 organizations, a mnemonic, HEARD, incorporates best practices for basic service recovery processes: Hearing the person's concern; Empathizing with the person raising the issue; Acknowledging, expressing appreciation to the person for sharing, and Apologizing when warranted; Responding to the problem, setting time lines and expectations for follow-up; and Documenting or Delegating the documentation to the appropriate person. Impartiality, chain of command, setting boundaries, and Documentation represent four advanced service recovery skills critical for addressing challenging situations. Using best practices in service recovery enables the organization to do its best to make right what patients and family members experience as wrong.

Cost efficiency and reimbursement of remote monitoring: a US perspective.

PubMed

Slotwiner, David; Wilkoff, Bruce

2013-06-01

Demographic and technological changes are driving increased utilization of cardiac implantable electronic devices (CIEDs) remote monitoring. In the USA, fee-for-service model of healthcare delivery, services rendered are valued based upon time, intensity, and technical or practice expense costs. As a consequence of this perspective, and to contain spending, Medicare has grouped physician services into families. Spending within each family of services must, by law, remain budget neutral. Cardiac implantable electronic devices monitoring services, remote and in-person, are grouped into one family. As the volume of services within this family increases, the individual encounters are destined to be discounted into ever decreasing portions. However, if the value of remote monitoring is demonstrated to extend beyond the previous boundaries of in-person interrogations, a rational request can be made to reconsider the relative value of remote monitoring. Outcome data supporting the value-added benefits of remote monitoring are rapidly accumulating, including (i) patient convenience, with reduced use of office services, (ii) equal safety compared with in-person evaluation, (iii) shorter detection time to actionable events (arrhythmias, cardiovascular disease progression, and device malfunction), (iv) reduced length of stay for hospitalizations, (v) reduced inappropriate shocks, (vi) increased battery longevity, and (vii) a relative reduction in the risk of death. Fully automatic wireless technology, only recently widely implemented, will add considerable clinical efficiencies and further increase the value of remote monitoring. The U.S. challenge will be to appropriately define the relative value of CIEDs remote monitoring now that outcome data have demonstrated its value extends beyond in-person interrogation.

The two voices of Alzheimer's: attitudes toward brain health by diagnosed individuals and support persons.

PubMed

Beard, Renée L; Fetterman, David J; Wu, Bei; Bryant, Lucinda

2009-06-01

Most individuals with Alzheimer's are cared for in their homes by unpaid family members. Research on caregiving focuses disproportionally on costs of care, service utilization, and negative psychosocial outcomes. Few narrative accounts of Alzheimer's exist; those that do suffer similar pejorative framings and narrow foci. No studies that we are aware of examine the health beliefs of diagnosed individuals and support persons, or their attitudes about brain health. This research reports perceptions of "aging well" held by those most intimately acquainted with Alzheimer's. Diagnosed individuals and their support persons (N = 85) were enrolled into 14 focus groups. Grounded theory methods were used to collect, code, and analyze textual interview data into overarching themes. Respondents found physical and mental health, social activity, independence, and happiness integral to aging well. An acceptance of various limitations was also deemed crucial. Support persons placed more emphasis on lifestyle factors and memory loss as potential obstacles. Diagnosed respondents defined memory loss in less medicalized terms, whereas support persons labeled it Alzheimer's and negatively characterized those affected. Both groups warned against discussing "prevention" of dementia: Diagnosed individuals noted the implication of "aging poorly" and support persons cautioned against blaming diagnosed individuals. These findings can be used to encourage positive health beliefs and behaviors tailored to the needs of diagnosed seniors and their families, to help practitioners and researchers identify and become sensitive to differences between and among older adults, and to further advance the utility of narrative accounts for informing health interventions and education efforts.

Processes of recovery through routine or specialist treatment for borderline personality disorder (BPD): a qualitative study.

PubMed

Katsakou, Christina; Pistrang, Nancy; Barnicot, Kirsten; White, Hayley; Priebe, Stefan

2017-07-04

Recovery processes in borderline personality disorder (BPD) are poorly understood. This study explored how recovery in BPD occurs through routine or specialist treatment, as perceived by service users (SUs) and therapists. SUs were recruited from two specialist BPD services, three community mental health teams, and one psychological therapies service. Semi-structured interviews were conducted with 48 SUs and 15 therapists. The "framework" approach was used to analyse the data. The findings were organized into two domains of themes. The first domain described three parallel processes that constituted SUs' recovery journey: fighting ambivalence and committing to taking action; moving from shame to self-acceptance and compassion; and moving from distrust and defensiveness to opening up to others. The second domain described four therapeutic challenges that needed to be addressed to support this journey: balancing self-exploration and finding solutions; balancing structure and flexibility; confronting interpersonal difficulties and practicing new ways of relating; and balancing support and independence. Therapies facilitating the identified processes may promote recovery. The recovery processes and therapeutic challenges identified in this study could provide a framework to guide future research.

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

PubMed

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

2013-12-01

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

Experience of Primary Care among Homeless Individuals with Mental Health Conditions

PubMed Central

Chrystal, Joya G.; Glover, Dawn L.; Young, Alexander S.; Whelan, Fiona; Austin, Erika L.; Johnson, Nancy K.; Pollio, David E.; Holt, Cheryl L.; Stringfellow, Erin; Gordon, Adam J.; Kim, Theresa A.; Daigle, Shanette G.; Steward, Jocelyn L.; Kertesz, Stefan G

2015-01-01

The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA), one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366) were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005), with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H) questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score). Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons’ needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers. PMID:25659142

"It's One of the Hardest Jobs in the World": The Experience and Understanding of Qualified Nurses Who Work with Individuals Diagnosed with Both Learning Disability and Personality Disorder

ERIC Educational Resources Information Center

Lee, Amy; Kiemle, Gundi

2015-01-01

Background: This study examines the experiences of qualified nurses working with individuals diagnosed with both intellectual disability and personality disorder (PD) in a medium-secure forensic intellectual disability setting. Potential training needs are highlighted, as well as other ways in which services could better support staff to work…

Automated Dental Epidemiology System. I. Preliminary Investigation and Literature Review,

DTIC Science & Technology

1983-03-01

system supported dental service to a 403,000 person, relatively stable population. Per-person oral health and orthodontic indices were developed, and...annual dental examination, topical fluoride application and oral hygiene instruction for all active duty Navy and Marine Corps personnel (70). In...Cobin, A. S. An Uncomplicated Method for Automating Endodontic Treatment Records. Oral Surg. 22:519, 1966. 32. Barrett, M. J., Brown, T. and Simmons

Jobs and Self-Sufficiency: Goals of the Project, "Technical Support Services to the Developmentally Disabled, Region III." Final Report, October 1976 to September 1979.

ERIC Educational Resources Information Center

Mallik, Kalisankar; Shaver, Elaine M.

The final report of a 3 year project to improve the quality of life of mentally retarded, cerebral palsied, and epileptic persons in Region III is presented. The first section details the efforts of the project staff in providing competitive employment opportunities or sheltered employment for 40 severely disabled persons. Equipment modification…

Update: Providing Quality Family Planning Services - Recommendations from CDC and the U.S. Office of Population Affairs, 2017.

PubMed

Gavin, Loretta; Pazol, Karen; Ahrens, Katherine

2017-12-22

In April 2014, CDC published "Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs" (QFP), which describes the scope of services that should be offered in a family planning visit and how to provide those services (e.g., periodicity of screening, which persons are in need of services, etc.) (1). The sections in QFP include the following: Determining the Client's Need for Services; Contraceptive Services; Pregnancy Testing and Counseling; Clients Who Want to Become Pregnant; Basic Infertility Services; Preconception Health Services; Sexually Transmitted Disease Services; and Related Preventive Health Services. In addition, the QFP includes an appendix entitled Screening Services for Which Evidence Does Not Support Screening.

Customer Decision Making in Web Services with an Integrated P6 Model

NASA Astrophysics Data System (ADS)

Sun, Zhaohao; Sun, Junqing; Meredith, Grant

Customer decision making (CDM) is an indispensable factor for web services. This article examines CDM in web services with a novel P6 model, which consists of the 6 Ps: privacy, perception, propensity, preference, personalization and promised experience. This model integrates the existing 6 P elements of marketing mix as the system environment of CDM in web services. The new integrated P6 model deals with the inner world of the customer and incorporates what the customer think during the DM process. The proposed approach will facilitate the research and development of web services and decision support systems.

From togetherness to loneliness: supporting people with dementia.

PubMed

Ryder, Elaine

2016-09-01

With demographic projections indicating that the number of people with dementia is increasing, the need for collaborative working between health, social care and the third sector is greater than ever. The District Nursing service is central to initiating and leading such collaborative developments. This article is an example of how a new third sector service can complement and share the care and support for people with dementia and their families, living in the community. It highlights what people with dementia want, how this underpinned the development of this new service and what such a service can offer, not only for the individual person with dementia but also their family/carers. It also highlights the value of working in partnership to meet the changing needs of individuals and their families/carers.

THE INFLUENCE OF SOCIAL SUPPORT ON PSYCHOLOGICAL DISTRESS IN OLDER PERSONS: AN EXAMINATION OF INTERACTION PROCESSES IN AUSTRALIA.

PubMed

Sharpley, Christopher; Hussain, Rafat; Wark, Stuart; Mcevoy, Mark; Attia, John

2015-12-01

Social support is proposed as a coping mechanism against anxiety and depression amongst older persons, but few data have examined how this occurs. This study assessed the contributions of two sub-components of social support as mediators against psychological distress-broadly defined as anxiety and depression. 1,560 men and 1,758 women from the Hunter Community Study (Australia) completed the Duke Social Support Scale and the Kessler Psychological Distress Scale. The Duke Social Support Scale examined the amount of social interaction and satisfaction with social interactions. Significant mediating effects of social support were found in the Kessler Psychological Distress Scale items measuring depression but not anxiety. Satisfaction with social support was a significant predictor of Kessler Psychological Distress Scale total score and Sadness items, but the amount of social support was not a predictor of stress. Social support may assist with symptoms of depression, i.e., specific sadness/depressed mood, but not necessarily with anxiety. Implications for policy and service delivery were discussed.

Army Public Service Advertising.

DTIC Science & Technology

1982-12-01

Department of the Army Civilian, Adver- tising and Sales Promotion . Personal interview. Sacramento, California, June 24, 1982. Driever, James, Captain...support, public relations, marketing research, and analysis. The N. W. Ayer field representative’s Army counterpart is the Advertising and Sales ... Promotion (A&SP) position in each USAREC district command, a position usually filled by a Department of the Army civilian (DAC) in the Civil Service grade

Exploring risk profiles and emergency frequency of purchasers and non-purchasers of personal emergency alarms: a prospective cohort study.

PubMed

De San Miguel, Kristen; Lewin, Gill; Burton, Elissa; Toye, Christine; Boldy, Duncan; Howat, Peter

2015-10-27

Personal alarms support independent living and have the potential to reduce serious consequences after a fall or during a medical emergency. While some Australian states have government funded personal alarm programs, others do not; but user-pays services are available. Although several studies have examined the profiles of alarm users, little is known about the risk profile of non-users. Specifically, whether there are "at risk" individuals who are unable, or choose not to purchase a service, who experience a home-based emergency in which an alarm could have mitigated an adverse outcome. This study aimed to describe the 'risk profile' of purchasers and non-purchasers of alarms; explore the reasons behind the decision to purchase or not to purchase and identify how often emergency assistance was needed and why. Purchasers and non-purchasers were followed for one year in this prospective cohort study. Demographic, decision-making and risk factor data were collected at an initial face-to-face interview, while information about emergencies was collected by monthly calls. One hundred and fifty-seven purchasers and sixty-five non-purchasers completed the study. The risk profiles between the groups were similar in terms of gender, living arrangements, fall history and medical conditions. Purchasers (Mean = 82.6 years) were significantly older than non-purchasers (Mean = 79.3 years), (t(220) = -3.38, p = 0.000) and more functionally dependent on the IADL (z = -2.57, p = 0.010) and ADL (z = -2.45 p = 0.014) function scores. Non-purchasers (Mean = 8.04, SD = 3.57) were more socially isolated with significantly fewer family networks than purchasers (Mean = 9.46, SD = 3.25) (t(220) = -2.86, p = 0.005). Both groups experienced similarly high numbers of emergencies, 38.2 % of purchasers and 41.5 % of non-purchasers had at least one emergency where an alarm could have assisted. Main reasons for non-purchase were: cost (77 %), limited alarm range (51 %), no need (39 %) and lack of suitable contacts (30 %). There are older individuals who are at high risk of an emergency who are choosing, often for financial and lack of family support reasons, not to purchase a personal alarm service. Greater availability of government funded subsidy schemes would enable these individuals to access a service. Increasing the range over which alarms work could increase their appeal to a broader range of older persons living in the community. Future research should consider how strategies that improve social isolation from family and challenge clients' beliefs about their own health and independence can support increased access to personal alarm services.

International Student Affairs.

ERIC Educational Resources Information Center

Wood, Melinda; Kia, Parandeh

2000-01-01

Describes international student service units in higher education, including their primary functions, staff roles and responsibilities, major functional challenges, professional challenges and support systems, professional literature, and tips for those interested in the field. Also describes the author's personal career path in international…

32 CFR 103.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... sexual assault incident provided by the victim to the SARC, SAPR VA, or healthcare personnel in a... sensitive to gender differences and gender-specific issues. Healthcare personnel. Persons assisting or otherwise supporting healthcare providers in providing healthcare services (e.g., administrative personnel...

32 CFR 103.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... sexual assault incident provided by the victim to the SARC, SAPR VA, or healthcare personnel in a... sensitive to gender differences and gender-specific issues. Healthcare personnel. Persons assisting or otherwise supporting healthcare providers in providing healthcare services (e.g., administrative personnel...

32 CFR 103.3 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... sexual assault incident provided by the victim to the SARC, SAPR VA, or healthcare personnel in a... sensitive to gender differences and gender-specific issues. Healthcare personnel. Persons assisting or otherwise supporting healthcare providers in providing healthcare services (e.g., administrative personnel...

40 CFR 45.135 - Supplemental conditions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... consistent with prevailing practices under comparable federally supported programs. (e) Training awards under... TRAINING ASSISTANCE § 45.135 Supplemental conditions. Training awards are subject to the following... personal services by individuals receiving training as a condition for assistance. (c) Trainees are...

40 CFR 45.135 - Supplemental conditions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... consistent with prevailing practices under comparable federally supported programs. (e) Training awards under... TRAINING ASSISTANCE § 45.135 Supplemental conditions. Training awards are subject to the following... personal services by individuals receiving training as a condition for assistance. (c) Trainees are...

40 CFR 45.135 - Supplemental conditions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... consistent with prevailing practices under comparable federally supported programs. (e) Training awards under... TRAINING ASSISTANCE § 45.135 Supplemental conditions. Training awards are subject to the following... personal services by individuals receiving training as a condition for assistance. (c) Trainees are...

'It's our everyday life' - The perspectives of persons with intellectual disabilities in Norway.

PubMed

Witsø, Aud Elisabeth; Hauger, Brit

2018-01-01

This study illuminates how adults with intellectual disabilities understand and describe their everyday life and its shortcomings when it comes to equal rights in the context of Norwegian community living. An inclusive research design, including nine persons with mild intellectual disability, two university researchers and two intellectual disability nurses from the municipality, was undertaken. An inductive thematic analysis of data identified three key themes: everyday life - context, rhythm and structure, social participation and staff - an ambiguous part of everyday life. Results show that service provision had institutional qualities; participants experienced lack of information and reduced possibilities for social inclusion and community participation like everyone else. More attention on the role of policy development, support staff and leadership, in relation to facilitating an everyday life with more user involvement, social inclusion and community participation of people needing support, is essential. Participatory, appreciative, action and reflection in workshops for persons with intellectual disabilities and support staff represent a promising approach to promote the voices and interests of persons with intellectual disabilities. Accessible abstract This article tells you about the everyday life of people with intellectual disabilities living in Norway. Nine people with intellectual disabilities worked together with two university researchers and two intellectual disability nurses in the community, in workshops. The people with intellectual disabilities liked to have their own apartment and going to work every day. They said that they wanted more social participation with friends and more participation in activities in the community, just like everyone else. They wanted to be treated with more respect by their staff. All participants in the project saw great value in working together and some of them are working together in a new project about involvement in the improvement of support services for people with intellectual disabilities.

