Does child and adolescent mental health in-service training result in equivalent knowledge gain among cadres of non-specialist health workers in Uganda? A pre-test post-test study.

PubMed

Akol, Angela; Nalugya, Joyce; Nshemereirwe, Sylvia; Babirye, Juliet N; Engebretsen, Ingunn Marie Stadskleiv

2017-01-01

Early identification and management of child and adolescent mental health (CAMH) disorders helps to avert mental illness in adulthood but a CAMH treatment gap exists in Uganda. CAMH integration into primary health care (PHC) through in-service training of non-specialist health workers (NSHW) using the World Health Organisation (WHO) Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) is a strategy to address this gap. However, results of such training are not supported by information on training development or delivery; and are undifferentiated by NSHW cadre. We aim to describe an in-service CAMH training for NSHW in Uganda and assess cadre-differentiated learning outcomes. Thirty-six clinical officers, nurses and midwives from 18 randomly selected PHC clinics in eastern Uganda were trained for 5 days on CAMH screening and referral using a curriculum based on the mhGAP-IG version 1.0 and PowerPoint slides from the International Association of Child and Adolescent Psychiatry and Allied Professions (IACAPAP). The residential training was evaluated through pre- and post- training tests of CAMH knowledge and attitudes using the participants' post-test scores; and the difference between pre-test and post-test scores. Two-tailed t-tests assessed differences in mean pre-test and post-test scores between the cadres; hierarchical linear regression tested the association between cadre and post test scores; and logistic regression evaluated the relationship between cadre and knowledge gain at three pre-determined cut off points. Thirty-three participants completed both pre-and post-tests. Improved mean scores from pre- to post-test were observed for both clinical officers (20% change) and nurse/midwives (18% change). Clinical officers had significantly higher mean test scores than nurses and midwives (p < 0.05) but cadre was not significantly associated with improvement in CAMH knowledge at the 10% (AOR 0.08; 95 CI [0.01, 1.19]; p = 0.066), 15% (AOR 0.16; 95% CI [0.01, 2.21]; p = 0.170), or 25% (AOR 0.13; 95% CI [0.01, 1.74]; p = 0.122) levels. We aimed to examine CAMH learning outcomes by NSHW cadre. NSHW cadre does not influence knowledge gain from in-service CAMH training. Thus, an option for integrating CAMH into PHC in Uganda using the mhGAP-IG and IACAPAP PowerPoint slides is to proceed without cadre differentiation.

Hypervelocity Impact of Unstressed and Stressed Titanium in a Whipple Configuration in Support of the Orion Crew Exploration Vehicle Service Module Propellant Tanks

NASA Technical Reports Server (NTRS)

Nahra, Henry K.; Christiansen, Eric; Piekutowski, Andrew; Lyons, Frankel; Keddy, Christopher; Salem, Jonathan; Miller, Joshua; Bohl, William; Poormon, Kevin; Greene, Nathanel;

Hypervelocity Impact of Unstressed and Stressed Titanium in a Whipple Configuration in Support of the Orion Crew Exploration Vehicle Service Module Propellant Tanks

NASA Technical Reports Server (NTRS)

Nahra, Henry K.; Christiansen, Eric; Piekutowski, Andrew; Lyons, Frankel; Keddy, Christopher; Salem, Jonathan; Poormon, Kevin; Bohl, William; Miller, Joshua; Greene, Nathanael;

77 FR 64366 - Market Test of Experimental Product-Metro Post

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-19

... POSTAL SERVICE Market Test of Experimental Product--Metro Post AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of a market test of an experimental product in... Service[supreg] hereby gives notice that, pursuant to 39 U.S.C. 3641(c)(1), it will begin a market test of...

Test and training simulator for ground-based teleoperated in-orbit servicing

NASA Technical Reports Server (NTRS)

Schaefer, Bernd E.

1989-01-01

For the Post-IOC(In-Orbit Construction)-Phase of COLUMBUS it is intended to use robotic devices for the routine operations of ground-based teleoperated In-Orbit Servicing. A hardware simulator for verification of the relevant in-orbit operations technologies, the Servicing Test Facility, is necessary which mainly will support the Flight Control Center for the Manned Space-Laboratories for operational specific tasks like system simulation, training of teleoperators, parallel operation simultaneously to actual in-orbit activities and for the verification of the ground operations segment for telerobotics. The present status of definition for the facility functional and operational concept is described.

Relationships between antenatal and postnatal care and post-partum modern contraceptive use: evidence from population surveys in Kenya and Zambia.

PubMed

Do, Mai; Hotchkiss, David

2013-01-04

It is often assumed, with little supportive, empirical evidence, that women who use maternal health care are more likely than those who do not to use modern contraceptives. This study aims to add to the existing literature on associations between the use of antenatal (ANC) and post-natal care (PNC) and post-partum modern contraceptives. Data come from the most recent Demographic and Health Surveys (DHS) in Kenya (2008-09) and Zambia (2007). Study samples include women who had a live birth within five years before the survey (3,667 in Kenya and 3,587 in Zambia). Multivariate proportional hazard models were used to examine the associations between the intensity of ANC and PNC service use and a woman's adoption of modern contraceptives after a recent live birth. Tests of exogeneity confirmed that the intensity of ANC and PNC service use and post-partum modern contraceptive practice were not influenced by common unobserved factors. Cox proportional hazard models showed significant associations between the service intensity of ANC and PNC and post-partum modern contraceptive use in both countries. This relationship is largely due to ANC services; no significant associations were observed between PNC service intensity and post-partum FP practice. While the lack of associations between PNC and post-partum FP use may be due to the limited measure of PNC service intensity, the study highlights a window of opportunity to promote the use of modern contraceptives after childbirth through ANC service delivery. Depending on the availability of data, further research should take into account community- and facility-level factors that may influence modern contraceptive use in examining associations between ANC and PNC use and post-partum FP practice.

Improving Interpersonal Communication through Community Service

ERIC Educational Resources Information Center

Hoffman, August John; Wallach, Julie; Sanchez, Eduardo; Afkhami, Hasti

2009-01-01

The current study sought to determine if community based gardening projects would reduce perceptions of the need to use communication devices--cell phones or text messaging--and increase the likelihood of participating in future volunteer projects. Results strongly support the predictions in that the experimental group post-test mean score of the…

The impact of assistive technology services in post-secondary education for students with disabilities: Intervention outcomes, use-profiles, and user-experiences.

PubMed

Malcolm, Matthew P; Roll, Marla C

2017-01-01

The outcomes of assistive technology (AT) support services for post-secondary education students with disabilities are under-reported, and little is known about use-profiles and user experiences when AT interventions are applied to this rapidly growing population. We examined AT service outcomes related to performance and satisfaction of common academic tasks (using the Canadian Occupational Performance Measure [COPM]), as well as how students with disabilities use and experience AT and AT services (employing an AT-use survey). Three-hundred fifty-three students with disabilities completed the AT-use survey, with a subset of these (n = 216) also participating with pre-post AT intervention COPM assessment. COPM performance and satisfaction ratings significantly increased from pre- to post-AT intervention in all academic task categories (reading, writing, note-taking, test-taking, and studying; p < 0.001). The AT-use survey most notably revealed these students preferred face-to-face training, used their AT at least 3 days per week, used AT in a variety of environments, felt AT positively impacted their academic success, and believed they would continue using AT post-graduation. The study findings contribute to evidence-base for AT services with a hope we may improve AT services to best meet the changing needs of the growing number of college students with disabilities.

Online health consultation: examining uses of an interactive cancer communication tool by low-income women with breast cancer.

PubMed

Lu, Hsueh-Yi; Shaw, Bret R; Gustafson, David H

2011-07-01

To examine how psychosocial variables predicted use of an online health consultation service among low-income breast cancer patients and in turn how using this service affected these same psychosocial outcomes. This retrospective study included 231 recently diagnosed, low-income (at or below 250% of the federal poverty level) breast cancer patients provided a free computer with 16 weeks of access to the Internet-based 'Ask an Expert' service offered as part of the Comprehensive Health Enhancement Support System (CHESS) "Living with Breast Cancer" program. The use activity included a total of 502 messages submitted to the online health consultation service. The data included five psychosocial variables: information seeking, social support, health self efficacy, participation in health care, and doctor-patient relationship, were collected at both the pre-test and 16-week post-test after using the service. Correlation tests were conducted to examine the relationship between pre- and post-test, and use activity. A multiple regression model was formed for each of five psychosocial variables to examine how use activity of the consultation service was associated with various psychosocial measurements. In total, 865 distinct consulting queries from 502 messages were identified as measurement of patients' use activities (3.74 consulting queries per participant). Use activity had significant negative relationships with pre-test scores across all five psychosocial variables. The regression models found significant positive main effects (use activity) associated with three of these psychosocial variables: health self efficacy, participation in health care and doctor-patient relationship. Use activity of the online consultation service did not have significant relationships with the dependent variables of information seeking and perceived social support. Low-income breast cancer patients sought out information from an online cancer information expert. Patients with more negative perceptions at pre-test tended to use the service more. Greater use of the service was associated with improvement in patients' perception of health self-efficacy, participation in health care and doctor-patient relationship. Moreover, use of online health consultation appears to level the differences, narrowing the gaps between those who were worse and better off at pre-test. These findings suggest that online health consultation can serve as an effective complement to other resources, which help low-income, breast cancer patients feel more confident to participate more actively in their health care, become more actively involved in making decisions about their treatments and enhance the relationship with their doctors. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

The Effectiveness of Computer Supported versus Real Laboratory Inquiry Learning Environments on the Understanding of Direct Current Electricity among Pre-Service Elementary School Teachers

ERIC Educational Resources Information Center

Baser, Mustafa; Durmus, Soner

2010-01-01

The purpose of this study was to compare the changes in conceptual understanding of Direct Current Electricity (DCE) in virtual (VLE) and real laboratory environment (RLE) among pre-service elementary school teachers. A pre- and post-test experimental design was used with two different groups. One of the groups was randomly assigned to VLE (n =…

Rocket Propulsion 21 Steering Committee Meeting (RP21) NASA In-Space Propulsion Update

NASA Technical Reports Server (NTRS)

Klem, Mark

2015-01-01

In-house Support of NEXT-C Contract Status Thruster NEXT Long Duration Test post-test destructive evaluation in progress Findings will be used to verify service life models identify potential design improvements Cathode heater fabrication initiated for cyclic life testing Thruster operating algorithm definition verification initiated to provide operating procedures for mission users High voltage propellant isolator life test voluntarily terminated after successfully operating 51,200 h Power processor unit (PPU) Replaced all problematic stacked multilayer ceramic dual inline pin capacitors within PPU Test bed Rebuilt installed discharge power supply primary power board Completed full functional performance characterization Final test report in progress Transferred PPU Testbed to contractor to support prototype design effort.

Service-learning's impact on dental students' attitude towards community service.

PubMed

Coe, J M; Best, A M; Warren, J J; McQuistan, M R; Kolker, J L; Isringhausen, K T

2015-08-01

This study evaluated service-learning programme's impact on senior dental students' attitude towards community service at Virginia Commonwealth University (VCU) School of Dentistry. Experience gained through service-learning in dental school may positively impact dental students' attitude towards community service that will eventually lead into providing care to the underserved. Two surveys (pre- and post-test) were administered to 105 senior dental students. For the first survey (post-test), seventy-six students of 105 responded and reported their attitude towards community service immediately after the service-learning programme completion. Three weeks later, 56 students of the 76 responded to the second survey (retrospective pre-test) and reported their recalled attitude prior to the programme retrospectively. A repeated-measure mixed-model analysis indicated that overall there was improvement between pre-test and post-test. Scales of connectedness, normative helping behaviour, benefits, career benefits and intention showed a significant pre-test and post-test difference. An association between attitude towards community service and student characteristics such as age, gender, ethnicity and volunteer activity was also examined. Only ethnicity showed an overall significant difference. White dental students appear to have a differing perception of the costs of community service. The service-learning programme at VCU School of Dentistry has positively impacted senior dental students' attitude towards community service. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Service-learning’s Impact on Dental Students’ Attitude toward Community Service

PubMed Central

Coe, J. M.; Best, A. M.; Warren, J. J.; McQuistan, M. R.; Kolker, J. L.; Isringhausen, K. T.

2014-01-01

Introduction This study evaluated service-learning program’s impact on senior dental students’ attitude toward community service at Virginia Commonwealth University (VCU) School of Dentistry. Experience gained through service-learning in dental school may positively impact dental students’ attitude toward community service that will eventually lead into providing care to the underserved. Materials and methods Two surveys (pre and post-test) were administered to 105 senior dental students. For the first survey (post-test), seventy six students out of 105 responded and reported their attitude toward community service immediately after the service-learning program completion. Three weeks later, fifty six students out of the 76 responded to the second survey (retrospective pre-test) and reported their recalled attitude prior to the program retrospectively. Results A repeated-measure mixed-model analysis indicated that overall there was improvement between pre-test and post-test. Scales of connectedness, normative helping behavior, benefits1, career benefits, and intention showed a significant pre-test and post-test difference. An association between attitude toward community service and student characteristics such as age, gender, ethnicity, and volunteer activity was also examined. Only ethnicity showed an overall significant difference. White dental students appear to have a differing perception of the costs of community service. Conclusions The service-learning program at VCU School of Dentistry has positively impacted senior dental students’ attitude toward community service. PMID:25142286

A web service system supporting three-dimensional post-processing of medical images based on WADO protocol.

PubMed

He, Longjun; Xu, Lang; Ming, Xing; Liu, Qian

2015-02-01

Three-dimensional post-processing operations on the volume data generated by a series of CT or MR images had important significance on image reading and diagnosis. As a part of the DIOCM standard, WADO service defined how to access DICOM objects on the Web, but it didn't involve three-dimensional post-processing operations on the series images. This paper analyzed the technical features of three-dimensional post-processing operations on the volume data, and then designed and implemented a web service system for three-dimensional post-processing operations of medical images based on the WADO protocol. In order to improve the scalability of the proposed system, the business tasks and calculation operations were separated into two modules. As results, it was proved that the proposed system could support three-dimensional post-processing service of medical images for multiple clients at the same moment, which met the demand of accessing three-dimensional post-processing operations on the volume data on the web.

Engagement of men in antenatal care services: Increased HIV testing and treatment uptake in a community participatory action program in Mozambique

PubMed Central

Audet, Carolyn M.; Blevins, Meridith; Chire, Yazalde Manuel; Aliyu, Muktar H; Vaz, Lara M. E.; Antonio, Elisio; Alvim, Fernanda; Bechtel, Ruth; Wester, C. William; Vermund, Sten H.

2016-01-01

Uptake of HIV testing and antiretroviral therapy (ART) services during antenatal care (ANC) in rural Mozambique is disappointing. To nurture supportive male engagement in ANC services, we partnered with Traditional Birth Attendants and trained a new type of male-to-male community health agent, “Male Champions”, who focused on counseling male partners to create new, male-friendly community norms around engagement in spousal/partner pregnancies. We assessed ANC service uptake using a pre-post intervention design. The intervention was associated with increases in: (1) uptake of provider-initiated counseling and testing among pregnant woman (81% vs. 92%; p<0.001); (2) male engagement in ANC (5% vs. 34%; p<0.001); and (3) uptake of ART (8% vs. 19%; p<0.001). When men accepted HIV testing, rates of testing rose markedly among pregnant women. With the challenges in scale-up of Option B+ in sub-Saharan Africa, similar interventions may increase testing and treatment acceptability during pregnancy. PMID:26906021

Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

PubMed

McNabb, Marion; Chukwu, Emeka; Ojo, Oluwayemisi; Shekhar, Navendu; Gill, Christopher J; Salami, Habeeb; Jega, Farouk

2015-01-01

Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs) are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre. Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care. Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001), out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education. These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

Use of Campus Support Services by Ontario College Students

ERIC Educational Resources Information Center

Dietsche, Peter

2012-01-01

Offering an array of support services to meet the diverse needs of post-secondary learners assumes that these services improve success by providing students with compensatory resources and opportunities for engagement (Purnell & Blank, 2004). Little Canadian research, however, has examined students' use of support services. This study…

Models of service delivery for cancer genetic risk assessment and counseling.

PubMed

Trepanier, Angela M; Allain, Dawn C

2014-04-01

Increasing awareness of and the potentially concomitant increasing demand for cancer genetic services is driving the need to explore more efficient models of service delivery. The aims of this study were to determine which service delivery models are most commonly used by genetic counselors, assess how often they are used, compare the efficiency of each model as well as impact on access to services, and investigate the perceived benefits and barriers of each. Full members of the NSGC Familial Cancer Special Interest Group who subscribe to its listserv were invited to participate in a web-based survey. Eligible respondents were asked which of ten defined service delivery models they use and specific questions related to aspects of model use. One-hundred ninety-two of the approximately 450 members of the listserv responded (42.7%); 177 (92.2%) had provided clinical service in the last year and were eligible to complete all sections of the survey. The four direct care models most commonly used were the (traditional) face-to-face pre- and post-test model (92.2%), the face-to-face pretest without face-to-face post-test model (86.5%), the post-test counseling only for complex results model (36.2%), and the post test counseling for all results model (18.3%). Those using the face-to-face pretest only, post-test all, and post-test complex models reported seeing more new patients than when they used the traditional model and these differences were statistically significantly. There were no significant differences in appointment wait times or distances traveled by patients when comparing use of the traditional model to the other three models. Respondents recognize that a benefit of using alternative service delivery models is increased access to services; however, some are concerned that this may affect quality of care.

42 CFR 414.310 - Determination of reasonable charges for physician services furnished to renal dialysis patients.

Code of Federal Regulations, 2010 CFR

2010-10-01

... supportive of the facility as a whole and of benefit to patients in general. Examples of administrative... laboratory test results, nurses' notes and any other medical documentation, as a basis for— (i) Adjustment of...) Pre-dialysis and post-dialysis examinations, or examinations that could have been furnished on a pre...

42 CFR 414.310 - Determination of reasonable charges for physician services furnished to renal dialysis patients.

Code of Federal Regulations, 2012 CFR

2012-10-01

... are supportive of the facility as a whole and of benefit to patients in general. Examples of... laboratory test results, nurses' notes and any other medical documentation, as a basis for— (i) Adjustment of...) Pre-dialysis and post-dialysis examinations, or examinations that could have been furnished on a pre...

School Improvement Plans and Student Achievement: Preliminary Evidence from the Quality and Merit Project in Italy

ERIC Educational Resources Information Center

Caputo, Andrea; Rastelli, Valentina

2014-01-01

This study provides preliminary evidence from an Italian in-service training program addressed to lower secondary school teachers which supports school improvement plans (SIPs). It aims at exploring the association between characteristics/contents of SIPs and student improvement in math achievement. Pre-post standardized tests and text analysis of…

Coaching in self-efficacy improves care responses, health and well-being in dementia carers: a pre/post-test/follow-up study.

PubMed

Chenoweth, Lynn; Stein-Parbury, Jane; White, Danielle; McNeill, Georgene; Jeon, Yun-Hee; Zaratan, Beverley

2016-05-04

Maintaining the health and well-being of family carers of people with dementia is vital, given their potential for experiencing burden associated with the role. The study aimed to help dementia carers develop self-efficacy, be less hassled by the caring role and improve their health and well-being with goal-directed behaviour, by participating in an eight module carer coaching program. The study used mixed methods in a pre/post-test/follow-up design over 24 months, with assignment of consented dementia carers to either individualised (n = 16) or group coaching (n = 32), or usual carer support services (n = 43), depending on preference. Care-giving self-efficacy and hassles, carer health, well-being and goal-directed behaviours were assessed over time. Analysis of Variance (ANOVA) was used to compare changes over time and the effects of coaching on carer self-efficacy, hassles and health, using the Univariate General Linear Model (GLM). All carers were hassled by many aspects of caring at baseline. Participants receiving coaching reported non-significant improvements in most areas of self-efficacy for caring, hassles associated with caring and self-reported health at post-test and follow-up, than did carers receiving usual carer support. Group coaching had greater success in helping carers to achieve their goals and to seek help from informal and formal support networks and services. The study outcomes were generally positive, but need to be interpreted cautiously, given some methodological limitations. It has been shown, however, that health staff can assist dementia carers to develop self-efficacy in better managing their family member's limitations and behaviour, seek help from others and attend to their health. Teaching carers to use goal-directed behaviour may help them achieve these outcomes.

Easing reintegration: telephone support groups for spouses of returning Iraq and Afghanistan service members.

PubMed

Nichols, Linda Olivia; Martindale-Adams, Jennifer; Graney, Marshall J; Zuber, Jeffrey; Burns, Robert

2013-01-01

Spouses of returning Iraq (Operation Iraqi Freedom, OIF) and Afghanistan (Operation Enduring Freedom, OEF) military service members report increased depression and anxiety post deployment as they work to reintegrate the family and service member. Reconnecting the family, renegotiating roles that have shifted, reestablishing communication patterns, and dealing with mental health concerns are all tasks that spouses must undertake as part of reintegration. We tested telephone support groups focusing on helping spouses with these basic reintegration tasks. Year-long telephone support groups focused on education, skills building (communication skills, problem solving training, cognitive behavioral techniques, stress management), and support. Spouse depression and anxiety were decreased and perceived social support was increased during the course of the study. In subgroup analyses, spouses with husbands whose injuries caused care difficulties had a positive response to the intervention. However, they were more likely to be depressed, be anxious, and have less social support compared to participants who had husbands who had no injury or whose injury did not cause care difficulty. Study findings suggest that this well-established, high-access intervention can help improve quality of life for military spouses who are struggling with reintegration of the service member and family.

Supporting the education goals of post-9/11 veterans with self-reported PTSD symptoms: a needs assessment.

PubMed

Ellison, Marsha Langer; Mueller, Lisa; Smelson, David; Corrigan, Patrick W; Torres Stone, Rosalie A; Bokhour, Barbara G; Najavits, Lisa M; Vessella, Jennifer M; Drebing, Charles

2012-01-01

The influx of young adult veterans with mental health challenges from recent wars combined with newly expanded veteran education benefits has highlighted the need for a supported education service within the Veterans Administration. However, it is unknown how such a service should be designed to best respond to these needs. This study undertook a qualitative needs assessment for education supports among veterans with post-9/11 service with self-reported PTSD symptoms. Focus groups were held with 31 veterans, 54% of whom were under age 30. Transcripts were analyzed and interpreted using a thematic approach and a Participatory Action Research team. Findings indicate a need for age relevant services that assist with: education planning and access, counseling for the G.I. Bill, accommodations for PTSD symptoms, community and family re-integration, and outreach and support. The veterans recommended that supported education be integrated with the delivery of mental health services, that services have varied intensity, and there be linkages between colleges and the Veterans Health Administration.

DETAIL, NORTHEAST POST SUPPORTING SHED PORCH ROOF ON NORTH FACADE; ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

DETAIL, NORTHEAST POST SUPPORTING SHED PORCH ROOF ON NORTH FACADE; VIEW TO EAST - Fort Bragg, Noncommissioned Officers' Service Club, Guest House Building, South of Butner Road, Fayetteville, Cumberland County, NC

Providing Post-Treatment Support in an Outpatient Alcohol and Other Drug Treatment Context: A Qualitative Study of Staff Opinion

ERIC Educational Resources Information Center

Pulford, Justin; Black, Stella; Wheeler, Amanda; Sheridan, Janie; Adams, Peter

2010-01-01

This paper examines the post-treatment support practices, attitudes and preferences of outpatient alcohol and other drug (AOD) treatment staff as well as perceived barriers to implementing a post-treatment support service in an outpatient AOD treatment context. Data were collected via semi-structured interview and group discussion (n = 23).…

Assessing Learners' Satisfication towards Support Services Delivery in National Open University Nigeria: Implications for Counselling Services

ERIC Educational Resources Information Center

Okopi, Fidel; Ofole, Ndidi

2013-01-01

This study aims at determining the level of students' satisfaction of learner support services in the study centres of NOUN--National Open University of Nigeria and whether the support services offered at the study centres have significant influence on the level of students' satisfaction. A descriptive survey of ex-post facto research design was…

Service life of fence posts treated by double-diffusion methods

Treesearch

Donald C. Markstrom; Lee R. Gjovik

1999-01-01

Service-life tests indicate that Engelmann spruce, lodgepole pine, and Rocky Mountain Douglas-fir fence posts treated by double-diffusion methods performed excellently after field exposure of 30 years with no failures. The test site was located in the semiarid Central Plains near Nunn, Colorado. Although Engelmann spruce posts generally defy treatment by other treating...

Social support and negative and positive outcomes of experienced traumatic events in a group of male emergency service workers.

PubMed

Ogińska-Bulik, Nina

2015-01-01

The paper investigates the relationship between perceived social support in the workplace and both negative (post-traumatic stress disorder (PTSD) symptoms) and positive outcomes (post-traumatic growth) of experienced traumatic events in a group of male emergency service workers. Data of 116 workers representing emergency services (37.1% firefighters, 37.1%, police officers and 30% medical rescue workers) who have experienced a traumatic event 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 Event Scale--Revised and the Post-traumatic Growth Inventory were used to assess the negative and positive outcomes of the experienced event. A perceived social support scale was measured by the scale What support you can count on. The data obtained from the study revealed the negative dependence of social support from supervisors with PTSD symptoms and positive--social support from co-workers with post-traumatic growth. Moreover the results of the study indicate the positive relationship between negative and positive outcomes of experienced traumatic events in the workplace. Perceived social support plays a more important role in gaining benefits from trauma than preventing negative outcomes of the experienced traumatic event. Support from co-workers, compared to support from supervisors, has greater importance.

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.

Utilizing Remote Real-Time Videoconferencing to Expand Access to Cancer Genetic Services in Community Practices: A Multicenter Feasibility Study.

PubMed

Bradbury, Angela; Patrick-Miller, Linda; Harris, Diana; Stevens, Evelyn; Egleston, Brian; Smith, Kyle; Mueller, Rebecca; Brandt, Amanda; Stopfer, Jill; Rauch, Shea; Forman, Andrea; Kim, Rebecca; Fetzer, Dominique; Fleisher, Linda; Daly, Mary; Domchek, Susan

2016-02-01

Videoconferencing has been used to expand medical services to low-access populations and could increase access to genetic services at community sites where in-person visits with genetic providers are not available. To evaluate the feasibility of, patient feedback of, and cognitive and affective responses to remote two-way videoconferencing (RVC) telegenetic services at multiple sociodemographically diverse community practices without access to genetic providers. Patients at 3 community sites in 2 US states outside the host center completed RVC pretest (visit 1, V1) and post-test (visit 2, V2) genetic counseling for cancer susceptibility. Surveys evaluated patient experiences, knowledge, satisfaction with telegenetic and cancer genetics services, anxiety, depression, and cancer worry. A total of 82 out of 100 (82.0%) approached patients consented to RVC services. A total of 61 out of 82 patients (74%) completed pretest counseling and 41 out of 61 (67%) proceeded with testing and post-test counseling. A total of 4 out of 41 (10%) mutation carriers were identified: BRCA2, MSH2, and PMS2. Patients reported many advantages (eg, lower travel burden and convenience) and few disadvantages to RVC telegenetic services. Most patients reported feeling comfortable with the video camera--post-V1: 52/57 (91%); post-V2: 39/41 (95%)--and that their privacy was respected--post-V1: 56/57 (98%); post-V2: 40/41 (98%); however, some reported concerns that RVC might increase the risk of a confidentiality breach of their health information--post-V1: 14/57 (25%); post-V2: 12/41 (29%). While the majority of patients reported having no trouble seeing or hearing the genetic counselor--post-V1: 47/57 (82%); post-V2: 39/41 (95%)--51 out of 98 (52%) patients reported technical difficulties. Nonetheless, all patients reported being satisfied with genetic services. Compared to baseline, knowledge increased significantly after pretest counseling (+1.11 mean score, P=.005); satisfaction with telegenetic (+1.74 mean score, P=.02) and genetic services (+2.22 mean score, P=.001) increased after post-test counseling. General anxiety and depression decreased after pretest (-0.97 mean anxiety score, P=.003; -0.37 mean depression score, P=.046) and post-test counseling (-1.13 mean anxiety score, P=.003; -0.75 mean depression score, P=.01); state anxiety and cancer-specific worry did not significantly increase. Remote videoconferencing telegenetic services are feasible, identify genetic carriers in community practices, and are associated with high patient satisfaction and favorable cognitive and affective outcomes, suggesting an innovative delivery model for further study to improve access to genetic providers and services. Potential barriers to dissemination include technology costs, unclear billing and reimbursement, and state requirements for provider licensure.