Evaluating the Supports Intensity Scale as a Potential Assessment Instrument for Resource Allocation for Persons with Intellectual Disability

ERIC Educational Resources Information Center

Chou, Yueh-Ching; Lee, Yue-Chune; Chang, Shu-chuan; Yu, Amy Pei-Lung

2013-01-01

This study evaluated the potential of using the Supports Intensity Scale (SIS) for resource allocation for people with intellectual disabilities (ID) in Taiwan. SIS scores were compared with those obtained from three tools that are currently used in Taiwan for homecare services: the medical diagnosis issued by local authorities and two scales…

"These People Just Keep Trying to Help Me"--Supporting Students to Succeed in College and Career Pathways

ERIC Educational Resources Information Center

Jobs For the Future, 2015

2015-01-01

Community college students today face multiple barriers--personal, financial, and academic--to achieving their postsecondary goals. In order to help more people juggle the myriad facets of daily life that make it difficult to stay in school and complete credentials, colleges need to deliver a broad range of support services in a coordinated…

An Effective Programme Is Not Enough: A Review of Factors Associated with Poor Attendance and Engagement with Parenting Support Programmes

ERIC Educational Resources Information Center

Whittaker, Karen A.; Cowley, Sarah

2012-01-01

The provision of parenting support is a key feature of wealthier nations' health and social care services. However, attendance and engagement by the neediest parents remains poor. Barriers experienced by parents include personal life factors (beliefs, lifestyles and limited resources) and programme-specific factors (delivery, content and support…

Comparing Models for the Restoration of Essential Services during Counterinsurgency Operations

DTIC Science & Technology

2011-05-19

individualistic cultures require more personal support, and collectivistic cultures require more support to the tribe, group, or organizational culture ...insurgent support. Any effective 31 Gambrel R Ciani, “Maslow’s hierarchy of needs: Does it apply in a collectivist culture ,” Journal of Applied...Gambrel R. “Maslow’s hierarchy of needs: Does it apply in a collectivist culture .” Journal of Applied Management and Entrepreneurship, 8 (2003), 143-161

Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems

PubMed Central

Slade, Mike; Amering, Michaela; Farkas, Marianne; Hamilton, Bridget; O'Hagan, Mary; Panther, Graham; Perkins, Rachel; Shepherd, Geoff; Tse, Samson; Whitley, Rob

2014-01-01

An understanding of recovery as a personal and subjective experience has emerged within mental health systems. This meaning of recovery now underpins mental health policy in many countries. Developing a focus on this type of recovery will involve transformation within mental health systems. Human systems do not easily transform. In this paper, we identify seven mis-uses (“abuses”) of the concept of recovery: recovery is the latest model; recovery does not apply to “my” patients; services can make people recover through effective treatment; compulsory detention and treatment aid recovery; a recovery orientation means closing services; recovery is about making people independent and normal; and contributing to society happens only after the person is recovered. We then identify ten empirically-validated interventions which support recovery, by targeting key recovery processes of connectedness, hope, identity, meaning and empowerment (the CHIME framework). The ten interventions are peer support workers, advance directives, wellness recovery action planning, illness management and recovery, REFOCUS, strengths model, recovery colleges or recovery education programs, individual placement and support, supported housing, and mental health trialogues. Finally, three scientific challenges are identified: broadening cultural understandings of recovery, implementing organizational transformation, and promoting citizenship. PMID:24497237

Employment programs and professionals with a disability.

PubMed

Donelly, Michelle; Given, Fiona

2010-01-01

It is unclear whether or not open (competitive) employment programs are meeting the needs of the growing numbers of people with a disability seeking professional employment. To understand and describe the experience of a newly graduated professional (Michael) who was seeking open employment support and to analyze those experiences in relation to principles of effective open employment support. Michael a recently graduated accountant who also has a physical disability. A review of the literature was undertaken to identify recommended principles and practices for the conduct of effective open employment and career development programs. A case study was used to describe Michael's experiences as he sought professional employment. Michael's experiences were analysed in relation to recommended principles and practice. The analysis confirmed that the concerns Michael experienced about the supported employment program compromised the effectiveness of the support he received. Employment services based on models of independent living, disability service standards and remediation are likely to focus on the 'pathology' or performance 'deficits' of the person with a disability. Successful open employment models are more likely to place pre-eminence on the perspective of the person with a disability and effective practices for securing employment.

Catastrophic Health Expenditures for Households with Disabled Members: Evidence from the Korean Health Panel

PubMed Central

2016-01-01

Persons with disabilities use more health care services due to ill health and face higher health care expenses and burden. This study explored the incidence of catastrophic health expenditures of households with persons with disabilities compared to that of those without such persons. We used the Korean Health Panel (KHP) dataset for the years 2010 and 2011. The final sample was 5,610 households; 800 (14.3%) of these were households with a person with a disability and 4,810 (85.7%) were households without such a person. Households with a person with a disability faced higher catastrophic health expenditures, spending about 1.2 to 1.4 times more of their annual living expenditures for out-of-pocket medical expenses, compared to households without persons with disabilities. Households having low economic status and members with chronic disease were more likely to face catastrophic health expenditures, while those receiving public assistance were less likely. Exemption or reduction of out-of-pocket payments in the National Health Insurance and additional financial support are needed so that the people with disabilities can use medical services without suffering financial crisis. PMID:26955233

Catastrophic Health Expenditures for Households with Disabled Members: Evidence from the Korean Health Panel.

PubMed

Lee, Jeong-Eun; Shin, Hyung-Ik; Do, Young Kyung; Yang, Eun Joo

2016-03-01

Persons with disabilities use more health care services due to ill health and face higher health care expenses and burden. This study explored the incidence of catastrophic health expenditures of households with persons with disabilities compared to that of those without such persons. We used the Korean Health Panel (KHP) dataset for the years 2010 and 2011. The final sample was 5,610 households; 800 (14.3%) of these were households with a person with a disability and 4,810 (85.7%) were households without such a person. Households with a person with a disability faced higher catastrophic health expenditures, spending about 1.2 to 1.4 times more of their annual living expenditures for out-of-pocket medical expenses, compared to households without persons with disabilities. Households having low economic status and members with chronic disease were more likely to face catastrophic health expenditures, while those receiving public assistance were less likely. Exemption or reduction of out-of-pocket payments in the National Health Insurance and additional financial support are needed so that the people with disabilities can use medical services without suffering financial crisis.

Personal experiences of people with serious mental illness when seeking, obtaining and maintaining competitive employment in Queensland, Australia.

PubMed

Gladman, Beverley; Waghorn, Geoff

2016-02-15

High non-participation in the labour force and unemployment remain challenging for adults with serious mental illness. This study examined the personal experiences of people with serious mental illness when seeking, obtaining and maintaining competitive employment. The aim was to increase understanding of personal experiences of employment and how these experiences can be used to inform the assistance provided in support of clients' competitive employment goals. Qualitative data from a two-year period were thematically analysed from one participating site in a multi-site trial of employment services integrated with public funded community mental health treatment and care. Both positive and negative themes arose. Positive themes included: Aspirations for a better life, receiving feedback on good job performance, employment displacing preoccupation with illness, and employment improving self-esteem and reducing financial stress. Negative themes included stigma experiences, stress, and health difficulties. Both positive and negative experiences did not depend on type of employment service assistance nor key client characteristics such as age, sex, and diagnostic category. Despite its many benefits, employment can also increase the risk of negative personal experiences. These findings suggest that employment service providers could do more to assist people who commence employment, to reduce the risk of negative personal experiences and to enhance the benefits of competitive employment.

Post opioid overdose outreach by public health and public safety agencies: Exploration of emerging programs in Massachusetts.

PubMed

Formica, Scott W; Apsler, Robert; Wilkins, Lindsay; Ruiz, Sarah; Reilly, Brittni; Walley, Alexander Y

2018-04-01

Opioid overdose is a significant public health problem. Collaborative programs between local public health and public safety agencies have emerged to connect overdose survivors and their personal networks with harm reduction and addiction treatment services following a non-fatal overdose event. This study explored the prevalence of these programs in Massachusetts and the different ways they have been structured and function. We sent an online screening questionnaire to police and fire departments in all 351 communities in Massachusetts to find instances in which they collaborated with a community-based public health agency to implement a post-overdose outreach and support program. We conducted telephone interviews with communities that implemented this type of program and categorized programs based on their structure, outreach approach, and other key characteristics. Police and fire personnel from 110 of the 351 communities in Massachusetts (31% response rate) completed the screening survey. Among respondents, 21% (23/110) had implemented a collaborative, community-based, post-overdose program with a well-defined process to connect overdose survivors and their personal networks with support services or addiction treatment services. Using data from the interviews, we identified four types of programs: (1) Multi-Disciplinary Team Visit, (2) Police Visit with Referrals, (3) Clinician Outreach, and (4) Location-Based Outreach. This study represents the first attempt to systematically document an emerging approach intended to connect opioid overdose survivors and their personal networks with harm reduction and addiction treatment services soon after a non-fatal overdose event. These programs have the potential to increase engagement with the social service and addiction treatment systems by those who are at elevated risk for experiencing a fatal opioid overdose. Copyright © 2018 Elsevier B.V. All rights reserved.

The Experience of Peer Mentors in an Intervention to Promote Smoking Cessation in Persons with Psychiatric Illness.

PubMed

Dickerson, Faith; Savage, Christina L G; Schweinfurth, Lucy A B; Goldberg, Richard W; Bennett, Melanie; Dixon, Lisa; Daumit, Gail; Chinman, Matthew; Lucksted, Alicia

2016-05-01

Peer support is an important component of services for persons with psychiatric illness but the experience of peer mentors is not well understood. This study explored the experiences of peer mentors, all former smokers and persons with psychiatric illness, who provided smoking cessation counseling as part of a 6 month professionally-led intervention. Data was obtained from 383 contact log entries and in-depth interviews with eight peer mentors. Qualitative analysis indicated that mentor roles were unexpectedly varied beyond the focus on smoking cessation. Of the two aspects of "peer-ness," shared smoking history was more prominent, while the shared experience of psychiatric illness was sometimes overlooked. Peer mentors experienced multiple challenges trying to help participants to change their smoking behaviors. Nonetheless, they described their experience as personally rewarding. Future interventions may be improved by anticipating peer mentor role complexity and the inherent tension between providing person-centered support and promoting behavior change.

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.

A vital signs telemonitoring system - interoperability supported by a personal health record systema and a cloud service.

PubMed

Gutiérrez, Miguel F; Cajiao, Alejandro; Hidalgo, José A; Cerón, Jesús D; López, Diego M; Quintero, Víctor M; Rendón, Alvaro

2014-01-01

This article presents the development process of an acquisition and data storage system managing clinical variables through a cloud storage service and a Personal Health Record (PHR) System. First, the paper explains how a Wireless Body Area Network (WBAN) that captures data from two sensors corresponding to arterial pressure and heart rate is designed. Second, this paper illustrates how data collected by the WBAN are transmitted to a cloud storage service. It is worth mentioning that this cloud service allows the data to be stored in a persistent way on an online database system. Finally, the paper describes, how the data stored in the cloud service are sent to the Indivo PHR System, where they are registered and charted for future revision by health professionals. The research demonstrated the feasibility of implementing WBAN networks for the acquisition of clinical data, and particularly for the use of Web technologies and standards to provide interoperability with PHR Systems at technical and syntactic levels.

Quality of Life and Unmet Need in People with Psychosis in the London Borough of Haringey, UK

PubMed Central

Lambri, Maria; Chakraborty, Apu; Leavey, Gerard; King, Michael

2012-01-01

Objectives. Deinstitutionalization of long-term psychiatric patients produced various community-based residential care facilities. However, inner-city areas have many patients with severe mental illness (SMI) as well as deprivation, unemployment, and crime. This makes meeting their community needs complex. We undertook a needs assessment of service provision and consonance between service users' evaluation of need and by care workers. Design. Cross-sectional study with random sample of SMI service users in four housing settings: rehabilitation units; high-supported; medium-supported; low-supported housing. Setting. London Borough of Haringey. Outcome Measures. 110 SMI service users and 110 keyworkers were interviewed, using Camberwell Assessment of Need; SF-36; Lancashire Quality-of-Life profile; demographic and clinical information. Results. People in “low-support” and “high-support” housing had similar symptom scores, though low support had significantly lower quality of life. Quality of life was positively predicted by self-reported mental-health score and negatively predicted by unmet-need score in whole sample and in medium-support residents. Residents' and care-workers' assessments of need differed considerably. Conclusions. Although patients' housing needs were broadly met, those in low-supported housing fared least well. Attendance to self-reported mental health and unmet social needs to quality of life underpins planning of residential services for those with SMI. Social and personal needs of people in supported housing may be underestimated and overlooked; service providers need to prioritise these if concept of “recovery” is to advance. PMID:23213300

Personal support networks, social capital, and risk of relapse among individuals treated for substance use issues.

PubMed

Panebianco, Daria; Gallupe, Owen; Carrington, Peter J; Colozzi, Ivo

2016-01-01

The success of treatment for substance use issues varies with personal and social factors, including the composition and structure of the individual's personal support network. This paper describes the personal support networks and social capital of a sample of Italian adults after long-term residential therapeutic treatment for substance use issues, and analyses network correlates of post-treatment substance use (relapse). Using a social network analysis approach, data were obtained from structured interviews (90-120 min long) with 80 former clients of a large non-governmental therapeutic treatment agency in Italy providing voluntary residential treatments and rehabilitation services for substance use issues. Participants had concluded the program at least six months prior. Data were collected on socio-demographic variables, addiction history, current drug use status (drug-free or relapsed), and the composition and structure of personal support networks. Factors related to risk of relapse were assessed using bivariate and multivariate logistic regression models. A main goal of this study was to identify differences between the support network profiles of drug free and relapsed participants. Drug free participants had larger, less dense, more heterogeneous and reciprocal support networks, and more brokerage social capital than relapsed participants. Additionally, a lower risk of relapse was associated with higher socio-economic status, being married/cohabiting, and having network members with higher socio-economic status, who have greater occupational heterogeneity, and reciprocate support. Post-treatment relapse was found to be negatively associated with the socioeconomic status and occupational heterogeneity of ego's support network, reciprocity in the ties between ego and network members, and a support network in which the members are relatively loosely connected with one another (i.e., ego possesses "brokerage social capital"). These findings suggest the incorporation into therapeutic programming of interventions that address those aspects of clients' personal support networks. Copyright © 2015 Elsevier B.V. All rights reserved.

How university students with reading difficulties are supported in achieving their goals.

PubMed

Stack-Cutler, Holly L; Parrila, Rauno K; Jokisaari, Markku; Nurmi, Jari-Erik

2015-01-01

We examine (a) what social ties university students with a history of reading difficulty (RD) report assisting them to achieve their goals, (b) outlets available for developing social ties, (c) resources mobilized within these relationships, and (d) the impact of social ties' status on academic achievement. Participants were 107 university students with RD who were currently completing or had recently completed a university degree. Results showed that university students with RD named friends, parents, and significant others (e.g., boy/girlfriend, spouse) as social ties most often. Personal social ties were developed through social media networking sites and within close relationships, and institutional social ties through academic centers and university general services, among others. Resources mobilized among personal and institutional social ties included emotional and social support, advice and planning, writing and studying help, and goal setting. Institutional social ties also afforded job search assistance, accommodations, skill development, financial support, and mental health services. Finally, the status of employed, but not student, social ties explained academic achievement. © Hammill Institute on Disabilities 2013.

iES - An Intelligent Electronic Sales Platform

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

Stanton, V L; Korbe III, W; Gao, J G

Current e-commerce systems support online shopping based on electronic product catalogs. The major issues associated with catalog-based commerce systems are: difficulty in distinguishing one retailer from another, complex navigation with confusing links, and a lack of personalized service. This paper reports an intelligent solution to address these issues. Our solution will provide a more personalized sales experience through the use of a transaction-based knowledge model that includes both the rules used for reasoning as well as the corresponding actions. Based on this solution, we have developed an intelligent electronic sales platform that is supported by a framework which provides themore » desired personalization as well as extensibility and customization capabilities. This paper reports our design and development of this system and application examples.« less

Marginalization and social change processes among lesbian, gay, bisexual and transgender persons in Swaziland: implications for HIV prevention.

PubMed

H Logie, Carmen; Perez-Brumer, Amaya; Jenkinson, Jesse; Madau, Veli; Nhlengethwa, Winnie; Baral, Stefan

2018-05-30

Swaziland has among the highest national adult HIV prevalence globally. There is limited knowledge of HIV vulnerabilities and prevention engagement among lesbian, gay, bisexual and transgender (LGBT) persons in the context of Swaziland's criminalization of consensual same-sex practices. This study explored social processes of marginalization to assess how they could potentiate HIV vulnerabilities and limit engagement in HIV prevention services. Additionally, we assessed positive change to better understand existing strategies employed by LGBT persons to challenge these HIV prevention barriers. Guided by community-based research methodology and conducted in Mbabane and Manzini, Swaziland, data were collected by LGBT peer-research assistants (PRA) in collaboration with an LGBT community organization in Manzini. Semi-structured interviews were conducted by trained PRAs and explored HIV prevention, including experiences of stigma and coping. Audio files were transcribed verbatim, translated to English, and analyzed using thematic techniques. Among participants (n = 51; mean age: 26.47, SD: 4.68), 40 self-identifed as gay or lesbian (78.4%), 11 bisexual (22.6%), and 12 (23.5%) identified as transgender. Findings highlighted three primary processes of marginalization and positive change in structural, community, and internal domains. First, structural marginalization, which included criminalization, healthcare discrimination, and a scarcity of LGBT tailored HIV prevention resources was challenged by grassroots networks created to access and share specific HIV resources with LGBT persons and the Ministry of Health. Second, community marginalization included stigma and multi-dimensional forms of violence, however, this was met with LGBT persons providing mutual peer support, including for accessing HIV testing services. Thirdly, internal marginalization comprised of self-stigma and associated sexual risk practices was contrasted with coping strategies focused on self-acceptance, stemming from social support and leading to healthcare utilization. Jointly, these findings can inform the implementation of community-based and rights affirming HIV prevention and care cascade strategies that improve coverage of services with LGBT persons in Swaziland.

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.

Long-term outcome of hypochondriacal personality disorder.

PubMed

Tyrer, P; Seivewright, N; Seivewright, H

1999-02-01

Hypochondriacal personality disorder diagnosed according to the Personality Assessment Schedule, a structured clinical interview, was related to outcome after 2 years and 5 years in a randomized, controlled trial of treatment of generalized anxiety, panic, and dysthymic disorders. Seventeen individuals (9%) from a population of 181 patients had hypochondriacal personality disorder and they experienced a significantly worse outcome than other patients, including those with other personality disorders, in terms of symptomatic change and health service utilization. This lack of improvement was associated with persistent somatization in hypochondriacal personality disorder. The results give further support to the belief that hypochondriacal personality disorder is a valid clinical diagnosis that has important clinical correlates, but further work is needed to establish the extent of its overlap with hypochondriasis as a mental state disorder.

Co-occurring Substance Abuse and Mental Health Problems among Homeless Persons: Suggestions for Research and Practice.

PubMed

Polcin, Douglas L

Communities throughout the U.S. are struggling to find solutions for serious and persistent homelessness. Alcohol and drug problems can be causes and consequences of homelessness, as well as co-occurring problems that complicate efforts to succeed in finding stable housing. Two prominent service models exist, one known as "Housing First" takes a harm reduction approach and the other known as the "linear" model typically supports a goal of abstinence from alcohol and drugs. Despite their popularity, the research supporting these models suffers from methodological problems and inconsistent findings. One purpose of this paper is to describe systematic reviews of the homelessness services literature, which illustrate weaknesses in research designs and inconsistent conclusions about the effectiveness of current models. Problems among some of the seminal studies on homelessness include poorly defined inclusion and exclusion criteria, inadequate measures of alcohol and drug use, unspecified or poorly implemented comparison conditions, and lack of procedures documenting adherence to service models. Several recent papers have suggested broader based approaches for homeless services that integrate alternatives and respond better to consumer needs. Practical considerations for implementing a broader system of services are described and peer managed recovery homes are presented as examples of services that address some of the gaps in current approaches. Three issues are identified that need more attention from researchers: 1) improving upon the methodological limitations in current studies, 2) assessing the impact of broader based, integrated services on outcome, and 3) assessing approaches to the service needs of homeless persons involved in the criminal justice system.

Co-occurring substance abuse and mental health problems among homeless persons: Suggestions for research and practice

PubMed Central

Polcin, Douglas L.

2016-01-01

Abstract Communities throughout the U.S. are struggling to find solutions for serious and persistent homelessness. Alcohol and drug problems can be causes and consequences of homelessness, as well as co-occurring problems that complicate efforts to succeed in finding stable housing. Two prominent service models exist, one known as “Housing First” takes a harm reduction approach and the other known as the “linear” model typically supports a goal of abstinence from alcohol and drugs. Despite their popularity, the research supporting these models suffers from methodological problems and inconsistent findings. One purpose of this paper is to describe systematic reviews of the homelessness services literature, which illustrate weaknesses in research designs and inconsistent conclusions about the effectiveness of current models. Problems among some of the seminal studies on homelessness include poorly defined inclusion and exclusion criteria, inadequate measures of alcohol and drug use, unspecified or poorly implemented comparison conditions, and lack of procedures documenting adherence to service models. Several recent papers have suggested broader based approaches for homeless services that integrate alternatives and respond better to consumer needs. Practical considerations for implementing a broader system of services are described and peer-managed recovery homes are presented as examples of services that address some of the gaps in current approaches. Three issues are identified that need more attention from researchers: (1) improving upon the methodological limitations in current studies, (2) assessing the impact of broader based, integrated services on outcome, and (3) assessing approaches to the service needs of homeless persons involved in the criminal justice system. PMID:27092027

Association between personality traits and future choice of specialisation among Swedish doctors: a cross-sectional study.

PubMed

Bexelius, Tomas S; Olsson, Caroline; Järnbert-Pettersson, Hans; Parmskog, Malin; Ponzer, Sari; Dahlin, Marie

2016-08-01

Medical students' choice of their future specialty is influenced by several factors, including working conditions and type of patient relations. The aim of this study was to investigate the association between the choice of specialty and personality traits. This is a cross-sectional questionnaire-based study of 399 alumni from Karolinska Institutet Medical School who were assumed to undergo specialty training at the time of the survey in 2013. The Big Five Inventory was used to assess the personality traits extraversion, agreeableness, conscientiousness, neuroticism and openness to experience. Medical specialties were categorised as primary care, psychiatry, internal medicine and surgical and hospital service specialties. Adjustments were made for demographic factors and the method of selection for medical school admission. The response rate was 72% (n=289, of which 262 were in training to become specialists). Among these, surgeons scored lower in agreeableness than physicians in primary care, internal medicine and hospital services. Psychiatrists and hospital service physicians showed lower conscientiousness compared with surgeons. We found distinctive differences in personality traits between medical specialties even after adjusting for other potential explanatory variables. Since there are differences between specialties, for example, surgeons and psychiatrists, this supports previous findings that personality may affect medical students' specialty choice also in a Swedish setting. 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/

3 CFR 13628 - Executive Order 13628 of October 9, 2012. Authorizing the Implementation of Certain Sanctions Set...

Code of Federal Regulations, 2013 CFR

2013-01-01

... specialized information or professional consulting, engineering, or support services, with respect to goods or... over the person.” (c) Subsection 1(d) is amended by inserting the words “agricultural commodities...

Caregivers' support needs and factors promoting resiliency after brain injury.

PubMed

Kitter, Bryony; Sharman, Rachael

2015-01-01

This article explores the challenges, support needs and coping strategies of caregivers of people with an acquired brain injury (ABI). Semi-structured interviews were conducted with caregivers (n = 20) to explore their support services received, access barriers, utility of services, needed supports, coping strategies and factors promoting life satisfaction. The team recorded, transcribed verbatim and inductively analysed all interviews. Through thematic data analysis, three central themes were revealed: (a) barriers impeding quality-of-life, (b) support needed to improve quality-of-life and (c) factors enabling quality-of-life. All perspectives from the participants involved are synthesized to provide a rich depiction of caregivers' support needs and coping strategies. Two specific findings of interest include a negative association between severity of brain injury and caregiver's desire to direct treatment, as well as a distinct service gap in assistance for caregivers who are caring for someone with violent/offending behaviours. This study recommends short- and long-term changes, given Australia's upcoming National Disability Insurance Scheme, to increase caregiver quality-of-life, which will ultimately affect the rehabilitation outcomes of persons with ABI.

Support networks and people with physical disabilities: social inclusion and access to health services.

PubMed

Holanda, Cristina Marques de Almeida; De Andrade, Fabienne Louise Juvêncio Paes; Bezerra, Maria Aparecida; Nascimento, João Paulo da Silva; Neves, Robson da Fonseca; Alves, Simone Bezerra; Ribeiro, Kátia Suely Queiroz Silva

2015-01-01

This study seeks to identify the formation of social support networks of people with physical disabilities, and how these networks can help facilitate access to health services and promote social inclusion. It is a cross-sectional study, with data collected via a form applied to physically disabled persons over eighteen years of age registered with the Family Health Teams of the municipal district of João Pessoa in the state of Paraíba. It was observed that the support networks of these individuals predominantly consist of family members (parents, siblings, children, spouses) and people outside the family (friends and neighbors). However, 50% of the interviewees declared that they could not count on any support from outside the family. It was observed that the support network contributes to access to the services and participation in social groups. However, reduced social inclusion was detected, due to locomotion difficulties, this being the main barrier to social interaction. Among those individuals who began to interact in society, the part played by social support was fundamental.

The direct support workforce in community supports to individuals with developmental disabilities: issues, implications, and promising practices.

PubMed

Hewitt, Amy; Larson, Sheryl

2007-01-01

Difficulties in finding, keeping, and ensuring the competence of the direct support workforce in community developmental disability services has long been a challenge for individuals, families, providers, and policy makers. Direct support staff recruitment, retention, and competence are widely reported as one of the most significant barriers to the sustainability, growth, and quality of community services for people with developmental disabilities (ANCOR [2001] State of the states report. Alexandria, VA: ANCOR; Colorado Department of Human Services, [2000] Response to Footnote 106 of the FY 2001 appropriations long bill: Capacity of the community services systems for persons with developmental disabilities in Colorado; Hewitt [2000] Dynamics of the workforce crisis. Presentation at the NASDDDS Fall meeting. Alexandria, VA). While long in existence, these challenges are ones of growing concern because the number of people demanding community services is increasing and the population of people from which to recruit workers is declining (Office of the Assistant Secretary for Planning and Evaluation [2006] The supply of direct support professionals serving individuals with intellectual disabilities and other developmental disabilities: Report to Congress. Washington, DC: Office of Disability, Aging and Long-Term Care Policy, ASPE, U.S. Department of Health and Human Services). As the service system moves towards consumer direction, managed care, and more noncategorical service delivery systems, the difficulties of providing for an adequate and well-prepared workforce to support people with developmental disabilities becomes more complex and multifaceted. The solutions to those challenges are also more complex. This article reviews the literature regarding the complexity of the direct support workforce crisis, the effects of this crisis on various stakeholder groups, promising practices designed to address the challenges, and the related practice and policy implications. (c) 2007 Wiley-Liss, Inc.

Consideration of the influence of place on access to employment for persons with serious mental illness in northeastern Ontario.

PubMed

Rebeiro Gruhl, K L; Kauppi, C; Montgomery, P; James, S

2012-01-01

Despite increasing attention to employment within the mental health sector, reports indicate that people with serious mental illness (SMI) continue to experience limited employment success in the province of Ontario, Canada. Research specifies that people with SMI who live in rural places are less likely than those living in urban centers to have access to satisfactory employment services or to become gainfully employed. The objective of this study was to examine access to employment from the perspectives of people with SMI, mental health and vocational service providers, and decision-makers, and to explore whether place influenced their access to work in northeastern Ontario. A qualitative case study using community-based participatory research methods was chosen to examine the experience of access to competitive employment in two northeastern Ontario communities. The cases selected for study were two geographic areas in northeastern Ontario which provided best-practice, mental health services to persons with SMI. Community-based site partners advertised and recruited participants, and a consumer advisory provided input on key stakeholders, questions, findings and the study action plan. The study findings were informed by individual and group interviews conducted with 46 individuals who resided in both rural and urban settings in the case communities, and feedback from 49 participants who attended town hall forums for presentation of study findings and development of an action plan. The qualitative data was supported by a secondary data source reporting on the employment outcomes of 4112 people with SMI who received disability income support and who resided in the case communities. Qualitative data were analyzed inductively, and categories and themes were developed. Findings were member checked with all informants and town hall participants in each case community. This article draws on the findings of a larger study and reports on the influence of place to the low employment success experienced by people with SMI who reside in the case communities; 91.3% of those receiving disability income support are unemployed, and rural residents experience higher levels of unemployment than those in urban places. Place was found to influence access to employment in five ways: by limited access to employment support services in rural places, and to recommended ratios in urban places; by the use of different models and practices that were inconsistent with best practices for people with SMI; by the lack of a plan for the implementation of employment services in the case communities; by limited use of the available, dedicated vocational resources for employment purposes; and by inadequate supports provided to persons with SMI who wish to enter the workforce. The results also underscore how people with SMI continue to be perceived negatively regarding their capacity for employment. Such stereotypical attitudes additionally contributed to employment marginalization of people with SMI from the workforce, especially in rural communities. The study highlights the influence of geography and human resources to the implementation of best practice employment services and supports for persons with SMI. Important policy implications include the need to consider place when implementing evidence-based practices in places where geography, distance and human health resources limit the communities' capacity to successfully do so. The study also underscores the need to build community capacity for supported employment, especially in rural places, in order to improve the participation of people with SMI in employment, and subsequently, to help shift the communities' thinking about their capacity for work.

Integrating medical, assistive, and universal design products and technologies: Assistive Technology Service Method (ATSM).

PubMed

Elsaesser, Linda-Jeanne; Bauer, Stephen

2012-07-01

ISO26000 provides guidance on effective organizational performance that recognizes social responsibility (including rights of persons with disabilities (PWD)), engages stakeholders, and contributes to sustainable development [1]. Millennium Development Goals 2010 state: while progress has been made, insufficient dedication to sustainable development, and inequalities to the most vulnerable people require attention [2]. World Report on Disability 2011 recommendations includes improved data collection and removal of barriers to rehabilitation that empower PWD [3]. The Assistive Technology Service Method (ATSM), Assistive Technology Device Classification (ATDC) and Matching Person and Technology (MPT) provide an evidence-based, standardized, internationally comparable framework to improve rehabilitation interventions [4-6]. The ATSM and ATDC support universal design (UD) principles and provision of universal technology. The MPT assures interventions are effective and satisfactory to end-users [7]. The ICF conceptual framework and common language are used throughout [8]. Research findings on healthcare needs are translated. ATSM applications in support of these findings are presented. National initiatives demonstrate the need and value of the ATSM as an evidence-based, user-centric, interdisciplinary method to improve individual and organizational performance for rehabilitation [including AT] services. Two Disability & Rehabilitation: Assistive Technology articles demonstrate ATSM and ATDC use to strengthen rehabilitation services and integrate Universal Design principles for socially responsible behavior.

Facilitating access to sexual health services for men who have sex with men and male-to-female transgender persons in Guatemala City.

PubMed

Boyce, Sabrina; Barrington, Clare; Bolaños, Herbert; Arandi, Cesar Galindo; Paz-Bailey, Gabriela

2012-01-01

The purpose of this study was to identify barriers to accessing sexual health services among gay, bisexual and heterosexual-identifying men who have sex with men and male-to-female transgender persons in Guatemala City, to inform the development of high quality and population-friendly services. In-depth, semi-structured interviews were conducted with 29 purposively sampled individuals, including 8 transgender, 16 gay/bisexual and 5 heterosexual-identifying participants. Topical codes were applied to the data using software Atlas.ti™ to compare data between sub-groups. Analysis revealed that public clinics were most commonly used due to their lower cost and greater accessibility, but many participants experienced discrimination, violation of confidentiality and distrust of these services. Transgender and gay/bisexual-identifying participants preferred clinics where they felt a sense of belonging, while heterosexual-identifying participants preferred clinics unassociated with the men who have sex with men community. The most prominent barriers to sexual health services included fear of discrimination, fear of having HIV, cost and lack of social support. Findings highlight the need to strengthen existing public sexually transmitted infection clinics so that they address the multiple layers of stigma and discrimination that men who have sex with men and transgender persons experience.

Denial of Treatment to Obese Patients—the Wrong Policy on Personal Responsibility for Health

PubMed Central

Eyal, Nir

2013-01-01

In many countries around the world, including Iran, obesity is reaching epidemic proportions. Doctors have recently taken, or expressed support for, an extreme ‘personal responsibility for health’ policy against obesity: refusing services to obese patients. This policy may initially seem to improve patients’ incentives to fight obesity. But turning access to medical services into a benefit dependent on health improvement is bad policy. It conditions the very aid that patients need in order to become healthier on success in becoming healthier. Whatever else we may think of personal responsibility for health policies, this particular one is absurd. Unfortunately, quite a few personal responsibility for health policies use similar absurd conditioning. They mistakenly use as ‘carrots’ or ‘sticks’ for adherence the basic means to the same health outcomes that they seek to promote. This perspective proposes the following rule of thumb: any conditional incentive for healthy choice should be in a currency other than the basic means to that healthy choice. PMID:24596846

[Improving Mental Health Care in People at Risk for Getting Homeless].

PubMed

Salize, Hans Joachim; Arnold, Maja; Uber, Elisa; Hoell, Andreas

2017-01-01

Objective: Overall aim was to reduce the untreated prevalence in persons with untreated mental disorders and at risk for loosing accommodation and descending into homelessness. Primary aim was treatment initiation and treatment adherence by motivational interviewing. Secondary aims were to reduce social or financial problems. Methods: Persons at risk were identified in social welfare services or labour agencies, diagnosed and motivated to initiate treatment in a community mental health service. Results: 58 persons were included, 24 were referred to regular mental health care, 8 were stabilized enough after the initial motivational to refrain from acute treatment, 26 dropped out. During a 6-month follow-up quality of life and social support was improved (partly statistically significant) and psycho-social needs for care decreased. Conclusion: Motivational interviewing is likely to increase insight into illness and acceptance of mental health care in untreated persons with mental disorders at risk for social decline. © Georg Thieme Verlag KG Stuttgart · New York.