Preservatives extend service life of ohia and robusta posts

Treesearch

Roger G. Skolmen

1968-01-01

Posts of ohia and robusta, pressure- treated with two preservatives--chromated copper arsenate and pentachlorophenol, are being tested for durability at the Makiki Exposure Site, Honolulu, Hawaii. All treated posts are still sound after 5 years. Untreated ohia posts averaged 4 years of service life before failing; untreated robusta posts averaged 4 ½ years....

Influences of Risk History and Adoption Preparation on Post-Adoption Services Use in U.S. Adoptions

ERIC Educational Resources Information Center

Wind, Leslie H.; Brooks, Devon; Barth, Richard P.

2007-01-01

In spite of the need for pre- and post-adoption support, studies indicate low levels of services utilization among adoptive families, particularly those involving children with special needs. This study examines the relationship between utilization of adoptions services and adoptive child and family characteristics, pre-adoptive risk history, and…

49 CFR 40.355 - What limitations apply to the activities of service agents?

Code of Federal Regulations, 2013 CFR

2013-10-01

... section, you must not make decisions to test an employee based upon reasonable suspicion, post-accident... this section, you may make decisions to test an employee based upon reasonable suspicion, post-accident... behalf of a service agent. (b) You must not act as an intermediary in the transmission of drug test...

49 CFR 40.355 - What limitations apply to the activities of service agents?

Code of Federal Regulations, 2011 CFR

2011-10-01

... section, you must not make decisions to test an employee based upon reasonable suspicion, post-accident... this section, you may make decisions to test an employee based upon reasonable suspicion, post-accident... behalf of a service agent. (b) You must not act as an intermediary in the transmission of drug test...

49 CFR 40.355 - What limitations apply to the activities of service agents?

Code of Federal Regulations, 2012 CFR

2012-10-01

... section, you must not make decisions to test an employee based upon reasonable suspicion, post-accident... this section, you may make decisions to test an employee based upon reasonable suspicion, post-accident... behalf of a service agent. (b) You must not act as an intermediary in the transmission of drug test...

49 CFR 40.355 - What limitations apply to the activities of service agents?

Code of Federal Regulations, 2010 CFR

2010-10-01

... section, you must not make decisions to test an employee based upon reasonable suspicion, post-accident... this section, you may make decisions to test an employee based upon reasonable suspicion, post-accident... behalf of a service agent. (b) You must not act as an intermediary in the transmission of drug test...

49 CFR 40.355 - What limitations apply to the activities of service agents?

Code of Federal Regulations, 2014 CFR

2014-10-01

... section, you must not make decisions to test an employee based upon reasonable suspicion, post-accident... this section, you may make decisions to test an employee based upon reasonable suspicion, post-accident... behalf of a service agent. (b) You must not act as an intermediary in the transmission of drug test...

Student Support Services for Post-Secondary Students with Visual Disabilities

ERIC Educational Resources Information Center

Moh, Chiou

2012-01-01

Increasingly, students with visual disabilities are pursuing higher education. The students need to face the challenges and difficulties of disorganized services and technology to be independent learners. Institutions should provide the support services to meet the requirements of the students. Such students in the United States expressed their…

Performance-based financing contributes to the resilience of health services affected by the Liberian Ebola outbreak

PubMed Central

Mapleh, L.; Ade, S.; Harries, A. D.; Bhat, P.; Kateh, F.; Dahn, B.

2017-01-01

Setting: The Liberian counties of Bong, with performance-based financing (PBF) for all 36 public primary-care facilities, and Margibi, with no PBF for its 24 public primary-care facilities. Objective: To compare whether specific maternal and child health indicators changed in the two counties during the pre-Ebola (2013), Ebola (2014) and post-Ebola (2015) disease outbreak periods from July to September each year. Design: This was a cross-sectional study. Results: For pregnant women, the numbers of antenatal visits, intermittent preventive malaria treatments, human immunodeficiency virus (HIV) tests and facility-based births with skilled attendants all fell during the Ebola period, with decreases being significantly more marked in Margibi County. Apart from HIV testing, which remained low in both counties, these indicators increased in the post-Ebola period, with increases significantly more marked in Bong than in Margibi. The number of childhood immunisations decreased significantly in Bong in the Ebola period compared with the pre-Ebola period, but increased to above pre-Ebola levels in the post-Ebola period. There were markedly larger decreases in childhood immunisations in Margibi County during the Ebola period, which remained significantly lower in the post-Ebola period compared with Bong County. Conclusion: In a PBF-supported county, selected maternal and childhood health indicators showed less deterioration during Ebola and better recovery post-Ebola than in a non-PBF-supported county. PMID:28744447

Performance-based financing contributes to the resilience of health services affected by the Liberian Ebola outbreak.

PubMed

Mussah, V G; Mapleh, L; Ade, S; Harries, A D; Bhat, P; Kateh, F; Dahn, B

2017-06-21

Setting: The Liberian counties of Bong, with performance-based financing (PBF) for all 36 public primary-care facilities, and Margibi, with no PBF for its 24 public primary-care facilities. Objective: To compare whether specific maternal and child health indicators changed in the two counties during the pre-Ebola (2013), Ebola (2014) and post-Ebola (2015) disease outbreak periods from July to September each year. Design: This was a cross-sectional study. Results: For pregnant women, the numbers of antenatal visits, intermittent preventive malaria treatments, human immunodeficiency virus (HIV) tests and facility-based births with skilled attendants all fell during the Ebola period, with decreases being significantly more marked in Margibi County. Apart from HIV testing, which remained low in both counties, these indicators increased in the post-Ebola period, with increases significantly more marked in Bong than in Margibi. The number of childhood immunisations decreased significantly in Bong in the Ebola period compared with the pre-Ebola period, but increased to above pre-Ebola levels in the post-Ebola period. There were markedly larger decreases in childhood immunisations in Margibi County during the Ebola period, which remained significantly lower in the post-Ebola period compared with Bong County. Conclusion: In a PBF-supported county, selected maternal and childhood health indicators showed less deterioration during Ebola and better recovery post-Ebola than in a non-PBF-supported county.

Peer-based education and the integration of HIV and Sexual and Reproductive Health services for young people in Vietnam: evidence from a project evaluation.

PubMed

Ngo, Anh D; Ha, Toan H; Rule, John; Dang, Chinh V

2013-01-01

This paper reports changes in behavioral outcomes related to the use of HIV testing service of a project that employed peer-based education strategies and integration of HIV voluntary counseling and testing (VCT) and Sexual and Reproductive Health (SRH) services targeting young people aged 15-24 across 5 provinces in Vietnam. A pre-test/post-test, non-experimental evaluation design was used. Data were collected from cross-sectional surveys of youth and client exit interviews at project supported SRH clinics conducted at baseline and again at 24 months following implementation. The baseline samples consisted of 813 youth and 399 exit clients. The end line samples included 501 youths and 399 exit clients. Z test was used to assess changes in behavioral outcomes. Results show that there was a significant increase (p<0.05) in the percentage of youth who wanted to obtain a HIV test (from 33% to 51%), who had ever had a test (from 7.5% to 15%), and who had a repeat test in the last 12 months (from 54.5% to 67.5%). Exit client interviews found a nearly five-fold increase in the percentage of clients seeking HIV VCT in their current visit (5.0% vs. 24.5%) and almost two-fold increase in the percentage of those having their last test at a project supported clinic (9.3% vs. 17.8%). There were also positive changes in some aspects of youth HIV/AIDS knowledge, attitudes, and risk perceptions. This study provides preliminary evidence regarding the benefits of the integration of HIV VCT-SRH services in terms of increased access to HIV services and testing in Vietnam. Benefits of peer-based education regarding increased HIV knowledge were also identified. Further investigations, including experimental studies with assessment of health outcomes and the uptake of HIV testing services, are required to better elucidate the effectiveness and challenges of this intervention model in Vietnam.

Understanding the dementia diagnosis gap in Norfolk and Suffolk: a survey of general practitioners.

PubMed

Fox, Margaret; Fox, Chris; Cruickshank, Willie; Penhale, Bridget; Poland, Fiona; Steel, Nicholas

2014-01-01

The National Health Service (NHS) has announced its new target to increase the 'shockingly low dementia diagnosis rate' in England from the current level of 45% to 66% by end of March 2015. Clinical commissioning groups (CCGs) in England have committed to meeting this target. The Norfolk and Suffolk dementia diagnosis rate (DDR) is below the rate for England in some areas; across the CCGs included in this study, the average DDR was 39.9% with a standard deviation of 5.3. This study aimed to explore and understand the low DDR in Norfolk and Suffolk and to learn what might be needed to support general practitioners (GPs) to meet the targets set by the UK Department of Health. An online survey was developed including questions from the National GP Audit 2009. The link to the online survey was sent via email to all GPs in four participating CCGs in Norfolk and Suffolk. SPSS was used for descriptive analysis. Chi-square tests were conducted to identify significant differences in response rates between groups of GPs. The survey was completed by 28% (N = 113) of 400 GPs in 108 practices across three CCGs receiving the survey link. There was a significant difference in response rates from GPs in each CCG, but there were no significant differences in terms of their answers to the questions in the survey. GP respondents expressed confidence in their ability to identify cases of dementia for onward referral to memory services. Participating GPs also acknowledged the benefits to patients and their carers of a timely dementia diagnosis at an early stage of the disease. However, they reported concerns about the quality and availability of post-diagnostic support services for people with dementia and their carers. In this survey, GPs' attitudes were more positive about diagnosing dementia than those responding to the National Audit 2009. Despite GPs' attitudes being more positive than in 2009 about diagnosing dementia, the Norfolk and Suffolk DDR remains low. This may reflect lack of GP confidence in the quality and availability of post-diagnostic support services. This study has identified a need to map the existing post-diagnostic support services for people with dementia and to identify gaps in services. This could lead to the development of a resource which might enable GPs to provide relevant advice to newly diagnosed patients and their carers, facilitate signposting to support services, and give GPs confidence to increase the DDR in their area.

Post-Observation Conferences with Bilingual Pre-Service Teachers: Revoicing and Rehearsing

ERIC Educational Resources Information Center

Wall, Dorothy J.; Hurie, Andrew H.

2017-01-01

Pre-service teachers need support in developing their teacher identities as they navigate the uncertain and complex terrain of student teaching and face the pressures of high-stakes accountability. This support is particularly important for bilingual pre-service teachers as they negotiate the many complexities of the bilingual classroom, and as…

School-Based Service-Learning for Promoting Citizenship in Young People: A Systematic Review

DTIC Science & Technology

2005-09-06

nonequivalent pre- and post-test design with control group was utilized but participants were not randomized to groups . The sample...other methodology. She notes the limitations of the research chosen for the review (i.e., most studies lack a control group , do not track effects over...experimental and control groups Pre- and post- test design Surveys “Service-learning”12 Intervention groups : Service-learning

77 FR 51649 - Federal Motor Vehicle Safety Standards; Motorcycle Brake Systems

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-24

... S7 include pre- and post-burnishment effectiveness tests, a fade and recovery test, a partial failure... visually inspected without removing the pads. Pre- and post-burnish tests. The service brake system and... to 8 mph less than the maximum motorcycle speed. The post-burnish tests are conducted in the same way...

The effect of need supportive text messages on motivation and physical activity behaviour.

PubMed

Kinnafick, Florence-Emilie; Thøgersen-Ntoumani, Cecilie; Duda, Joan

2016-08-01

Few short messaging service (SMS) studies to support behaviour change have used a theoretical underpinning. Using a self-determination theory perspective, we explored the effects of need supportive (NS) SMS on physical activity in 65 (BMI = 24.06 kg/m(2), SD = 5.49; M = 25.76 years, SD = 10.23) insufficiently active individuals embarking on an existing exercise programme. For 10 weeks participants were randomised to an intervention group (NS) or control group (neutral). SMS were sent twice weekly, randomly, via an online SMS service. Mixed design ANCOVA and MANCOVA analyses of measures taken at baseline, mid and post intervention revealed increased levels of perceived autonomy support and psychological need satisfaction in the intervention group post intervention. Both groups reported increases in intrinsic motivation from pre to post intervention. Moderate intensity physical activity was greater in the intervention than the control group at 4-month post intervention with control group returning to baseline levels. Findings provide preliminary causal evidence to support the use of NS SMS to optimise physical activity behaviour change in individuals who are insufficiently active.

Assessment of a Post-deployment Yellow Ribbon Reintegration Program for National Guard Members and Supporters

PubMed Central

Scherrer, Jeffrey F.; Widner, Greg; Shroff, Manan; Matthieu, Monica; Balan, Sundari; van den Berk-Clark, Carissa; Price, Rumi Kato

2014-01-01

The Yellow Ribbon Reintegration Program (YRRP) was created to meet the needs of National Guard members and their families throughout the deployment cycle. This study examined the perceived utility of the YRRP’s delivery of information and assistance during the post-deployment reintegration period by National Guard members and accompanying supporters who were mostly spouses. Over 22 months, from 10 YRRP events, 683 service members and 411 supporters completed questionnaires immediately after the YRRP. We analyzed questions on information and help provision, timeliness and concerns related to education, employment, legal, family, and health. Service members and supporters most often endorsed education needs being met (76.8% and 78.2% respectively) and were least likely to endorse legal needs being met (63.5% and 60% respectively). Significantly more supporters than service members (p < 0.0001) reported that the YRRP was the first time they learned of available services across all domains. Service members were significantly more likely than supporters to report concerns about education, employment, and health; while supporters were significantly more likely to report concerns about family. Results suggest the YRRP fills gaps in supporter knowledge and provides needed information and resources to most National Guard families 2-4 months after a deployment. PMID:25373071

A pre-test and post-test study of the physical and psychological effects of out-of-home respite care on caregivers of children with life-threatening conditions.

PubMed

Remedios, Cheryl; Willenberg, Lisa; Zordan, Rachel; Murphy, Andrea; Hessel, Gail; Philip, Jennifer

2015-03-01

Respite services are recommended as an important support for caregivers of children with life-threatening conditions. However, the benefits of respite have not been convincingly demonstrated through quantitative research. To determine the impact of out-of home respite care on levels of fatigue, psychological adjustment, quality of life and relationship satisfaction among caregivers of children with life-threatening conditions. A mixed-methods, pre-test and post-test study A consecutive sample of 58 parental caregivers whose children were admitted to a children's hospice for out-of-home respite over an average of 4 days. Caregivers had below-standard levels of quality of life compared to normative populations. Paired t-tests demonstrated that caregivers' average psychological adjustment scores significantly improved from pre-respite (mean = 13.9, standard error = 0.71) to post-respite (mean = 10.7, standard error = 1); p < 0.001, 95% confidence interval: 1.25-5.11). Furthermore, caregivers' average fatigue scores significantly improved from pre-respite (mean = 14.3, standard error = 0.85) to post-respite (mean = 10.9, standard error = 1.01; p < 0.001, 95% confidence interval: 1.69-7.94), and caregivers' average mental health quality of life scores significantly improved from pre-respite (mean = 44.2, standard error = 1.8) to post-respite (mean = 49.1, standard error = 1.6; p < 0.01, 95% confidence interval: -9.56 to 0.36). Qualitative data showed caregivers sought respite for relief from intensive care provision and believed this was essential to their well-being. Findings indicate the effectiveness of out-of-home respite care in improving the fatigue and psychological adjustment of caregivers of children with life-threatening conditions. Study outcomes inform service provision and future research efforts in paediatric palliative care. © The Author(s) 2015.

Using Video Games to Support Pre-Service Elementary Teachers Learning of Basic Physics Principles

NASA Astrophysics Data System (ADS)

Anderson, Janice; Barnett, Michael

2011-08-01

The purpose of this work is to share our findings in using video gaming technology to facilitate the understanding of basic electromagnetism with pre-service elementary teachers. To this end we explored the impact of using a game called Supercharged! on pre-service teachers' understanding of electromagnetic concepts compared to students who conducted a more traditional inquiry oriented investigation of the same concepts. This study was a part of a larger design experiment examining the pedagogical potential of Supercharged! the control group learned through a series of guided inquiry methods while the experimental group played Supercharged! during the laboratory sections of the science course. There was significant difference F(2,134) = 4.8, p < 0.05, η2 = 0.59 between the control and experimental groups on the gains from pre-to-post assessment with an effect size of d = 0.72. However, while students in the experimental group performed better than their control group peers, they rated their knowledge of the topic lower than the control group ( M post-control = 3.0, M post-experiment = 2.7), leading to further examination of their laboratory journals. Results of this study show that video games can lead to positive learning outcomes, as demonstrated by the increase in test scores from pre- to post-assessment. Additionally, this study also suggests that a complementary approach, in which video games and hands-on activities are integrated, with each activity informing the other, could be a very powerful technique for supporting student scientific understanding. Further, our findings suggest that video game designers should embed meta-cognitive activities such as reflective opportunities into educational video games to provide scaffolds for students and to reinforce that they are engaged in an educational learning experience.

Research Strategies To Improve the Outcome of Secondary Special Education Programs for Mildly Handicapped Students: System Support Strategies.

ERIC Educational Resources Information Center

Edgar, Eugene; Vadasy, Patricia F.

This paper proposes system supports to improve the post-school status of mildly disabled special education students and recommends that such supports be a focus of research supported by the federal Office of Special Education and Rehabilitation Services. Each service is discussed in terms of its rationale, possible content, process measures,…

Validation of an instrument to measure inter-organisational linkages in general practice.

PubMed

Amoroso, Cheryl; Proudfoot, Judith; Bubner, Tanya; Jayasinghe, Upali W; Holton, Christine; Winstanley, Julie; Beilby, Justin; Harris, Mark F

2007-12-03

Linkages between general medical practices and external services are important for high quality chronic disease care. The purpose of this research is to describe the development, evaluation and use of a brief tool that measures the comprehensiveness and quality of a general practice's linkages with external providers for the management of patients with chronic disease. In this study, clinical linkages are defined as the communication, support, and referral arrangements between services for the care and assistance of patients with chronic disease. An interview to measure surgery-level (rather than individual clinician-level) clinical linkages was developed, piloted, reviewed, and evaluated with 97 Australian general practices. Two validated survey instruments were posted to patients, and a survey of locally available services was developed and posted to participating Divisions of General Practice (support organisations). Hypotheses regarding internal validity, association with local services, and patient satisfaction were tested using factor analysis, logistic regression and multilevel regression models. The resulting General Practice Clinical Linkages Interview (GP-CLI) is a nine-item tool with three underlying factors: referral and advice linkages, shared care and care planning linkages, and community access and awareness linkages. Local availability of chronic disease services has no affect on the comprehensiveness of services with which practices link, however, comprehensiveness of clinical linkages has an association with patient assessment of access, receptionist services, and of continuity of care in their general practice. The GP-CLI may be useful to researchers examining comparable health care systems for measuring the comprehensiveness and quality of linkages at a general practice-level with related services, possessing both internal and external validity. The tool can be used with large samples exploring the impact, outcomes, and facilitators of high quality clinical linkages in general practice.

A Case Study of Education Support and Services for Foster Children

ERIC Educational Resources Information Center

Chambers-Nash, Carmen Jeneice

2013-01-01

The research problem was a case study to understand the problem of a significant number of high school graduates leaving foster care without receiving the services necessary to survive as adults. The purpose of the study was to explore services and supports for youths that are necessary for post-graduation success. The research questions in this…

Retention of basic life support knowledge, self-efficacy and chest compression performance in Thai undergraduate nursing students.

PubMed

Partiprajak, Suphamas; Thongpo, Pichaya

2016-01-01

This study explored the retention of basic life support knowledge, self-efficacy, and chest compression performance among Thai nursing students at a university in Thailand. A one-group, pre-test and post-test design time series was used. Participants were 30 nursing students undertaking basic life support training as a care provider. Repeated measure analysis of variance was used to test the retention of knowledge and self-efficacy between pre-test, immediate post-test, and re-test after 3 months. A Wilcoxon signed-rank test was used to compare the difference in chest compression performance two times. Basic life support knowledge was measured using the Basic Life Support Standard Test for Cognitive Knowledge. Self-efficacy was measured using the Basic Life Support Self-Efficacy Questionnaire. Chest compression performance was evaluated using a data printout from Resusci Anne and Laerdal skillmeter within two cycles. The training had an immediate significant effect on the knowledge, self-efficacy, and skill of chest compression; however, the knowledge and self-efficacy significantly declined after post-training for 3 months. Chest compression performance after training for 3 months was positively retaining compared to the first post-test but was not significant. Therefore, a retraining program to maintain knowledge and self-efficacy for a longer period of time should be established after post-training for 3 months. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Comparative Study of the Effects of Using Dynamic Geometry Software and Physical Manipulatives on the Spatial Visualisation Skills of Pre-Service Mathematics Teachers

ERIC Educational Resources Information Center

Baki, Adnan; Kosa, Temel; Guven, Bulent

2011-01-01

The study compared the effects of dynamic geometry software and physical manipulatives on the spatial visualisation skills of first-year pre-service mathematics teachers. A pre- and post-test quasi-experimental design was used. The Purdue Spatial Visualisation Test (PSVT) was used for the pre- and post-test. There were three treatment groups. The…

Evaluation of a teen parent program designed to reduce child abuse and neglect and to strengthen families.

PubMed

Marshall, E; Buckner, E; Powell, K

1991-01-01

The purpose of this study was to evaluate a teen parent program designed to increase parents' self-esteem, improve parenting skills, and increase parental knowledge about child development. Subjects (n = 30) in the program were referred from public health services. Control subjects (n = 30) were served by a local health department. Subjects were tested before and on completion of the program (or 6-9 months later for controls) using the Coopersmith Self-Esteem Inventory (SEI), the Inventory of Parents' Experiences (IPE), and the Denver Developmental Screening Test (DDST). Findings included (a) intervention subjects scored lower than control subjects on the pretesting in self-esteem (p less than 0.05), parental role satisfaction (p less than 0.05), and community support (p less than 0.0001); (b) control subjects scored lower on satisfaction with intimate relationships (p less than 0.0001); (c) at post-test, there were no statistically significant differences, and intervention subjects recorded self-esteem scores had increased to control levels; and (d) no developmental delays were detected in newborns at either pre- or post-testing. Implications of this study include (a) data support effectiveness of the program in enhancing self-esteem, maintaining satisfaction in parental role, and increasing community support for teen parents; and (b) evaluation of teen parent programs' effects should be done every 3-6 months to reduce subject attrition.

Service quality and corporate social responsibility, influence on post-purchase intentions of sheltered employment institutions.

PubMed

Chen, Chao-Chien; Lin, Shih-Yen; Cheng, Chia-Hsin; Tsai, Chia-Ching

2012-01-01

The main purpose of this study is to investigate the impact of service quality and corporate social responsibility (CSR) on customer satisfaction, and customer satisfaction toward post-purchase intentions from sheltered employment institutions. Work experience plays an important role in career development for those people with intellectual disabilities. When they are not yet capable of obtaining a job in the open market, they must receive job training and daily care in sheltered employment institutions. If the sheltered employment institutions cannot operate properly, they will greatly affect intellectual disabilities. From the study of "Children Are Us Bakeries and Restaurants" sheltered employment institutions are one kind of food service business that has been found to request and improve service quality and execution of CSR. These are two main factors which can enhance brand value and create a good reputation for sheltered employment institutions. The questionnaire results indicate that perceived service quality has a positive relationship with customer satisfaction and the reliability dimension is the most important factor for customers to assess service quality. Meanwhile, correlation analysis shows that customer satisfaction regarding service quality influences post-purchase intentions, indicating that friendly and helpful employees can please customers and enhance their satisfaction level and also induce positive post-purchase intentions of consumers. Regarding the CSR of "Children Are Us Bakeries and Restaurants" sheltered employment institutions, the analysis reveals a statistical significance: the greater customer satisfaction of CSR, the higher the post-purchase intention. In addition, in the work, paired-sample t test analysis reveals there is a significant difference (p<.05) in service quality and CSR in terms of "perceived" and "expected" responses. In summary, since those with intellectual disabilities usually are enthusiastic at work and do their best to provide good service and execute CSR well, the value of sheltered employment institutions establishments should be recognized by all should receive continued support and there should be a willingness to hire these intellectually disabled citizens. Copyright © 2012 Elsevier Ltd. All rights reserved.

Post-Test Inspection of NASA's Evolutionary Xenon Thruster Long-Duration Test Hardware: Discharge and Neutralizer Cathodes

NASA Technical Reports Server (NTRS)

Shastry, Rohit; Soulas, George C.

2016-01-01

The NEXT Long-Duration Test is part of a comprehensive thruster service life assessment intended to demonstrate overall throughput capability, validate service life models, quantify wear rates as a function of time and operating condition, and identify any unknown life-limiting mechanisms. The test was voluntarily terminated in April 2014 after demonstrating 51,184 hours of high-voltage operation, 918 kg of propellant throughput, and 35.5 MN-s of total impulse. The post-test inspection of the thruster hardware began shortly afterwards with a combination of non-destructive and destructive analysis techniques, and is presently nearing completion. This presentation presents relevant results of the post-test inspection for both discharge and neutralizer cathodes.

Changes in knowledge, attitude and involvement of fathers in supporting exclusive breastfeeding: a community-based intervention study in a rural area of Vietnam.

PubMed

Bich, Tran Huu; Cuong, Nguyen Manh

2017-02-01

To test the hypotheses of positive changes of fathers' knowledge, attitude and involvement in supporting exclusive breastfeeding (EBF) after receiving breastfeeding education materials and counseling services. A quasi-experimental, pre-test-post-test, non-equivalent control group design was used. At baseline, 251 and 241 pregnant women and their husbands were enrolled into the intervention and control groups, respectively. The 1-year intervention targeting fathers included mass media, game show-style community events, group and individual counseling at health facilities and home visits. Compared to fathers in the control group, fathers in the intervention group had higher BF knowledge scores and higher attitude scores reflecting more positive attitudes toward early initiation of BF and 6 months EBF. Fathers in the intervention group were also more likely to report active involvement in supporting mothers to practice EBF during antenatal and postpartum periods. The community-based education model should be maintained and considered for conducting further test in wider application to mobilize fathers in supporting EBF.

Improving Parolees' Participation in Drug Treatment and Other Services through Strengths Case Management.

PubMed

Prendergast, Michael; Cartier, Jerome J

2008-01-01

In an effort to increase participation in community aftercare treatment for substance-abusing parolees, an intervention based on a transitional case management (TCM) model that focuses mainly on offenders' strengths has been developed and is under testing. This model consists of completion, by the inmate, of a self-assessment of strengths that informs the development of the continuing care plan, a case conference call shortly before release, and strengths case management for three months post-release to promote retention in substance abuse treatment and support the participant's access to designated services in the community. The post-release component consists of a minimum of one weekly client/case manager meeting (in person or by telephone) for 12 weeks. The intervention is intended to improve the transition process from prison to community at both the individual and systems level. Specifically, the intervention is designed to improve outcomes in parolee admission to, and retention in, community-based substance-abuse treatment, parolee access to other needed services, and recidivism rates during the first year of parole. On the systems level, the intervention is intended to improve the communication and collaboration between criminal justice agencies, community-based treatment organizations, and other social and governmental service providers. The TCM model is being tested in a multisite study through the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative funded by the National Institute of Drug Abuse.

Student Experiences Utilizing Disability Support Services in a University Setting

ERIC Educational Resources Information Center

Abreu, Marlene; Hillier, Ashleigh; Frye, Alice; Goldstein, Jody

2016-01-01

Students with disabilities are a growing population in post-secondary institutions, yet present poorer academic outcomes compared to students without disabilities. The current study examined university students' own perceptions and experiences with disability support services (SDS) including how helpful they found the accommodations they were…

Aids and the Military: Policy Seminars June 5-6, 1993

DTIC Science & Technology

1993-09-01

education in schools and through the ruiss media; DEPARTMENTS promothiopi of condom use by prostitutes and their clients; maintenance of a safe blood...ettects of post-test coun- India’s National AIDS Committee decided in March that, in the seling on condom use 1110ng prostitutes in the interest of...supportive services, including legal counseling, the two fami- lies work together to ensure both an eased transition from family -Michael Merson, to family

Is a structured, manualized, evidence-based treatment protocol culturally competent and equivalently effective among American Indian parents in child welfare?