Thai people living with tuberculosis and how they adhere to treatment: A grounded theory study.

PubMed

Choowong, Jiraporn; Tillgren, Per; Söderbäck, Maja

2017-12-01

To develop a conceptual framework of adherence to treatment among Thai people living with tuberculosis, a grounded theory approach was used. A purposive sample of 20 Thai people living with tuberculosis, aged from 23 to 85 years, was interviewed. From the participants' perspective, a core category of social belonging was highlighted, with three categories of conditions connected: personal barriers, personal resilience, and social facilitation. Personal barriers encompassed fear of stigma, concealing the illness, and lack of knowledge and motivation to complete the treatment regime. Personal resilience encompassed positive thinking and self-awareness. Social facilitation encompassed the ease of access to health services, continuity in the health service's ability to choose a directly-observed therapy observer, and social support. This study contributes a deeper understanding of the perspective of Thai people living with tuberculosis with regards to adherence to tuberculosis treatment. It might improve how local healthcare workers provide tuberculosis care, and inspire them to tailor care to people living with tuberculosis in a local community to increase personal resilience and reduce stigma. © 2017 John Wiley & Sons Australia, Ltd.

The World Report on Disability and recent developments in South Korea.

PubMed

Kim, Wan Ho; Park, Yoon Ghil; Shin, Hyung-Ik; Im, Sang Hee

2014-01-01

The latest National Survey on Persons with Disabilities estimated 2,683,400 persons with disabilities in South Korea, of whom 58% were men and 42% were women. People with physical disability represent approximately 50% of the entire population with disability. Disability-related policies and services to improve the participation of persons with disabilities have been expanded in the last decades, guided by 5-yr plans. The number of physiatrists has increased, although it still varies significantly by location. As part of the comprehensive measures to expand rehabilitation services, several regional rehabilitation centers have been established. In addition, a community-based rehabilitation program has been implemented that comprises Strong Point Public Health Centers, which provide local health promotion programs for persons with disabilities, family support programs, and community participation programs. As the aged population increases, it is predicted that the population of persons with disabilities in South Korea will also increase. A long-term and innovative financial model will be required to meet the corresponding needs. A recent milestone of evidence-based practice is the publication of Clinical Practice Guideline for Stroke Rehabilitation in Korea.

The Contribution of Social Networks to the Health and Self-Management of Patients with Long-Term Conditions: A Longitudinal Study

PubMed Central

Reeves, David; Blickem, Christian; Vassilev, Ivaylo; Brooks, Helen; Kennedy, Anne; Richardson, Gerry; Rogers, Anne

2014-01-01

Evidence for the effectiveness of patient education programmes in changing individual self-management behaviour is equivocal. More distal elements of personal social relationships and the availability of social capital at the community level may be key to the mobilisation of resources needed for long-term condition self-management to be effective. Aim To determine how the social networks of people with long-term conditions (diabetes and heart disease) are associated with health-related outcomes and changes in outcomes over time. Methods Patients with chronic heart disease (CHD) or diabetes (n = 300) randomly selected from the disease registers of 19 GP practices in the North West of England. Data on personal social networks collected using a postal questionnaire, alongside face-to-face interviewing. Follow-up at 12 months via postal questionnaire using a self-report grid for network members identified at baseline. Analysis Multiple regression analysis of relationships between health status, self-management and health-economics outcomes, and characteristics of patients' social networks. Results Findings indicated that: (1) social involvement with a wider variety of people and groups supports personal self-management and physical and mental well-being; (2) support work undertaken by personal networks expands in accordance with health needs helping people to cope with their condition; (3) network support substitutes for formal care and can produce substantial saving in traditional health service utilisation costs. Health service costs were significantly (p<0.01) reduced for patients receiving greater levels of illness work through their networks. Conclusions Support for self-management which achieves desirable policy outcomes should be construed less as an individualised set of actions and behaviour and more as a social network phenomenon. This study shows the need for a greater focus on harnessing and sustaining the capacity of networks and the importance of social involvement with community groups and resources for producing a more desirable and cost-effective way of supporting long term illness management. PMID:24887107

The contribution of social networks to the health and self-management of patients with long-term conditions: a longitudinal study.

PubMed

Reeves, David; Blickem, Christian; Vassilev, Ivaylo; Brooks, Helen; Kennedy, Anne; Richardson, Gerry; Rogers, Anne

2014-01-01

Evidence for the effectiveness of patient education programmes in changing individual self-management behaviour is equivocal. More distal elements of personal social relationships and the availability of social capital at the community level may be key to the mobilisation of resources needed for long-term condition self-management to be effective. To determine how the social networks of people with long-term conditions (diabetes and heart disease) are associated with health-related outcomes and changes in outcomes over time. Patients with chronic heart disease (CHD) or diabetes (n = 300) randomly selected from the disease registers of 19 GP practices in the North West of England. Data on personal social networks collected using a postal questionnaire, alongside face-to-face interviewing. Follow-up at 12 months via postal questionnaire using a self-report grid for network members identified at baseline. Multiple regression analysis of relationships between health status, self-management and health-economics outcomes, and characteristics of patients' social networks. Findings indicated that: (1) social involvement with a wider variety of people and groups supports personal self-management and physical and mental well-being; (2) support work undertaken by personal networks expands in accordance with health needs helping people to cope with their condition; (3) network support substitutes for formal care and can produce substantial saving in traditional health service utilisation costs. Health service costs were significantly (p<0.01) reduced for patients receiving greater levels of illness work through their networks. Support for self-management which achieves desirable policy outcomes should be construed less as an individualised set of actions and behaviour and more as a social network phenomenon. This study shows the need for a greater focus on harnessing and sustaining the capacity of networks and the importance of social involvement with community groups and resources for producing a more desirable and cost-effective way of supporting long term illness management.

Primary care support for tackling obesity: a qualitative study of the perceptions of obese patients.

PubMed

Brown, Ian; Thompson, Joanne; Tod, Angela; Jones, Georgina

2006-09-01

Obesity has become a major public health issue and there is concern about the response of health services to patients who are obese. The perceptions of obese patients using primary care services have not been studied in depth. To explore obese patients' experiences and perceptions of support in primary care. Qualitative study with semi-structured interviews conducted in participants' homes. Five general practices contrasting in socioeconomic populations in Sheffield. Purposive sampling and semi-structured interviewing of 28 patients with a diverse range of ages, backgrounds, levels of obesity and experiences of primary care services. Participants typically felt reluctance when presenting with concerns about weight and ambivalence about the services received. They also perceived there to be ambivalence and a lack of resources on the part of the health services. Participants showed a strong sense of personal responsibility about their condition and stigma-related cognitions were common. These contributed to their ambivalence about using services and their sensitivity to its features. Good relationships with primary care professionals and more intensive support partly ameliorated these effects. The challenges of improving access to and quality of primary care support in tackling obesity are made more complex by patients' ambivalence and other effects of the stigma associated with obesity.

Family support and cardiac rehabilitation: a comparative study of the experiences of South Asian and White-European patients and their carer's living in the United Kingdom.

PubMed

Astin, Felicity; Atkin, Karl; Darr, Aliya

2008-03-01

Effective lifestyle modification facilitated by cardiac rehabilitation is known to reduce the occurrence of adverse coronary events and mortality. South Asians have poorer outcomes after a myocardial infarction than the general UK population, but little is known about their experiences of family support, cardiac rehabilitation and lifestyle change. To explore the nature of family support available to a sample of South Asian and White-European cardiac patients and to highlight similarities and differences between these groups with regard to cardiac rehabilitation and lifestyle modification. Using a qualitative approach, semi-structured interviews (in 1 of 6 languages) were conducted by researchers with; 45 South Asian patients and 37 carers and 20 White-European patients and 17 carers. Interviews were conducted in a home setting, up to eighteen months after discharge from hospital following myocardial infarction, coronary artery bypass surgery or unstable angina. The main themes that emerged related to the provision of advice and information, family support and burden, dietary change and exercise regimes. Several cultural and ethnic differences were identified between patients and their families alongside similarities, irrespective of ethnicity. These may represent generic characteristics of recovery after a cardiac event. Health professionals should develop a cultural repertoire to engage with diversity and difference. Not every difficulty a person encounters as they try to access appropriate service delivery can be attributed to ethnic background. By improving services generally, support for South Asian populations can be improved. The challenge is to know when ethnicity makes a difference and mediates a person's relationship with service support and when it does not.

Worker Dislocation and Its Consequences.

ERIC Educational Resources Information Center

Rosenbaum, Allan; Zirkin, Barbara G.

A study examined the socioeconomic characteristcs, family and social supportive services, economic and social difficulties, education and training levels, and ways in which dislocated workers in Maryland found reemployment. Data were collected from in-depth personal interviews with 9 dislocated workers, questionnaires administered to 45 unemployed…

Classroom Community and Possible Selves: Implications for Midcareer Teacher Seminars

ERIC Educational Resources Information Center

Holbert, Romena M. Garrett

2015-01-01

Much research examines professional learning for pre-service and beginning teachers. However, in midcareer, teaching satisfaction and effectiveness are challenged by decreased recognition and support and increasing stressors including isolation, accountability demands, mentorship roles, and personal/family responsibilities. Often, midcareer…

The Other Infrastructure: Distance Education's Digital Plant.

ERIC Educational Resources Information Center

Boettcher, Judith V.; Kumar, M. S. Vijay

2000-01-01

Suggests a new infrastructure--the digital plant--for supporting flexible Web campus environments. Describes four categories which make up the infrastructure: personal communication tools and applications; network of networks for the Web campus; dedicated servers and software applications; software applications and services from external…

75 FR 8726 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-25

...) to improve the ability of State child support enforcement agencies to locate noncustodial parents and... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Submission for...: Public Law 104-193, the ``Personal Responsibility and Work Opportunity Reconciliation Act of 1996...

76 FR 21386 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-15

....395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel, Protein Technologies...

Transformative Learning and the Road to Maternal Leadership

ERIC Educational Resources Information Center

Panton, Rachel

2016-01-01

This study of three Africana (Black women of the Diaspora) holistic health educators shows how their woman-centered learning cultures led them to personal transformation and leadership roles. Understanding their development can inform educational programming and support services for Black women students.

The sexual health needs of people with learning disabilities.

PubMed

Cambridge, Paul

The sexual health of people with learning disabilities raises important management and practice issues for health services, and should be examined in the context of the current policy emphasis on advocacy, person-centred services and social inclusion (Department of Health, 2001). People with learning disabilities may have limited access to mainstream health services, and sexual health and genitourinary medicine (GUM) services are no exception (DoH, 2001; 1998). They are often excluded from society, either because they are 'segregated' within specialist support services in the community or because they live in isolation with carers, and health and social care models do not always join up locally to meet their needs.

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

Experiences of older people following the introduction of consumer-directed care to home care packages: A qualitative descriptive study.

PubMed

Day, Jenny; Thorington Taylor, Ann C; Hunter, Sharyn; Summons, Peter; van der Riet, Pamela; Harris, Margaret; Maguire, Jane; Dilworth, Sophie; Jeong, Sarah; Bellchambers, Helen; Haydon, Gunilla; Higgins, Isabel

2018-06-12

To explore the experiences of older people receiving home care package (HCP) support following the introduction of consumer-directed care (CDC) by the Australian government on 1 July 2015. Thirty-one older people with existing HCP support from two service providers in regional New South Wales, Australia, participated in a face-to-face interview and/or a qualitative survey. Analysis revealed the theme of Choices: Preferences, constraints, balancing and choosing. Participants described choosing to live at home with HCP support; however, they were constrained by poor communication and information about service changes and options, personal budgets and access to future care. HCP services remained largely unchanged during transition to CDC. Many aspects of the initial implementation of CDC were challenging for older people. Clear, relevant and timely communication and information about CDC and its consequences for consumers appear to be needed to enhance CDC. © 2018 AJA Inc.

A human rights approach to advocacy for people with dementia: A review of current provision in England and Wales.

PubMed

Dixon, Jeremy; Laing, Judy; Valentine, Christine

2018-01-01

In this article, we review current advocacy services for people with dementia in England and Wales (provided, respectively, under the Mental Capacity Act 2005 , the Mental Health Act 1983 /2007 and the Care Act 2014) through the lens of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). We examine what a human rights' approach to advocacy support would entail, and whether current frameworks in England and Wales are adequate for this approach and provide a sufficient safeguard. First, we consider how the human rights of persons with dementia have become increasingly important and the extent to which the CRPD provides an opportunity to bolster safeguards and protection. Second, we discuss cause and case advocacy, and how these advocacy models could be shaped by the CRPD to promote the rights of persons with dementia at each stage of the disease. Third, we highlight current dilemmas and challenges in the provision of advocacy support in England and Wales by focusing on case law, commissioning of services and current practice. In particular, we analyse how the different legislative schemes have given rise to some confusion about the various advocacy provisions, as well as potential for overlap and discrepancies between different regimes. We also highlight the need for further research to address important gaps in knowledge, including the scale of need, patterns of referral and attitudes to advocacy services. The article concludes by highlighting how advocacy support could be recalibrated as a universal right to promote the aims and aspirations of the CRPD, and how education is needed to address the stigma of dementia and promote the benefits of advocacy in protecting the rights of those with dementia.

Relationship between family quality of life and day occupations of young people with Down syndrome.

PubMed

Foley, Kitty-Rose; Girdler, Sonya; Downs, Jenny; Jacoby, Peter; Bourke, Jenny; Lennox, Nick; Einfeld, Stewart; Llewellyn, Gwynnyth; Parmenter, Trevor R; Leonard, Helen

2014-09-01

To explore relationships between family quality of life, day occupations and activities of daily living (ADL) of young persons with Down syndrome. Data were collected from 150 families with a young person with Down syndrome aged 16-30 years participating in the Down syndrome "Needs Opinions Wishes" database. Data described the young person's characteristics (including functional abilities, behaviour and day occupations) and family characteristics (including income, family and community supports and quality of life). Compared to families of young people attending open employment, families of young people participating in sheltered employment tended to report poorer family quality of life, after adjusting for personal characteristics, behaviour and income (coeff -6.78, 95 % CI -14.38, 0.81). Family supports reduced this relationship (coeff -6.00, 95 % CI -12.76, 0.76). Families of young people with greater functioning in ADL reported better family quality of life regardless of personal and environmental factors (coeff 0.45, 95 % CI 0.05, 0.85) and inclusion of family factors such as family supports reduced this association (coeff 0.29, 95 % CI -0.10, 0.67). Participation of young people with Down syndrome in open employment may positively influence family quality of life. Services that facilitate functioning in ADL and assist the families in accessing suitable family supports have the potential to positively influence family quality of life.

Reducing depression in older home care clients: design of a prospective study of a nurse-led interprofessional mental health promotion intervention.

PubMed

Markle-Reid, Maureen F; McAiney, Carrie; Forbes, Dorothy; Thabane, Lehana; Gibson, Maggie; Hoch, Jeffrey S; Browne, Gina; Peirce, Thomas; Busing, Barbara

2011-08-25

Very little research has been conducted in the area of depression among older home care clients using personal support services. These older adults are particularly vulnerable to depression because of decreased cognition, comorbid chronic conditions, functional limitations, lack of social support, and reduced access to health services. To date, research has focused on collaborative, nurse-led depression care programs among older adults in primary care settings. Optimal management of depression among older home care clients is not currently known. The objective of this study is to evaluate the feasibility, acceptability and effectiveness of a 6-month nurse-led, interprofessional mental health promotion intervention aimed at older home care clients with depressive symptoms using personal support services. This one-group pre-test post-test study aims to recruit a total of 250 long-stay (> 60 days) home care clients, 70 years or older, with depressive symptoms who are receiving personal support services through a home care program in Ontario, Canada. The nurse-led intervention is a multi-faceted 6-month program led by a Registered Nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach. The primary outcome is the change in severity of depressive symptoms from baseline to 6 months using the Centre for Epidemiological Studies in Depression Scale. Secondary outcomes include changes in the prevalence of depressive symptoms and anxiety, health-related quality of life, cognitive function, and the rate and appropriateness of depression treatment from baseline to 12 months. Changes in the costs of use of health services will be assessed from a societal perspective. Descriptive and qualitative data will be collected to examine the feasibility and acceptability of the intervention and identify barriers and facilitators to implementation. Data collection began in May 2010 and is expected to be completed by July 2012. A collaborative nurse-led strategy may provide a feasible, acceptable and effective means for improving the health of older home care clients by improving the prevention, recognition, and management of depression in this vulnerable population. The challenges involved in designing a practical, transferable and sustainable nurse-led intervention in home care are also discussed. ClinicalTrials.gov: NCT01407926.