PubMed

Chaffin, Mark; Bard, David; Bigfoot, Dolores Subia; Maher, Erin J

2012-08-01

In a statewide implementation, the manualized SafeCare home-based model was effective in reducing child welfare recidivism and producing high client satisfaction. Concerns about the effectiveness and acceptability of structured, manualized models with American Indians have been raised in the literature, but have rarely been directly tested. This study tests recidivism reduction equivalency and acceptability among American Indian parents. A subpopulation of 354 American Indian parents was drawn from a larger trial that compared services with versus without modules of the SafeCare model. Outcomes were 6-year recidivism, pre/post/follow-up measures of depression and child abuse potential, and posttreatment consumer ratings of working alliance, service satisfaction, and cultural competency. Recidivism reduction among American Indian parents was found to be equivalent for cases falling within customary SafeCare inclusion criteria. When extended to cases outside customary inclusion boundaries, there was no apparent recidivism advantage or disadvantage. Contrary to concerns, SafeCare had higher consumer ratings of cultural competency, working alliance, service quality, and service benefit. Findings support using SafeCare with American Indians parents who meet customary SafeCare inclusion criteria. Findings do not support concerns in the literature that a manualized, structured, evidence-based model might be less effective or culturally unacceptable for American Indians.

Is a Structured, Manualized, Evidence-Based Treatment Protocol Culturally Competent and Equivalently Effective Among American Indian Parents in Child Welfare?

PubMed Central

Chaffin, Mark; Bard, David; Bigfoot, Dolores Subia; Maher, Erin J.

2015-01-01

In a statewide implementation, the manualized SafeCare home–based model was effective in reducing child welfare recidivism and producing high client satisfaction. Concerns about the effectiveness and acceptability of structured, manualized models with American Indians have been raised in the literature, but have rarely been directly tested. This study tests recidivism reduction equivalency and acceptability among American Indian parents. A subpopulation of 354 American Indian parents was drawn from a larger trial that compared services with versus without modules of the SafeCare model. Outcomes were 6-year recidivism, pre/post/follow-up measures of depression and child abuse potential, and posttreatment consumer ratings of working alliance, service satisfaction, and cultural competency. Recidivism reduction among American Indian parents was found to be equivalent for cases falling within customary SafeCare inclusion criteria. When extended to cases outside customary inclusion boundaries, there was no apparent recidivism advantage or disadvantage. Contrary to concerns, SafeCare had higher consumer ratings of cultural competency, working alliance, service quality, and service benefit. Findings support using SafeCare with American Indians parents who meet customary SafeCare inclusion criteria. Findings do not support concerns in the literature that a manualized, structured, evidence-based model might be less effective or culturally unacceptable for American Indians. PMID:22927674

28 CFR 115.353 - Resident access to outside support services and legal representation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... provide residents with access to outside victim advocates for emotional support services related to sexual abuse, by providing, posting, or otherwise making accessible mailing addresses and telephone numbers... reports of abuse will be forwarded to authorities in accordance with mandatory reporting laws. (c) The...

28 CFR 115.353 - Resident access to outside support services and legal representation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... provide residents with access to outside victim advocates for emotional support services related to sexual abuse, by providing, posting, or otherwise making accessible mailing addresses and telephone numbers... reports of abuse will be forwarded to authorities in accordance with mandatory reporting laws. (c) The...

28 CFR 115.353 - Resident access to outside support services and legal representation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... provide residents with access to outside victim advocates for emotional support services related to sexual abuse, by providing, posting, or otherwise making accessible mailing addresses and telephone numbers... reports of abuse will be forwarded to authorities in accordance with mandatory reporting laws. (c) The...

76 FR 66766 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-27

... supporting financial documentation as a separate Excel file. Australia Post Agreement. The Postal Service... of the Australia Post Agreement is provided in the Excel file included with the filing. Notice at 1-2...

Psychometric properties of the Interpersonal Relationship Inventory-Short Form for active duty female service members.

PubMed

Nayback-Beebe, Ann M; Yoder, Linda H

2011-06-01

The Interpersonal Relationship Inventory-Short Form (IPRI-SF) has demonstrated psychometric consistency across several demographic and clinical populations; however, it has not been psychometrically tested in a military population. The purpose of this study was to psychometrically evaluate the reliability and component structure of the IPRI-SF in active duty United States Army female service members (FSMs). The reliability estimates were .93 for the social support subscale and .91 for the conflict subscale. Principal component analysis demonstrated an obliquely rotated three-component solution that accounted for 58.9% of the variance. The results of this study support the reliability and validity of the IPRI-SF for use in FSMs; however, a three-factor structure emerged in this sample of FSMs post-deployment that represents "cultural context." Copyright © 2011 Wiley Periodicals, Inc.

PREFER: a European service providing forest fire management support products

NASA Astrophysics Data System (ADS)

Eftychidis, George; Laneve, Giovanni; Ferrucci, Fabrizio; Sebastian Lopez, Ana; Lourenco, Louciano; Clandillon, Stephen; Tampellini, Lucia; Hirn, Barbara; Diagourtas, Dimitris; Leventakis, George

2015-06-01

PREFER is a Copernicus project of the EC-FP7 program which aims developing spatial information products that may support fire prevention and burned areas restoration decisions and establish a relevant web-based regional service for making these products available to fire management stakeholders. The service focuses to the Mediterranean region, where fire risk is high and damages from wildfires are quite important, and develop its products for pilot areas located in Spain, Portugal, Italy, France and Greece. PREFER aims to allow fire managers to have access to online resources, which shall facilitate fire prevention measures, fire hazard and risk assessment, estimation of fire impact and damages caused by wildfire as well as support monitoring of post-fire regeneration and vegetation recovery. It makes use of a variety of products delivered by space borne sensors and develop seasonal and daily products using multi-payload, multi-scale and multi-temporal analysis of EO data. The PREFER Service portfolio consists of two main suite of products. The first refers to mapping products for supporting decisions concerning the Preparedness/Prevention Phase (ISP Service). The service delivers Fuel, Hazard and Fire risk maps for this purpose. Furthermore the PREFER portfolio includes Post-fire vegetation recovery, burn scar maps, damage severity and 3D fire damage assessment products in order to support relative assessments required in context of the Recovery/Reconstruction Phase (ISR Service) of fire management.

Development and Feasibility of a Cell Phone-Based Transitional Intervention for Women Prisoners with Comorbid Substance Use and Depression

PubMed Central

Johnson, Jennifer E.; Williams, Collette; Zlotnick, Caron

2013-01-01

This article describes the development and feasibility testing of a cell phone-based intervention (Sober Network IPT) among 22 women with comorbid substance use and depressive disorders transitioning from prison to surrounding communities. Feasibility/acceptability measures included phone logs, exit interviews, and pre-post measures of substance use and depressive symptoms up to 9 months post-release. Results indicated that phone-based transitional treatment is feasible and acceptable. Participants valued the opportunity to maintain contact with familiar prison treatment providers by phone after release, and used the cell phones for help with service linkage, support, and crisis management. We describe relational and practical lessons learned. PMID:26508805

Baseline vestibular and auditory findings in a trial of post-concussive syndrome

PubMed

Meehan, Anna; Searing, Elizabeth; Weaver, Lindell; Lewandowski, Andrew

2016-01-01

Previous studies have reported high rates of auditory and vestibular-balance deficits immediately following head injury. This study uses a comprehensive battery of assessments to characterize auditory and vestibular function in 71 U.S. military service members with chronic symptoms following mild traumatic brain injury that did not resolve with traditional interventions. The majority of the study population reported hearing loss (70%) and recent vestibular symptoms (83%). Central auditory deficits were most prevalent, with 58% of participants failing the SCAN3:A screening test and 45% showing abnormal responses on auditory steady-state response testing presented at a suprathreshold intensity. Only 17% of the participants had abnormal hearing (⟩25 dB hearing loss) based on the pure-tone average. Objective vestibular testing supported significant deficits in this population, regardless of whether the participant self-reported active symptoms. Composite score on the Sensory Organization Test was lower than expected from normative data (mean 69.6 ±vestibular tests, vestibulo-ocular reflex, central auditory dysfunction, mild traumatic brain injury, post-concussive symptoms, hearing15.6). High abnormality rates were found in funduscopy torsion (58%), oculomotor assessments (49%), ocular and cervical vestibular evoked myogenic potentials (46% and 33%, respectively), and monothermal calorics (40%). It is recommended that a full peripheral and central auditory, oculomotor, and vestibular-balance evaluation be completed on military service members who have sustained head trauma.

Improving health worker performance of abortion services: an assessment of post-training support to providers in India, Nepal and Nigeria.

PubMed

Benson, Janie; Healy, Joan; Dijkerman, Sally; Andersen, Kathryn

2017-11-21

Health worker performance has been the focus of numerous interventions and evaluation studies in low- and middle-income countries. Few have examined changes in individual provider performance with an intervention encompassing post-training support contacts to improve their clinical practice and resolve programmatic problems. This paper reports the results of an intervention with 3471 abortion providers in India, Nepal and Nigeria. Following abortion care training, providers received in-person visits and virtual contacts by a clinical and programmatic support team for a 12-month period, designed to address their individual practice issues. The intervention also included technical assistance to and upgrades in facilities where the providers worked. Quantitative measures to assess provider performance were established, including: 1) Increase in service provision; 2) Consistent service provision; 3) Provision of high quality of care through use of World Health Organization-recommended uterine evacuation technologies, management of pain and provision of post-abortion contraception; and 4) Post-abortion contraception method mix. Descriptive univariate analysis was conducted, followed by examination of the bivariate relationships between all independent variables and the four dependent performance outcome variables by calculating unadjusted odds ratios, by country and overall. Finally, multivariate logistic regression was performed for each outcome. Providers received an average of 5.7 contacts. Sixty-two percent and 46% of providers met measures for consistent service provision and quality of care, respectively. Fewer providers achieved an increased number of services (24%). Forty-six percent provided an appropriate postabortion contraceptive mix to clients. Most providers met the quality components for use of WHO-recommended abortion methods and provision of pain management. Factors significantly associated with achievement of all measures were providers working in sites offering community outreach and those trained in intervention year two. The number of in-person contacts was significantly associated with achievement of three of four measures. Post-training support holds promise for strengthening health worker performance. Further research is needed to compare this intervention with other approaches and assess how post-training contacts could be incorporated into current health system supervision.

Joint Ordnance Test Procedure (JOTP)-010 Safety and Suitability for Service Assessment Testing for Shoulder Launched Munitions

DTIC Science & Technology

2016-05-09

electromagnetic environment for which they are designed to be used. These tests are performed on a powered weapon during simulated normal operation and are...010B SAFETY AND SUITABILITY FOR SERVICE ASSESSMENT TESTING FOR SHOULDER LAUNCHED MUNITIONS Joint Services Munition Safety Test Working Group JOTP...12 6.8 Test Sample Quantities .......................................................... 13 7. PRE- AND POST - TEST INSPECTIONS

Implementation of a new 'community' laboratory CD4 service in a rural health district in South Africa extends laboratory services and substantially improves local reporting turnaround time.

PubMed

Coetzee, L M; Cassim, N; Glencross, D K

2015-12-16

The CD4 integrated service delivery model (ITSDM) provides for reasonable access to pathology services across South Africa (SA) by offering three new service tiers that extend services into remote, under-serviced areas. ITSDM identified Pixley ka Seme as such an under-serviced district. To address the poor service delivery in this area, a new ITSDM community (tier 3) laboratory was established in De Aar, SA. Laboratory performance and turnaround time (TAT) were monitored post implementation to assess the impact on local service delivery. Using the National Health Laboratory Service Corporate Data Warehouse, CD4 data were extracted for the period April 2012-July 2013 (n=11,964). Total mean TAT (in hours) was calculated and pre-analytical and analytical components assessed. Ongoing testing volumes, as well as external quality assessment performance across ten trials, were used to indicate post-implementation success. Data were analysed using Stata 12. Prior to the implementation of CD4 testing at De Aar, the total mean TAT was 20.5 hours. This fell to 8.2 hours post implementation, predominantly as a result of a lower pre-analytical mean TAT reducing from a mean of 18.9 to 1.8 hours. The analytical testing TAT remained unchanged after implementation and monthly test volumes increased by up to 20%. External quality assessment indicated adequate performance. Although subjective, questionnaires sent to facilities reported improved service delivery. Establishing CD4 testing in a remote community laboratory substantially reduces overall TAT. Additional community CD4 laboratories should be established in under-serviced areas, especially where laboratory infrastructure is already in place.

Fence Posts From Delta Hardwoods Give Good Service

Treesearch

J. S. McKnight; J. W. Johnson

1953-01-01

Do bottomland hardwoods make durable fence posts? To answer this question, the Southern Forest Experiment Station and the Mississippi Agricultural Experiment Station have been carrying on two tests of the life of fence pasts in actual service in the Delta.

Tests of measurement invariance failed to support the application of the "then-test".

PubMed

Nolte, Sandra; Elsworth, Gerald R; Sinclair, Andrew J; Osborne, Richard H

2009-11-01

The use of then-test (retrospective pre-test) scores has frequently been proposed as a solution to potential confounding of change scores because of response shift, as it is assumed that then-test and post-test responses are provided from the same perspective. However, this assumption has not been formally tested using robust quantitative methods. The aim of this study was to compare the psychometric performance of then-test/post-test with traditional pre-test/post-test data and assessing whether the resulting data structures support the application of the then-test for evaluations of chronic disease self-management interventions. Pre-test, post-test, and then-test data were collected from 314 participants of self-management courses using the Health Education Impact Questionnaire (heiQ). The derived change scores (pre-test/post-test; then-test/post-test) were examined for their psychometric performance using tests of measurement invariance. Few questionnaire items were noninvariant across pre-test/post-test, with four items identified and requiring removal to enable an unbiased comparison of factor means. In contrast, 12 items were identified and required removal in then-test/post-test data to avoid biased change score estimates. Traditional pre-test/post-test data appear to be robust with little indication of response shift. In contrast, the weaker psychometric performance of then-test/post-test data suggests psychometric flaws that may be the result of implicit theory of change, social desirability, and recall bias.

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.

Psychosocial support for adolescent girls in post-conflict settings: beyond a health systems approach

PubMed Central

Samuels, Fiona; Jones, Nicola; Abu Hamad, Bassam

2017-01-01

Abstract Adaptive and adequately resourced health systems are necessary to achieve good health outcomes in post-conflict settings, however domains beyond the health system are also critical to ensure broader wellbeing. This paper focuses on the importance of psychosocial support services for adolescent girls in fragile contexts. Its starting point is that adolescence is a pivotal time in the life course but given the physical, cognitive and emotional changes triggered by the onset of puberty, it can also be a period of heightened sensitivity and vulnerability to trauma, social isolation, bullying by peers, a lack of supportive adults and gender-based and sexual violence. Our findings highlight why humanitarian and biomedical approaches in their current form are inadequate to address these complexities. Drawing on qualitative fieldwork (consisting of in-depth and key informant interviews as well as group discussions in Gaza, Liberia and Sri Lanka involving a total of 386 respondents across the three countries), we argue that going beyond biomedical approaches and considering the social determinants of health, including approaches to tackle discriminatory gendered norms and barriers to service access, are critical for achieving broader health and wellbeing. While all three case study countries are classified as post-conflict, the political economy dynamics vary with associated implications for experiences of psychosocial vulnerabilities and the service environment. The study concludes by reflecting on actions to address psychosocial vulnerabilities facing adolescent girls. These include: tailoring services to ensure gender and age-sensitivity; investing in capacity building of service providers to promote service uptake; and enhancing strategies to regulate and coordinate actors providing mental health and psychosocial support services. PMID:29244106

Benefits of peer support groups in the treatment of addiction

PubMed Central

Tracy, Kathlene; Wallace, Samantha P

2016-01-01

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

Global Health Diplomacy, Monitoring & Evaluation, and the Importance of Quality Assurance & Control: Findings from NIMH Project Accept (HPTN 043): A Phase III Randomized Controlled Trial of Community Mobilization, Mobile Testing, Same-Day Results, and Post-Test Support for HIV in Sub-Saharan Africa and Thailand.

PubMed

Kevany, Sebastian; Khumalo-Sakutukwa, Gertrude; Singh, Basant; Chingono, Alfred; Morin, Stephen

2016-01-01

Provision and scale-up of high quality, evidence-based services is essential for successful international HIV prevention interventions in order to generate and maintain intervention uptake, study integrity and participant trust, from both health service delivery and diplomatic perspectives. We developed quality assurance (QAC) procedures to evaluate staff fidelity to a cluster-randomized trial of the NIMH Project Accept (HPTN 043) assessing the effectiveness of a community-based voluntary counseling and testing strategy. The intervention was comprised of three components-Mobile Voluntary Counseling and Testing (MVCT), Community Mobilization (CM) and Post-Test Support Services (PTSS). QAC procedures were based on standardized criteria, and were designed to assess both provider skills and adherence to the intervention protocol. Supervisors observed a random sample of 5% to 10% of sessions each month and evaluated staff against multiple criteria on scales of 1-5. A score of 5 indicated 100% adherence, 4 indicated 95% adherence, and 3 indicated 90% adherence. Scores below 3 were considered unsatisfactory, and protocol deviations were discussed with the respective staff. During the first year of the intervention, the mean scores of MVCT and CM staff across the 5 study sites were 4 (95% adherence) or greater and continued to improve over time. Mean QAC scores for the PTSS component were lower and displayed greater fluctuations. Challenges to PTSS staff were identified as coping with the wide range of activities in the PTSS component and the novelty of the PTSS process. QAC fluctuations for PTSS were also associated with new staff hires or changes in staff responsibilities. Through constant staff monitoring and support, by Year 2, QAC scores for PTSS activities had reached those of MVCT and CM. The implementation of a large-sale, evidence based HIV intervention requires extensive QAC to ensure implementation effectiveness. Ongoing appraisal of study staff across sites ensures consistent and high quality delivery of all intervention components, in keeping with the goals of the study protocol, while also providing a forum for corrective feedback, additional supervision and retraining of staff. QAC ensures staff fidelity to study procedures and is critical to the successful delivery of multi-site HIV prevention interventions, as well as the delivery of services scaled up in programmatic situations.

45 CFR 1356.83 - Reporting requirements and data elements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... specifically designed instruction, at no cost to parents, to meet the unique needs of a child with a disability... element must be left blank. (21) Academic support. Academic supports are services designed to help a youth... are services designed to help a youth enter or complete a post-secondary education and include the...

45 CFR 1356.83 - Reporting requirements and data elements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... specifically designed instruction, at no cost to parents, to meet the unique needs of a child with a disability... element must be left blank. (21) Academic support. Academic supports are services designed to help a youth... are services designed to help a youth enter or complete a post-secondary education and include the...

45 CFR 1356.83 - Reporting requirements and data elements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... specifically designed instruction, at no cost to parents, to meet the unique needs of a child with a disability... element must be left blank. (21) Academic support. Academic supports are services designed to help a youth... are services designed to help a youth enter or complete a post-secondary education and include the...

45 CFR 1356.83 - Reporting requirements and data elements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... specifically designed instruction, at no cost to parents, to meet the unique needs of a child with a disability... element must be left blank. (21) Academic support. Academic supports are services designed to help a youth... are services designed to help a youth enter or complete a post-secondary education and include the...

Preliminary description of the feasibility of using peer leaders to encourage hypertension self-management.

PubMed

Hayes, Avery; Morzinski, Jeffrey; Ertl, Kristyn; Wurm, Christine; Patterson, Leslie; Wilke, Nancy; Whittle, Jeff

2010-04-01

Despite consensus that effective treatment of hypertension reduces morbidity and mortality, control rates remain relatively low. This report describes key features of a peer support program designed to motivate individuals to improve self-management of hypertension. We recruited Veterans of Foreign Wars posts in southeastern Wisconsin and trained members of these posts to be peer health leaders over a period of 18 months. The curriculum covered information important to blood pressure control, as well as peer educator skills. During this time, the peer leaders presented educational materials and encouraged self-monitoring of blood pressure at post meetings. Surveys and focus groups were conducted to evaluate the adoption of the program at the posts. After a series of informational mailings and visits to veteran posts, 15 posts and 27 peer leaders volunteered to participate. Fourteen posts (93%) continued active participation throughout the study period, as did 24 peer leaders. Peer leaders reported that they gained health knowledge, skills, and confidence to perform as informational resources at their posts, resulting in greater levels of health support among post members. The partnership of health care professional, medical school, and veteran service organization successfully organized and maintained a community-based, peer-led program to promote healthy behaviors among Wisconsin's armed services veterans. Community physicians should be familiar with programs of this type as chronic disease self-management grows in appeal in our communities and increasing numbers of veterans return from armed service duty.

VA Health Care: VA Spends Millions on Post-Traumatic Stress Disorder Research and Incorporates Research Outcomes into Guidelines and Policy for Post-Traumatic Stress Disorder Services

DTIC Science & Technology

2011-01-01

post - traumatic stress disorder ( PTSD ) and...Veterans Affairs (VA) Intramural Post - Traumatic Stress Disorder ( PTSD ) Research Funding and VA’s Medical and Prosthetic Research Appropriation...Table 6: Department of Veterans Affairs (VA) Research Centers and Programs That Conduct or Support Post - Traumatic Stress Disorder ( PTSD ) Research

Aft Skirt Electrical Umbilical (ASEU) and Vehicle Support Post (

NASA Image and Video Library

2016-12-09

A view from underneath one of the vertical support posts for NASA's Space Launch System rocket. Two after skirt electrical umbilicals (ASEUs) and the first of the vertical support post were transported by flatbed truck from the Launch Equipment Test Facility to the Mobile Launcher Yard as NASA's Kennedy Space Center in Florida. The ASEUs and the VSP underwent a series of tests to confirm they are functioning properly and ready to support the SLS for launch. The ASEUs will connect to the SLS rocket at the bottom outer edge of each booster and provide electrical power and data connections to the rocket until it lifts off from the launch pad. The eight VSPs will support the load of the solid rocket boosters, with four posts for each of the boosters. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Aft Skirt Electrical Umbilical (ASEU) and Vehicle Support Post (

NASA Image and Video Library

2016-12-09

Construction workers assist as a crane is used to lower a vertical support post for NASA's Space Launch System (SLS) onto a platform at the Mobile Launcher Yard at NASA's Kennedy Space Center in Florida. Two ASEUs and the first of the vertical support posts underwent a series of tests at the Launch Equipment Test Facility to confirm they are functioning properly and ready to support the SLS for launch. The ASEUs will connect to the SLS rocket at the bottom outer edge of each booster and provide electrical power and data connections to the rocket until it lifts off from the launch pad. The eight VSPs will support the load of the solid rocket boosters, with four posts for each of the boosters. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Test Analysis Guidelines

NASA Technical Reports Server (NTRS)

Jeng, Frank F.

2007-01-01

Development of analysis guidelines for Exploration Life Support (ELS) technology tests was completed. The guidelines were developed based on analysis experiences gained from supporting Environmental Control and Life Support System (ECLSS) technology development in air revitalization systems and water recovery systems. Analyses are vital during all three phases of the ELS technology test: pre-test, during test and post test. Pre-test analyses of a test system help define hardware components, predict system and component performances, required test duration, sampling frequencies of operation parameters, etc. Analyses conducted during tests could verify the consistency of all the measurements and the performance of the test system. Post test analyses are an essential part of the test task. Results of post test analyses are an important factor in judging whether the technology development is a successful one. In addition, development of a rigorous model for a test system is an important objective of any new technology development. Test data analyses, especially post test data analyses, serve to verify the model. Test analyses have supported development of many ECLSS technologies. Some test analysis tasks in ECLSS technology development are listed in the Appendix. To have effective analysis support for ECLSS technology tests, analysis guidelines would be a useful tool. These test guidelines were developed based on experiences gained through previous analysis support of various ECLSS technology tests. A comment on analysis from an experienced NASA ECLSS manager (1) follows: "Bad analysis was one that bent the test to prove that the analysis was right to begin with. Good analysis was one that directed where the testing should go and also bridged the gap between the reality of the test facility and what was expected on orbit."

Can trained lay providers perform HIV testing services? A review of national HIV testing policies.

PubMed

Flynn, David E; Johnson, Cheryl; Sands, Anita; Wong, Vincent; Figueroa, Carmen; Baggaley, Rachel

2017-01-04

Only an estimated 54% of people living with HIV are aware of their status. Despite progress scaling up HIV testing services (HTS), a testing gap remains. Delivery of HTS by lay providers may help close this testing gap, while also increasing uptake and acceptability of HIV testing among key populations and other priority groups. 50 National HIV testing policies were collated from WHO country intelligence databases, contacts and testing program websites. Data regarding lay provider use for HTS was extracted and collated. Our search had no geographical or language restrictions. This data was then compared with reported data from the Global AIDS Response Progress Reporting (GARPR) from July 2015. Forty-two percent of countries permit lay providers to perform HIV testing and 56% permit lay providers to administer pre-and post-test counseling. Comparative analysis with GARPR found that less than half (46%) of reported data from countries were consistent with their corresponding national HIV testing policy. Given the low uptake of lay provider use globally and their proven use in increasing HIV testing, countries should consider revising policies to support lay provider testing using rapid diagnostic tests.

Application of social network analysis in the assessment of organization infrastructure for service delivery: a three district case study from post-conflict northern Uganda

PubMed Central

Ssengooba, Freddie; Kawooya, Vincent; Namakula, Justine; Fustukian, Suzanne

2017-01-01

Abstract In post-conflict settings, service coverage indices are unlikely to be sustained if health systems are built on weak and unstable inter-organization networks—here referred to as infrastructure. The objective of this study was to assess the inter-organization infrastructure that supports the provision of selected health services in the reconstruction phase after conflict in northern Uganda. Applied social network analysis was used to establish the structure, size and function among organizations supporting the provision of (1) HIV treatment, (2) maternal delivery services and (3) workforce strengthening. Overall, 87 organizations were identified from 48 respondent organizations in the three post-conflict districts in northern Uganda. A two-stage snowball approach was used starting with service provider organizations in each district. Data included a list of organizations and their key attributes related to the provision of each service for the year 2012–13. The findings show that inter-organization networks are mostly focused on HIV treatment and least for workforce strengthening. The networks for HIV treatment and maternal services were about 3–4 times denser relative to the network for workforce strengthening. The network for HIV treatment accounted for 69–81% of the aggregated network in Gulu and Kitgum districts. In contrast, the network for workforce strengthening contributed the least (6% and 10%) in these two districts. Likewise, the networks supporting a young district (Amuru) was under invested with few organizations and sparse connections. Overall, organizations exhibited a broad range of functional roles in supporting HIV treatment compared to other services in the study. Basic information about the inter-organization setup (infrastructure)—can contribute to knowledge for building organization networks in more equitable ways. More connected organizations can be leveraged for faster communication and resource flow to boost the delivery of health services. PMID:28637228

Application of social network analysis in the assessment of organization infrastructure for service delivery: a three district case study from post-conflict northern Uganda.

PubMed

Ssengooba, Freddie; Kawooya, Vincent; Namakula, Justine; Fustukian, Suzanne

2017-10-01

In post-conflict settings, service coverage indices are unlikely to be sustained if health systems are built on weak and unstable inter-organization networks-here referred to as infrastructure. The objective of this study was to assess the inter-organization infrastructure that supports the provision of selected health services in the reconstruction phase after conflict in northern Uganda. Applied social network analysis was used to establish the structure, size and function among organizations supporting the provision of (1) HIV treatment, (2) maternal delivery services and (3) workforce strengthening. Overall, 87 organizations were identified from 48 respondent organizations in the three post-conflict districts in northern Uganda. A two-stage snowball approach was used starting with service provider organizations in each district. Data included a list of organizations and their key attributes related to the provision of each service for the year 2012-13. The findings show that inter-organization networks are mostly focused on HIV treatment and least for workforce strengthening. The networks for HIV treatment and maternal services were about 3-4 times denser relative to the network for workforce strengthening. The network for HIV treatment accounted for 69-81% of the aggregated network in Gulu and Kitgum districts. In contrast, the network for workforce strengthening contributed the least (6% and 10%) in these two districts. Likewise, the networks supporting a young district (Amuru) was under invested with few organizations and sparse connections. Overall, organizations exhibited a broad range of functional roles in supporting HIV treatment compared to other services in the study. Basic information about the inter-organization setup (infrastructure)-can contribute to knowledge for building organization networks in more equitable ways. More connected organizations can be leveraged for faster communication and resource flow to boost the delivery of health services. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

The development of supported employment services for people with mental illness: local experience in Hong Kong.

PubMed

Chiu, Frank P.F.