Reducing depression in older home care clients: design of a prospective study of a nurse-led interprofessional mental health promotion intervention

PubMed Central

2011-01-01

Background Very little research has been conducted in the area of depression among older home care clients using personal support services. These older adults are particularly vulnerable to depression because of decreased cognition, comorbid chronic conditions, functional limitations, lack of social support, and reduced access to health services. To date, research has focused on collaborative, nurse-led depression care programs among older adults in primary care settings. Optimal management of depression among older home care clients is not currently known. The objective of this study is to evaluate the feasibility, acceptability and effectiveness of a 6-month nurse-led, interprofessional mental health promotion intervention aimed at older home care clients with depressive symptoms using personal support services. Methods/Design This one-group pre-test post-test study aims to recruit a total of 250 long-stay (> 60 days) home care clients, 70 years or older, with depressive symptoms who are receiving personal support services through a home care program in Ontario, Canada. The nurse-led intervention is a multi-faceted 6-month program led by a Registered Nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach. The primary outcome is the change in severity of depressive symptoms from baseline to 6 months using the Centre for Epidemiological Studies in Depression Scale. Secondary outcomes include changes in the prevalence of depressive symptoms and anxiety, health-related quality of life, cognitive function, and the rate and appropriateness of depression treatment from baseline to 12 months. Changes in the costs of use of health services will be assessed from a societal perspective. Descriptive and qualitative data will be collected to examine the feasibility and acceptability of the intervention and identify barriers and facilitators to implementation. Discussion Data collection began in May 2010 and is expected to be completed by July 2012. A collaborative nurse-led strategy may provide a feasible, acceptable and effective means for improving the health of older home care clients by improving the prevention, recognition, and management of depression in this vulnerable population. The challenges involved in designing a practical, transferable and sustainable nurse-led intervention in home care are also discussed. Trial Registration ClinicalTrials.gov: NCT01407926 PMID:21867539

Developing human rights based indicators to support country monitoring of rehabilitation services and programmes for people with disabilities: a study protocol.

PubMed

Skempes, Dimitrios; Bickenbach, Jerome

2015-09-24

Rehabilitation care is fundamental to health and human dignity and a human right enshrined in the United Nations Convention on the Rights of Persons with Disabilities. The provision of rehabilitation is important for reducing the need for formal support and enabling persons with disabilities to lead an independent life. Increasingly scholars and advocacy groups voice concerns over the significant barriers facing people with disabilities in accessing appropriate and quality rehabilitation. A growing body of research highlights a "respond-need" gap in the provision of rehabilitation and assistive technologies and underscore the lack of indicators for assessing performance of rehabilitation systems and monitoring States compliance with human rights standards in rehabilitation service planning and programming. While research on human rights and health monitoring has increased exponentially over the last decade far too little attention has been paid to rehabilitation services. The proposed research aims to reduce this knowledge gap by developing a human rights based monitoring framework with indicators to support human rights accountability and performance assessment in rehabilitation. Concept mapping, a stakeholder-driven approach will be used as the core method to identify rights based indicators and develop the rehabilitation services monitoring framework. Concept mapping requires participants from various stakeholders groups to generate a list of the potential indicators through on line brainstorming, sort the indicators for conceptual similarity into clusters and rate them against predefined criteria. Multidimensional scaling and hierarchical cluster data analysis will be performed to develop the monitoring framework while bridging analysis will provide useful insights about patterns of agreement or disagreement among participants views on indicators. This study has the potential to influence future practices on data collection and measurement of compliance with human rights standards in rehabilitation service delivery and organization. The development of a valid and universally applicable set of indicators will have a profound impact on the design and implementation of evidence informed disability policies and programs as it can support countries in strengthening performance measurement through documentation of comparative information on rehabilitation care systems. Most importantly, the resulting indicators can be used by disabled people's organizations as well as national and international institutions to define a minimal standard for monitoring and reporting progress on the implementation of the Convention on the Rights of Persons with Disabilities in the area of rehabilitation.

[The model program of psycho-social treatment and staff training].

PubMed

Ikebuchi, Emi

2012-01-01

The model program of psycho-social treatment and staff training were reported in this issue. The mission of model program is supporting recovery of persons with mental illness and their family as well as empowering their hope and sense of values. The personal support specialists belonging to multi-disciplinary team have responsibility to support life-long process of recovery across hospitalization, out-patients clinic, day treatment, and outreach service. The shared value of multi-disciplinary team (the community life supporting team) is recovery so that the team renders self directive life, various alternatives of their lives, and peer group with models of recovery to persons with mental illness. There should be several technologies which are used in the team such as engagement, psycho-education, cognitive-behavior therapy, care-management, cooperating with other resources. The responsibility, assessment and evaluation techniques, guarantee of opportunities for training, and auditing system of the team and process of treatment are important factors to educate team staff. Raising effective multi-disciplinary team requires existence of a mentor or good model near the team.

Enhancing work-focused supports for people with severe mental illnesses in australia.

PubMed

Contreras, Natalia; Rossell, Susan L; Castle, David J; Fossey, Ellie; Morgan, Dea; Crosse, Caroline; Harvey, Carol

2012-01-01

Persons with severe mental illness (SMI) have reduced workforce participation, which leads to significant economic and social disadvantage. This theoretical review introduces the strategies that have been implemented to address this issue. These include Individual Placement and Support (IPS) services, the most widely researched form of supported employment, to which cognitive remediation has more recently been recognised in the USA, as an intervention to improve employment outcomes by addressing the cognitive impairments often experienced by people with SMI. The authors review the international literature and discuss specifically the Australian context. They suggest that Australia is in a prime position to engage clients in such a dual intervention, having had recent success with increasing access to supported employment programs and workforce reentry, through implementation of the Health Optimisation Program for Employment (HOPE). Such programs assist with gaining and maintaining employment. However, they do not address the cognitive issues that often prevent persons with SMI from effectively participating in work. Thus, optimising current interventions, with work-focused cognitive skills development is critical to enhancing employment rates that remain low for persons with SMI.

2004 Annual Health Physics Report for the HEU Transparency Program

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

Radev, R

2005-04-01

During the 2004 calendar year, LLNL provided health physics support for the Highly Enriched Uranium Transparency Implementation Program (HEU-TIP) in external and internal radiation protection and technical expertise into matters related to BDMS radioactive sources and Russian radiation safety regulatory compliance. For the calendar year 2004, there were 200 person-trips that required dose monitoring of the U.S. monitors. Of the 200 person-trips, 183 person-trips were SMVs and 17 person-trips were Transparency Monitoring Office (TMO) trips. Eight person-trips from the SMV trips were continuation trips of TMO monitors to facilities other than UEIP. The LLNL Safety Laboratories' Division provided the dosimetrymore » services for the HEU-TIP monitors.« less

Global Voyeurism or Sustainable Ethical Practice?

PubMed

Finn, Cris; Coast, Mary Jo

This is a conceptual article exploring global voyeurism and service, overlaying ethical considerations in service within the profession of forensic nursing. Key elements considered include examining and reflecting on personal motivations, benefits, and consequences of service when viewed through an ethical perspective. Through this article we seek to examine the relationships between poverty tourism and service, while better supporting individual forensic nurses in their quest to align their actions with the ethical and practice comportment standards within the profession of nursing service globally. We include definition of terms, including professional identity, ethics and social justice, poverty tourism and voyeurism, global and professional service, cultural humility, partnerships, and trusting relationships. We conclude with implications, and considerations for forensic nursing.

Individual support plans of people with intellectual disabilities in residential services: content analysis of goals and resources in relation to client characteristics.

PubMed

Herps, M A; Buntinx, W H E; Schalock, R L; van Breukelen, G J P; Curfs, L M G

2016-03-01

Goals and objectives as mentioned in Individual Support Plans (ISPs) were analysed to explore what domains of quality of life they are associated with, what support resources are referenced for achieving the goals, and how domains and resources are related to clients age, gender and intellectual disability (ID) level. A total of 209 ISPs for persons with ID from eight residential Dutch service provider organisations were analysed. Mixed linear regression analyses were conducted to examine the relations between client characteristics and the content of goals and support resources. Results showed that ISPs of people with mild and moderate ID had significantly more goals related to independence and social participation as compared to the ISPs of people with severe and profound ID. ISPs of clients with profound ID addressed quality of life factors related to 'well-being' more than ISPs of all other clients. ISPs of people aged 20-34 years had significantly more goals on independence than the two other age groups. ISPs of people under the age of 50 had significantly fewer goals with respect to well-being than found in ISPs of older people. Regarding the use of resources, 42.6% of the ISP goals were associated with resources from specialised services, 31.5% associated with natural resources and 25.9% associated with a combination of both natural and specialised services. In ISPs of people with mild ID, natural resources are more often mentioned, and specialised service-based resources are less often mentioned than for other people. This study offers empirical feedback on ISP practices in the field of ID in the Netherlands. In light of current ISP practices, results suggest that attention should be paid to: (1) distinguishing between a 'service contract' and an ISP; (2) keeping a focus on the whole person in all age groups and levels of functioning and (3) involving the service recipient in ISP development and implementation. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Evaluating the effectiveness of using personal tailored risk information and taster sessions to increase the uptake of smoking cessation services: study protocol for a randomised controlled trial

PubMed Central

2012-01-01

Background Although government-funded specialist smoking cessation services in England offer advice and support to smokers motivated to quit, only a small proportion of smokers make use of this service. Evidence suggests that if smokers are proactively and personally invited to use services, use will be higher than with a standard referral made by health professionals. Computer-based systems generating personalised tailored communications also have the potential to engage with a larger proportion of the smoking population. In this study smokers are proactively invited to use the NHS Stop Smoking Service (SSS), with a personal computer-tailored letter and the offer of a no-commitment introductory session designed to give more information about the service. The primary objective is to assess the relative effectiveness on attendance at the NHS SSS, of proactive recruitment by a brief personal letter, tailored to individual characteristics, and invitation to a taster session, over a standard generic letter advertising the service. Method/design This randomised controlled trial will recruit smokers from general practice who are motivated to quit and have not recently attended the NHS SSS. Smokers aged 16 years and over, identified from medical records in participating practices, are sent a brief screening questionnaire and cover letter from their GP. Smokers giving consent are randomised to the Control group to receive a standard generic letter advertising the local service, or to the Intervention group to receive a brief personal, tailored letter with risk information and an invitation to attend a ‘Come and Try it’ taster session. The primary outcome, assessed 6 months after the date of randomisation, is the proportion of people attending the NHS SSS for at least one session. Planned recruitment is to secure 4,500 participants, from 18 regions in England served by an NHS SSS. Discussion Personal risk information generated by computer, with the addition of taster sessions, could be widely replicated and delivered cost effectively to a large proportion of the smoking population. The results of this trial will inform the potential of this method to increase referrals to specialised smoking cessation services and prompt more quit attempts. Trial registration Current Controlled Trials ISRCTN76561916 PMID:23078797

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

PubMed

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

2017-06-01

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

Mortality in NHS Greater Glasgow and Clyde employees: 2007-2009.

PubMed

Freer, K; Waclawski, E

2013-09-01

Just over a fifth of all deaths in Scotland occur in those under the age of 65. This study examined deaths in service in employees of the National Health Service Greater Glasgow and Clyde (NHS GG&C) Health Board over a 3-year period. To assess crude death rates by occupational group, the main causes of death and evidence of causes that could have been prevented or modified by lifestyle changes. Demographic details, occupational grouping and death certificate data were obtained for all NHS GG&C employees who died in service between 2007 and 2009. A total of 138 employees died in this period. The occupational groups in which most deaths occurred were support services (porters, domestic and catering staff; 35%) and nurses (34%). The commonest causes of death were lung cancer (15%), ischaemic heart disease (9%) and suicide (9%). The overall crude death rate was 1.2/1000 persons/year (females 1.0 and males 1.7) and was highest among support services employees (2.4) and lowest among medical staff (0.5). The relative risk of death in support services was significantly greater than the majority of occupational groups. These findings suggest health inequality within this workforce. The main causes of death identified in the support services group could potentially be modified through workplace risk factor screening and health promotion.

Reflecting on the World Report on Disability: a short report from Argentina.

PubMed

Schiappacasse, Carolina; Longoni, Melina; Paleo, Maria Alicia; Vitale, Myrtha

2014-01-01

In 2003, the National Survey of Persons with Disabilities identified 2,176,123 persons (7.1% of the total population of the country) with an impairment that affects some of the most important aspects of everyday life (walking, standing up, sitting down, seeing, hearing, learning, or general behavior). In Argentina, several laws support the rights of persons with disabilities. However, inappropriate implementation of these legislations, particularly in the inland provinces, results in shortage of services, low labor force participation, and poor housing conditions. The number of rehabilitation professionals is not sufficient to satisfy the demand for rehabilitation.

Predicting use of case management support services for adolescents and adults living in community following brain injury: A longitudinal Canadian database study with implications for life care planning.

PubMed

Baptiste, B; Dawson, D R; Streiner, D

2015-01-01

To determine factors associated with case management (CM) service use in people with traumatic brain injury (TBI), using a published model for service use. A retrospective cohort, with nested case-control design. Correlational and logistic regression analyses of questionnaires from a longitudinal community data base. Questionnaires of 203 users of CM services and 273 non-users, complete for all outcome and predictor variables. Individuals with TBI, 15 years of age and older. Out of a dataset of 1,960 questionnaires, 476 met the inclusion criteria. Eight predictor variables and one outcome variable (use or non-use of the service). Predictor variables considered the framework of the Behaviour Model of Health Service Use (BMHSU); specifically, pre-disposing, need and enabling factor groups as these relate to health service use and access. Analyses revealed significant differences between users and non-users of CM services. In particular, users were significantly younger than non-users as the older the person the less likely to use the service. Also, users had less education and more severe activity limitations and lower community integration. Persons living alone are less likely to use case management. Funding groups also significantly impact users. This study advances an empirical understanding of equity of access to health services usage in the practice of CM for persons living with TBI as a fairly new area of research, and considers direct relevance to Life Care Planning (LCP). Many life care planers are CM and the genesis of LCP is CM. The findings relate to health service use and access, rather than health outcomes. These findings may assist with development of a modified model for prediction of use to advance future cost of care predictions.

Living With Dementia in Correctional Settings: A Case Report.

PubMed

Peacock, Shelley; Hodson, Alexandra; MacRae, Rhoda; Peternelj-Taylor, Cindy

2018-04-24

The prison population is aging at an alarming rate and many older persons have the potential to develop dementia while in prison. This case report aims to explore the needs of older people living with dementia in prison and discusses the interventions that exist to address these needs. As the condition progresses, persons with dementia become increasingly reliant on the support of others for their health and well-being because of the increasing complexity of physical healthcare and psychosocial needs. Very few interventions are cited in the research literature regarding the use, acceptability, and/or effectiveness of programming for people living with dementia in prison. To support the unique and complex needs of these persons, research is needed to guide the development of evidence-informed dementia programs and services as well as consideration of interdisciplinary collaboration with community organizations.

Provision of Personal Healthcare Services by Local Health Departments: 2008-2013.

PubMed

Luo, Huabin; Sotnikov, Sergey; Winterbauer, Nancy

2015-09-01

The scope of local health department (LHD) involvement in providing personal healthcare services versus population-based services has been debated for decades. A 2012 IOM report suggests that LHDs should gradually withdraw from providing personal healthcare services. The purpose of this study is to assess the level of LHD involvement in provision of personal healthcare services during 2008-2013 and examine the association between provision of personal healthcare services and per capita public health expenditures. Data are from the 2013 survey of LHDs and Area Health Resource Files. The number, ratio, and share of revenue from personal healthcare services were estimated. Both linear and panel fixed effects models were used to examine the association between provision of personal healthcare services and per capita public health expenditures. Data were analyzed in 2014. The mean number of personal healthcare services provided by LHDs did not change significantly in 2008-2013. Overall, personal services constituted 28% of total service items. The share of revenue from personal services increased from 16.8% in 2008 to 20.3% in 2013. Results from the fixed effect panel models show a positive association between personal healthcare services' share of revenue and per capita expenditures (b=0.57, p<0.001). A lower share of revenue from personal healthcare services is associated with lower per capita expenditures. LHDs, especially those serving <25,000 people, are highly dependent on personal healthcare revenue to sustain per capita expenditures. LHDs may need to consider strategies to replace lost revenue from discontinuing provision of personal healthcare services. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

Service users' expectations of treatment and support at the Community Mental Health Centre in their recovery.

PubMed

Biringer, Eva; Davidson, Larry; Sundfør, Bengt; Ruud, Torleif; Borg, Marit

2017-09-01

Focus on service users' needs, coping and empowerment, user involvement, and comprehensiveness are supposed to be key elements of the Community Mental Health Centres in Norway. Taking a user-oriented approach means acknowledging the individual's own expectations, aims and hopes. However, studies that have investigated service users' expectations of treatment and support at Community Mental Health Centres are hard to find. The aim of the study was therefore to explore service users' expectations at the start of treatment at a Community Mental Health Centre. Within a collaborative framework, taking a hermeneutic-phenomenological approach, ten service users participated in in-depth interviews about their expectations, hopes and aims for treatment and recovery. The participants sought help due to various mental health issues that had interfered with their lives and created disability and suffering. A data-driven stepwise approach in line with thematic analysis was used. The study was approved by the Norwegian Social Science Data Services. The following four main themes representing participants' expectations at the start of treatment were elicited: hope for recovery, developing understanding, finding tools for coping and receiving counselling and practical assistance. Participants' expectations about treatment were tightly interwoven with their personal aims and hopes for their future life, and expectations were often related to practical and financial problems, the solution of which being deemed necessary to gain a safe basis for recovery in the long run. The transferability of the results may be limited by the small number of participants. The study emphasises how important it is that service users' personal aims and expectations guide the collaborative treatment process. In addition to providing treatment aimed at improving symptoms, Community Mental Health Centres should take a more comprehensive approach than today by providing more support with family issues, social life, education, work and financial issues. © 2016 Nordic College of Caring Science.