2000-01-01

Before the 1960s in Hong Kong, specialized vocational services for people with mental illness were very limited, and sheltered workshop seemed to be the only option for their future vocational placement at that time. As discussed in the literature, there are still many shortcomings of the sheltered workshop model, that brings us to the emergence of another community-based vocational service: Supported Employment. Unlike traditional vocational services, the concept of supported employment emphasizes the placing of the clients into integrated work environments and then providing on-going support and work-related skills training in the job post. Though supported employment services help many clients to sustain a job in the competitive market, many service barriers and problems still remain unsolved. These service barriers and problems will be discussed in this article, and suggestions will be made.

The Role of Natural Support Systems in the Post-deployment Adjustment of Active Duty Military Personnel.

PubMed

Welsh, Janet A; Olson, Jonathan; Perkins, Daniel F; Travis, Wendy J; Ormsby, LaJuana

2015-09-01

This study examined the relations among three different types of naturally occurring social support (from romantic partners, friends and neighbors, and unit leaders) and three indices of service member well-being (self reports of depressive symptoms, satisfaction with military life, and perceptions of unit readiness) for service members who did and did not report negative experiences associated with military deployment. Data were drawn from the 2011 Community Assessment completed anonymously by more than 63,000 USAF personnel. Regression analyses revealed that higher levels of social support was associated with better outcomes regardless of negative deployment experiences. Evidence of moderation was also noted, with all forms of social support moderating the impact of negative deployment experiences on depressive symptoms and support from unit leaders moderating the impact of negative deployment experience on satisfaction with military life. No moderation was found for perceptions of unit readiness. Subgroup analyses revealed slightly different patterns for male and female service members, with support providing fewer moderation effects for women. These findings may have value for military leaders and mental health professionals working to harness the power of naturally occurring relationships to maximize the positive adjustment of service members and their families. Implications for practices related to re-integration of post-deployment military personnel are discussed.

Support Services for Mainstream Deaf College Student Writers: Three Institutional Case Studies

ERIC Educational Resources Information Center

Williams, Heidi Maria

2017-01-01

This dissertation acknowledges the fact that research regarding deaf student writers at the post-secondary level is practically void. To initiate an avenue of research that is meant to foreground future research regarding support services for deaf college student writers, I set out to find how college institutions are serving deaf student writers…

Physical health symptoms reported by trafficked women receiving post-trafficking support in Moldova: prevalence, severity and associated factors

PubMed Central

2012-01-01

Background Many trafficked people suffer high levels of physical, sexual and psychological abuse. Yet, there has been limited research on the physical health problems associated with human trafficking or how the health needs of women in post-trafficking support settings vary according to socio-demographic or trafficking characteristics. Methods We analysed the prevalence and severity of 15 health symptoms reported by 120 trafficked women who had returned to Moldova between December 2007 and December 2008 and were registered with the International Organisation for Migration Assistance and Protection Programme. Women had returned to Moldova an average of 5.9 months prior to interview (range 2-12 months). Results Headaches (61.7%), stomach pain (60.9%), memory problems (44.2%), back pain (42.5%), loss of appetite (35%), and tooth pain (35%) were amongst the most commonly reported symptoms amongst both women trafficked for sexual exploitation and women trafficked for labour exploitation. The prevalence of headache and memory problems was strongly associated with duration of exploitation. Conclusions Trafficked women who register for post-trafficking support services after returning to their country of origin are likely to have long-term physical and dental health needs and should be provided with access to comprehensive medical services. Health problems among women who register for post-trafficking support services after returning to their country of origin are not limited to women trafficked for sexual exploitation but are also experienced by victims of labour exploitation. PMID:22834807

Physical health symptoms reported by trafficked women receiving post-trafficking support in Moldova: prevalence, severity and associated factors.

PubMed

Oram, Siân; Ostrovschi, Nicolae V; Gorceag, Viorel I; Hotineanu, Mihai A; Gorceag, Lilia; Trigub, Carolina; Abas, Melanie

2012-07-26

Many trafficked people suffer high levels of physical, sexual and psychological abuse. Yet, there has been limited research on the physical health problems associated with human trafficking or how the health needs of women in post-trafficking support settings vary according to socio-demographic or trafficking characteristics. We analysed the prevalence and severity of 15 health symptoms reported by 120 trafficked women who had returned to Moldova between December 2007 and December 2008 and were registered with the International Organisation for Migration Assistance and Protection Programme. Women had returned to Moldova an average of 5.9 months prior to interview (range 2-12 months). Headaches (61.7%), stomach pain (60.9%), memory problems (44.2%), back pain (42.5%), loss of appetite (35%), and tooth pain (35%) were amongst the most commonly reported symptoms amongst both women trafficked for sexual exploitation and women trafficked for labour exploitation. The prevalence of headache and memory problems was strongly associated with duration of exploitation. Trafficked women who register for post-trafficking support services after returning to their country of origin are likely to have long-term physical and dental health needs and should be provided with access to comprehensive medical services. Health problems among women who register for post-trafficking support services after returning to their country of origin are not limited to women trafficked for sexual exploitation but are also experienced by victims of labour exploitation.

Patient outcomes and experiences of an acupuncture and self-care service for persistent low back pain in the NHS: a mixed methods approach

PubMed Central

2013-01-01

Background Supported self-management, acupuncture and information can help reduce the symptoms of low back pain. These approaches are currently recommended by NICE guidance as treatment options for patients with persistent low back pain. However, there has been no previous evaluation of a service providing them together for this common problem. The purpose of this service evaluation was to report patient outcomes and experiences of the Beating Back Pain Service (BBPS), a pilot service based in a primary and community care setting, delivering acupuncture, self-management and information to patients with chronic low back pain. Methods Patients completed a questionnaire at three time points: pre-BBPS, immediately post-BBPS and three months post-BBPS. Outcome measures included the Bournemouth Questionnaire (measuring musculoskeletal, MSK, problems), EuroQoL-5D (measuring quality of life), Pain and Self-efficacy Questionnaire, and additional questions on medication use, physical activity, understanding of pain and positive well-being. Additionally, the STarT Back (measuring risk of developing chronic pain) was collected at BBPS information sessions. Non-parametric tests were used to evaluate pre- and post- variables. Questionnaires also collected qualitative data (open-text responses) regarding patient views and experiences of the BBPS, which were analysed using thematic analysis. Results 80 (out of 108) patients who attended the initial BBPS information session agreed to participate in the service evaluation (mean age 47 years, 65% female). 65 patients attended subsequent BBPS acupuncture and/or self-management sessions and were asked to complete post-treatment questionnaires; complete datasets were available for 61 patients. There were statistically significant improvements over time for pain (p <0.0001), quality of life (p = 0.006), understanding of pain (p <0.001), physical activity (p = 0.047) and relaxation (p = 0.012). Post-hoc analysis revealed that scores improved between baseline and post-treatment, these improvements were maintained at 3-month follow-up (except relaxation). Patients receiving a combination of acupuncture and self-management sessions produced the most positive results. Patient satisfaction with the BBPS was high. Conclusions The BBPS provided a MSK pain management service that many patients found effective and valuable. Combining self-management with acupuncture was found to be particularly effective, although further consideration is required regarding how best to engage patients in self-management. PMID:24180515

Web-Based Activity Within a Sexual Health Economy: Observational Study.

PubMed

Turner, Katy Me; Zienkiewicz, Adam K; Syred, Jonathan; Looker, Katharine J; de Sa, Joia; Brady, Michael; Free, Caroline; Holdsworth, Gillian; Baraitser, Paula

2018-03-07

Regular testing for sexually transmitted infections (STIs) is important to maintain sexual health. Self-sampling kits ordered online and delivered in the post may increase access, convenience, and cost-effectiveness. Sexual health economies may target limited resources more effectively by signposting users toward Web-based or face-to-face services according to clinical need. The aim of this paper was to investigate the impact of two interventions on testing activity across a whole sexual health economy: (1) the introduction of open access Web-based STI testing services and (2) a clinic policy of triage and signpost online where users without symptoms who attended clinics for STI testing were supported to access the Web-based service instead. Data on attendances at all specialist public sexual health providers in an inner-London area were collated into a single database. Each record included information on user demographics, service type accessed, and clinical activity provided, including test results. Clinical activity was categorized as a simple STI test (could be done in a clinic or online), a complex visit (requiring face-to-face consultation), or other. Introduction of Web-based services increased total testing activity across the whole sexual health economy by 18.47% (from 36,373 to 43,091 in the same 6-month period-2014-2015 and 2015-2016), suggesting unmet need for testing in the area. Triage and signposting shifted activity out of the clinic onto the Web-based service, with simple STI testing in the clinic decreasing from 16.90% (920/5443) to 12.25% (511/4172) of total activity, P<.001, and complex activity in the clinic increasing from 69.15% (3764/5443) to 74.86% (3123/4172) of total activity, P<.001. This intervention created a new population of online users with different demographic and clinical profiles from those who use Web-based services spontaneously. Some triage and signposted users (29.62%, 375/1266) did not complete the Web-based testing process, suggesting the potential for missed diagnoses. This evaluation shows that users can effectively be transitioned from face-to-face to Web-based services and that this introduces a new population to Web-based service use and changes the focus of clinic-based activity. Further development is underway to optimize the triage and signposting process to support test completion. ©Katy ME Turner, Adam K Zienkiewicz, Jonathan Syred, Katharine J Looker, Joia de Sa, Michael Brady, Caroline Free, Gillian Holdsworth, Paula Baraitser. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 07.03.2018.

20 CFR 668.500 - What services may INA grantees provide to or for employers under section 166?

Code of Federal Regulations, 2010 CFR

2010-04-01

...-employment training; (4) Customized training; (5) On-the-Job training (OJT); (6) Post-employment services, including training and support services to encourage job retention and upgrading; (7) Work experience for... participants, including job restructuring services; (2) Recruitment and assessment of potential employees, with...

Services Receipt Following Veteran Outpatients' Positive Screen for Homelessness.

PubMed

Montgomery, Ann E; Dichter, Melissa E; Thomasson, Arwin M; Roberts, Christopher B

2016-03-01

The Veterans Health Administration seeks to reduce homelessness among Veterans by identifying, and providing prevention and supportive services to, patients with housing concerns. The objectives of this study were to assess the proportion of Veterans Health Administration patients who received homeless or social work services within 6 months of a positive screen for homelessness or risk in the Veterans Health Administration and the demographic and clinical characteristics that predicted services utilization. Data were from a cohort of 27,403 Veteran outpatients who screened positive for homelessness or risk between November 1, 2012 and January 31, 2013. During 2013, AORs were calculated using a mixed-effects logistic regression to estimate the likelihood of patients' receipt of VHA homeless or social work services based on demographic and clinical characteristics. The majority of patients received services within 6 months post-screening; predictors of services utilization varied by gender. Among women, diagnosis of drug abuse and psychosis predicted receipt of services, being unmarried increased the odds of using services among those screening positive for homelessness, and a diagnosis of post-traumatic stress disorder increased the odds of receiving services for at-risk women. Among men, being younger, unmarried, not service-connected/Medicaid-eligible, and having a medical or behavioral health condition predicted receipt of services. Receipt of housing support services among Veterans post-homelessness screening differs by patient demographic and clinical characteristics. Future research should investigate the role that primary and secondary prevention interventions play in Veterans' resolution of risk for homelessness and experience of homelessness. Published by Elsevier Inc.

Integration of post-abortion care: the role of township medical officers and midwives in Myanmar.

PubMed

Htay, Thein Thein; Sauvarin, Josephine; Khan, Saba

2003-05-01

Complications of unsafe abortion are a significant cause of maternal morbidity and mortality in Myanmar, and are recognised by the Ministry of Health as a priority. The Department of Health developed a strategy to address the problem of abortion complications by integrating post-abortion care and contraceptive services into the existing township health system. The quality of post-abortion care was assessed by the Department of Health in 2000, using a baseline survey of health providers and post-abortion women in Bago Division. The integration of post-abortion care was led by the Township Medical Officers, who provided monthly in-service training and supervision of health care workers in each township. Hospital-based doctors and nurses, clinic midwives, village midwives and other volunteer health providers, including traditional birth attendants, were all trained. The role of the local clinic midwife was extended to make follow-up home visits to the women with post-abortion complications and provide them with contraception when requested. Preliminary results show positive outcomes. However, donor-funded projects may have a destabilizing effect on township services by diverting attention and resources; donors need to work with government to support its priorities for health care. The future nationwide integration of post-abortion care services into township services should be planned in consultation with Township Medical Officers and midwives, the key providers of these services.

Reducing child abuse amongst adolescents in low- and middle-income countries: A pre-post trial in South Africa.

PubMed

Cluver, Lucie; Meinck, Franziska; Yakubovich, Alexa; Doubt, Jenny; Redfern, Alice; Ward, Catherine; Salah, Nasteha; De Stone, Sachin; Petersen, Tshiamo; Mpimpilashe, Phelisa; Romero, Rocio Herrero; Ncobo, Lulu; Lachman, Jamie; Tsoanyane, Sibongile; Shenderovich, Yulia; Loening, Heidi; Byrne, Jasmina; Sherr, Lorraine; Kaplan, Lauren; Gardner, Frances

2016-07-13

No known studies have tested the effectiveness of child abuse prevention programmes for adolescents in low- or middle-income countries. 'Parenting for Lifelong Health' ( http://tiny.cc/whoPLH ) is a collaborative project to develop and rigorously test abuse-prevention parenting programmes for free use in low-resource contexts. Research aims of this first pre-post trial in South Africa were: i) to identify indicative effects of the programme on child abuse and related outcomes; ii) to investigate programme safety for testing in a future randomised trial, and iii) to identify potential adaptations. Two hundred thirty participants (adolescents and their primary caregivers) were recruited from schools, welfare services and community-sampling in rural, high-poverty South Africa (no exclusion criteria). All participated in a 12-week parenting programme, implemented by local NGO childcare workers to ensure real-world external validity. Standardised pre-post measures with adolescents and caregivers were used, and paired t-tests were conducted for primary outcomes: abuse (physical, emotional abuse and neglect), adolescent behaviour problems and parenting (positive and involved parenting, poor monitoring and inconsistent discipline), and secondary outcomes: mental health, social support and substance use. Participants reported high levels of socio-economic deprivation, e.g. 60 % of adolescents had either an HIV-positive caregiver or were orphaned by AIDS, and 50 % of caregivers experienced intimate partner violence. i) indicative effects: Primary outcomes comparing pre-test and post-test assessments showed reductions reported by adolescents and caregivers in child abuse (adolescent report 63.0 % pre-test to 29.5 % post-test, caregiver report 75.5 % pre-test to 36.5 % post-test, both p < 0.001) poor monitoring/inconsistent discipline (p < .001), adolescent delinquency/aggressive behaviour (both p < .001), and improvements in positive/involved parenting (p < .01 adolescent report, p < .001 caregiver report). Secondary outcomes showed improved social support (p < .001 adolescent and caregiver reports), reduced parental and adolescent depression (both p < .001), parenting stress (p < .001 caregiver report) and caregiver substance use (p < .002 caregiver report). There were no changes in adolescent substance use. No negative effects were detected. ii) Programme acceptability and attendance was high. There was unanticipated programme diffusion within some study villages, with families initiating parenting groups in churches, and diffusion through school assemblies and religious sermons. iii) potential adaptations identified included the need to strengthen components on adolescent substance use and to consider how to support spontaneous programme diffusion with fidelity. The programme showed no signs of harm and initial evidence of reductions in child abuse and improved caregiver and adolescent outcomes. It showed high acceptability and unexpected community-level diffusion. Findings indicate needs for adaptations, and suitability for the next research step of more rigorous testing in randomised trials, using cluster randomization to allow for diffusion effects.

Microteaching and Pre-Service Teachers' Sense of Self-Efficacy in Teaching

ERIC Educational Resources Information Center

Arsal, Zeki

2014-01-01

This study examined the effect of microteaching on pre-service teachers' sense of self-efficacy in teaching using a pre-test/post-test quasi-experimental design. The sample of the study consisted of 70 pre-service teachers on a special education teacher preparation programme. The pre-service teachers in the experimental group were exposed to…

Comprehensive Support for Family Caregivers of Post-9/11 Veterans Increases Veteran Utilization of Long-term Services and Supports: A Propensity Score Analysis

PubMed Central

Shepherd-Banigan, Megan; Smith, Valerie A.; Stechuchak, Karen M.; Miller, Katherine E. M.; Hastings, Susan Nicole; Wieland, Gilbert Darryl; Olsen, Maren K.; Kabat, Margaret; Henius, Jennifer; Campbell-Kotler, Margaret; Van Houtven, Courtney Harold

2018-01-01

Family caregivers are an important component of the long-term services and supports (LTSS) system. However, caregiving may have negative consequences for caregiver physical and emotional health. Connecting caregivers to formal short-term home- and community-based services (HCBS), through information resources and referrals, might alleviate family caregiver burden and delay nursing home entry for the patient. The aim of this study was to evaluate the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) (established by P.L. 111-163 for family caregivers of seriously injured post-9/11 Veterans) on Veteran use of LTSS. A two-cohort pre-post design with a nonequivalent comparison group (treated n = 15 650; comparison n = 8339) was used to (1) examine the association between caregiver enrollment in PCAFC and any VA-purchased or VA-provided LTSS use among Veterans and (2) describe program-related trends in HCBS and institutional LTSS use. The comparison group was an inverse-propensity-score weighted sample of Veterans whose caregivers applied for, but were not accepted into, the program. From baseline through 24 months post application, use of any LTSS ranged from 13.1% to 17.8% for Veterans whose caregivers were enrolled in PCAFC versus from 3.8% to 5.3% for Veterans in the comparison group. Participation in PCAFC was associated with a statistically significant increased use of any LTSS from 1 to 24 months post application (over time odds ratios ranged from 2.71 [95% confidence interval: 2.31-3.17] to 4.86 [3.93-6.02]). Support for family caregivers may enhance utilization of LTSS for Veterans with physical, emotional, and/or cognitive conditions. PMID:29591540

Dementia diagnosis and post-diagnostic support in Scottish rural communities: experiences of people with dementia and their families.

PubMed

Innes, Anthea; Szymczynska, Paulina; Stark, Cameron

2014-03-01

This paper explores the reported difficulties and satisfactions with diagnostic processes and post-diagnostic support offered to people with dementia and their families living in the largest remote and rural region in Scotland. A consultation with 18 participants, six people with dementia and 12 family members, was held using semi-structured interviews between September and November 2010. Three points in the diagnostic process were explored: events and experiences pre-diagnosis; the experience of the diagnostic process; and post-diagnostic support. Experiences of people with dementia and their carers varied at all three points in the diagnostic process. Participant experiences in this study suggest greater efforts are required to meet Government diagnosis targets and that post-diagnostic support needs to be developed and monitored to ensure that once a diagnosis is given people are well-supported. Without post-diagnostic provision Government targets for diagnosis are just that, quota targets, rather than a means to improve service experiences.

Barriers and facilitators to smoking cessation in pregnancy and in the post-partum period: The health care professionals' perspective.

PubMed

Naughton, Felix; Hopewell, Sarah; Sinclair, Lesley; McCaughan, Dorothy; McKell, Jennifer; Bauld, Linda

2018-05-15

Health care professionals and the health care environment play a central role in protecting pregnant and post-partum women and their infants from smoking-related harms. This study aimed to better understand the health professional's perspective on how interactions between women, health care professionals, and the environment influence how smoking is managed. Semi-structured interviews and focus groups. Data were from 48 health care staff involved in antenatal or post-partum care at two UK sites, including midwives, obstetricians, health visitors, GPs, pharmacists, service commissioners, and Stop Smoking Service (SSS) advisors and managers. Thematic analysis was guided by a social-ecological framework (SEF). Themes were divided across three SEF levels and represented factors connected to the management of smoking in the health care context and the beliefs and behaviour of pregnant or post-partum smokers. Organizational level: Service reconfigurations, 'last resort' nicotine replacement therapy prescribing policies, and non-mandatory training were largely negative factors. There were mixed views on opt-out referral pathways and positive views on carbon monoxide monitoring. Interpersonal level: Protection of client-professional relationships often inhibited frank discussions about smoking, and weak interservice relationships affected SSS referral motivation and quality. Individual level: Professionals felt community midwives had primary responsibility for managing smoking, although midwives felt underskilled doing this. Midwives' perceived priority for addressing smoking was influenced by the demands from unrelated organizational initiatives. Opportunities to improve clinical support for pregnant smokers exist at organizational, interservice, and health care professional levels. Interactions between levels reflect the importance of simultaneously addressing different level-specific barriers to smoking cessation in pregnancy. Statement of contribution What is already known on this subject? Few health care professionals discuss smoking cessation support with pregnant or post-partum women. Identified health care professional-related barriers to supporting pregnant and post-partum women to stop smoking include deficits in knowledge and confidence, perceived lack of time, and concerns about damaging client relationships. There is currently a gap in understanding regarding the barriers and facilitators to supporting this group and how interactions between the health care environment and health care professionals influence the way smoking is addressed. What does this study add? This study identifies modifiable factors that can influence cessation support delivery to pregnant and post-partum women. These factors are mapped across organizational, interpersonal, and individual health care professional levels. Service structure, communication pathways, and policies appear to influence what cessation support is offered. Interpersonal and individual factors influence how this support is delivered. © 2018 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.

Lessons from the organisation of the UK medical services deployed in support of Operation TELIC (Iraq) and Operation HERRICK (Afghanistan).

PubMed

Bricknell, Martin C M; Nadin, M

2017-08-01

This paper provides the definitive record of the UK Defence Medical Services (DMS) lessons from the organisation of medical services in support of Operation (Op) TELIC (Iraq) and Op HERRICK (Afghanistan). The analysis involved a detailed review of the published academic literature, internal post-operational tour reports and post-tour interviews. The list of lessons was reviewed through three Military Judgement Panel cycles producing the single synthesis ' the golden thread ' and eight ' silver bullets ' as themes to institutionalise the learning to deliver the golden thread. One additional theme, mentoring indigenous healthcare systems and providers, emerged as a completely new capability requirement. The DMS has established a programme of work to implement these lessons. 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/.

Lessons from the organisation of the UK medical services deployed in support of Operation TELIC (Iraq) and Operation HERRICK (Afghanistan)

PubMed Central

Bricknell, Martin C M; Nadin, M

2017-01-01

This paper provides the definitive record of the UK Defence Medical Services (DMS) lessons from the organisation of medical services in support of Operation (Op) TELIC (Iraq) and Op HERRICK (Afghanistan). The analysis involved a detailed review of the published academic literature, internal post-operational tour reports and post-tour interviews. The list of lessons was reviewed through three Military Judgement Panel cycles producing the single synthesis ‘the golden thread’ and eight ‘silver bullets’ as themes to institutionalise the learning to deliver the golden thread. One additional theme, mentoring indigenous healthcare systems and providers, emerged as a completely new capability requirement. The DMS has established a programme of work to implement these lessons. PMID:28062527

Peer Communication in Online Mental Health Forums for Young People: Directional and Nondirectional Support

PubMed Central

Hanley, Terry; Ujhelyi, Katalin

2017-01-01

Background The Internet has the potential to help young people by reducing the stigma associated with mental health and enabling young people to access services and professionals which they may not otherwise access. Online support can empower young people, help them develop new online friendships, share personal experiences, communicate with others who understand, provide information and emotional support, and most importantly help them feel less alone and normalize their experiences in the world. Objective The aim of the research was to gain an understanding of how young people use an online forum for emotional and mental health issues. Specifically, the project examined what young people discuss and how they seek support on the forum (objective 1). Furthermore, it looked at how the young service users responded to posts to gain an understanding of how young people provided each other with peer-to-peer support (objective 2). Methods Kooth is an online counseling service for young people aged 11-25 years and experiencing emotional and mental health problems. It is based in the United Kingdom and provides support that is anonymous, confidential, and free at the point of delivery. Kooth provided the researchers with all the online forum posts between a 2-year period, which resulted in a dataset of 622 initial posts and 3657 initial posts with responses. Thematic analysis was employed to elicit key themes from the dataset. Results The findings support the literature that online forums provide young people with both informational and emotional support around a wide array of topics. The findings from this large dataset also reveal that this informational or emotional support can be viewed as directive or nondirective. The nondirective approach refers to when young people provide others with support by sharing their own experiences. These posts do not include explicit advice to act in a particular way, but the sharing process is hoped to be of use to the poster. The directive approach, in contrast, involves individuals making an explicit suggestion of what they believe the poster should do. Conclusions This study adds to the research exploring what young people discuss within online forums and provides insights into how these communications take place. Furthermore, it highlights the challenge that organizations may encounter in mediating support that is multidimensional in nature (informational-emotional, directive-nondirective). PMID:28768607

The detection and prevention of unintentional consumption of DOx and 25x-NBOMe at Portugal's Boom Festival.

PubMed

Martins, Daniel; Barratt, Monica J; Pires, Cristiana Vale; Carvalho, Helena; Vilamala, Mireia Ventura; Espinosa, Iván Fornís; Valente, Helena

2017-05-01

This paper describes the misrepresentation of LSD at Portugal's Boom Festival 2014 and the prevention of unintentional consumption of DOx and 25x-NBOMe among LSD consumers attending a drug-checking service. Two hundred forty-five drug samples expected to contain LSD were submitted to the drug-checking service for chemical analysis. One hundred ten post-test questionnaires were successfully matched with test results. About 67.3% of the alleged LSD samples tested contained only LSD; 0.8% contained LSD combined with adulterants; 24.1% did not contain LSD but did contain another psychoactive substance, including 11.4% that were 2,5-dimethoxyamphetamine derivatives and 9.8% that were N-benzyl-2,5-dimethoxyphenethylamine derivatives; and no psychoactive substance was detected in 7.8%. The majority of service users who received unexpected test results regarding their alleged LSD (74.2%) reported that they did not intend to consume the drug. Following dissemination of alerts on day 2, a larger than expected proportion of all tests conducted were for LSD, when comparing the 2014 festival to 2012, where no such alert was disseminated. Although these results support the provision of integrated drug-checking services in party settings, evidence of their utility and effectiveness would be improved through future research incorporating more robust measures of outcomes following provision of drug-checking results. Copyright © 2017 John Wiley & Sons, Ltd.

Myths and Misinformation About Gunshot Wounds may Adversely Affect Proper Treatment.

PubMed

Hafertepen, Stephen C; Davis, James W; Townsend, Ricard N; Sue, Lawrence P; Kaups, Krista L; Cagle, Kathleen M

2015-07-01

Poorly designed experiments and popular media have led to multiple myths about wound ballistics. Some of these myths have been incorporated into the trauma literature as fact and are included in Advanced Trauma Life Support (ATLS). We hypothesized that these erroneous beliefs would be prevalent, even among those providing care for patients with gunshot wounds (GSWs), but could be addressed through education. ATLS course content was reviewed. Several myths involving wound ballistics were identified. Clinically relevant myths were chosen including wounding mechanism, lead poisoning, debridement, and antibiotic use. Subsequently, surgery and emergency medicine services at three different trauma centers were studied. All three sites were busy, urban trauma centers with a significant amount of penetrating trauma. A pre-test was administered prior to a lecture on wound ballistics followed by a post-test. Pre- and post-test scores were compared and correlated with demographic data including ATLS course completion, firearm/ballistics experience, and years of post-graduate medical experience (PGME). One-hundred and fifteen clinicians participated in the study. A mean pre-test score of 34 % improved to 78 % on the post-test with associated improvements in all areas of knowledge (p < 0.001). Years of PGME correlated with higher pre-test score (p = 0.021); however, ATLS status did not (p = 0.774). Erroneous beliefs involving wound ballistics are prevalent even among clinicians who frequently treat victims of GSWs and could lead to inappropriate treatment. Focused education markedly improved knowledge. The ATLS course and manual promulgate some of these myths and should be revised.

Mobile Device Intervention for Student Support Services in Distance Education Context--FRAME Model Perspective

ERIC Educational Resources Information Center

Kumar, Lalita S.; Jamatia, Biplab; Aggarwal, A. K.; Kannan, S.

2011-01-01

This paper reports the findings of a study conducted to analyse the effect of mobile device intervention for student support services and to gauge its use for enhancing teaching--learning process as a future study in the context of offer of Distance Education programmes. The study was conducted with the learners of the coveted Post Graduate…

Reducing recurrence in child protective services: impact of a targeted safety protocol.

PubMed

Fluke, J; Edwards, M; Bussey, M; Wells, S; Johnson, W

2001-08-01

Statewide implementation of a child safety assessment protocol by the Illinois Department of Children and Family Services (DCFS) in 1995 is assessed to determine its impact on near-term recurrence of child maltreatment. Literature on the use of risk and safety assessment as a decision-making tool supports the DCFS's approach. The literature on the use of recurrence as a summative measure for evaluation is described. Survival analysis is used with an administrative data set of 400,000 children reported to DCFS between October 1994 and November 1997. An ex-post facto design tests the hypothesis that the use of the protocol cannot be ruled out as an explanation for the observed decline in recurrence following implementation. Several alternative hypotheses are tested: change in use of protective custody, other concurrent changes in state policy, and the concurrent experience of other states. The impact of the protocol to reduce recurrence was not ruled out.

Psychosocial risk factors and treatment of new onset and recurrent depression during the post-partum period.

PubMed

Kettunen, Pirjo; Hintikka, Jukka

2017-07-01

When developing maternity care services, it is important to know how psychosocial factors affect the course of post-partum depression (PPD), and how depressed mothers are treated. The aim of this study is to assess how adverse childhood experiences, poor present support and violence, and low socioeconomic status (SES) associate with PPD, specifically in new onset and recurrent post-partum depression. The second aim is to assess the treatment received for PPD. This is a cross-sectional study. The study group comprises 104 mothers with a current episode of PPD, and a control group of 104 mothers without an episode. The Structured Clinical Interview for DSM-IV Axis I Disorders was used for data collection. Psychosocial risk factors, treatment issues, and the course of depression were assessed with a structured self-report questionnaire. In age-adjusted multivariate analyses, adverse childhood experiences, a low level of present support in close relationships, and a poor SES were associated significantly with PPD. Childhood adversity was associated with both new onset and recurrent depression. Nevertheless, a low level of support and a poor SES were also associated with recurrent depression. A quarter of mothers with a major depressive episode in the post-partum period attended psychiatric services. In mothers with new onset depression, the proportion was only 5%. There is an urgent need to develop the diagnostics of depression in maternity care services. An awareness of psychosocial risk factors might help in this. More depressed mothers should be referred to psychiatric services.

Implementing an educational program to improve critical care nurses' enteral nutritional support.

PubMed

Kim, Hyunjung; Chang, Sun Ju

2018-05-11

Although international nutrition societies recommend enteral nutrition guidelines for patients in intensive care units (ICUs), large gaps exist between these recommendations and actual clinical practice. Education programs designed to improve nurses' knowledge about enteral nutrition are therefore required. In Korea, there are no educational intervention studies about evidence-based guidelines of enteral nutrition for critically ill patients. We aimed to evaluate the effects of an education program to improve critical care nurses' perceptions, knowledge, and practices towards providing enteral nutritional support for ICU patients. A quasi-experimental, one-group study with a pre- and post-test design was conducted from March to April 2015. Nurses (N = 205) were recruited from nine ICUs from four tertiary hospitals in South Korea. The education program comprised two sessions of didactic lectures. Data were collected before (pre-test) and 1 month after (post-test) the education program using questionnaires that addressed nurses' perceptions, knowledge, and practices relating to providing enteral nutritional support for ICU patients. After the program, nurses showed a significant improvement in their perceptions and knowledge of enteral nutrition for ICU patients. There was a significant improvement in inspecting nostrils daily, flushing the feeding tube before administration, providing medication that needs to be crushed correctly, changing feeding sets, and adjusting feeding schedules. The findings indicate that an enteral nutrition education program could be an effective strategy to increase critical care nurses' support for the critically ill. This education program can be incorporated into hospital education or in-service training for critical care nurses to strengthen their perceptions and knowledge of nutritional support in the ICU. This may improve the clinical outcomes of ICU patients. Copyright © 2018 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Aft Skirt Electrical Umbilical (ASEU) and Vehicle Support Post (

NASA Image and Video Library

2016-12-09

A flatbed truck carries a vertical support post (VSP) for NASA's Space Launch System (SLS) rocket to the Mobile Launcher Yard at NASA's Kennedy Space Center in Florida. The two aft skirt electrical umbilicals (ASEUs) and the first of the vehicle support posts underwent a series of tests to confirm they are functioning properly and ready to support the SLS for launch. The ASEUs will connect to the SLS rocket at the bottom outer edge of each booster and provide electrical power and data connections to the rocket until it lifts off from the launch pad. The eight VSPs will support the load of the solid rocket boosters, with four posts for each of the boosters. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Cyberinfrastructure for Aircraft Mission Support

NASA Technical Reports Server (NTRS)

Freudinger, Lawrence C.

2010-01-01

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

Medical and pharmacy student concerns about participating on international service-learning trips.

PubMed

Chuang, Chih; Khatri, Siddique H; Gill, Manpal S; Trehan, Naveen; Masineni, Silpa; Chikkam, Vineela; Farah, Guillaume G; Khan, Amber; Levine, Diane L

2015-12-23

International Service Learning Trips (ISLT) provide health professional students the opportunity to provide healthcare, under the direction of trained faculty, to underserved populations in developing countries. Despite recent increases in international service learning trips, there is scant literature addressing concerns students have prior to attending such trips. This study focuses on identifying concerns before and after attending an ISLT and their impact on students. A survey comprised of closed and open-ended questions was developed to elucidate student concerns prior to attending an ISLT and experiences which might influence concerns. A five-point Likert-scale (extremely concerned = 1, minimally concerned = 5) was used to rate apprehension and satisfaction. Paired t-test was used to compare pre- and post-trip concerns; Chi-Square test was used to compare groups. Thirty-five students (27 medical, 8 pharmacy) attended ISLTs in December 2013. All completed pre and post-trip surveys. Significant decreases were seen in concerns related to cultural barriers (4.14 vs 4.46, P = .047), disease/epidemics (3.34 vs 4.60, P < .001), natural disasters (3.94 vs 4.94, P < .001), terrorism (4.34 vs 4.94, P < .001), travel (3.86 vs 4.51, P < .001) monetary issues (3.80 vs 4.60, P < .001), hospitality (3.94 vs 4.74, P = .001) and food (3.83 vs 4.60, P < .001). Language and group dynamics remained concerns post-trip. On open-ended questions, students described benefits of attending an ISLT. Students had multiple concerns prior to attending an ISLT. Most decreased upon return. Addressing concerns has the potential to decrease student apprehension. The results of this study highlight the benefits of providing ISLTs and supporting development of a curriculum incorporating trip-related concerns.

A Community of Practice Approach to Delivering Research Support Services in a Post-92 Higher Education Institution: A Reflective Case Study

ERIC Educational Resources Information Center

Coombs, Jenny; Thomas, Mandy; Rush, Nathan; Martin, Elizabeth

2017-01-01

The need for research support in U.K. universities is growing at a fast pace and a number of different professional and academic units within universities are involved in the process. This case study takes place in a post-92 higher education institution and discusses the benefit of utilizing a cross-university Community of Practice (CoP) approach…

Time devoted to pre- and post-HIV test counselling in different health services according to participants of a rapid testing program in Madrid, Spain.

PubMed

Hoyos Miller, Juan; Fernández-Balbuena, Sonia; Belza Egozcue, María José; García de Olalla, Patricia; Pulido Manzanero, Jose; Molist Señe, Gemma; de la Fuente de Hoz, Luis

2014-02-01

The role of pre- and post-test counselling in new HIV testing strategies to reduce delayed diagnosis has been debated. Data on time devoted to counselling are scarce. One approach to this problem is to explore patients' views on the time devoted to counselling by venue of their last HIV test. We analysed data from 1568 people with a previous HIV test who attended a mobile HIV testing program in Madrid between May and December 2008. The majority (71%) were men (48% had had sex with other men), 51% were <30 years, 40% were foreigners, 56% had a university degree, and 40% had the most recent HIV test within the last year. As regards pre-test counselling, 30% stated they were told only that they would receive the test; 26.3% reported <10 min; 20.4% about 10 min; and 24.2%, 15 min or more. For post-test counselling: 40.2% stated they were told only that the test was negative; 24.9% reported 2-6 min; 16.4% about 10 min; and 18.5%, 15 min or more. The percentage of participants who reported no counselling time was higher among those tested in general health services: primary care, hospital settings and private laboratories (over 40% in pre-test, over 50% in post-test counselling). Women received less counselling time than men in almost all settings. Policies to expand HIV testing in general health services should take this current medical behaviour into account. Any mention of the need for counselling can be a barrier to expansion, because HIV is becoming less of a priority in developed countries. Oral consent should be the only requirement. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Secondary analysis of the "Love Me...Never Shake Me" SBS education program.

PubMed

Deyo, Grace; Skybo, Theresa; Carroll, Alisa

2008-11-01

Shaken baby syndrome (SBS) is preventable; however, an estimated 21-74 per 100,000 children worldwide are victims annually. This study examined the effectiveness of an SBS prevention program in the US. A descriptive, secondary analysis of the Prevent Child Abuse Ohio (PCAO) "Love Me...Never Shake Me" SBS education program database included 7,051 women who completed a commitment statement, pre and post-test, and follow-up survey. Participants were mostly White (76%), had at least some college education (62%), were privately insured (62%), and lived with the father and infant (63%). Mothers knew of the dangers of shaking (96%) and recommended SBS education for all parents (98%) because they found it helpful (97%). Scores on the pre and post-tests were significantly different, but there was no difference based on education site or demographics. There was a significant increase in a pre/post-test item pertaining to infant crying. At follow-up, participants remembered postpartum SBS education (98%), but post-discharge did not receive SBS education from their primary care provider (62%). Most mothers practiced infant soothing techniques (79%) provided in the education; however, few women practiced self-coping techniques (36%) and accessed community support services (9%). Postpartum SBS prevention education should continue. Development of SBS programs should result from these study findings focusing on education content and program evaluation. Mothers report that shaken baby syndrome education is important for all parents and memorable at follow-up. Postpartum SBS education should continue because the hospital is the primary place they receive education. Mothers' report they less frequently receive education from healthcare sources post-discharge. Diligence of primary care providers to incorporate SBS prevention education in well child visits will increase parental exposure to this information. Education may need to place greater emphasis on infant crying and soothing, as well as parent support and self-coping techniques versus the dangers of shaking.

Use of inpatient psychiatric services on a U.S. Army combat support post during Operations Desert Shield and Desert Storm: the stress of non-deployment.

PubMed

Koshes, R J; Rothberg, J M

1994-06-01

We studied the utilization of inpatient psychiatric services during Operations Desert Shield and Desert Storm (the Persian Gulf War of 1990-1991) on a U.S. Army combat support post. Inpatient psychiatric admissions and dispositions for the post's catchment area were tallied before, during, and after Operations Desert Shield and Desert Storm. Subjects included active duty soldiers (deployed soldiers were not studied while they were away from the post), their families, and retirees. Overall, there was no increase in psychiatric hospitalizations for active duty soldiers, their family members, or retirees. However, coincident with the return of soldiers from Operations Desert Shield and Desert Storm, the psychiatric proportion of all hospitalizations increased in the subpopulation of soldiers not deployed who had served less than 1 year. These soldiers in training may be more susceptible to increased stress levels associated with the return of soldiers from war because of their inadequate group bonding.

Mediators of disability and hope for people with spinal cord injury.

PubMed

Phillips, Brian N; Smedema, Susan M; Fleming, Allison R; Sung, Connie; Allen, Michael G

2016-08-01

To test potential strength-based mediators of functional disability and hope in adults with spinal cord injury. Two hundred and forty-two participants with spinal cord injury were recruited for this study. The mean age of participants was 44.6 years (standard deviation = 13.2), and 66.1% were men. Participants completed a survey containing a demographic questionnaire, as well as measures of functional disability, hope, self-esteem, proactive coping, perceived social support and disability acceptance. Mediation analysis was conducted using a bootstrap test for multiple mediators. Proactive coping, self-esteem and perceived social support significantly mediated the relationship between functional disability and hope, while disability acceptance did not. The combination of mediators resulted in functional disability no longer being a significant predictor of hope. The strength-based constructs of proactive coping, self-esteem and social support appear effective in predicting hope regardless of severity of spinal cord injury. Functional disability was no longer predictive of hope after controlling for these strength-based constructs. Disability acceptance did not significantly add to the mediation model. These results provide further evidence for strength-based interventions in rehabilitation. Implications for Rehabilitation Strength-based constructs of proactive coping, self-esteem and social support are important factors for addressing hope following spinal cord injury, regardless of level of severity. Rehabilitation services providers should focus efforts on supporting clients in the accurate appraisal of predictable stressors and then generate means for addressing them as a form of proactive coping. Rehabilitation services providers must be cautious when addressing self-esteem to focus on perceived competence and learning processes rather than self-esteem directly or through the accomplishment of goals that may not be achieved. Knowing that social supports are related to hope post-spinal cord injury, it is important for rehabilitation services providers to recognize potential social supports early in the rehabilitation process and involve those social supports in the rehabilitation process when possible.

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...

Evaluation of Wood Species and Preservatives for Use in Wisconsin Highway Sign Posts

Treesearch

Stan T. Lebow; Robert J. Ross; Samuel L. Zelinka

2014-01-01

The Wisconsin Department of Transportation (WisDOT) uses wooden posts to support many types of signs along state highways. WisDOT currently uses red pine or Southern Pine posts treated with chromated copper arsenate (CCA) and has generally experienced satisfactory performance and service life. However, there are some areas of concern, as well as potential opportunities...

Building social networks for maternal and newborn health in poor urban settlements: a cross-sectional study in Bangladesh.

PubMed

Adams, Alayne M; Nababan, Herfina Y; Hanifi, S M Manzoor Ahmed

2015-01-01

The beneficial influence of social networks on health and wellbeing is well-established. In poor urban settlements in Bangladesh, BRAC's Manoshi programme trains community health workers (CHWs) to support women through pregnancy, delivery and postpartum periods. This paper test the hypothesis that the introduction of CHWs as weak ties into the social networks of Manoshi members mediates improvements in maternal and neonatal health (MNH) best practices by providing support, facilitating ideational change, connecting mother to resources, and strengthening or countering the influence of strong ties. 1000 women who had given birth in the last three months were identified and interviewed as part of ongoing monitoring of 5 poor urban settlements in Dhaka, Bangladesh. A social networks questionnaire was administered which elicited women's perceived networks around pregnancy, delivery and post-partum periods. Mediation analysis was performed to test the hypothesis that penetration of Manoshi CHWs into women's perceived networks has a beneficial effect on MNH best practises. The presence and influence of Manoshi CHWs in women's networks significantly mediated the effect of Manoshi membership on MNH best practices. Respondents who were Manoshi members and who listed Manoshi CHWs as part of their support networks were significantly more likely to deliver with a trained birth attendant (OR 3.61; 95%CI 2.36-5.51), to use postnatal care (OR 3.09; 95%CI 1.83-5.22), and to give colostrum to their newborn (OR 7.51; 95%CI 3.51-16.05). Manoshi has succeeded in penetrating the perceived pregnancy, delivery and post-partum networks of poor urban women through the introduction of trained CHWs. Study findings demonstrate the benefits of moving beyond urban health care delivery models that concentrate on the provision of clinical services by medical providers, to an approach that nurtures the power of social networks as a means to support the poorest and most marginalized in changing behaviour and effectively accessing appropriate maternal services.

JSpOC Mission System Application Development Environment

NASA Astrophysics Data System (ADS)

Luce, R.; Reele, P.; Sabol, C.; Zetocha, P.; Echeverry, J.; Kim, R.; Golf, B.

2012-09-01

The Joint Space Operations Center (JSpOC) Mission System (JMS) is the program of record tasked with replacing the legacy Space Defense Operations Center (SPADOC) and Astrodynamics Support Workstation (ASW) capabilities by the end of FY2015 as well as providing additional Space Situational Awareness (SSA) and Command and Control (C2) capabilities post-FY2015. To meet the legacy replacement goal, the JMS program is maturing a government Service Oriented Architecture (SOA) infrastructure that supports the integration of mission applications while acquiring mature industry and government mission applications. Future capabilities required by the JSpOC after 2015 will require development of new applications and procedures as well as the exploitation of new SSA data sources. To support the post FY2015 efforts, the JMS program is partnering with the Air Force Research Laboratory (AFRL) to build a JMS application development environment. The purpose of this environment is to: 1) empower the research & development community, through access to relevant tools and data, to accelerate technology development, 2) allow the JMS program to communicate user capability priorities and requirements to the developer community, 3) provide the JMS program with access to state-of-the-art research, development, and computing capabilities, and 4) support market research efforts by identifying outstanding performers that are available to shepherd into the formal transition process. The application development environment will consist of both unclassified and classified environments that can be accessed over common networks (including the Internet) to provide software developers, scientists, and engineers everything they need (e.g., building block JMS services, modeling and simulation tools, relevant test scenarios, documentation, data sources, user priorities/requirements, and SOA integration tools) to develop and test mission applications. The developed applications will be exercised in these relevant environments with representative data sets to help bridge the gap between development and integration into the operational JMS enterprise.

Predictors of Well-Being in the Lives of Student Service Members and Veterans

ERIC Educational Resources Information Center

Williston, Sarah Krill; Roemer, Lizabeth

2017-01-01

Objective: The current study examined predictors of well-being, including quality of life and academic engagement, in a sample of student service members and veteran college students. Methods: Eighty-seven student service members/veterans (SSM/V) completed an online survey containing questions about post-deployment social support, emotion…

Developing Web Services for Technology Education. The Graphic Communication Electronic Publishing Project.

ERIC Educational Resources Information Center

Sanders, Mark

1999-01-01

Graphic Communication Electronic Publishing Project supports a Web site (http://TechEd.vt.edu/gcc/) for graphic communication teachers and students, providing links to Web materials, conversion of print materials to electronic formats, and electronic products and services including job listings, resume posting service, and a listserv. (SK)

47 CFR 54.702 - Administrator's functions and responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... schools and libraries support mechanism, the rural health care support mechanism, the high cost support...) The Administrator may not make policy, interpret unclear provisions of the statute or rules, or..., on which applications for services will be posted on behalf of schools, libraries and rural health...

Re-Designing Community Mental Health Services for Urban Children: Supporting Schooling to Promote Mental Health

PubMed Central

Atkins, Marc S.; Shernoff, Elisa S.; Frazier, Stacy L.; Schoenwald, Sonja K.; Cappella, Elise; Marinez-Lora, Ane; Mehta, Tara G.; Lakind, Davielle; Cua, Grace; Bhaumik, Runa; Bhaumik, Dulal

2015-01-01

Objective This study examined a school- and home-based mental health service model, Links to Learning (L2L), focused on empirical predictors of learning as primary goals for services in high poverty urban communities. Method Teacher key opinion leaders (KOLs) were identified through sociometric surveys and trained, with mental health providers (MHPs) and parent advocates (PAs), on evidence-based practices to enhance children’s learning. KOLs and MHPs co-facilitated professional development sessions for classroom teachers to disseminate two universal (Good Behavior Game, Peer Assisted Learning) and two targeted (Good News Notes, Daily Report Card) interventions. Group-based and home-based family education and support were delivered by MHPs and PAs for K-4th grade children diagnosed with one or more disruptive behavior disorder. Services were Medicaid-funded through four social service agencies (N = 17 providers) in seven schools (N = 136 teachers, 171 children) in a two (L2L vs. services-as-usual SAU]) by six (pre- and post-tests for three years) longitudinal design with random assignment of schools to conditions. SAU consisted of supported referral to a nearby social service agency. Results Mixed effects regression models indicated significant positive effects of L2L on mental health service use, classroom observations of academic engagement, teacher report of academic competence and social skills, and parent report of social skills. Nonsignificant between-group effects were found on teacher and parent report of problem behaviors, daily hassles, and curriculum based measures. Effects were strongest for young children, girls, and children with fewer symptoms. Conclusions Community mental health services targeting empirical predictors of learning can improve school and home behavior for children living in high poverty urban communities. PMID:26302252

Aft Skirt Electrical Umbilical (ASEU) and Vehicle Support Post (

NASA Image and Video Library

2016-12-09

A construction worker is in view as a flatbed truck passes by carrying a vertical support post (VSP) for NASA's Space Launch System (SLS) rocket to the Mobile Launcher Yard at NASA's Kennedy Space Center in Florida. The two aft skirt electrical umbilicals (ASEUs) and the first of the vehicle support posts underwent a series of tests to confirm they are functioning properly and ready to support the SLS for launch. The ASEUs will connect to the SLS rocket at the bottom outer edge of each booster and provide electrical power and data connections to the rocket until it lifts off from the launch pad. The eight VSPs will support the load of the solid rocket boosters, with four posts for each of the boosters. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Aft Skirt Electrical Umbilical (ASEU) and Vehicle Support Post (

NASA Image and Video Library

2016-12-09

A flatbed truck carries a vertical support post (VSP) for NASA's Space Launch System (SLS) rocket to the Mobile Launcher Yard at NASA's Kennedy Space Center in Florida. In view is the mobile launcher. The two aft skirt electrical umbilicals (ASEUs) and the first of the vehicle support posts underwent a series of tests to confirm they are functioning properly and ready to support the SLS for launch. The ASEUs will connect to the SLS rocket at the bottom outer edge of each booster and provide electrical power and data connections to the rocket until it lifts off from the launch pad. The eight VSPs will support the load of the solid rocket boosters, with four posts for each of the boosters. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Unmet needs and service satisfaction of victim support for the direct and indirect victims of serious violence: Results from a cross-sectional survey in Taiwan

PubMed Central

2018-01-01

Victim support services, in mature societies, aim to help victims recover after suffering a traumatic event. The effectiveness of victim support has traditionally been evaluated through rates of service utilization and incidence of psychopathology such as posttraumatic stress disorder. The current study, instead, inquires into service users’ unmet needs and satisfaction, and identifies factors that mediate such subjective measures, using data from a national cross-sectional survey on victims and surviving families of violent crime in Taiwan in 2011. The results reveal: 1) a gap between available and expected services, and 2) a correlation between service utilization and satisfaction, both consistent with previous studies. In addition, the current study identifies unsatisfied service users: They are homicidally bereaved, live with their spouse, suffer from post-crime financial distress and are still waiting for a court verdict on the incident. Victim support that helps victims heal through tailored services incorporating relationship counseling is proposed. PMID:29466463

Development of Test Protocols for International Space Station Particulate Filters

NASA Technical Reports Server (NTRS)

Green, Robert D.; Vijayakumar, R.; Agui, Juan H.

2014-01-01

Air quality control on the International Space Station (ISS) is a vital requirement for maintaining a clean environment for the crew and the hardware. This becomes a serious challenge in pressurized space compartments since no outside air ventilation is possible, and a larger particulate load is imposed on the filtration system due to lack of gravitational settling. The ISS Environmental Control and Life Support System (ECLSS) uses a filtration system that has been in use for over 14 years and has proven to meet this challenge. The heart of this system is a traditional High- Efficiency Particulate Air (HEPA) filter configured to interface with the rest of the life support elements and provide effective cabin filtration. Over the years, the service life of these filters has been re-evaluated based on limited post-flight tests of returned filters and risk factors. On earth, a well designed and installed HEPA filter will last for several years, e.g. in industrial and research clean room applications. Test methods for evaluating these filters are being developed on the basis of established test protocols used by the industry and the military. This paper will discuss the test methods adopted and test results on prototypes of the ISS filters. The results will assist in establishing whether the service life can be extended for these filters. Results from unused filters that have been in storage will also be presented to ascertain the shelf life and performance deterioration, if any and determine if the shelf life may be extended.

Fall Risk, Supports and Services, and Falls Following a Nursing Home Discharge.

PubMed

Noureldin, Marwa; Hass, Zachary; Abrahamson, Kathleen; Arling, Greg

2017-09-04

Falls are a major source of morbidity and mortality among older adults; however, little is known regarding fall occurrence during a nursing home (NH) to community transition. This study sought to examine whether the presence of supports and services impacts the relationship between fall-related risk factors and fall occurrence post NH discharge. Participants in the Minnesota Return to Community Initiative who were assisted in achieving a community discharge (N = 1459) comprised the study sample. The main outcome was fall occurrence within 30 days of discharge. Factor analyses were used to estimate latent models from variables of interest. A structural equation model (SEM) was estimated to determine the relationship between the emerging latent variables and falls. Fifteen percent of participants fell within 30 days of NH discharge. Factor analysis of fall-related risk factors produced three latent variables: fall concerns/history; activities of daily living impairments; and use of high-risk medications. A supports/services latent variable also emerged that included caregiver support frequency, medication management assistance, durable medical equipment use, discharge location, and receipt of home health or skilled nursing services. In the SEM model, high-risk medications use and fall concerns/history had direct positive effects on falling. Receiving supports/services did not affect falling directly; however, it reduced the effect of high-risk medication use on falling (p < .05). Within the context of a state-implemented transition program, findings highlight the importance of supports/services in mitigating against medication-related risk of falling post NH discharge. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Feasibility test of a UK-scalable electronic system for regular collection of patient-reported outcome measures and linkage with clinical cancer registry data: the electronic Patient-reported Outcomes from Cancer Survivors (ePOCS) system.

PubMed

Ashley, Laura; Jones, Helen; Forman, David; Newsham, Alex; Brown, Julia; Downing, Amy; Velikova, Galina; Wright, Penny

2011-10-26

Cancer survivors can face significant physical and psychosocial challenges; there is a need to identify and predict which survivors experience what sorts of difficulties. As highlighted in the UK National Cancer Survivorship Initiative, routine post-diagnostic collection of patient reported outcome measures (PROMs) is required; to be most informative, PROMs must be linked and analysed with patients' diagnostic and treatment information. We have designed and built a potentially cost-efficient UK-scalable electronic system for collecting PROMs via the internet, at regular post-diagnostic time-points, for linking these data with patients' clinical data in cancer registries, and for electronically managing the associated patient monitoring and communications; the electronic Patient-reported Outcomes from Cancer Survivors (ePOCS) system. This study aims to test the feasibility of the ePOCS system, by running it for 2 years in two Yorkshire NHS Trusts, and using the Northern and Yorkshire Cancer Registry and Information Service. Non-metastatic breast, colorectal and prostate cancer patients (largest survivor groups), within 6 months post-diagnosis, will be recruited from hospitals in the Yorkshire Cancer Network. Participants will be asked to complete PROMS, assessing a range of health-related quality-of-life outcomes, at three time-points up to 15 months post-diagnosis, and subsequently to provide opinion on the ePOCS system via a feedback questionnaire. Feasibility will be examined primarily in terms of patient recruitment and retention rates, the representativeness of participating patients, the quantity and quality of collected PROMs data, patients' feedback, the success and reliability of the underpinning informatics, and the system running costs. If sufficient data are generated during system testing, these will be analysed to assess the health-related quality-of-life outcomes reported by patients, and to explore if and how they relate to disease, treatment and/or individual differences characteristics. There is currently no system in the UK for collecting PROMs online and linking these with patients' clinical data in cancer registries. If feasible, ePOCS has potential to provide an affordable UK-scalable technical platform to facilitate and support longitudinal cohort research, and improve understanding of cancer survivors' experiences. Comprehensive understanding of survivorship difficulties is vital to inform the development and provision of supportive services and interventions.

Fifty-Year Durability Evaluation of Posts Treated with Industrial Wood Preservatives

Treesearch

Stan T. Lebow; Patricia Lebow; Bessie Woodward; Grant T. Kirker; Rachel Arango

2015-01-01

Long-term durability data are needed to improve service life estimates for treated wood products used as critical structural supports in industrial applications. This article reports the durability of longleaf pine (Pinus palustris) posts pressure treated with ammoniacal copper arsenate (ACA), chromated copper arsenate (CCA), creosote, or...

Integrating post-manufacturing issues into design and manufacturing decisions

NASA Technical Reports Server (NTRS)

Eubanks, Charles F.

1996-01-01

An investigation is conducted on research into some of the fundamental issues underlying the design for manufacturing, service and recycling that affect engineering decisions early in the conceptual design phase of mechanical systems. The investigation focuses on a system-based approach to material selection, manufacturing methods and assembly processes related to overall product requirements, performance and life-cycle costs. Particular emphasis is placed on concurrent engineering decision support for post-manufacturing issues such as serviceability, recyclability, and product retirement.

Transition and Post-School Outcomes for Youth with Disabilities: Closing the Gaps to Post-Secondary Education and Employment.

ERIC Educational Resources Information Center

National Council on Disability, Washington, DC.