Scale-up of national antiretroviral therapy programs: progress and challenges in the Asia Pacific region.

PubMed

Srikantiah, Padmini; Ghidinelli, Massimo; Bachani, Damodar; Chasombat, Sanchai; Daoni, Esorom; Mustikawati, Dyah E; Nhan, Do T; Pathak, Laxmi R; San, Khin O; Vun, Mean C; Zhang, Fujie; Lo, Ying-Ru; Narain, Jai P

2010-09-01

There has been tremendous scale-up of antiretroviral therapy (ART) services in the Asia Pacific region, which is home to an estimated 4.7 million persons living with HIV/AIDS. We examined treatment scale-up, ART program practices, and clinical outcome data in the nine low-and-middle-income countries that share over 95% of the HIV burden in the region. Standardized indicators for ART scale-up and treatment outcomes were examined for Cambodia, China, India, Indonesia, Myanmar, Nepal, Papua New Guinea, Thailand, and Vietnam using data submitted by each country to the WHO/The Joint United Nations Programme on HIV/AIDS (UNAIDS)/UNICEF joint framework tool for monitoring the health sector response to HIV/AIDS. Data on ART program practices were abstracted from National HIV Treatment Guidelines for each country. At the end of 2009, over 700,000 HIV-infected persons were receiving ART in the nine focus countries. Treatment coverage varies widely in the region, ranging from 16 to 93%. All nine countries employ a public health approach to ART services and provide a standardized first-line nonnucleoside reverse transcriptase inhibitor-based regimen. Among patients initiated on first-line ART in these countries, 65-88% remain alive and on treatment 12 months later. Over 50% of mortality occurs in the first 6 months of therapy, and losses to follow-up range from 8 to 16% at 2 years. Impressive ART scale-up efforts in the region have resulted in significant improvements in survival among persons receiving therapy. Continued funding support and political commitment will be essential for further expansion of public sector ART services to those in need. To improve treatment outcomes, national programs should focus on earlier identification of persons requiring ART, decentralization of ART services, and the development of stronger healthcare systems to support the provision of a continuum of HIV care.

The Mining Minds digital health and wellness framework.

PubMed

Banos, Oresti; Bilal Amin, Muhammad; Ali Khan, Wajahat; Afzal, Muhammad; Hussain, Maqbool; Kang, Byeong Ho; Lee, Sungyong

2016-07-15

The provision of health and wellness care is undergoing an enormous transformation. A key element of this revolution consists in prioritizing prevention and proactivity based on the analysis of people's conducts and the empowerment of individuals in their self-management. Digital technologies are unquestionably destined to be the main engine of this change, with an increasing number of domain-specific applications and devices commercialized every year; however, there is an apparent lack of frameworks capable of orchestrating and intelligently leveraging, all the data, information and knowledge generated through these systems. This work presents Mining Minds, a novel framework that builds on the core ideas of the digital health and wellness paradigms to enable the provision of personalized support. Mining Minds embraces some of the most prominent digital technologies, ranging from Big Data and Cloud Computing to Wearables and Internet of Things, as well as modern concepts and methods, such as context-awareness, knowledge bases or analytics, to holistically and continuously investigate on people's lifestyles and provide a variety of smart coaching and support services. This paper comprehensively describes the efficient and rational combination and interoperation of these technologies and methods through Mining Minds, while meeting the essential requirements posed by a framework for personalized health and wellness support. Moreover, this work presents a realization of the key architectural components of Mining Minds, as well as various exemplary user applications and expert tools to illustrate some of the potential services supported by the proposed framework. Mining Minds constitutes an innovative holistic means to inspect human behavior and provide personalized health and wellness support. The principles behind this framework uncover new research ideas and may serve as a reference for similar initiatives.

75 FR 66770 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-29

... Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; Clinical Proteomic...

Current Screening Procedures for the Usher Syndrome at Residential Schools for the Deaf.

ERIC Educational Resources Information Center

Day, Creagh Walker

1982-01-01

The results indicated that 53 percent of the schools that responded are screening students for Usher syndrome. One-half of the schools with screening programs offered some support services: personal counseling, genetic counseling, curricular modifications, and vocational counseling. (Author)

Exploring Planet PDA: The Librarian as Astronaut, Innovator, and Expert.

ERIC Educational Resources Information Center

Galganski, Carol; Peters, Tom; Bell, Lori

2002-01-01

Describes the integration of personal digital assistants into a medical center library's services in Illinois. Discusses training for users; hardware selection; software selection and content; technical support; the role of libraries, including the creation of policies and procedures; and future challenges. (LRW)

Divergent Collaboration (service mark)

DTIC Science & Technology

2012-12-01

a person resilient and support them in continuing that behavior • Explore Forensics • Morale assessment • Educate people on how to move in and...acupressure • Measure electromagnetic Aura • Use hypnosis • Measure Non-traditional Human Energies • New paradigm for conops • Train to induce vivid

75 FR 44907 - Lebanon Sanctions Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-30

... through politically motivated violence and intimidation, to reassert Syrian control or contribute to... pose a significant risk of taking, actions, including acts of violence, that have the purpose or effect... services in support of, such actions, including acts of violence, or any person whose property and...

The Nature and Operation of Training Institutes: A Generic Marketing Plan for Community Colleges.

ERIC Educational Resources Information Center

Vivelo, Frank R.

1991-01-01

Discusses marketing problems and opportunities associated with satisfying demand, product-consumer match, support services, personnel, and personal involvement. Identifies overall marketing and business/financial goals and related objectives. Covers action plans, performance evaluations, curriculum design, advisory committee participation and…

Disability inclusion in higher education in Uganda: Status and strategies.

PubMed

Emong, Paul; Eron, Lawrence

2016-01-01

Uganda has embraced inclusive education and evidently committed itself to bringing about disability inclusion at every level of education. Both legal and non-legal frameworks have been adopted and arguably are in line with the intent of the Convention on the Rights of Persons with Disabilities (CRPD) on education. The CRPD, in Article 24, requires states to attain a right to education for persons with disabilities without discrimination and on the basis of equal opportunities at all levels of education. Despite Uganda's robust disability legal and policy framework on education, there is evidence of exclusion and discrimination of students with disabilities in the higher education institutions. The main objective of this article is to explore the status of disability inclusion in higher education and strategies for its realisation, using evidence from Emong's study, workshop proceedings where the authors facilitated and additional individual interviews with four students with disabilities by the authors. The results show that there are discrimination and exclusion tendencies in matters related to admissions, access to lectures, assessment and examinations, access to library services, halls of residence and other disability support services. The article recommends that institutional policies and guidelines on support services for students with disabilities and special needs in higher education be developed, data on students with disabilities collected to help planning, collaboration between Disabled Peoples Organisations (DPO's) strengthened to ensure disability inclusion and the establishment of disability support centres.

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.

Description of the person-environment interaction: methodological issues and empirical results of an Italian large-scale disability assessment study using an ICF-based protocol.

PubMed

Francescutti, Carlo; Gongolo, Francesco; Simoncello, Andrea; Frattura, Lucilla

2011-05-31

There is a connection between the definition of disability in a person-environment framework, the development of appropriate assessment strategies and instruments, and the logic underpinning the organization of benefits and services to confront disability. The Italian Ministry of Health and Ministry of Labor and Social Policies supported a three-year project for the definition of a common framework and a standardised protocol for disability evaluation based on ICF. The research agenda of the project identified 6 phases: 1) adoption of a definition of disability; 2) analytical breakdown of the contents of disability definition, so as to indicate as clearly as possible the core information essential to guide the evaluation process; 3) definition of a data collection protocol; 4) national implementation of the protocol and collection of approximately 1,000 profiles; 5) proposal of a profile analysis and definition of groups of cases with similar functioning profiles; 6) trial of the proposal with the collected data. The data was analyzed in different ways: descriptive analysis, application of the person-environment interactions classification tree, and cluster analysis. A sample of 1,051 persons from 8 Italian regions was collected that represented different functioning conditions in all the phases of the life cycle. The aggregate result of the person-environment interactions was summarized. The majority of activities resulted with no problems in all of the A&P chapters. Nearly 50.000 facilitators codes were opened. The main frequent facilitators were family members, health and social professionals, assistive devices and both health and social systems, services and politics. The focus of the person-environment interaction evaluation was on the A&P domains, differentiating those in which performance presented limitations and restrictions from those in which performance had no or light limitations and restrictions. Communication(d3) and Learning and Applying Knowledge(d1) appeared as the more problematic A&P areas. Self Care(d5) was the domain in which facilitators were more effective in supporting functioning, suggesting that the Italian welfare system is mainly focused on providing care services for activities of daily living, jointly with the family. The cluster analysis was limited to those categories that were common to all age classes (38 categories out of 55). For a final representation, a solution with 6 clusters was chosen. An example is provided of how it is possible to plan empirical studies in which theoretical advances and operative goals on disability in a person-environment framework can support the definition of a research design, measurement strategies, and data analysis. The description of functioning and disability at population level is no more based on individual deficits or limitations. Personal profiles may be elaborated and groups created based on the characteristics of the person-environment interactions. Personal profiles may also be used as a "rationale" for defining personalized intervention programs.

Exploring stigma by association among front-line care providers serving sex workers.

PubMed

Phillips, Rachel; Benoit, Cecilia

2013-10-01

Stigma by association, also referred to as "courtesy stigma," involves public disapproval evoked as a consequence of associating with stigmatized persons. While a small number of sociological studies have shown how stigma by association limits the social support and social opportunities available to family members, there is a paucity of research examining this phenomenon among the large network of persons who provide health and social services to stigmatized groups. This paper presents results from a primarily qualitative study of the work-place experiences of a purposive sample of staff from an organization providing services to sex workers. The findings suggest that stigma by association has an impact on staff health because it shapes both the workplace environment as well as staff perceptions of others' support. At the same time, it is evident that some staff, owing to their more advantaged social location, are better able to manage courtesy stigma than others. Copyright © 2013 Longwoods Publishing.

Predictors of Nursing Facility Entry by Medicaid-Only Older Adults and Persons With Disabilities in California

PubMed Central

Ko, Michelle; Newcomer, Robert J.; Harrington, Charlene; Hulett, Denis; Kang, Taewoon; Bindman, Andrew B.

2018-01-01

Nearly one-third of adult Medicaid beneficiaries who receive long-term services and supports (LTSS) consist of older adults and persons with disabilities who are not eligible for Medicare. Beneficiaries, advocates, and policymakers have all sought to shift LTSS to home and community settings as an alternative to institutional care. We conducted a retrospective cohort study of Medicaid-only adults in California with new use of LTSS in 2006-2007 (N = 31 849) to identify unique predictors of entering nursing facilities versus receiving Medicaid home and community-based services (HCBS). Among new users, 18.3% entered into nursing facilities, whereas 81.7% initiated HCBS. In addition to chronic conditions, functional and cognitive limitations, substance abuse disorders (odds ratio [OR] 1.35; 95% confidence interval [CI]: 1.23, 1.48), and homelessness (OR: 4.35, 9% CI: 3.72, 5.08) were associated with higher odds of nursing facility entry. For older adults and persons with disabilities covered by Medicaid only, integration with housing and behavioral health services may be key to enabling beneficiaries to receive LTSS in noninstitutional settings. PMID:29633899

Commercial products that convey personal health information in emergencies.

PubMed

Potini, Vishnu C; Weerasuriya, Dilani N; Lowery-North, Douglas W; Kellermann, Arthur L

2011-12-01

Describe commercially available products and services designed to convey personal health information in emergencies. The search engine Google®, supplemented by print ads, was used to identify companies and organizations that offer relevant products and services to the general market. Disease-specific, health system, and health plan-specific offerings were excluded. Vendor web sites were the primary sources of information, supplemented by telephone and e-mail queries to sales representatives. Perfect inter-rater agreement was achieved. Thirty-nine unique vendors were identified. Eight sell engraved jewelry. Three offer an embossed card or pamphlet. Twelve supply USB drives with various features. Eleven support password-protected web sites. Five maintain national call centers. Available media differed markedly with respect to capacity and accessibility. Quoted prices ranged from a one-time expenditure of $3.50 to an annual fee of $200. Associated features and annual fees varied widely. A wide range of products and services exist to help patients convey personal health information. Health care providers should be familiar with their features, so they can access the information in a disaster or emergency.

Peer support groups, mobile phones and refugee women in Melbourne.

PubMed

Liamputtong, Pranee; Koh, Lee; Wollersheim, Dennis; Walker, Rae

2016-09-01

In this article, we discuss qualitative findings basing on the experiences of refugee women living in Melbourne, Australia, who participated in a peer support training programme and received a free mobile phone. We pay attention to social support as a health enhancing strategy and empowerment that occurred among the participants. Participation in peer support groups and access to a mobile phone were beneficial for the women. Peer support functioned as social support among group members. The programme allowed the women to be connected to their families and the wider communities and assisted them to access health care and other settlement aspects with greater ease. It also increased personal empowerment among the women. Our programme shows that by tapping on community resources to ameliorate personal or resettlement issues, the burden on service providers can be reduced. Our findings also offer a model for future research and programmes regarding refugee people elsewhere. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Technology and the environment: supportive resource or barrier for people with developmental disabilities?

PubMed

Hammel, Joy

2003-06-01

Findings from needs assessments and abandonment studies point to issues with health care providers, particularly in their ability to listen to the needs of the consumer and important others regarding AT-EI. Professionals need to listen to what people are telling them or, in many cases, what they are not telling them. Actions and nonverbal messages can speak very loudly. Strategies to communicate and collaborate with consumers need to be developed. Regardless of ability to communicate or the severity of the impairments the person may be experiencing, it is important to withhold judgments that may underestimate a person's potential or desire to be in control of life decisions. AT-EI service have often seen people labeled with severe or profound intellectual disabilities challenge that diagnosis after accessing a communication or access system. Likewise, a person with a severe disability has the right to supportive resources and to the same level of respect, dignity, and quality of life as any other member of society. Using the technology and adapting the environment to provide opportunities for consumers to "voice" their wishes and control their lives can be an effective strategy to collaborate. When focusing on a rights-based philosophy, recognizing the difference between physical independence (e.g., physical and/or cognitive ability to do a task by oneself) and self-care management (e.g., access to and power to manage the supportive resources to live in the community regardless of level of physical ability) is important. We all rely on supports in our lives, whether it be tools or technology to help us do a job or another person, yet when we evaluate people with disabilities, the expectation is for people to function independently [23,24]. They even receive lower scores on functional assessments if they are using a piece of technology to do an activity. By shifting the focus to management of and access to resources versus level of physical dependence or burden, health care professionals can play a role in linking people to such resources as AT-EI and related services and strategies to support community living. Such a shift in focus also enables professionals to validate interdependence; that is, the give-take relationships that people have with each other to support each other [25]. The use of AT-EI by people with developmental disabilities often involves an interdependent relationship in which another person may help set up the environment or technology and, in turn, the consumer can then reciprocate and engage in an activity or a relationship [1]. Health care professionals also need to better understand and take into consideration the social context, its influence on consumers' use or nonuse of AT-EI, and the long-term influence on community living and participation decisions [1]. Nurses can involve important others in the process by listening to and considering their needs, and ensuring that they are informed about options, the benefits of using AT-EI for the consumer and themselves, and how to set up and troubleshoot the AT-EI. In cases where important others are not supportive, health care professionals may be in a position to link the consumer with other consumers and advocacy groups such as Centers for Independent Living or Self Advocates Becoming Empowered that may offer that support as well as membership in a collective community engaged in systems change. Health care professionals can serve as a system interface by linking people to information and resources to make informed decisions [26]. Resources on developmental disability and health, common issues that may occur, and life course planning help people identify functional issues and early signs of accelerated aging and proactively use the environment and technology to stay in living situations of choice. Few health care professionals are well prepared to provide services to people with developmental disabilities as they age; a great need exists for providers of such specialized services and for proactive later-life screenings that can identify issues early and make the most use of AT-EI strategies to address aging issues [26,28]. At any given point in time in the life of people with developmental disabilities, many different professionals and systems may be involved in decisions that could include AT-EI. Medical, educational, vocational, independent living, and case management systems may all be working with the person; however, there is often limited or no communication between them, particularly as the person ages or transitions between settings. Health care professionals, even when they are working with an individual on a limited basis, can and should take on active roles in linking consumers and important others with other systems and should ensure that information about their AT-EI needs is transferred accurately between systems. Most likely, nurses may be in a role to refer a person to specialized services, whether they may be medical, rehabilitative, AT-EI-specific, or disability advocacy groups that can help support the person as they face barriers or seek out AT. Nurses may also be in a role to pass on important information about the person's health and medical status that can help to better inform AT-EI decisions to ensure the AT meets the person's needs across contexts. As an interface, nurses may assume a role as a supporting advocate for accessing resources, not as a gatekeeper who makes decisions for people. This includes referring individuals with developmental disabilities to people and groups that know how to get AT-EI, how to fund it, and how to troubleshoot it, and linking them to other people with disabilities who are sharing strategies in person and on-line. It also includes focusing beyond basic self-care and considers AT-EI strategies that enable a person to participate in high meaning activities and roles in the home and the community. Participation in activities identified as highly meaningful and important to the person, such as participating in a religious community, networking with other people on-line, gardening, or being a member of a community group, to name a few, can positively contribute to health, wellness, and quality of life; the challenge is to create and adapt the environment (social, physical, and societal) to support participation choices and control.

Information technology in the foxhole.

PubMed

Eyestone, S M

1995-08-01

The importance of digital data capture at the point of health care service within the military environment is highlighted. Current paper-based data capture does not allow for efficient data reuse throughout the medical support information domain. A simple, high-level process and data flow model is used to demonstrate the importance of data capture at point of service. The Department of Defense is developing a personal digital assistant, called MEDTAG, that accomplishes point of service data capture in the field using a prototype smart card as a data store in austere environments.

Service users' experiences of participation in decision making in mental health services.

PubMed

Dahlqvist Jönsson, P; Schön, U-K; Rosenberg, D; Sandlund, M; Svedberg, P

2015-11-01

Despite the potential positive impact of shared decision making on service users knowledge and experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. This study highlights the desire of users to participate more actively in decision making and demonstrates that persons with SMI struggle to be seen as competent and equal partners in decision-making situations. Those interviewed did not feel that their strengths, abilities and needs were being recognized, which resulted in a feeling of being omitted from involvement in decision-making situations. The service users describe some essential conditions that could work to promote participation in decision making. These included having personal support, having access to knowledge, being involved in a dialogue and clarity about responsibilities. Mental health nurses can play an essential role for developing and implementing shared decision making as a tool to promote recovery-oriented mental health services. Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core category that emerged in the analysis described a 'struggle to be perceived as a competent and equal person' while three related categories including being the underdog, being controlled and being omitted described the difficulties of participating in decisions. The data analysis resulted in a model that describes internal and external conditions that influence the promotion of participation in decision making. The findings offer new insights from a user perspective and these can be utilized to develop and investigate concrete methods in order to promote user's participation in decisions. © 2015 John Wiley & Sons Ltd.

Effectiveness of a Unique Support Group for Physicians in a Physician Health Program.

PubMed

Sanchez, Luis T; Candilis, Philip J; Arnstein, Fredrick; Eaton, Judith; Barnes Blood, Diana; Chinman, Gary A; Bresnahan, Linda R

2016-01-01

State Physician Health Programs (PHPs) assess, support, and monitor physicians with mental, behavioral, medical, and substance abuse problems. Since their formation in the 1970s, PHPs have offered support groups following the 12-step model for recovery from substance use disorders (SUDs). However, few programs have developed support groups for physicians without SUDs. This study at the Massachusetts PHP (Physician Health Services Inc.) represents the first effort to survey physician attitudes concerning a unique support group that goes beyond classic addiction models. The group was initiated because of the observation that physicians with problems other than SUDs did not fit easily into the 12-step framework. It was hypothesized that such a group would be effective in helping participants control workplace stress, improve professional and personal relationships, and manage medical and psychiatric difficulties. With a response rate of 43% (85 respondents), the survey identified a strong overall impact of the Physician Health Services Inc. support group, identifying positive effects in all areas of personal and professional life: family and friends, wellness, professional relationships, and career. Respondents identified the role of the facilitator as particularly important, underscoring the facilitator's capacity to welcome participants, manage interactions, set limits, and maintain a supportive emotional tone. The implications for physician health extend from supporting a broader application of this model to using a skilled facilitator to manage groups intended to reduce the stress and burnout of present-day medical practice. The results encourage PHPs, hospitals, medical practices, and physician groups to consider implementing facilitated support groups as an additional tool for maintaining physician health.

A two-state comparative implementation of peer-support intervention to link veterans to health-related services after incarceration: a study protocol.

PubMed

Simmons, Molly M; Fincke, Benjamin G; Drainoni, Mari-Lynn; Kim, Bo; Byrne, Tom; Smelson, David; Casey, Kevin; Ellison, Marsha L; Visher, Christy; Blue-Howells, Jessica; McInnes, D Keith

2017-09-12

Approximately 600,000 persons are released from prison annually in the United States. Relatively few receive sufficient re-entry services and are at risk for unemployment, homelessness, poverty, substance abuse relapse and recidivism. Persons leaving prison who have a mental illness and/or a substance use disorder are particularly challenged. This project aims to create a peer mentor program to extend the reach and effectiveness of reentry services provided by the Department of Veterans' Affairs (VA). We will implement a peer support for reentry veterans sequentially in two states. Our outcome measures are 1) fidelity of the intervention, 2) linkage to VA health care and, 3) continued engagement in health care. The aims for this project are as follows: (1) Conduct contextual analysis to identify VA and community reentry resources, and describe how reentry veterans use them. (2) Implement peer-support, in one state, to link reentry veterans to Veterans' Health Administration (VHA) primary care, mental health, and SUD services. (3) Port the peer-support intervention to another, geographically, and contextually different state. This intervention involves a 2-state sequential implementation study (Massachusetts, followed by Pennsylvania) using a Facilitation Implementation strategy. We will conduct formative and summative analyses, including assessment of fidelity, and a matched comparison group to evaluate the intervention's outcomes of veteran linkage and engagement in VHA health care (using health care utilization measures). The study proceeds in 3 phases. We anticipate that a peer support program will be effective at improving the reentry process for veterans, particularly in linking them to health, mental health, and SUD services and helping them to stay engaged in those services. It will fill a gap by providing veterans with access to a trusted individual, who understands their experience as a veteran and who has experienced justice involvement. The outputs from this project, including training materials, peer guidebooks, and implementation strategies can be adapted by other states and regions that wish to enhance services for veterans (or other populations) leaving incarceration. A larger cluster-randomized implementation-effectiveness study is planned. This protocol is registered with clinicaltrials.gov on November 4, 2016 and was assigned the number NCT02964897 .

[A review of pension status quo in China and domestic and overseas pension models].

PubMed

Si, J H; Li, L M

2016-10-10

With the aging of population and progressive decline of traditional pension model, the problems in the aged supporting have caused serious social concern in China. Since 1980' s, different opinions about pension models have been suggested in many research papers. This paper summarizes the characteristics of different pension model used in both China and abroad in terms of the financial sources of the aged supporting, life style and the combination with medical service, suggesting to establish a pension model with Chinese characteristics to provide multiple and personalized services on the basis of China' s national situation and successful experiences of other countries.

Determining the Water Bootprint of the Army’s Supply Chain

DTIC Science & Technology

2011-05-01

water, flue gas desulfurization ) • Water consumption estimates will be compared with other modeling techniques Utility Energy Methods Army End Users...Sector Gas /Petroleum Refining Retail Less Gas /Retail Trade Food & Beverages/ Food & Drinking Places Concession/Personal Care Services CY10 Retail...this study • Data collected to support initial reporting of Greenhouse Gas (GHG) Inventory (pursuant to EO 13514) can be leveraged to support this

Does improvement of cognitive functioning by cognitive remediation therapy effect work outcomes in severe mental illness? A secondary analysis of a randomized controlled trial.

PubMed

Ikebuchi, Emi; Sato, Sayaka; Yamaguchi, Sosei; Shimodaira, Michiyo; Taneda, Ayano; Hatsuse, Norifumi; Watanabe, Yukako; Sakata, Masuhiro; Satake, Naoko; Nishio, Masaaki; Ito, Jun-Ichiro

2017-05-01

The aim of this study was to clarify whether improvement of cognitive functioning by cognitive remediation therapy can improve work outcome in schizophrenia and other severe mental illnesses when combined with supported employment. The subjects of this study were persons with severe mental illness diagnosed with schizophrenia, major depression, or bipolar disorder (ICD-10) and cognitive dysfunction who participated in both cognitive remediation using the Thinking Skills for Work program and a supported employment program in a multisite, randomized controlled study. Logistic and multiple linear regression analyses were performed to clarify the influence of cognitive functioning on vocational outcomes, adjusting for demographic and clinical variables. Improvement of cognitive functioning with cognitive remediation significantly contributed to the total days employed and total earnings of competitive employment in supported employment service during the study period. Any baseline demographic and clinical variables did not significantly contribute to the work-related outcomes. A cognitive remediation program transferring learning skills into the real world is useful to increase the quality of working life in supported employment services for persons with severe mental illness and cognitive dysfunction who want to work competitively. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

The complex terrain of peer support in mental health: What does it all mean?

PubMed

Murphy, Rebecca; Higgins, Agnes

2018-05-24

Emerging from cumulative socio-political movements forged by persons with self-experience of mental health difficulties, since the 1970s the practice of peer support has rapidly developed within mental health care. Now revered as a critical component to recovery oriented mental health service, peer support features prominently in international mental health policy and practice (Penney, 2018; Watts & Higgins, 2017; Cyr et al., 2016; Stamou, 2014; Bassett et al., 2010). As a consequence of this extensive growth, the field of peer support is flooded with various models including, but not limited to, individual and collective models that can be face-to-face or online, and positioned within mainstream mental health services, and/or peer-run organisations. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The role and impact of personal faith and religion among genetic service providers.

PubMed

Geller, Gail; Micco, Ellyn; Silver, Rachel J; Kolodner, Ken; Bernhardt, Barbara A

2009-02-15

This paper describes the impact of genetic service providers' personal faith and religious values on their experiences interacting with colleagues and patients. We surveyed 480 clinical geneticists (MDs), genetic counselors (GCs), and genetic nurses randomly selected from their professional associations, and then interviewed a sample of survey respondents. Outcomes included religiosity, coping with distress through spiritual beliefs, and personal value conflicts (PVCs). Two hundred fourteen providers completed the survey out of an estimated 348 eligible (61% response rate). Importance attributed to regular attendance at religious services ranged from 39% (not at all important) to 27% (very important). Reliance on religion and spiritual beliefs as a source of comfort ranged from 48% (never) to 33% (sometimes or often). Religiosity varied by discipline with 58% of nurses thinking regular attendance at religious services was moderately or very important as compared to 47% of GCs and 30% of MDs (P = 0.006). Ten percent of respondents had difficulty reconciling their own faith with being a genetics professional, 14% felt the need to hide their own faith from their colleagues or patients, 7% thought their professional stance was not consistent with their personal values, and 4% felt ostracized by the genetics community because of their personal beliefs. The experience of such PVCs was positively correlated with religiosity (r = 0.35; P < 0.0001). GCs were more likely to experience PVCs than MDs or nurses (P = 0.013). Data from the interviews (N = 54) support these findings. A significant minority of genetic service providers are religiously observant and rely on their religious values to cope with distress. These individuals often experience difficulty reconciling their religious beliefs with the expectations of their profession, and sharing their beliefs with their colleagues and patients. Efforts should be made to prevent or reduce the secrecy surrounding personal faith and religion among genetics professionals. (c) 2009 Wiley-Liss, Inc.

Demographic characteristics, call details and psychosocial support needs of the family/friends of someone diagnosed with cancer who access Australian Cancer Council telephone information and support services.

PubMed

Heckel, Leila; Fennell, Kate M; Mohebbi, Mohammadreza; Byrnes, Monica; Livingston, Patricia M

2017-06-01

Community-based cancer organizations provide telephone-based information and support services to assist people diagnosed with cancer and their family/friends. We investigated the demographic characteristics and psychosocial support needs of family/friends who contacted Australian Cancer Council 13 11 20 information and support helplines. Data collected on 42,892 family/friends who contacted a 13 11 20 service across Australia from January 2010 to December 2012 were analyzed. Chi-square analysis was used to examine associations between caller groups and reasons for calling, logistic regression to examine age and gender interaction effects. The majority of calls received were from women (81%) of middle- (40%) and high-socio-economic backgrounds (41%), aged 40-59 years (46%); 52% phoned for information on cancer diagnosis (including early detection, risk factors), 22% on treatment/disease management, and 26% phoned seeking psychological/emotional support. Information on a diagnosis was significantly more often the reason older males called, compared to female callers of any age. Overall, 32% found out about the service through Cancer Council resources or events, 20% from the media, 18% from the internet; 11% from health professionals. Family/friends of persons diagnosed with cancer have specific information and support needs. This study identifies groups of family/friends to whom the promotion of this service could be targeted. Within Australia and internationally, clinicians and oncology nurses as well as allied health professionals can provide an important role in increasing access to cancer telephone support services to ensure the needs of the family and friends of people affected by cancer are being met. Copyright © 2017 Elsevier Ltd. All rights reserved.

FORECAST - A cloud-based personalized intelligent virtual coaching platform for the well-being of cancer patients.

PubMed

Kyriazakos, Sofoklis; Valentini, Vincenzo; Cesario, Alfredo; Zachariae, Robert

2018-01-01

Well-being of cancer patients and survivors is a challenge worldwide, considering the often chronic nature of the disease. Today, a large number of initiatives, products and services are available that aim to provide strategies to face the challenge of well-being in cancer patients; nevertheless the proposed solutions are often non-sustainable, costly, unavailable to those in need, and less well-received by patients. These challenges were considered in designing FORECAST, a cloud-based personalized intelligent virtual coaching platform for improving the well-being of cancer patients. Personalized coaching for cancer patients focuses on physical, mental, and emotional concerns, which FORECAST is able to identify. Cancer patients can benefit from coaching that addresses their emotional problems, helps them focus on their goals, and supports them in coping with their disease-related stressors. Personalized coaching in FORECAST offers support, encouragement, motivation, confidence, and hope and is a valuable tool for the wellbeing of a patient.

Contribution of personal and environmental factors on positive psychological functioning in adolescents.

PubMed

Fadda, Daniela; Scalas, L Francesca; Meleddu, Mauro

2015-08-01

This study examined self-esteem as mediator in the relations of personal (extraversion, neuroticism) and environmental (maternal, paternal, peer-relationships) variables with domains of positive psychological functioning (PPF) in adolescence (Satisfaction with life, Mastery, Vigor, Social Interest, Social Cheerfulness). We compared one-sided and multidimensional models using a sample of 1193 high school students (592 males and 601 females). We examined variations in adolescent PPF as a function of parenting styles via independent examination of maternal and paternal bonding. Results supported the multidimensional models, which indicated direct effects of personality traits, maternal care and peer relationships, as well as indirect effects, mediated by self-esteem, of all predictors on most PPF dimensions. Overall, our study provided a broader picture of personal and environmental predictors on different dimensions of PPF, which supported the mediating role of self-esteem and emphasized the importance of considering multidimensional models to characterize PPF in adolescents. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Home e-health system integration in the Smart Home through a common media server.

PubMed

Pau, I; Seoane, F; Lindecrantz, K; Valero, M A; Carracedo, J

2009-01-01

Home e-health systems and services are revealed as one of the most important challenges to promote Quality of Life related to Health in the Information Society. Leading companies have worked on e-health systems although the majority of them are addressed to hospital or primary care settings. The solution detailed in this paper offers a personal health system to be integrated with Smart Home services platform to support home based e-care. Thus, the home e-health system and architecture detailed in this research work is ready to supply a seamless personal care solution both from the biomedical data analysis, service provision, security guarantee and information management s point of view. The solution is ready to be integrated within the Accessible Digital Home, a living lab managed by Universidad Politécnica de Madrid for R&D activities.

Treating Patients as Persons: A Capabilities Approach to Support Delivery of Person-Centered Care

PubMed Central

Entwistle, Vikki A.; Watt, Ian S.

2013-01-01

Health services internationally struggle to ensure health care is “person-centered” (or similar). In part, this is because there are many interpretations of “person-centered care” (and near synonyms), some of which seem unrealistic for some patients or situations and obscure the intrinsic value of patients’ experiences of health care delivery. The general concern behind calls for person-centered care is an ethical one: Patients should be “treated as persons.” We made novel use of insights from the capabilities approach to characterize person-centered care as care that recognizes and cultivates the capabilities associated with the concept of persons. This characterization unifies key features from previous characterisations and can render person-centered care applicable to diverse patients and situations. By tying person-centered care to intrinsically valuable capability outcomes, it incorporates a requirement for responsiveness to individuals and explains why person-centered care is required independently of any contribution it may make to health gain. PMID:23862598

Noah's Ark-Red Cross Foundation: a Swedish model.

PubMed

Florence, M E

1993-01-01

During the Spring of 1991, the author spent many weeks at the Noah's Ark-Red Cross Foundation, a support service for HIV infected persons, and their families and friends, located in Stockholm, Sweden. The purpose was to study, through interviews, observation and participation, the foundation's interactive model in order to discover what makes it work and share that knowledge with other professionals. The Noah's Ark Model consists of three spheres of activity: service, including reception services and the volunteer programme; information and education, including the Hot Line and the Newsletter; and counselling and support, including the guest house. Staff from each area interact freely with and participate in the activities of other areas. The foundation also utilizes the services of carefully trained volunteers. This use of volunteers makes it unique in Sweden. It is the dedication and flexibility of the staff and volunteers that make this model work. The report of the study follows.