This report presents an analysis of research on the state of transition, post-secondary education, and employment outcomes for youth and young adults with disabilities over the past 25 years. It identifies what has worked in the areas of transition planning, services, and supports. It also considers what should work in light of unmet needs and…

The Effect of Tutoring on Math Scores for the Praxis I Exam

ERIC Educational Resources Information Center

Longwell-Grice, Robert; McIlheran, Janine; Schroeder, Mark; Scheele, Steve

2013-01-01

The Praxis test is one of a series of national teacher certification exams written and administered by the Education Testing Service (ETS) since 1947. Currently, forty states now require some form of the Praxis Series (Educational Testing Service, 2011). Using pre- and post-tests similar to the Praxis I math exam, this study examined the affect…

Effect of Current Electricity Simulation Supported Learning on the Conceptual Understanding of Elementary and Secondary Teachers

ERIC Educational Resources Information Center

Kumar, David Devraj; Thomas, P. V.; Morris, John D.; Tobias, Karen M.; Baker, Mary; Jermanovich, Trudy

2011-01-01

This study examined the impact of computer simulation and supported science learning on a teacher's understanding and conceptual knowledge of current electricity. Pre/Post tests were used to measure the teachers' concept attainment. Overall, there was a significant and large knowledge difference effect from Pre to Post test. Two interesting…

Perceptions of Student Affairs and Services Practitioners in Ontario's Post-Secondary Institutions: An Examination of Colleges and Universities

ERIC Educational Resources Information Center

Seifert, Tricia A.; Burrow, Jeff

2013-01-01

Student affairs and services divisions and the partnerships and collaborations in which they engage with faculty, students, and the community form the structural centre of institutions' approaches to student support. Although past research has identified areas typically associated with the student affairs and services portfolio and factors that…

Evaluation of the Ticket to Work Program: Assessment of Post-Rollout Implementation and Early Impacts, Volume 1

ERIC Educational Resources Information Center

Thornton, Craig; Livermore, Gina; Fraker, Thomas; Stapleton, David; O'Day, Bonnie; Wittenburg, David; Weathers, Robert; Goodman, Nanette; Silva, Tim; Martin, Emily Sama; Gregory, Jesse; Wright, Debra; Mamun, Arif

2007-01-01

Ticket to Work and Self-Sufficiency program (TTW) was designed to enhance the market for services that help disability beneficiaries become economically self-sufficient by providing beneficiaries with a wide range of choices for obtaining services and to give employment-support service providers new financial incentives to serve beneficiaries…

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.

Hospital support services and the impacts of outsourcing on occupational health and safety.

PubMed

Siganporia, Pearl; Astrakianakis, George; Alamgir, Hasanat; Ostry, Aleck; Nicol, Anne-Marie; Koehoorn, Mieke

2016-10-01

Outsourcing labor is linked to negative impacts on occupational health and safety (OHS). In British Columbia, Canada, provincial health care service providers outsource support services such as cleaners and food service workers (CFSWs) to external contractors. This study investigates the impact of outsourcing on the occupational health safety of hospital CFSWs through a mixed methods approach. Worker's compensation data for hospital CFSWs were analyzed by negative binomial and multiple linear regressions supplemented by iterative thematic analysis of telephone interviews of the same job groups. Non-significant decreases in injury rates and days lost per injury were observed in outsourced CFSWs post outsourcing. Significant decreases (P < 0.05) were observed in average costs per injury for cleaners post outsourcing. Outsourced workers interviewed implied instances of underreporting workplace injuries. This mixed methods study describes the impact of outsourcing on OHS of healthcare workers in British Columbia. Results will be helpful for policy-makers and workplace regulators to assess program effectiveness for outsourced workers.

Hospital support services and the impacts of outsourcing on occupational health and safety

PubMed Central

Alamgir, Hasanat; Ostry, Aleck; Nicol, Anne-Marie; Koehoorn, Mieke

2016-01-01

Background Outsourcing labor is linked to negative impacts on occupational health and safety (OHS). In British Columbia, Canada, provincial health care service providers outsource support services such as cleaners and food service workers (CFSWs) to external contractors. Objectives This study investigates the impact of outsourcing on the occupational health safety of hospital CFSWs through a mixed methods approach. Methods Worker’s compensation data for hospital CFSWs were analyzed by negative binomial and multiple linear regressions supplemented by iterative thematic analysis of telephone interviews of the same job groups. Results Non-significant decreases in injury rates and days lost per injury were observed in outsourced CFSWs post outsourcing. Significant decreases (P < 0.05) were observed in average costs per injury for cleaners post outsourcing. Outsourced workers interviewed implied instances of underreporting workplace injuries. Conclusions This mixed methods study describes the impact of outsourcing on OHS of healthcare workers in British Columbia. Results will be helpful for policy-makers and workplace regulators to assess program effectiveness for outsourced workers. PMID:27696988

Peer Communication in Online Mental Health Forums for Young People: Directional and Nondirectional Support.

PubMed

Prescott, Julie; Hanley, Terry; Ujhelyi, Katalin

2017-08-02

The Internet has the potential to help young people by reducing the stigma associated with mental health and enabling young people to access services and professionals which they may not otherwise access. Online support can empower young people, help them develop new online friendships, share personal experiences, communicate with others who understand, provide information and emotional support, and most importantly help them feel less alone and normalize their experiences in the world. The aim of the research was to gain an understanding of how young people use an online forum for emotional and mental health issues. Specifically, the project examined what young people discuss and how they seek support on the forum (objective 1). Furthermore, it looked at how the young service users responded to posts to gain an understanding of how young people provided each other with peer-to-peer support (objective 2). Kooth is an online counseling service for young people aged 11-25 years and experiencing emotional and mental health problems. It is based in the United Kingdom and provides support that is anonymous, confidential, and free at the point of delivery. Kooth provided the researchers with all the online forum posts between a 2-year period, which resulted in a dataset of 622 initial posts and 3657 initial posts with responses. Thematic analysis was employed to elicit key themes from the dataset. The findings support the literature that online forums provide young people with both informational and emotional support around a wide array of topics. The findings from this large dataset also reveal that this informational or emotional support can be viewed as directive or nondirective. The nondirective approach refers to when young people provide others with support by sharing their own experiences. These posts do not include explicit advice to act in a particular way, but the sharing process is hoped to be of use to the poster. The directive approach, in contrast, involves individuals making an explicit suggestion of what they believe the poster should do. This study adds to the research exploring what young people discuss within online forums and provides insights into how these communications take place. Furthermore, it highlights the challenge that organizations may encounter in mediating support that is multidimensional in nature (informational-emotional, directive-nondirective). ©Julie Prescott, Terry Hanley, Katalin Ujhelyi. Originally published in JMIR Mental Health (http://mental.jmir.org), 02.08.2017.

Bundling Post-Acute Care Services into MS-DRG Payments

PubMed Central

Vertrees, James C.; Averill, Richard F.; Eisenhandler, Jon; Quain, Anthony; Switalski, James

2013-01-01

Objective A bundled hospital payment system that encompasses both acute and post-acute care has been proposed as a means of creating financial incentives in the Medicare fee-for-service system to foster care coordination and to improve the current disorganized system of post care. The objective of this study was to evaluate the statistical stability of alternative designs of a hospital payment system that includes post-acute care services to determine the feasibility of using a combined hospital and post-acute care bundle as a unit of payment. Methods The Medicare Severity-Diagnosis Related Groups (MS-DRGs) were subdivided into clinical subclasses that measured a patient's chronic illness burden to test whether a patient's chronic illness burden had a substantial impact on post-acute care expenditures. Using Medicare data the statistical performance of the MS-DRGs with and without the chronic illness subclasses was evaluated across a wide range of post-acute care windows and combinations of post-acute care service bundles using both submitted charges and Medicare payments. Results The statistical performance of the MS-DRGs as measured by R2 was consistently better when the chronic illness subclasses are included indicating that MS-DRGs by themselves are an inadequate unit of payment for post-acute care payment bundles. In general, R2 values increased as the post-acute care window length increased and decreased as more services were added to the post-acute care bundle. Discussion The study results suggest that it is feasible to develop a payment system that incorporates significant post-acute care services into the MS-DRG inpatient payment bundle. This expansion of the basic DRG payment approach can provide a strong financial incentive for providers to better coordinate care potentially leading to improved efficiency and outcome quality. PMID:24753970

Developing Quality Improvement capacity and capability across the Children in Fife partnership.

PubMed

Morris, Craig; Alexander, Ingrid

2016-01-01

A Project Manager from the Fife Early Years Collaborative facilitated a large-scale Quality Improvement (herein QI) project to build organisational capacity and capability across the Children in Fife partnership through three separate, eight month training cohorts. This 18 month QI project enabled 32 practitioners to increase their skills, knowledge, and experiences in a variety of QI tools including the Model for Improvement which then supported the delivery of high quality improvement projects and improved outcomes for children and families. Essentially growing the confidence and capability of practitioners to deliver sustainable QI. 27 respective improvement projects were delivered, some leading to service redesign, reduced waiting times, increased uptake of health entitlements, and improved accessibility to front-line health services. 13 improvement projects spread or scaled beyond the initial site and informal QI mentoring took place with peers in respective agencies. Multiple PDSA cycles were conducted testing the most efficient and effective support mechanisms during and post training, maintaining regular contact, and utilising social media to share progress and achievements.

Evaluation of the integrated clinic model for HIV/AIDS services in Ho Chi Minh City, Viet Nam, 2013-2014.

PubMed

Hung, V; Nguyen, S T; Tieu, V T T; Nguyen, T T T; Duong, T H; Lyss, S; Oeltmann, J E

2016-12-21

Setting: Ho Chi Minh City (HCMC), Viet Nam. Objective: To evaluate a new integrated service model for human immunodeficiency virus/acquired immune-deficiency syndrome (HIV/AIDS) care. Design: In HCMC, co-located services, including voluntary HIV counseling and testing (VCT), HIV treatment at out-patient clinics (OPC), and methadone maintenance therapy (MMT) for persons who inject drugs, have operated under different administrative structures. In the context of decreasing international financial support, integration of these services into one administrative structure with reduced staff occurred in seven districts in HCMC between October 2013 and June 2014. We used a pre-post study design to compare service-related outcomes from routinely collected data at health facilities 6 months before and 6 months after integration. Results: The proportion of HIV-infected persons linked from VCT to OPCs was unchanged or increased following integration. A higher percentage of patients eligible for antiretroviral therapy (ART) were started on ART. The proportion of ART patients lost to follow-up remained unchanged. The proportions of MMT patients who tested positive for heroin or other substances decreased or were unchanged. Conclusions: VCT, OPC and MMT service delivery quality remained the same or improved during the 6 months following the integration. Expansion of the integrated model should be considered for HIV-related services.

The Effect of Learning the History of Physics on the Scientific Epistemological Beliefs of Pre-Service Teachers

ERIC Educational Resources Information Center

Tanel, Zafer

2013-01-01

This study examined the effect of learning the history of physics on the epistemological beliefs of pre-service physics teachers. The research was conducted with 25 pre-service physics teachers using a single-group pre-test/post-test experimental model. The quantitative data of the research were collected using the Turkish version of the…

Parents’ Management of Children’s Pain at Home after Surgery

PubMed Central

Vincent, Catherine; Chiappetta, Maria; Beach, Abigail; Kiolbasa, Carolyn; Latta, Kelsey; Maloney, Rebekah; Van Roeyen, Linda Sue

2012-01-01

Purpose We tested Home Pain Management for Children (HPMC) for effects on pain intensity, analgesics administered, satisfaction, and use of healthcare services over 3 post-discharge days. Design and Methods In this quasi-experimental study with 108 children and their parents, we used the numeric rating scale (NRS) or the Faces Pain Scale-Revised (FPS-R), calculated percentages of analgesics administered, and asked questions about expectations, satisfaction, and services. Between-group differences were tested with t-tests and ANOVA. Results After HPMC, children reported moderate pain and parents administered more analgesics on 2 study days. Parents and children were satisfied; parents used few services. Written instructions and a brief interactive session were not sufficient to change parents’ analgesic administration practices to relieve their children’s pain. Practice Implications Further research is needed to develop and test effective education interventions to facilitate relief of children’s post-operative pain. PMID:22463471

47 CFR 54.601 - Eligibility.

Code of Federal Regulations, 2011 CFR

2011-10-01

...). (2) Internet access and limited toll-free access to internet. (i) For purposes of this subpart, eligible Internet access is an information service that enables rural health care providers to post their...) Internet access shall be eligible for universal service support under § 54.621(a). (iii) Limited toll-free...

Stigma of HIV Testing on Online HIV Forums: Self-Stigma and the Unspoken.

PubMed

Ho, Chia-Ling Lynn; Pan, Wenjing; Taylor, Laramie D

2017-12-01

Most studies examining HIV-related content in web forums have revolved around the most frequently used terms in HIV-related messages and topics, as well as the supportive nature of those messages. The current study explored barriers that prevent individuals from seeking HIV testing (specifically stigma). The current study analyzed a total of 210 threads and 319 posts, yielding 13 threads that revealed how individuals self-stigmatize and expressed how the fear of being diagnosed prevented them from seeking HIV testing. Results suggest that forums or online communities may perpetuate subculture values that deviate from mainstream values. Another important finding is that there is a lack of HIV testing information in forums for adolescents, which may contribute to the trend of young individuals engaging in risky sexual behaviors not getting tested in a timely fashion. [Journal of Psychosocial Nursing and Mental Health Services, 55(12), 34-43.]. Copyright 2017, SLACK Incorporated.

Pilot study of home-based delivery of HIV testing and counseling and contraceptive services to couples in Malawi.

PubMed

Becker, Stan; Taulo, Frank O; Hindin, Michelle J; Chipeta, Effie K; Loll, Dana; Tsui, Amy

2014-12-20

HIV counseling and testing for couples is an important component of HIV prevention strategies, particularly in Sub Saharan Africa. The purpose of this pilot study is to estimate the uptake of couple HIV counseling and testing (CHCT) and couple family planning (CFP) services in a single home visit in peri-urban Malawi and to assess related factors. This study involved offering CHCT and CFP services to couples in their homes; 180 couples were sampled from households in a peri-urban area of Blantyre. Baseline data were collected from both partners and follow-up data were collected one week later. A pair of male and female counselors approached each partner separately about HIV testing and counseling and contraceptive services and then, if both consented, CHCT and CFP services (pills, condoms and referrals for other methods) were given. Bivariate and multivariate logistic regression analyses were done to examine the relationship between individual partner characteristics and acceptance of the services. Selected behaviors reported pre- and post-intervention, particularly couple reports on contraceptive use and condom use at last sex, were also tested for differences. 89% of couples accepted at least one of the services (58% CHCT-only, 29% CHCT + CFP, 2% CFP-only). Among women, prior testing experience (p < 0.05), parity (p < 0.01), and emotional closeness to partner (p < 0.01) had significant bivariate associations with acceptance of at least one service. Reported condom use at last sex increased from 6% to 25% among couples receiving any intervention. First-ever HIV testing was delivered to 25 women and 69 men, resulting, respectively, in 4 and 11 newly detected infections. Home-based CHCT and CFP were very successful in this pilot study with high proportions of previously untested husbands and wives accepting CHCT and there were virtually no negative outcomes within one week. This study supports the need for further research and testing of home- and couple-based approaches to expand access to HCT and contraceptive services to prevent the undesired consequences of sexually transmitted infection and unintended pregnancy via unprotected sex.

Care for post-stroke patients at Malaysian public health centres: self-reported practices of family medicine specialists.

PubMed

Abdul Aziz, Aznida F; Mohd Nordin, Nor Azlin; Abd Aziz, Noor; Abdullah, Suhazeli; Sulong, Saperi; Aljunid, Syed M

2014-03-02

Provision of post stroke care in developing countries is hampered by discoordination of services and limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems among Family Medicine Specialists managing public primary health care services. A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire assessed respondents background and practice details i.e. estimated stroke care burden, current service provision and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data, constant comparison method was used until saturation of themes was reached. Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2 patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%). Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on 'as needed' basis. Referrals ranked in order of frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The FMS' perceived 4 important 'needs' in managing stroke patients at primary care level; access to rehabilitation services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a standardized guideline and family and caregiver support. Post discharge stroke care guidelines and access to rehabilitation services at primary care is needed for post stroke patients residing at home in the community.

A durability test of wood posts in Hawaii...third progress report

Treesearch

Roger G. Skolmen

1971-01-01

Round posts of 10 Hawaii-grown wood species were treated with copper chromate-copper arsenate by the double-diffusion process. These and untreated posts were exposed for 10 years. Except with two coniferous species, the treatment did not lengthen service life enough to be judged worthwhile.

Post-Test Inspection of Nasa's Evolutionary Xenon Thruster Long Duration Test Hardware: Ion Optics

NASA Technical Reports Server (NTRS)

Soulas, George C.; Shastry, Rohit

2016-01-01

A Long Duration Test (LDT) was initiated in June 2005 as a part of NASAs Evolutionary Xenon Thruster (NEXT) service life validation approach. Testing was voluntarily terminated in February 2014, with the thruster accumulating 51,184 hours of operation, processing 918 kg of xenon propellant, and delivering 35.5 MN-s of total impulse. This presentation will present the post-test inspection results to date for the thrusters ion optics.

Post-Issuance Compliance: How to Live with a Bond Issue

ERIC Educational Resources Information Center

Kreiser, Donna L.; Cowburn, Laura

2010-01-01

The Internal Revenue Service (IRS) has announced that post-issuance tax compliance is among its highest priorities. This is supported by the recently imposed annual reporting requirement on nonprofit corporations regarding the application and use of tax-exempt bonds issued for their benefit. School districts issuing tax-exempt bonds often spend…

An educational video program to increase aging services technology awareness among older adults.

PubMed

Tam, Joyce W; Van Son, Catherine; Dyck, Dennis; Schmitter-Edgecombe, Maureen

2017-08-01

Aging services technologies (ASTs), health technology that meets the needs of seniors, are being underutilized due to a lack of awareness. This study evaluated a video-based educational program to increase AST awareness. Two hundred and thirty-one older adults completed AST measures pre- and post-program. Participants endorsed significantly improved AST knowledge and attitude and a lower level of perceived stigma post-program. Hierarchical regression analyses showed that a greater reduction in stigma post-program and a higher number of physical/cognitive needs supported by ASTs at baseline were significant predictors of a greater increase in expressed intention to use ASTs following the video program. Furthermore, individuals living in their own homes, with a lower level of education, fewer physical and/or cognitive needs supported by ASTs at baseline, and greater functional limitations were found to be more likely to report a significant reduction in perceived stigma post-program. Four-week follow-up data from 75 individuals showed stable program gains. Program feedback was positive. The current findings provide support for the utility of the AST videos. The educational materials used in this study can be used clinically or for public health education to increase awareness and adoption of ASTs. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluation of a multiple-encounter in situ simulation for orientation of staff to a new paediatric emergency service: a single-group pretest/post-test study

PubMed Central

Kinnear, Frances B; Fulbrook, Paul

2017-01-01

Aim To assess the utility of a multiple-encounter in-situ (MEIS) simulation as an orientation tool for multidisciplinary staff prior to opening a new paediatric emergency service. Methods A single-group pretest/post-test study was conducted. During the MEIS simulation, multidisciplinary staff with participant or observer roles managed eight children (mannequins) who attended triage with their parent/guardians (clinical facilitators) for a range of emergency presentations (structured scenarios designed to represent the expected range of presentations plus test various clinical pathways/systems). Participants were debriefed to explore clinical, systems and crisis-resource management issues. Participants also completed a pre-intervention and post-intervention questionnaire comprising statements about role confidence and orientation adequacy. Pre-test and post-test results were analysed using t-test and Wilcoxon signed rank test. Results Eighty-nine staff participated in the MEIS simulation, with the majority completing the pre-simulation and post-simulation questionnaire. There was a significant improvement in post-intervention versus pre-intervention Likert scores for role confidence and orientation adequacy (p=0.001 and <0.001, respectively); effect sizes suggested the greatest impact was on orientation adequacy. Nearly all scenarios resulted in significant increases in participants’ confidence levels. Conclusions The MEIS simulation was of utility in orientation of staff, at least with respect to self-reported role confidence and orientation adequacy. Its effectiveness in practice or compared with other orientation techniques was not assessed, but it did identify several flaws in planned systems allowing remediation prior to opening. PMID:29354279

Evaluation of a multiple-encounter in situ simulation for orientation of staff to a new paediatric emergency service: a single-group pretest/post-test study.

PubMed

Davison, Michelle; Kinnear, Frances B; Fulbrook, Paul

2017-10-01

To assess the utility of a multiple-encounter in-situ (MEIS) simulation as an orientation tool for multidisciplinary staff prior to opening a new paediatric emergency service. A single-group pretest/post-test study was conducted. During the MEIS simulation, multidisciplinary staff with participant or observer roles managed eight children (mannequins) who attended triage with their parent/guardians (clinical facilitators) for a range of emergency presentations (structured scenarios designed to represent the expected range of presentations plus test various clinical pathways/systems). Participants were debriefed to explore clinical, systems and crisis-resource management issues. Participants also completed a pre-intervention and post-intervention questionnaire comprising statements about role confidence and orientation adequacy. Pre-test and post-test results were analysed using t-test and Wilcoxon signed rank test. Eighty-nine staff participated in the MEIS simulation, with the majority completing the pre-simulation and post-simulation questionnaire. There was a significant improvement in post-intervention versus pre-intervention Likert scores for role confidence and orientation adequacy (p=0.001 and <0.001, respectively); effect sizes suggested the greatest impact was on orientation adequacy. Nearly all scenarios resulted in significant increases in participants' confidence levels. The MEIS simulation was of utility in orientation of staff, at least with respect to self-reported role confidence and orientation adequacy. Its effectiveness in practice or compared with other orientation techniques was not assessed, but it did identify several flaws in planned systems allowing remediation prior to opening.

42 CFR 414.40 - Coding and ancillary policies.

Code of Federal Regulations, 2011 CFR

2011-10-01

... surgery policy (for example, post- and pre-operative periods and services, and intra-operative services... typically comprise a technical component (the taking of the test) and a professional component (the...

42 CFR 414.40 - Coding and ancillary policies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... surgery policy (for example, post- and pre-operative periods and services, and intra-operative services... typically comprise a technical component (the taking of the test) and a professional component (the...

The Higher Education Landscape for US Student Service Members and Veterans in Indiana

ERIC Educational Resources Information Center

Hitt, Stacie; Sternberg, Martina; Wadsworth, Shelley MacDermid; Vaughan, Joyce; Carlson, Rhiannon; Dansie, Elizabeth; Mohrbacher, Martina

2015-01-01

The Post-9/11 Veterans Educational Assistance Act of 2008 or "New GI Bill" has resulted in rising enrollment and related demand for services by students in the USA. We examined current supports for student service members and veterans at institutions of higher education in Indiana in the context of this national trend. We employed…

A Tool that Can be Effective in the Self-Regulated Learning of Pre-Service Teachers: The Mind Map

ERIC Educational Resources Information Center

Tanriseven, Isil

2014-01-01

The aim of this study is to analyse the effect of task planning with mind maps on the self-regulation strategies and motivational beliefs of pre-service teachers. A quasi-experimental design, with a pre-test and post-test control group, was applied in the research. The research group comprised of 60 pre-service teachers taking "Teaching…

Update of the NEXT Ion Thruster Service Life Assessment with Post-Test Correlation to the Long Duration Test

NASA Technical Reports Server (NTRS)

Yim, John T.; Soulas, George C.; Shastry, Rohit; Choi, Maria; Mackey, Jonathan A.; Sarver-Verhey, Timothy R.

2017-01-01

The service life assessment for NASA's Evolutionary Xenon Thruster is updated to incorporate the results from the successful and voluntarily early completion of the 51,184 hour long duration test which demonstrated 918 kg of total xenon throughput. The results of the numerous post-test investigations including destructive interrogations have been assessed against all of the critical known and suspected failure mechanisms to update the life and throughput expectations for each major component. Analysis results of two of the most acute failure mechanisms, namely pit-and-groove erosion and aperture enlargement of the accelerator grid, are not updated in this work but will be published at a future time after analysis completion.

Crash testing of Louisiana's multi-directional, single steel post, small sign support.

DOT National Transportation Integrated Search

1992-06-01

The Louisiana Department of Transportation and Development (LDOTD) contracted with the Texas Transportation Institute (TTI) to evaluate the impact characteristics of Louisiana's multi-directional 5 inch diameter steel post, small sign support when im...

How supportive supervision influences immunization session site practices: a quasi-experimental study in Odisha, India.

PubMed

Panda, Bhuputra; Pati, Sanghamitra; Nallala, Srinivas; Chauhan, Abhimanyu S; Anasuya, Anita; Som, Meena; Zodpey, Sanjay

2015-01-01

Routine immunization (RI) is a key child survival intervention. Ensuring acceptable standards of RI service delivery is critical for optimal outcomes. Accumulated evidences suggest that 'supportive supervision' improves the quality of health care services in general. During 2009-2010, the Government of Odisha and UNICEF jointly piloted this strategy in four districts to improve RI program outcomes. The present study aims to assess the effect of this strategy on improvement of skills and practices at immunization session sites. A quasi-experimental 'post-test only' study design was adopted to compare the opinion and practices of frontline health workers and their supervisors in four intervention districts (IDs) with two control districts (CDs). Altogether, we interviewed 111 supervisor-supervisee (health worker) pairs using semi-structured interview schedules and case vignettes. We also directly observed health workers' practices during immunization sessions at 111 sites. Data were analyzed with SPSS version 16.0. The mean knowledge score of supervisors in CDs was significantly higher than in intervention groups. Variegated responses were obtained on case vignettes. The control group performed better in solving certain hypothetically asked problems, whereas the intervention group scored better in others. Health workers in IDs gave a lower rating to their respective supervisors' knowledge, skill, and frequency of supervision. Logistics and vaccine availability were better in CDs. Notwithstanding other limitations, supportive supervision may not have independent effects on improving the quality of immunization services. Addressing systemic issues, such as the availability of essential logistics, supply chain management, timely indenting, and financial resources, could complement the supportive supervision strategy in improving immunization service delivery.

An Effort to Improve Teacher Perceptions and Knowledge of Cyberbullying: A Pre-Post Assessment

ERIC Educational Resources Information Center

Nesshengel-Hopp, Marleny T.

2017-01-01

Cyberbullying is a growing concern, confounded by the limited training resources available for teachers. The problem undertaken in this study was determining the most effective way to teach teachers about cyberbullying given the limited 1-hour time constraint of a typical school in-service activity. Using a pre-test, post-test experimental…

Trafficking of Vietnamese women and girls for marriage in China.

PubMed

Stöckl, Heidi; Kiss, Ligia; Koehler, Jobst; Dong, Dung Thuy; Zimmerman, Cathy

2017-01-01

Bride-trafficking has been a growing phenomenon in Southeast Asia, particularly in China, where one-child policies have resulted in demographic imbalances favoring males. Yet, empirical evidence about women and girls sold into marriage in China remains sparse. This study describes the experiences of 51 Vietnamese women and girls as young as 14 in post-trafficking services who were sold into marriage in China. A consecutive sample of individuals from five services in Vietnam were invited to be interviewed within the first 2 weeks of admission. It is part of a wider dataset for research on the health of men, women, and children in post-trafficking services in Cambodia, Thailand, and Vietnam, the largest study to date on human trafficking and health. We calculated proportions for all variables and conducted bivariate analyses using Fisher Exact Tests for their associations with mental health disorders symptoms. Before leaving home, 31% ( n  = 15) participants were married. Participants reported high levels of sexual violence ( n  = 43; 86%) while trafficked and59% ( n  = 30) spent time in detention before returning to Vietnam. Once in post-trafficking care 52.9% ( n  = 27) reported probable depression, anxiety or post-traumatic stress disorders (PTSD), two women (4%) attempted suicide in the past month and 38 (75%) remained afraid of their trafficker. Ten (22%) became pregnant while trafficked, and seven (16%) were pregnant at the interview. The cross-border bride trade between Vietnam and China raises complex policy issues, including questions about detention and immigration rights and strategies for supported return processes, including maternal and child health services. As the repercussions of China's absent female population will persist, Vietnam and China must grapple with the political and social conditions to implement prevention strategies, and resources for women who fall prey to this cross-border bride trade.

Knowledge Discovery from Posts in Online Health Communities Using Unified Medical Language System.

PubMed

Chen, Donghua; Zhang, Runtong; Liu, Kecheng; Hou, Lei

2018-06-19

Patient-reported posts in Online Health Communities (OHCs) contain various valuable information that can help establish knowledge-based online support for online patients. However, utilizing these reports to improve online patient services in the absence of appropriate medical and healthcare expert knowledge is difficult. Thus, we propose a comprehensive knowledge discovery method that is based on the Unified Medical Language System for the analysis of narrative posts in OHCs. First, we propose a domain-knowledge support framework for OHCs to provide a basis for post analysis. Second, we develop a Knowledge-Involved Topic Modeling (KI-TM) method to extract and expand explicit knowledge within the text. We propose four metrics, namely, explicit knowledge rate, latent knowledge rate, knowledge correlation rate, and perplexity, for the evaluation of the KI-TM method. Our experimental results indicate that our proposed method outperforms existing methods in terms of providing knowledge support. Our method enhances knowledge support for online patients and can help develop intelligent OHCs in the future.

LDSD POST2 Simulation and SFDT-1 Pre-Flight Launch Operations Analyses

NASA Technical Reports Server (NTRS)

Bowes, Angela L.; Davis, Jody L.; Dutta, Soumyo; Striepe, Scott A.; Ivanov, Mark C.; Powell, Richard W.; White, Joseph

2015-01-01

The Low-Density Supersonic Decelerator (LDSD) Project's first Supersonic Flight Dynamics Test (SFDT-1) occurred June 28, 2014. Program to Optimize Simulated Trajectories II (POST2) was utilized to develop trajectory simulations characterizing all SFDT-1 flight phases from drop to splashdown. These POST2 simulations were used to validate the targeting parameters developed for SFDT- 1, predict performance and understand the sensitivity of the vehicle and nominal mission designs, and to support flight test operations with trajectory performance and splashdown location predictions for vehicle recovery. This paper provides an overview of the POST2 simulations developed for LDSD and presents the POST2 simulation flight dynamics support during the SFDT-1 launch, operations, and recovery.

Post-Test Inspection of NASA's Evolutionary Xenon Thruster Long-Duration Test Hardware: Discharge Chamber

NASA Technical Reports Server (NTRS)

Shastry, Rohit; Soulas, George C.

2016-01-01

NASAs Evolutionary Xenon Thruster (NEXT) Long-Duration Test (LDT) is part of the comprehensive service life assessment of the NEXT thruster. The test was voluntarily terminated in April 2014 after accumulating 51,184 hours of high voltage operation, processing 918 kg of xenon, and delivering 35.5 MN-s of total impulse. This presentation covers the post-test inspection of the thruster hardware, in particular of the discharge chamber and other miscellaneous components such as propellant isolators and electrical cabling.

Sperm-mucus interaction and artificial insemination.

PubMed

Joyce, D; Vassilopoulos, D

1981-12-01

Artificial insemination techniques form an important part of the spectrum of modern infertility treatment, and together account for nearly half (43.8 per cent) of the treatment-related pregnancies in our comprehensive infertility clinic. Disorders of sperm-mucus invasion and survival are not uncommon but have been very frequently overlooked in the past. Assessment by post-coital tests with a minimum six hour post-coital delay and mucus penetration tests for those with negative post-coital tests should be part of every clinic routine. We believe that these tests pick up a range of problems, the most important of which is antisperm immunological infertility, which can be treated with a fair degree of success by intrauterine AIH. The demand for AID has increased appreciably on a world-wide scale and provision of AID facilities in this and other countries is inadequate. An AID service should ideally be part of every organized infertility service. The future of AID probably lies with frozen semen banks serving satellite clinics within their area.

Beyond recidivism: changes in health and social service involvement following exposure to drug treatment court.

PubMed

Rezansoff, Stefanie N; Moniruzzaman, Akm; Clark, Elenore; Somers, Julian M

2015-10-31

The majority of Drug Treatment Court (DTC) research has examined the impact of DTCs on criminal recidivism. Comparatively little research has addressed the association between DTC participation and engagement with community-based health and social services. The present study investigated changes in participant involvement with outpatient healthcare and income assistance within a DTC cohort. We hypothesized that involvement with community-based (outpatient) health and social services would increase post-DTC participation, and that service levels would be higher among program graduates and offenders with histories of co-occurring mental and substance use disorders. Participants were 631 offenders at the DTC in Vancouver, Canada (DTCV). Administrative data representing hospital, outpatient medical care, and income assistance were examined one-year pre/post program to assess differences over time. Generalized estimating equations were used to investigate the association between changes in service use and program involvement. We also examined the relationship between level of service use and offender characteristics. Members of the cohort were disproportionately Aboriginal (33 %), had been sentenced 2.7 times in the 2 years preceding their index offence, and 50 % had been diagnosed with a non substance-related mental disorder in the five years preceding the index offence. The mean number of outpatient services post DTCV was 51, and the mean amount of social assistance paid was $5,897. Outpatient service use increased following exposure to DTCV (Adjusted Rate Ratio (ARR) = 1.45) and was significantly higher among women (ARR = 1.47), program graduation (ARR = 1.23), and those previously diagnosed with concurrent substance use and mental disorders (ARR = 4.92). Overall, hospital admissions did not increase post-program, although rates were significantly higher among women (ARR = 1.76) and those with concurrent disorders (ARR = 2.71). Income assistance increased significantly post program (ARR = 1.16), and was significantly higher among women (ARR = 1.03), and those diagnosed with substance use disorders (ARR = 1.42) and concurrent disorders (ARR = 1.72). These findings suggest that the DTCV was a catalyst for increased participant engagement with community health and social supports, and that rates of service use were consistently higher among women and individuals with concurrent disorders. Research is needed to investigate the potential link between health and social support and reductions in recidivism associated with DTCs.

Evaluating workforce developments to support children of mentally ill parents: implementing new interventions in the adult mental healthcare in Northern Norway

PubMed Central

Lauritzen, Camilla; van Doesum, Karin T M

2012-01-01

Background According to new Norwegian laws, mental healthcare for adults are obligated to assess all patients who are parents and to act on their children's needs. This article describes the study protocol of implementing the interventions Family Assessment and Child Talks for children of patients in the adult psychiatry of the University Hospital of Northern Norway. The project is designed to evaluate the process of changes in clinical practice due to the implementation of two interventions. The interventions to be implemented are a standardised Family Assessment Form and the intervention called Child Talks. The family assessment form is an intervention to identify children of mentally ill parents and their needs. The intervention Child Talks is a health-promoting and preventive intervention where the mental health workers talk with the family about the situation of the children and their needs. Methods/design There are two groups of participants in this study: (1) mental health workers in the clinic (N=220) and (2) patients who are parents (N=200) receiving treatment in the clinic. (1) In the evaluation of clinical practice, the authors use a pre-test, post-test and 1-year follow-up design. At pre-test, the authors evaluate status quo among mental health workers in the clinic regarding knowledge, attitudes, collaborative routines and clinical practice related to families with parental mental illness. After the pre-test is finished, the project move on to implement the interventions Family Assessment Form and Child Talks in the clinic. At post-test and 1-year follow-up, the authors evaluate the impact of implementing the Family Assessment Form in terms of how many children were identified and offered Child Talks in the clinic or referred to other services for additional support. (2) In the evaluation of parents/patients experience with the interventions, the authors use a pre-test post-test design. To identify children of mentally ill patients, the authors collect data on demographical variables for the patient and the child at pre-measures, as well as data on parental competence (PSOC) and parental concerns (PEDS) about their children. At post-measures, the authors evaluate the impact of the intervention in terms of user satisfaction, as well as changes between pre- and post-measures on parental competence (PSOC) and parental concerns (PEDS) about their children. Discussion The implication of implementing new interventions to safeguard children of mentally ill patients and the limitation of not measuring child development directly are discussed. PMID:22556160

Evaluating workforce developments to support children of mentally ill parents: implementing new interventions in the adult mental healthcare in Northern Norway.

PubMed

Reedtz, Charlotte; Lauritzen, Camilla; van Doesum, Karin T M

2012-01-01

According to new Norwegian laws, mental healthcare for adults are obligated to assess all patients who are parents and to act on their children's needs. This article describes the study protocol of implementing the interventions Family Assessment and Child Talks for children of patients in the adult psychiatry of the University Hospital of Northern Norway. The project is designed to evaluate the process of changes in clinical practice due to the implementation of two interventions. The interventions to be implemented are a standardised Family Assessment Form and the intervention called Child Talks. The family assessment form is an intervention to identify children of mentally ill parents and their needs. The intervention Child Talks is a health-promoting and preventive intervention where the mental health workers talk with the family about the situation of the children and their needs. There are two groups of participants in this study: (1) mental health workers in the clinic (N=220) and (2) patients who are parents (N=200) receiving treatment in the clinic. (1) In the evaluation of clinical practice, the authors use a pre-test, post-test and 1-year follow-up design. At pre-test, the authors evaluate status quo among mental health workers in the clinic regarding knowledge, attitudes, collaborative routines and clinical practice related to families with parental mental illness. After the pre-test is finished, the project move on to implement the interventions Family Assessment Form and Child Talks in the clinic. At post-test and 1-year follow-up, the authors evaluate the impact of implementing the Family Assessment Form in terms of how many children were identified and offered Child Talks in the clinic or referred to other services for additional support. (2) In the evaluation of parents/patients experience with the interventions, the authors use a pre-test post-test design. To identify children of mentally ill patients, the authors collect data on demographical variables for the patient and the child at pre-measures, as well as data on parental competence (PSOC) and parental concerns (PEDS) about their children. At post-measures, the authors evaluate the impact of the intervention in terms of user satisfaction, as well as changes between pre- and post-measures on parental competence (PSOC) and parental concerns (PEDS) about their children. The implication of implementing new interventions to safeguard children of mentally ill patients and the limitation of not measuring child development directly are discussed.

Making the Transition to Post-Secondary Education: Opportunities and Challenges Experienced by Students with ASD in the Republic of Ireland

ERIC Educational Resources Information Center

Bell, Sheena; Devecchi, Cristina; Mc Guckin, Conor; Shevlin, Michael

2017-01-01

Internationally there are increasing numbers of young people on the ASD spectrum attending higher education. Early transition planning is essential and students with ASD often require support to articulate their post-school educational goals and actively participate in transition planning meetings. Services within higher education are primarily…

77 FR 19589 - Electronic On-Board Recorders and Hours of Service Supporting Documents

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-02

... Grand Ballroom IJK on the 2nd floor. Internet Address for Live Webcast. FMCSA will post specific... number for this notice. Note that DOT posts all comments received without change to www.regulations.gov... study of these problems with EOBRs already in use, and a comparison with carriers that do not use these...

Post-abortion care and voluntary HIV counselling and testing--an example of integrating HIV prevention into reproductive health services.

PubMed

Rasch, Vibeke; Yambesi, Fortunata; Massawe, Siriel

2006-05-01

To assess the acceptance and outcome of voluntary HIV counselling and testing (VCT) among women who had an unsafe abortion. 706 women were provided with post-abortion contraceptive service and offered VCT. We collected data on socioeconomic characteristics and contraceptive use and determined the HIV status of those who accepted VCT. Using a nested case-control design, we compared women who accepted HIV testing with women who did not. To study the association between socioeconomic factors, HIV testing acceptance and condom use in more detail, we did stratified analyses based on age and marital status. 58% of the women who had an unsafe abortion accepted HIV testing. Women who earned an income were more likely to accept testing than housewives. Women who accepted testing were more likely to accept using a condom. The HIV prevalence rate was 19% among single women aged 20-24 years and 25% among single women aged 25-45 years. HIV testing and condoms were accepted by most women who had an unsafe abortion. The poor reproductive health of these women could be improved by good post-abortion care that includes contraceptive counselling, VCT and condom promotion.

TESTS - APOLLO 13

NASA Image and Video Library

1970-06-10

S70-41983 (June 1970) --- Second photograph in sequence of three of panel separation test at Langley Research Center. The test was part of the Apollo 13 post flight investigation of the Service Module explosion incident. Photo credit: NASA

Testing Services

NASA Technical Reports Server (NTRS)

1993-01-01

Trace Laboratories is an independent testing laboratory specializing in testing printed circuit boards, automotive products and military hardware. Technical information from NASA Tech Briefs and two subsequent JPL Technical Support packages have assisted Trace in testing surface insulation resistance on printed circuit board materials. Testing time was reduced and customer service was improved because of Jet Propulsion Laboratory technical support packages.

Investigating the Effect of van Hiele Phase-Based Instruction on Pre-Service Teachers' Geometric Thinking

ERIC Educational Resources Information Center

Armah, Robert Benjamin; Cofie, Primrose Otokonor; Okpoti, Christopher Adjei

2018-01-01

This study investigated the effect of van Hiele Phase-based Instruction (VHPI) on Ghanaian Pre-service Teachers' (PTs') geometric thinking in terms of the van Hiele Levels. A pre-test post-test quasi-experimental design was employed. There were 75 PTs each in the experimental group and the control group. Van Hiele Geometry Test (VHGT) was…

TESTS - APOLLO 13

NASA Image and Video Library

1970-06-10

S70-41984 (June 1970) --- Full-scale propagation test at the NASA Manned Spacecraft Center (MSC) of fire inside an Apollo Service Module (SM) oxygen tank. The photograph from a motion picture sequence taken from outside the vessel shows failure of tank conduit with abrupt loss of oxygen pressure. The test was part of the Apollo 13 post flight investigation of the Service Module explosion incident. Photo credit: NASA

Support Services for Students with Asperger's Syndrome in Higher Education

ERIC Educational Resources Information Center

Smith, Caroline P.

2007-01-01

The study examines the following research question: "What are the needs of students with Asperger's Syndrome (AS), and what are the services and accommodations available to them at the post-secondary level?" An increasing number of individuals diagnosed with AS are entering institutions of higher education. This study is exploratory in nature,…

Dynamic Test of a Collision Post of a State-of-the-Art End Frame Design

DOT National Transportation Integrated Search

2008-09-24

In support of the Federal Railroad Administration's (FRA) : Railroad Equipment Safety Program, a full-scale dynamic test : of a collision post of a state-of-the-art (SOA) end frame was : conducted on April 16, 2008. The purpose of the test was to : e...

Assessing fidelity of delivery of smoking cessation behavioural support in practice.

PubMed

Lorencatto, Fabiana; West, Robert; Christopherson, Charlotte; Michie, Susan

2013-04-04

Effectiveness of evidence-based behaviour change interventions is likely to be undermined by failure to deliver interventions as planned. Behavioural support for smoking cessation can be a highly cost-effective, life-saving intervention. However, in practice, outcomes are highly variable. Part of this may be due to variability in fidelity of intervention implementation. To date, there have been no published studies on this. The present study aimed to: evaluate a method for assessing fidelity of behavioural support; assess fidelity of delivery in two English Stop-Smoking Services; and compare the extent of fidelity according to session types, duration, individual practitioners, and component behaviour change techniques (BCTs). Treatment manuals and transcripts of 34 audio-recorded behavioural support sessions were obtained from two Stop-Smoking Services and coded into component BCTs using a taxonomy of 43 BCTs. Inter-rater reliability was assessed using percentage agreement. Fidelity was assessed by examining the proportion of BCTs specified in the manuals that were delivered in individual sessions. This was assessed by session type (i.e., pre-quit, quit, post-quit), duration, individual practitioner, and BCT. Inter-coder reliability was high (87.1%). On average, 66% of manual-specified BCTs were delivered per session (SD 15.3, range: 35% to 90%). In Service 1, average fidelity was highest for post-quit sessions (69%) and lowest for pre-quit (58%). In Service 2, fidelity was highest for quit-day (81%) and lowest for post-quit sessions (56%). Session duration was not significantly correlated with fidelity. Individual practitioner fidelity ranged from 55% to 78%. Individual manual-specified BCTs were delivered on average 63% of the time (SD 28.5, range: 0 to 100%). The extent to which smoking cessation behavioural support is delivered as specified in treatment manuals can be reliably assessed using transcripts of audiotaped sessions. This allows the investigation of the implementation of evidence-based practice in relation to smoking cessation, a first step in designing interventions to improve it. There are grounds for believing that fidelity in the English Stop-Smoking Services may be low and that routine monitoring is warranted.

Pre-post, mixed-methods feasibility study of the WorkingWell mobile support tool for individuals with serious mental illness in the USA: a pilot study protocol.

PubMed

Nicholson, Joanne; Wright, Spenser M; Carlisle, Alyssa M

2018-02-06

Successful competitive employment has been found to be related to enhanced self-esteem, higher quality of life and reduced mental health service use for individuals living with serious mental illnesses (SMIs) including schizophrenia, bipolar disorder and major depression. The effectiveness of the individual placement and support model has been demonstrated in multiple randomised controlled trials in many countries. The management of stress, depression and anxiety in the workplace may be effectively enhanced through digital mental health interventions. The WorkingWell mobile support tool ('app') is specifically designed to meet the need for illness management support for individuals with SMI in the workplace, as an adjunct to professional treatment. The WorkingWell app, grounded in evidence-based supported employment, is informed by user experience design. It will be tested in a pre-post design, mixed-methods pilot study to explore issues of feasibility, acceptability and usefulness, and to provide preliminary data on the impact of use. Putative mediators of improved job tenure and psychological well-being, including postintervention changes in social support, self-efficacy and work-related motivation, will be investigated. Forty individuals at least 18 years of age, meeting the eligibility requirements for supported employment services (ie, diagnosed with a mental illness meeting the criteria for severity, duration and treatment), working a minimum of 10 hours per week at study enrolment, and speaking, reading and writing in English will be recruited for the pilot study. Research staff will recruit individuals at community-based mental health agencies; provide orientation to the study, the study smartphones and the WorkingWell app; conduct research interviews including standardised measures as well as semistructured items; and provide technical assistance in telephone calls and inperson meetings. A sample of 10 agency staff will be recruited to obtain further information on the feasibility, acceptability and usefulness of WorkingWell. The study design and procedures are approved by the Dartmouth-Hitchcock Medical Center Committee for the Protection of Human Subjects, the Massachusetts Department of Mental Health Central Office Research Review Committee and the Vermont Agency of Human Services Institutional Review Board. Study findings will be disseminated to agency partners, state agencies and funders, and to the research and technology development communities. Findings from the study will inform the design, data collection procedures and protocol for future full-scale randomised controlled trial testing of the effectiveness of the WorkingWell app, as well as investigations of work-related variables as mediators of psychological well-being and quality of life for individuals with SMI. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Forensic testing of post tensioned concrete girders.

DOT National Transportation Integrated Search

2014-07-01

Recently, two separate Interstate 15 highway bridges over the 400 South roadway in Orem, Utah were demolished : after 50 years of service. A total of four post-tensioned girders were salvaged from both the north-bound and : south-bound bridge. A seri...

Increasing mental health awareness and appropriate service use in older Chinese Americans: a pilot intervention.

PubMed

Teng, Ellen J; Friedman, Lois C

2009-07-01

This study evaluated the effectiveness of a community intervention in increasing awareness of mental health issues and available resources among elderly Chinese Americans. Twenty-seven members of a community church received a 1-h didactic presentation, in English and Mandarin, and completed surveys regarding their help-seeking preferences before and after the intervention. Results were analyzed using a series of Wilcoxon matched-pair signed rank tests and comparing pre- and post-test scores. Findings indicated an increase (p<.05) in intention to consult a mental health professional for psychiatric symptoms at post-test. A significant increase also was found in preference for consulting a physician for physical symptoms. The pilot educational intervention increased awareness of mental health and treatment issues and the role of mental health professionals, lending support to evaluate the intervention on a larger scale. Greater awareness of mental health among Chinese Americans can be promoted via education forums provided through faith-based organizations. Stigma of mental illness leads many Chinese individuals to seek help for psychiatric problems from primary care physicians. Integrating mental health practitioners in primary care settings may help decrease stigma and encourage appropriate help-seeking behavior.

Safer disclosure of HIV serostatus for women living with HIV who experience or fear violence: a systematic review.

PubMed

Kennedy, Caitlin E; Haberlen, Sabina; Amin, Avni; Baggaley, Rachel; Narasimhan, Manjulaa

2015-01-01

Supporting individuals as they disclose their HIV serostatus may lead to a variety of individual and public health benefits. However, many women living with HIV are hesitant to disclose their HIV status due to fear of negative outcomes such as violence, abandonment, relationship dissolution and stigma. We conducted a systematic review of studies evaluating interventions to facilitate safer disclosure of HIV status for women living with HIV who experience or fear violence. Articles, conference abstracts and programme reports were included if they reported post-intervention evaluation results and were published before 1 April 2015. Searching was conducted through electronic databases for peer-reviewed articles and conference abstracts, reviewing websites of relevant organizations for grey literature, hand searching reference lists of included studies and contacting experts. Systematic methods were used for screening and data abstraction, which was conducted in duplicate. Study quality (rigor) was assessed with the Cochrane risk of bias tool. Two interventions met the inclusion criteria: the Safe Homes and Respect for Everyone cluster-randomized trial of combination HIV and intimate partner violence (IPV) services in Rakai, Uganda, and the South Africa HIV/AIDS Antenatal Post-Test Support study individual randomized trial of an enhanced counselling intervention for pregnant women undergoing HIV testing and counselling. Both programmes integrated screening for IPV into HIV testing services and trained counsellors to facilitate discussions about disclosure based on a woman's risk of violence. However, both were implemented as part of multiple-component interventions, making it impossible to isolate the impact of the safer disclosure components. The existing evidence base for interventions to facilitate safe HIV serostatus disclosure for women who experience or fear violence is limited. Development and implementation of new approaches and rigorous evaluation of safe disclosure outcomes is needed to guide programme planners and policy makers.

[The Influence of Subjective Health Status, Post-Traumatic Growth, and Social Support on Successful Aging in Middle-Aged Women].

PubMed

Lee, Seung Hee; Jang, Hyung Suk; Yang, Young Hee

2016-10-01

This study was done to investigate factors influencing successful aging in middle-aged women. A convenience sample of 103 middle-aged women was selected from the community. Data were collected using a structured questionnaire and analyzed using descriptive statistics, two-sample t-test, one-way ANOVA, Kruskal Wallis test, Pearson correlations, Spearman correlations and multiple regression analysis with the SPSS/WIN 22.0 program. Results of regression analysis showed that significant factors influencing successful aging were post-traumatic growth and social support. This regression model explained 48% of the variance in successful aging. Findings show that the concept 'post-traumatic growth' is an important factor influencing successful aging in middle-aged women. In addition, social support from friends/co-workers had greater influence on successful aging than social support from family. Thus, we need to consider the positive impact of post-traumatic growth and increase the chances of social participation in a successful aging program for middle-aged women.

Applying Strengths Model principles to build a rural community-based mental health support service and achieve recovery outcomes.

PubMed

Dunstan, Debra; Anderson, Donnah

2018-02-01

The Personal Helpers and Mentors (PHaMs) service is a non-clinical, community-based Australian Government initiative aimed at increasing opportunities for recovery for people whose lives are severely affected by mental illness. Using a strengths-based recovery model, PHaMs caseworkers support and mentor people 'at risk of falling through the gaps' between state funded clinical treatment services and federally funded social services (such as supported housing, education and employment). While there is evidence that PHaMs realises its aim in metropolitan areas, little is known about how services are developed and function in low resource rural settings and what outcomes are achieved. These questions were addressed in a case study of a PHaMs service in a rural town in the state of New South Wales, Australia. Data were collected from two sources: local service documents prepared for staff orientation and operational purposes, and records and reports of service participants\\' performance and achievements. Participants\\' gains in wellbeing, recovery goals, and the target outcome areas of increased access to services, increased personal capacity and self-reliance, and increased community participation, were gathered from self-reports. The Role Functioning Scale was used as a measure of caseworker ratings of participants\\' adaptive functioning. The qualitative data were examined for semantic content and underlying themes. The quantitative analyses involved repeated measures and between-groups comparisons of uncontrolled pre-test–post-test and retrospective pre-test data. From commencement of the service in October 2009 to June 2014, an estimated 31% of the people living with severe mental illness in the local government area had accessed the PHaMs service (N=126; mean age 31.9 years; 42% male, 27% Aboriginal). The document analysis revealed that despite a lack of detail on how a PHaMs service should be developed or delivered, by focusing on the goal of client recovery, and taking a strengths-based rather than a deficit approach to the human and other resources that were available, the PHaMs service was established and is maintained by applying Strengths Model principles and being committed to teamwork and interagency respect. Caseworker ratings of participants who had completed an Individual Recovery Plan indicated significant gains in adaptive functioning, including improvements in physical health and wellbeing, management of symptoms, accommodation, vocational skills development and increased community involvement. Strengths-based recovery services offered by a rural PHaMs service can assist Australians with severe mental illness to achieve meaningful gains towards recovery. Furthermore, a Strengths Model approach to service development and operations – one that recognises individual abilities and prizes interpersonal relationships and teamwork – can maximise the potential of local human and other resources, and serve as a solution to resolving apparent service gaps and perceived deficits in rural and regional areas.

TESTS - APOLLO 13

NASA Image and Video Library

1970-06-10

S70-41985 (15 June 1970) --- The third photograph in sequence of three showing panel separation test at Langley Research Center (LRC). The test was part of the Apollo 13 post flight investigation of the Service Module explosion incident. Photo credit: NASA

The role of international NGOs in health systems strengthening: the case of Timor-Leste.

PubMed

Mercer, Mary Anne; Thompson, Susan M; de Araujo, Rui Maria

2014-01-01

Achieving the United Nations Millennium Development Goals for health will require that programs supporting health in developing countries focus on strengthening national health care systems. However, the dominant neoliberal model of development mandates reduced public spending on health and other social services, often resulting in increased funding for nongovernmental organizations (NGOs) at the expense of support for government systems. East Timor, later Timor-Leste, is an example of a post-crisis country where international NGO efforts were initially critical to providing relief efforts to a traumatized population. Those groups were not prepared to help develop and support a standardized Timorese national health plan, however, and the cost of their support was unsustainable in the long term. In response, local authorities designed and implemented a post-crisis NGO phase-over plan that addressed risks to service disruption and monitored the process. Since then, some NGOs have worked collaboratively with the Ministry of Health to support specific efforts and initiatives under a framework provided by the ministry. Timor-Leste has shown that ministries of health can facilitate an effective transition of NGO support from crisis to development if they are allowed to plan and manage the process.

Service-learning in nursing education: its impact on leadership and social justice.

PubMed

Groh, Carla J; Stallwood, Lynda G; Daniels, John J

2011-01-01

Although studies suggest that service-learning is positive for students, findings reported are primarily qualitative. A convenience sample of 306 senior-level nursing students completed the Service-Learning Self-Evaluation Tool (SLSET) pre- and post-service-learning experience over a six-year span. The constructs measured were leadership skills and social justice. Paired t-tests were calculated. Statistically significant differences were noted between pre- and post-service-learning experience, with students rating themselves higher on leadership and social justice items after the experience. Cronbach's alpha for leadership and social justice were greater than 0.80. Service-learning as an educational methodology that combines community service with academic learning objectives is a viable strategy for facilitating leadership skills and increased awareness of social justice issues in nursing students.

Service life of treated and untreated Black Hills ponderosa pine fenceposts

Treesearch

Donald C. Markstrom; Lee R. Gjovik

1992-01-01

Service-life tests indicate that ponderosa pine fenceposts treated with preservatives performed well after field exposure of 30 years. Treating plants in the Black Hills area used commercial methods to treat the posts with creosote, pentachlorophenol, and waterborne arsenicals. Test sites were in the northern Great Plains-one in the semiarid western portion near Scenic...

The effects of an online basic life support course on undergraduate nursing students' learning.

PubMed

Tobase, Lucia; Peres, Heloisa H C; Gianotto-Oliveira, Renan; Smith, Nicole; Polastri, Thatiane F; Timerman, Sergio

2017-08-25

To describe learning outcomes of undergraduate nursing students following an online basic life support course (BLS). An online BLS course was developed and administered to 94 nursing students. Pre- and post-tests were used to assess theoretical learning. Checklist simulations and feedback devices were used to assess the cardiopulmonary resuscitation (CPR) skills of the 62 students who completed the course. A paired t-test revealed a significant increase in learning [pre-test (6.4 ± 1.61), post-test (9.3 ± 0.82), p < 0.001]. The increase in the average grade after taking the online course was significant (p<0.001). No learning differences (p=0.475) had been observed between 1st and 2nd year (9.20 ± 1.60), and between 3rd and 4th year (9.67 ± 0.61) students. A CPR simulation was performed after completing the course: students checked for a response (90%), exposed the chest (98%), checked for breathing (97%), called emergency services (76%), requested for a defibrillator (92%), checked for a pulse (77%), positioned their hands properly (87%), performed 30 compressions/cycle (95%), performed compressions of at least 5 cm depth (89%), released the chest (90%), applied two breaths (97%), used the automated external defibrillator (97%), and positioned the pads (100%). The online course was an effective method for teaching and learning key BLS skills wherein students were able to accurately apply BLS procedures during the CPR simulation. This short-term online training, which likely improves learning and self-efficacy in BLS providers, can be used for the continuing education of health professionals.