[Service robots in elderly care. Possible application areas and current state of developments].

PubMed

Graf, B; Heyer, T; Klein, B; Wallhoff, F

2013-08-01

The term "Service robotics" describes semi- or fully autonomous technical systems able to perform services useful to the well-being of humans. Service robots have the potential to support and disburden both persons in need of care as well as nursing care staff. In addition, they can be used in prevention and rehabilitation in order to reduce or avoid the need for help. Products currently available to support people in domestic environments are mainly cleaning or remote-controlled communication robots. Examples of current research activities are the (further) development of mobile robots as advanced communication assistants or the development of (semi) autonomous manipulation aids and multifunctional household assistants. Transport robots are commonly used in many hospitals. In nursing care facilities, the first evaluations have already been made. So-called emotional robots are now sold as products and can be used for therapeutic, occupational, or entertainment activities.

Longitudinal Study-Based Dementia Prediction for Public Health

PubMed Central

Kim, HeeChel; Chun, Hong-Woo; Kim, Seonho; Coh, Byoung-Youl; Kwon, Oh-Jin; Moon, Yeong-Ho

2017-01-01

The issue of public health in Korea has attracted significant attention given the aging of the country’s population, which has created many types of social problems. The approach proposed in this article aims to address dementia, one of the most significant symptoms of aging and a public health care issue in Korea. The Korean National Health Insurance Service Senior Cohort Database contains personal medical data of every citizen in Korea. There are many different medical history patterns between individuals with dementia and normal controls. The approach used in this study involved examination of personal medical history features from personal disease history, sociodemographic data, and personal health examinations to develop a prediction model. The prediction model used a support-vector machine learning technique to perform a 10-fold cross-validation analysis. The experimental results demonstrated promising performance (80.9% F-measure). The proposed approach supported the significant influence of personal medical history features during an optimal observation period. It is anticipated that a biomedical “big data”-based disease prediction model may assist the diagnosis of any disease more correctly. PMID:28867810

[Evaluation of the quality of life in people with Autistic Spectrum Disorder].

PubMed

Cuesta Gómez, José L; Casado Muñoz, Raquel; Lezcano Barbero, Fernando

2010-01-01

The search for quality of life and the trend towards continual improvement has today become a true reference which guides most social organizations. The bodies which offer support to persons with Autistic Spectrum Disorder (referred to hereon as ASD) have not gone untouched by the influence of this concept of quality. The serious difficulties which are associated with this disorder affect the main areas of one ??s personal development: socialisation, communication, comprehension, and adaptation to ones environment, and they require that organizations promote integral networks of resources which guarantee a lifetime of quality services and support. The difficulties of assessing quality of life in persons with ASD from the subjective perspective, make it especially necessary to find valid indicators that help us to favour certain conditions in the ASD person ??s environment. This identified need is justification for the objective put forward: to design an instrument capable of being used to assess the quality of life of persons with ASD, made up of a Guide of Indicators, which organizations and programmes can then use to promote favourable conditions.

'It is not the State's fault that we have a person like this': relations, institutions and the meaning of 'rights' to carers of People with Psychosocial Disabilities in Chile.

PubMed

Montenegro, C R; Cornish, F

2015-01-01

The UN Convention on the Rights of Persons with Disabilities (CRPD) has been adopted by national governments to advance the interests and wellbeing of people with psychosocial disabilities (PPSD). It is often assumed that the adoption of a 'rights' framework will advance the dignity and autonomy of PPSD. However, little is known about how families and communities understand 'rights'. The present paper, based on research conducted in Santiago, Chile, takes a contextual approach to rights, asking: How do family carers of PPSD understand and use the idea of 'rights'? How does the context of caregiving shape families' understanding of rights? Four focus groups were conducted with a total of 25 family carers (predominantly mothers) of people diagnosed with schizophrenia and other severe neuropsychiatric conditions. Thematic analysis was conducted. Carers' experience of caregiving was marked by isolation, stigmatization, a lack of support and mistreatment by public services. Their family networks did not provide sustained help and support, and the public services they had used were characterized by scarce resources and inadequate support. Carers did not refer to rights of dignity or autonomy. Given an unsupportive context, and worries about who would care for their child after the carer's death, their primary interest in 'rights' was a right to guaranteed, long-term care. While carers endorsed the idea of universal, state-supported rights, appeals to compassion and the exchange of favours were spoken of as the most effective strategies for gaining a minimum level of services and support. Carers' understandings, framed against a background of unmet needs and shaped by a history of unsatisfactory interactions with services and institutions, do not resonate with the principles of the CRPD. We suggest an expanded, relational struggle for rights that acknowledges the role of families and the tensions surrounding the distribution of rights within the family.

Knowledge management in dementia care networks: a qualitative analysis of successful information and support strategies for people with dementia living at home and their family caregivers.

PubMed

Heinrich, S; Laporte Uribe, F; Roes, M; Hoffmann, W; Thyrian, J R; Wolf-Ostermann, K; Holle, B

2016-02-01

Stakeholders involved in community dementia support services often work on their own and without coordination with other services. These circumstances can result in a lack of information and support for people with dementia and their family caregivers at home. To increase the coordination between existing support services, so-called 'Dementia Care Networks' (DCNs) have been established. Most of the tasks that are performed in DCNs are based on communication strategies. Therefore, knowledge management (KM) is a key process in these networks. However, few studies have focused on this topic. This study attempted to evaluate KM strategies in DCNs across Germany as part of the DemNet-D study. A qualitative interview study design was used. Qualitative data were collected during single and group interviews with key persons associated with thirteen DCNs. Interviews were audiotaped and transcribed, and a structured content analysis was conducted. The framework for the analysis was derived from a KM model. Information dissemination strategies for people with dementia and their informal caregivers based on actively established contacts appear to be more successful than passive strategies. General practitioners often play a key role as external gatekeepers in initiating contact between a network and a person affected by dementia. In this context, case managers can help integrate external stakeholders, such as general practitioners or pharmacists, into DCNs using different KM strategies. The systematic development of common objectives under an agency-neutral leadership seems to be an important aspect of successful KM within DCNs. The findings reported here can help DCNs optimize their KM strategies for generating tailored information and support services for people with dementia living at home and their family caregivers. In particular, the identified potential knowledge distribution barriers and facilitators will be of practical use to DCN stakeholders. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Planning estimates for the provision of core mental health services in Queensland 2007 to 2017.

PubMed

Harris, Meredith G; Buckingham, William J; Pirkis, Jane; Groves, Aaron; Whiteford, Harvey

2012-10-01

To derive planning estimates for the provision of public mental health services in Queensland 2007-2017. We used a five-step approach that involved: (i) estimating the prevalence and severity of mental disorders in Queensland, and the number of people at each level of severity treated by health services; (ii) benchmarking the level and mix of specialised mental health services in Queensland against national data; (iii) examining 5-year trends in Queensland public sector mental health service utilisation; (iv) reviewing Australian and international planning benchmarks; and (v) setting resource targets based on the results of the preceding four steps. Best available evidence was used where possible, supplemented by value judgements as required. Recommended resource targets for inpatient service were: 20 acute beds per 100,000 population, consistent with national average service provision but 13% above Queensland provision in 2005; and 10 non-acute beds per 100,000, 65% below Queensland levels in 2005. Growth in service provision was recommended for all other components. Adult residential rehabilitation service targets were 10 clinical 24-hour staffed beds per 100,000, and 18 non-clinical beds per 100,000. Supported accommodation targets were 35 beds per 100,000 in supervised hostels and 35 places per 100,000 in supported public housing. A direct care clinical workforce of 70 FTE per 100,000 for ambulatory care services was recommended. Fifteen per cent of total mental health funding was recommended for community support services provided by non-government organisations. The recommended targets pointed to specific areas for priority in Queensland, notably the need for additional acute inpatient services for older persons and expansion of clinical ambulatory care, residential rehabilitation and supported accommodation services. The development of nationally agreed planning targets for public mental health services and the mental health community support sector were identified as priorities.

Social support needs identified by mothers affected by intimate partner violence.

PubMed

Letourneau, Nicole; Morris, Catherine Young; Stewart, Miriam; Hughes, Jean; Critchley, Kim A; Secco, Loretta

2013-09-01

In order to offer optimal supports and services for mothers affected by intimate partner violence (IPV), an understanding of these mothers' perceptions of support needs, resources, barriers to support, and preferences for support intervention is warranted. Moreover, the growing recognition of the effects of IPV on maternal-infant relationships and of the importance of these early relationships to long-term child health outcomes suggests interventions are needed to support optimal maternal-infant relationships in these families. Thus, 64 mothers exposed to IPV when their infants were below 12 months of age participated in a retrospective qualitative study to identify mothers' support needs, resources, barriers to support, and preferences for specific support interventions to promote optimal mother-infant relationships. Participants identified both personal needs (including needs for leaving or staying with the violent partner), along with intertwined needs to care for, and help, their infants cope with the experience of violence. Mothers reported that integrated services that include information and practical support from professionals with emotional and affirmation support from peers would promote positive, nurturing mother-infant relationships and healthy child development.

24 CFR 7.16 - Responsibilities of employees.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Department's EEO/ADR programs; (b) Adopting an attitude of full acceptance and respect for minorities... support for and participation in ADR; (c) Providing equality of treatment and service to all persons with... supervisors and managers in carrying out their responsibilities in the EEO/ADR programs; and (e) Cooperating...

44 CFR 206.181 - Use of gifts and bequests for disaster assistance purposes.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., services to the elderly, to children, or to handicapped persons, such as transportation, recreational... victim's behalf by providing documentation describing the needs of the disaster victim, a verification of... Administrator shall submit his/her recommendation and supporting documentation to the Assistant Administrator...

31 CFR 598.314 - Specially designated narcotics trafficker.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Central Intelligence, the Director of the Federal Bureau of Investigation, the Administrator of the Drug... goods or services in support of, the international narcotics trafficking activities of a specially... trafficking. Note 1 to § 598.314: The names of persons determined to fall within this definition, whose...

48 CFR 237.104 - Personal services contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... procedures do not apply to contracts awarded to business entities other than individuals. Selections made... intelligence component or counter-intelligence organization of DoD; or (iii) Directly support the mission of... travel between home or place of business and official duty station. (iii) Coordinate with the civilian...

24 CFR Appendix to Part 135 - Unknown Title

Code of Federal Regulations, 2010 CFR

2010-04-01

... contract opportunities in a timely manner so that section 3 business concerns can take advantage of... low income persons by linking them to the support services available through the Small Business... each of the competitive procurement methods authorized in 24 CFR 85.36(d). (1) Small Purchase...

76 FR 81958 - Notice of Submission of Proposed Information Collection to OMB; Limited English Proficiency...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-29

... Proposed Information Collection to OMB; Limited English Proficiency Initiative (LEPI) Program AGENCY... that support the assistance of persons with limited English proficiency in utilizing the services...: Limited English Proficiency Initiative (LEPI) Program. OMB Approval Number: 2529-0051. Form Numbers...

A call for collaboration on respectful, person-centered health care in family planning and maternal health.

PubMed

Holt, Kelsey; Caglia, Jacquelyn M; Peca, Emily; Sherry, James M; Langer, Ana

2017-02-02

Striking tales of people judged, disrespected, or abused in reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services are commonly exchanged among friends and families throughout the world while remaining sorely under-addressed in global health. Disrespect and abuse of individuals and providers in health services across the RMNCAH continuum must be stopped through collaborative, multi-tiered efforts. A new focus on health care quality in the Sustainable Development Goals offers an opportunity to seriously reexamine user experiences and their impact on health care utilization. The new framework provides an opening to redress the insidious problem of negative interactions with care across the RMNCAH services continuum and redraft the blueprint for service delivery and performance measurement, placing individuals and their needs at the center. Both the maternal health and family planning fields are at a turning point in their histories of defining and addressing individuals' experiences of care. In this commentary, we review these histories and the current state-of-the-art in both fields. Though the approaches and language in each sub-field vary, person-centered care principles related to the essential role of individuals' preferences, needs and values, and the importance of informed decision-making, respect, privacy and confidentiality, and non-discrimination, are integral to all. Promoting respectful, person-centered care also requires recognizing the factors that lead to poor treatment of clients, including gender norms and unsupportive working conditions for providers. Lessons can be learned from innovative efforts across the continuum to support health care providers to provide respectful, person-centered care. Efforts in the maternal health and family planning fields to define respectful, person-centered care provide a useful foundation from which to connect across the continuum of RMNCAH services. Now is the time to creatively work together to develop new approaches for promoting respectful treatment of individuals in all RMNCAH services.

The evaluation of NIMROD, a community-based service for people with mental handicap: revenue costs.

PubMed

Davies, L; Felce, D; Lowe, K; de Paiva, S

1991-11-01

The cost implications of moving from a system of services for people with mental handicaps centred on large institutions to a network of community-based services are not precisely known. The provision of the NIMROD service in a part of Cardiff, with its aim not only to meet the residential needs of adults comprehensively by providing a number of houses in the community but also to develop a support service to people living in their family home, gave an opportunity to investigate and report the revenue costs of a number of service elements with respect to a defined total population. The residential costs of intensively staffed houses in 1986-87, varying in size from two to six places, were found to range between pounds 16,473 and pounds 23,319 per person per year. With the addition of community support costs, such as the provision of day services, the total costs of care per resident averaged pounds 21,708; range, pounds 18,883-pounds 26,009. These compared to the total costs in a minimally staffed house of pounds 9,678 per resident. The costs of community support services for people living in their family homes averaged pounds 5,614 inclusive of DSS benefits, of which pounds 1,743 was accounted for by the NIMROD domiciliary support service, office base and administrative overheads. The residential costs reported were compared to other cost data in the literature. The study supports previous conclusions that there is little evidence of diseconomy attached to small scale per se but that the way staffing levels and therefore staff costs are determined is critical. No evidence was found in this study to link greater cost to better quality.

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

PubMed

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

2007-12-01

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

The Role of Adult Day Services in Supporting the Occupational Participation of People with Dementia and Their Carers: An Integrative Review.

PubMed

Du Preez, Janice; Millsteed, Jeannine; Marquis, Ruth; Richmond, Janet

2018-05-08

The increasing numbers of people with dementia places considerable stress on health and aged care services and has resulted in the development of community adult day services. Aim : The aim of this integrative review is to determine the extent to which these services support the occupational participation of people with dementia, and how they impact their primary carers. Method : The mixed-methods appraisal tool (MMAT) was used to identify relevant studies in the period 2011⁻2016. Results : Nine databases were searched and yielded 16 articles with a variety of research designs for inclusion in the review. Conclusions : Findings indicate that adult day services use a range of approaches to support attendees and their carers. In spite of these efforts, there appears to be a lack of interest in utilizing these services while a person is in the early stages of dementia. This suggests that policies in aged care, such as aging-in-place, need to consider the pressure and stress they exert on carer’s quality of life. Another consideration is to better promote the benefits of participating in adult day services in the early stages of dementia for both the attendees and their carers, thereby delaying the tendency towards early institutionalization.

HIV-positive mothers in Viet Nam: using their status to build support groups and access essential services.

PubMed

Oosterhoff, Pauline; Anh, Nguyen Thu; Yen, Pham Ngoc; Wright, Pamela; Hardon, Anita

2008-11-01

Various support and self-help groups for people living with HIV and their families have developed in Viet Nam in recent years. This paper reports on a case study of Sunflowers, the first support group for HIV positive mothers in Hanoi, begun in 2004, and a sister group begun in 2005 in Thai Nguyen province. From April 2004 to early 2007, we carried out semi-structured interviews with 275 health care workers and 153 HIV-positive women and members of their families, as well as participant observation of group meetings and activities. Sunflowers have successfully organised themselves to access vital social, medical and economic support and services for themselves, their children and partners. They gained self-confidence, and learned to communicate with their peers and voice their needs to service providers. Based on personal development plans, they have accessed other state services, such as loans, job counselling and legal advice. They have also gained access to school and treatment for their children, who had previously been excluded. Although the women were vulnerable to HIV as wives and mothers, motherhood also provided them with social status and an identity they used to help build organisations and develop strategies to access the essential services that they and their families need.

Rapid, Value-based, Evolutionary Acquisition and Its Application to a USMC Tactical Service Oriented Architecture

DTIC Science & Technology

2009-06-01

Availability C2PC Command and Control Personal Computer CAS Close Air Support CCA Clinger-Cohen Act CDR Critical Design Review CJCSI Chairman of the Joint... kids , Jackie and Anna and my future boy whose name is TBD, I think my time at NPS has made me a better person and hopefully a better father. Thank... can the USMC apply the essential principles of rapid, value-based, evolutionary acquisition to the development and procurement of a TSOA? 4 THIS