Cost savings associated with an alternative payment model for integrating behavioral health in primary care.

PubMed

Ross, Kaile M; Gilchrist, Emma C; Melek, Stephen P; Gordon, Patrick D; Ruland, Sandra L; Miller, Benjamin F

2018-05-23

Financially supporting and sustaining behavioral health services integrated into primary care settings remains a major barrier to widespread implementation. Sustaining Healthcare Across Integrated Primary Care Efforts (SHAPE) was a demonstration project designed to prospectively examine the cost savings associated with utilizing an alternative payment methodology to support behavioral health services in primary care practices with integrated behavioral health services. Six primary care practices in Colorado participated in this project. Each practice had at least one on-site behavioral health clinician providing integrated behavioral health services. Three practices received non-fee-for-service payments (i.e., SHAPE payment) to support provision of behavioral health services for 18 months. Three practices did not receive the SHAPE payment and served as control practices for comparison purposes. Assignment to condition was nonrandom. Patient claims data were collected for 9 months before the start of the SHAPE demonstration project (pre-period) and for 18 months during the SHAPE project (post-period) to evaluate cost savings. During the 18-month post-period, analysis of the practices' claims data demonstrated that practices receiving the SHAPE payment generated approximately $1.08 million in net cost savings for their public payer population (i.e., Medicare, Medicaid, and Dual Eligible; N = 9,042). The cost savings were primarily achieved through reduction in downstream utilization (e.g., hospitalizations). The SHAPE demonstration project found that non-fee-for-service payments for behavioral health integrated into primary care may be associated with significant cost savings for public payers, which could have implications on future delivery and payment work in public programs (e.g., Medicaid).

Building Social Networks for Maternal and Newborn Health in Poor Urban Settlements: A Cross-Sectional Study in Bangladesh

PubMed Central

Adams, Alayne M.; Nababan, Herfina Y.; Hanifi, S. M. Manzoor Ahmed

2015-01-01

Background The beneficial influence of social networks on health and wellbeing is well-established. In poor urban settlements in Bangladesh, BRAC’s Manoshi programme trains community health workers (CHWs) to support women through pregnancy, delivery and postpartum periods. This paper test the hypothesis that the introduction of CHWs as weak ties into the social networks of Manoshi members mediates improvements in maternal and neonatal health (MNH) best practices by providing support, facilitating ideational change, connecting mother to resources, and strengthening or countering the influence of strong ties. Methods 1000 women who had given birth in the last three months were identified and interviewed as part of ongoing monitoring of 5 poor urban settlements in Dhaka, Bangladesh. A social networks questionnaire was administered which elicited women’s perceived networks around pregnancy, delivery and post-partum periods. Mediation analysis was performed to test the hypothesis that penetration of Manoshi CHWs into women’s perceived networks has a beneficial effect on MNH best practises. Results The presence and influence of Manoshi CHWs in women’s networks significantly mediated the effect of Manoshi membership on MNH best practices. Respondents who were Manoshi members and who listed Manoshi CHWs as part of their support networks were significantly more likely to deliver with a trained birth attendant (OR 3.61; 95%CI 2.36–5.51), to use postnatal care (OR 3.09; 95%CI 1.83–5.22), and to give colostrum to their newborn (OR 7.51; 95%CI 3.51–16.05). Conclusion Manoshi has succeeded in penetrating the perceived pregnancy, delivery and post-partum networks of poor urban women through the introduction of trained CHWs. Study findings demonstrate the benefits of moving beyond urban health care delivery models that concentrate on the provision of clinical services by medical providers, to an approach that nurtures the power of social networks as a means to support the poorest and most marginalized in changing behaviour and effectively accessing appropriate maternal services. PMID:25910191

'She didn't have a word of English; we didn't have a word of Vietnamese': Exploring parent experiences of communication with toddlers who were adopted internationally.

PubMed

McAndrew, Brid; Malley-Keighran, Mary-Pat O

2017-07-01

The purpose of this study was to explore in detail parents' experiences of communicating with toddlers who were adopted internationally. Often, there is a mismatch between parents and children in terms of language, particularly in the early post-adoption period. There is a gap in the literature regarding parent experiences of this phase of their lives. Changing patterns in international adoption have led to an increase in adoptions of toddlers and older children. Due to institutional care, these toddlers and older children often lack exposure to their native language which may lead to language delay. When they are brought home, they are immersed in English. As well beginning to acquire English, these children are also forming an attachment with their parents. While research has investigated speech and language skills in this population, there is a lack of literature exploring the experiences of parents regarding communicating with toddlers who are adopted internationally in the early months following adoption. This is a qualitative study where interviews and thematic analysis were used to explore the experiences of 12 parents of 12 toddlers who were adopted internationally. Three main themes: 'Getting ready', 'Support', and 'Challenges' emerged from the data. The results highlight the ways in which adoptive parents facilitated communication with their toddlers, supporting their acquisition of English. The results also reveal gaps in service provision for this population. Results also illustrate the proactive way in which parents dealt with challenges, even in the presence of limited support services. Gaps in service provision where intense focus pre-adoption was followed by a lack of support post-adoption were identified by parents. The dual needs of developing attachment and common language development strategies were also described by parents. The study demonstrates the need for pre- and post-adoptive speech and language services for this client group. It highlights the importance of the role of speech and language pathology in working with parents of toddlers and children who were adopted internationally. This role is in health promotion and prevention, as well as providing a service to this population as part of a multidisciplinary team, post-adoption. Copyright © 2017 Elsevier Inc. All rights reserved.

Needs, Preferences, and Functional Abilities of Veterans and Service Members with Upper-Limb Amputation

DTIC Science & Technology

2017-10-01

its Impact on Post-Acute Outcomes” has been added to active support.  “Impact of Hospital-Based Physical Therapy Services on Hospital Readmission... Physical Therapy Sponsor: Foundation for Physical Therapy Dario Dieguez, PhD Scientific Programs & Communications Manager 1033 N Fairfax St...destination and b. hospital readmission Overlap: None 11) Title: Impact of Hospital-Based Physical Therapy Services on Hospital Readmission: Implications

Preference phenotypes can be used to support shared decision-making at point-of-care for patients with rheumatoid arthritis: A proof of concept study.

PubMed

Hsiao, Betty; Binder-Finnema, Pauline; Benjamin Nowell, W; Michel, George; Wiedmeyer, Carole; Fraenkel, Liana

2018-06-28

In this proof-of-concept study, we sought to evaluate whether a value clarification tool enabling patients to view a set of rheumatoid arthritis (RA) treatment preference phenotypes could be used to support shared decision-making (SDM) at the point-of-care. We conducted a pre-post test study. All English-speaking RA patients presenting to their scheduled outpatient visits were asked to participate. Visits for patients with active RA were transcribed. SDM components were measured using a quantitative coding scheme based on an established model of SDM. Forty-six visits were included in the pre-test and 40 in the post-test phase. Providers offered more DMARDs (two or more) in the post-test visits (60%) compared to the pre-test visits (47.8%). Overall, more patients vocalized their values and/or preferences in the post-test visits compared to the pre-test visits for treatment escalation decisions including choice of one new DMARD (90.9% versus 56.3%), two or more new DMARDs (95.8% versus 86.4%), as well as prednisone (87.5% versus 66.7%). Providers were also more likely to base their recommendations on patients' values and/or preferences in the post-test (100% of six visits) than pre-test (64.3% of 14 visits) phase during visits in which a recommendation was made. The average (SD) length of the visit was 29.9 (11.6) minutes and 25.1 (10.7) minutes in the pre- and post-test phases respectively. This study provides an early indication that a value clarification tool allowing patients to consider a set of preference phenotypes can support SDM at the point-of-care without extending visit time. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Home-based HIV counseling and testing: client experiences and perceptions in Eastern Uganda.

PubMed

Kyaddondo, David; Wanyenze, Rhoda K; Kinsman, John; Hardon, Anita

2012-11-12

Though prevention and treatment depend on individuals knowing their HIV status, the uptake of testing remains low in Sub-Saharan Africa. One initiative to encourage HIV testing involves delivering services at home. However, doubts have been cast about the ability of Home-Based HIV Counseling and Testing (HBHCT) to adhere to ethical practices including consent, confidentiality, and access to HIV care post-test. This study explored client experiences in relation these ethical issues. We conducted 395 individual interviews in Kumi district, Uganda, where teams providing HBHCT had visited 6-12 months prior to the interviews. Semi-structured questionnaires elicited information on clients' experiences, from initial community mobilization up to receipt of results and access to HIV services post-test. We found that 95% of our respondents had ever tested (average for Uganda was 38%). Among those who were approached by HBHCT providers, 98% were informed of their right to decline HIV testing. Most respondents were counseled individually, but 69% of the married/cohabiting were counseled as couples. The majority of respondents (94%) were satisfied with the information given to them and the interaction with the HBHCT providers. Most respondents considered their own homes as more private than health facilities. Twelve respondents reported that they tested positive, 11 were referred for follow-up care, seven actually went for care, and only 5 knew their CD4 counts. All HIV infected individuals who were married or cohabiting had disclosed their status to their partners. These findings show a very high uptake of HIV testing and satisfaction with HBHCT, a large proportion of married respondents tested as couples, and high disclosure rates. HBHCT can play a major role in expanding access to testing and overcoming disclosure challenges. However, access to HIV services post-test may require attention.

Care for post-stroke patients at Malaysian public health centres: self-reported practices of family medicine specialists

PubMed Central

2014-01-01

Background Provision of post stroke care in developing countries is hampered by discoordination of services and limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems among Family Medicine Specialists managing public primary health care services. Methods A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire assessed respondents background and practice details i.e. estimated stroke care burden, current service provision and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data, constant comparison method was used until saturation of themes was reached. Results Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2 patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%). Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on ‘as needed’ basis. Referrals ranked in order of frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The FMS’ perceived 4 important ‘needs’ in managing stroke patients at primary care level; access to rehabilitation services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a standardized guideline and family and caregiver support. Conclusions Post discharge stroke care guidelines and access to rehabilitation services at primary care is needed for post stroke patients residing at home in the community. PMID:24580779

Development of early mathematical skills with a tablet intervention: a randomized control trial in Malawi.

PubMed

Pitchford, Nicola J

2015-01-01

Evaluation of educational interventions is necessary prior to wide-scale rollout. Yet very few rigorous studies have been conducted on the effectiveness of tablet-based interventions, especially in the early years and in developing countries. This study reports a randomized control trial to evaluate the effectiveness of a tablet intervention for supporting the development of early mathematical skills in primary school children in Malawi. A total sample of 318 children, spanning Standards 1-3, attending a medium-sized urban primary school, were randomized to one of three groups: maths tablet intervention, non-maths tablet control, and standard face-to-face practice. Children were pre-tested using tablets at the start of the school year on two tests of mathematical knowledge and a range of basic skills related to scholastic progression. Class teachers then delivered the intervention over an 8-weeks period, for the equivalent of 30-min per day. Technical support was provided from the local Voluntary Service Overseas (VSO). Children were then post-tested on the same assessments as given at pre-test. A final sample of 283 children, from Standards 1-3, present at both pre- and post-test, was analyzed to investigate the effectiveness of the maths tablet intervention. Significant effects of the maths tablet intervention over and above standard face-to-face practice or using tablets without the maths software were found in Standards 2 and 3. In Standard 3 the greater learning gains shown by the maths tablet intervention group compared to both of the control groups on the tablet-based assessments transferred to paper and pencil format, illustrating generalization of knowledge gained. Thus, tablet technology can effectively support early years mathematical skills in developing countries if the software is carefully designed to engage the child in the learning process and the content is grounded in a solid well-constructed curriculum appropriate for the child's developmental stage.

Development of early mathematical skills with a tablet intervention: a randomized control trial in Malawi

PubMed Central

Pitchford, Nicola J.

2015-01-01

Evaluation of educational interventions is necessary prior to wide-scale rollout. Yet very few rigorous studies have been conducted on the effectiveness of tablet-based interventions, especially in the early years and in developing countries. This study reports a randomized control trial to evaluate the effectiveness of a tablet intervention for supporting the development of early mathematical skills in primary school children in Malawi. A total sample of 318 children, spanning Standards 1–3, attending a medium-sized urban primary school, were randomized to one of three groups: maths tablet intervention, non-maths tablet control, and standard face-to-face practice. Children were pre-tested using tablets at the start of the school year on two tests of mathematical knowledge and a range of basic skills related to scholastic progression. Class teachers then delivered the intervention over an 8-weeks period, for the equivalent of 30-min per day. Technical support was provided from the local Voluntary Service Overseas (VSO). Children were then post-tested on the same assessments as given at pre-test. A final sample of 283 children, from Standards 1–3, present at both pre- and post-test, was analyzed to investigate the effectiveness of the maths tablet intervention. Significant effects of the maths tablet intervention over and above standard face-to-face practice or using tablets without the maths software were found in Standards 2 and 3. In Standard 3 the greater learning gains shown by the maths tablet intervention group compared to both of the control groups on the tablet-based assessments transferred to paper and pencil format, illustrating generalization of knowledge gained. Thus, tablet technology can effectively support early years mathematical skills in developing countries if the software is carefully designed to engage the child in the learning process and the content is grounded in a solid well-constructed curriculum appropriate for the child’s developmental stage. PMID:25954236

Pragmatic cluster randomised trial of a free telephone-based health coaching program to support women in managing weight gain during pregnancy: the Get Healthy in Pregnancy Trial.

PubMed

Clements, Vanessa; Leung, Kit; Khanal, Santosh; Raymond, Jane; Maxwell, Michelle; Rissel, Chris

2016-08-30

Excessive gestational weight gain can result in poor maternal and child health outcomes. Estimates from single studies indicate the prevalence of excessive gestational weight gain in Australia could lie between 38 and 67 %. The risk of excessive weight gain can be reduced through healthy eating and exercise. We describe the rationale and methods of the Get Healthy in Pregnancy Service, a trial service which aims to support women in achieving appropriate gestational weight gain through an existing telephone-based health coaching service. This study aims to compare the effectiveness of a telephone-based health coaching program versus provision of information only in supporting pregnant women to achieve appropriate gestational weight gain. A pragmatic stratified clustered randomised controlled trial will be conducted with 710 women who present to 5 hospitals for their first antenatal appointment during the recruitment period (6-8 months), have a pre-pregnancy body mass index (BMI) ≥ 18.50 (healthy weight or above), are 18 years and over, singleton gestation, English speaking, have no pre-existing medical conditions that may limit their ability to exercise or require a restricted diet and are 18 weeks or less gestation. Hospitals will be randomised into one of two intervention models: a) information only; or b) information plus 10 telephone-based health coaching sessions with a university qualified coach. Both interventions will set a weight-range target with pregnant women. The women attending antenatal clinics at participating hospitals will be screened at their initial hospital appointment to assess their eligibility. Women recruited to the trial will have a number of measures recorded including anthropometrics (self-reported height and weight) and dietary and physical activity scores during and following pregnancy. These measurements will be collected at baseline (prior to 18 weeks gestation), 36 weeks gestation and 12 months post-birth. This study responds to a need for an effective intervention that targets excessive gestational weight gain at a population level. This study investigates the potential for an innovative intervention combining two existing services; a free state-wide telephone-based health coaching service and hospital-based antenatal care to support pregnant women to achieve healthy weight gain during pregnancy. The use of existing services provides the potential for immediate post-study implementation. While the impacts of telephone-based lifestyle programmes have been tested in a number of settings, there are few studies which evaluate the effectiveness and acceptability of telephone support in achieving healthy gestational weight gain in association with routine antenatal care. ACTRN12615000397516 (Registration date: 26 June 2014, retrospectively registered).

Interprofessional practice and learning in a youth mental health service: A case study using network analysis.

PubMed

Barnett, Tony; Hoang, Ha; Cross, Merylin; Bridgman, Heather

2015-01-01

Few studies have examined interprofessional practice (IPP) from a mental health service perspective. This study applied a mixed-method approach to examine the IPP and learning occurring in a youth mental health service in Tasmania, Australia. The aims of the study were to investigate the extent to which staff were networked, how collaboratively they practiced and supported student learning, and to elicit the organisation's strengths and opportunities regarding IPP and learning. Six data sets were collected: pre- and post-test readiness for interprofessional learning surveys, Social Network survey, organisational readiness for IPP and learning checklist, "talking wall" role clarification activity, and observations of participants working through a clinical case study. Participants (n = 19) were well-networked and demonstrated a patient-centred approach. Results confirmed participants' positive attitudes to IPP and learning and identified ways to strengthen the organisation's interprofessional capability. This mixed-method approach could assist others to investigate IPP and learning.

Effect of a multidisciplinary supportive program for family caregivers of patients with heart failure on caregiver burden, quality of life, and depression: A randomized controlled study.

PubMed

Hu, Xiaolin; Dolansky, Mary A; Su, Yonglin; Hu, Xiuying; Qu, Moying; Zhou, Lingjuan

2016-10-01

Caregivers of patients with heart failure experience burden and negative health outcomes. Adequate support for family caregivers improves their well-being and the quality of care provided to the patients. However, little is known about the benefits of interventions for caregivers of patients with heart failure in China. To test the effects of a multidisciplinary supportive program for family caregivers on caregiver burden, quality of life, and depression. A randomized controlled design with repeated measures was used in this study. A total of 118 participants were randomized into experimental (n=59) and control groups (n=59) from May to December 2014 in one hospital in Chengdu, People's Republic of China. Participants in the experimental group received a 3-month multidisciplinary supportive program, consisting of three 60-min sessions of group classes, three 30-min peer support groups, and regular telephone follow-ups and consultations, while participants in the control group received usual care only. Outcomes were caregiver burden, quality of life, and depression. Data were collected at baseline, post-test (3 months after discharge), and 3 months after post-test (6 months after discharge). The repeated measures analysis of variance was used to examine the effects of groups, changes over time, and time-group interaction on outcome variables. There were significant improvements in caregiver burden, mental health, and depression after post-test and 3 months after post-test in the experimental group. However, there was no significant improvement in caregivers' physical health at either 3 or 6 months following discharge. A multidisciplinary supportive program for caregivers of heart failure patients had positive effects and provides a unique perspective of an intervention considering Chinese culture and customs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Policies and clinical practices relating to the management of gestational diabetes mellitus in the public health sector, South Africa - a qualitative study.

PubMed

Muhwava, Lorrein Shamiso; Murphy, Katherine; Zarowsky, Christina; Levitt, Naomi

2018-05-10

Women with a prior gestational diabetes have an increased lifetime risk of developing type 2 diabetes. Although post-partum follow-up for GDM women is essential to prevent progression to type 2 diabetes, it is poorly attended. The need for health systems interventions to support postpartum follow-up for GDM women is evident, but there is little knowledge of actual current practice. The aim of this study was to explore current policies and clinical practices relating to antenatal and post-natal care for women with GDM in South Africa, as well as health sector stakeholders' perspectives on the barriers to -- and opportunities for -- delivering an integrated mother - baby health service that extends beyond the first week post-partum, to the infant's first year of life. Following a document review of policy and clinical practice guidelines, in-depth interviews were conducted with 11 key informants who were key policy makers, health service managers and clinicians working in the public health services in South Africa's two major cities (Johannesburg and Cape Town). Data were analysed using qualitative content analysis procedures. The document review and interviews established that it is policy that health services adhere to international guidelines for GDM diagnosis and management, in addition to locally developed guidelines and protocols for clinical practice. All key informants confirmed that lack of postpartum follow-up for GDM women is a significant problem. Health systems barriers include fragmentation of care and the absence of standardised postnatal care for post-GDM women. Key informants also raised patient - related challenges including lack of perceived future risk of developing type 2 diabetes and non-attendance for postpartum follow up, as barriers to postnatal care for GDM women. All participants supported integrated primary health services but cautioned against overloading health workers. Although there is alignment between international guidelines, local policy and reported clinical practice in the management of GDM, there is a gap in continuation of care in the postpartum period. Health systems interventions that support and facilitate active follow-up for women with prior GDM are needed if high rates of progression to type 2 diabetes are to be avoided.

28 CFR 549.12 - Testing.

Code of Federal Regulations, 2014 CFR

2014-07-01

... warranted. (5) Counseling. Inmates being tested for HIV will receive pre- and post-test counseling... Bureau tests inmates who have sentences of six months or more if health services staff determine, taking... for refusing to obey an order. (2) Exposure incidents. The Bureau tests an inmate, regardless of the...

28 CFR 549.12 - Testing.

Code of Federal Regulations, 2011 CFR

2011-07-01

... warranted. (5) Counseling. Inmates being tested for HIV will receive pre- and post-test counseling... Bureau tests inmates who have sentences of six months or more if health services staff determine, taking... for refusing to obey an order. (2) Exposure incidents. The Bureau tests an inmate, regardless of the...

28 CFR 549.12 - Testing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... warranted. (5) Counseling. Inmates being tested for HIV will receive pre- and post-test counseling... Bureau tests inmates who have sentences of six months or more if health services staff determine, taking... for refusing to obey an order. (2) Exposure incidents. The Bureau tests an inmate, regardless of the...

28 CFR 549.12 - Testing.

Code of Federal Regulations, 2012 CFR

2012-07-01

... warranted. (5) Counseling. Inmates being tested for HIV will receive pre- and post-test counseling... Bureau tests inmates who have sentences of six months or more if health services staff determine, taking... for refusing to obey an order. (2) Exposure incidents. The Bureau tests an inmate, regardless of the...

28 CFR 549.12 - Testing.

Code of Federal Regulations, 2013 CFR

2013-07-01

... warranted. (5) Counseling. Inmates being tested for HIV will receive pre- and post-test counseling... Bureau tests inmates who have sentences of six months or more if health services staff determine, taking... for refusing to obey an order. (2) Exposure incidents. The Bureau tests an inmate, regardless of the...

77 FR 58295 - National Employer Support of the Guard and Reserve Week, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-19

... America A Proclamation During the 236 years since our fundamental rights to life, liberty, and the pursuit... members of the United States Armed Forces. Today's service members represent the latest in the long line of heroes who have answered their country's call, and their exceptional service in a post-9/11 world...

An Analysis of Homeless Veterans Participating in the Homeless Veteran Reintegration Program

ERIC Educational Resources Information Center

Campbell, Katrina Lanelle

2010-01-01

The purpose of this study was to conduct an analysis on ex post facto data of the federal grant supported Homeless Veterans Reintegration Program (HVRP) administered at Goodwill Industries of Lower South Carolina. Pre-existing data on variables such as performance goals, training activities, support services, and demographics from program years…

Design Study for Project on Standard Operating Procedures for Technical Library Services.

ERIC Educational Resources Information Center

Libbey, Miles A.; And Others

The overall objective of the Technical Information Support Activities (TISA) Project is the production of a "Post Commander's Handbook." The handbook will be instrumental in achieving greater utilization of available technical information resources to assist army scientists and engineers engaged in the support of army combat and other…

Predicting adaptation to presymptomatic DNA testing for late onset disorders: who will experience distress? Rotterdam Leiden Genetics Workgroup.

PubMed Central

DudokdeWit, A C; Tibben, A; Duivenvoorden, H J; Niermeijer, M F; Passchier, J

1998-01-01

The first comparative study on predicting post-test distress (conceptualised by intrusion and avoidance, measured with the Impact of Event Scale) after presymptomatic genetic testing for Huntington's disease (HD, n=25), cancer syndromes (familial adenomatous polyposis (FAP, n=23)), and hereditary breast and ovarian cancer (HBOC, n=10) is reported. The variables with the highest predictive potential of post-test distress are presented. Participants who were depressed before the test were more distressed after testing, but we found that those who were anxious before the test were less distressed, that is, had less intrusive thoughts post-test. Other factors associated with a higher level of post-test intrusion were gender (being a woman), having children, and pre-test intrusion. Religion and being at risk for HBOC were associated with less post-test intrusion. Participants who showed avoidance behaviour before the test and those who had many people available for support showed more avoidance behaviour post-test. The test result did not additionally contribute to post-test distress. The prima facie simple notion that the test result, as such, determines the distress experienced seems to be a misrepresentation of the complex reality. PMID:9733033

Support as a complement, intrusion and right--evidence from ageing and disability support service users in Sweden and Australia.

PubMed

Laragy, Carmel; Fisher, Karen R; Cedersund, Elisabet; Campbell-McLean, Carolyn

2011-12-01

How service users conceptualise their personal support services is under researched, even though this understanding is important for responsive policy development and service implementation. This paper tests the proposition that service users understand formal support in three ways: support is a complement to their other arrangements, an intrusion into their personal life and a right. These three concepts were identified using discourse analysis in a Swedish study of older people wanting in-home support services. To test generalisability of these concepts, they were applied to data from an Australian study of people using disability personal support. The analysis found that the three concepts were core to people's views of their support, although the construction of the concepts differed in the two countries. Service users in Sweden asserted their right to services more forcefully than those in Australia, and they had higher expectations that their support needs would be met. These differences reflect the impact of each country's social policy environment on service users' expectations. The analysis suggests that service users and their families want to control their formal support arrangements to complement their informal care and their life preferences and to minimise the intrusive aspects of formal support. The findings imply that the three concepts have utility for theorising service users' perspectives, informing policy and developing implementation strategies which enhance peoples' quality of life. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

The effectiveness of simulated robots for supporting the learning of introductory programming: a multi-case case study

NASA Astrophysics Data System (ADS)

Major, Louis; Kyriacou, Theocharis; Brereton, Pearl

2014-07-01

This work investigates the effectiveness of simulated robots as tools to support the learning of programming. After the completion of a systematic review and exploratory research, a multi-case case study was undertaken. A simulator, named Kebot, was developed and used to run four 10-hour programming workshops. Twenty-three student participants (aged 16-18) in addition to 23 pre-service, and 3 in-service, teachers took part. The effectiveness of this intervention was determined by considering opinions, attitudes, and motivation as well as by analysing students' programming performance. Pre- and post-questionnaires, in- and post-workshop exercises, and interviews were used. Participants enjoyed learning using the simulator and believed the approach to be valuable and engaging. The performance of students indicates that the simulator aids learning as most completed tasks to a satisfactory standard. Evidence suggests robot simulators can offer an effective means of introducing programming. Recommendations to support the development of other simulators are provided.

An assessment of quality of home-based HIV counseling and testing performed by lay counselors in a rural sub-district of KwaZulu-Natal, South Africa.

PubMed

Magasana, Vuyolwethu; Zembe, Wanga; Tabana, Hanani; Naik, Reshma; Jackson, Debra; Swanevelder, Sonja; Doherty, Tanya

2016-12-01

HIV counseling and testing (HCT) has been prioritized as one of the prevention strategies for HIV/AIDS, and promoted as an essential tool in scaling up and improving access to treatment, care and support especially in community settings. Home-based HCT (HBHCT) is a model that has consistently been found to be highly acceptable and has improved HCT coverage and uptake in low- and middle-income countries since 2002. It involves trained lay counselors going door-to-door offering pre-test counseling and providing HCT services to consenting eligible household members. Currently, there are few studies reporting on the quality of HBHCT services offered by lay counselors especially in Sub-Saharan Africa, including South Africa. This is a quantitative descriptive sub-study of a community randomized trial (Good Start HBHCT trial) which describes the quality of HBHCT provided by lay counselors. Quality of HBHCT was measured as scores comparing observed practice to prescribed protocols using direct observation. Data were collected through periodic observations of HCT sessions and exit interviews with clients. Counselor quality scores for pre-test counseling and post-test counseling sessions were created to determine the level of quality. For the client exit interviews a continuous score was created to assess how satisfied the clients were with the counseling session. A total of 196 (3%) observational assessments and 406 (6%) client exit interviews were completed. Overall, median scores for quality of counseling and testing were high for both HIV-negative and HIV-positive clients. For exit interviews all 406 (100%) clients had overall satisfaction with the counseling and testing services they received, however 11% were concerned about the counselor keeping their discussion confidential. Of all 406 clients, 393 (96.8%) intended to recommend the service to other people. In ensuring good quality HCT services, ongoing quality assessments are important to monitor quality of HCT after training.

Food Service Supervisor. Dietetic Support Personnel Achievement Test.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Vocational and Technical Education, Stillwater.

This guide contains a series of multiple-choice items and guidelines to assist instructors in composing criterion-referenced tests for use in the food service supervisor component of Oklahoma's Dietetic Support Personnel training program. Test items addressing each of the following occupational duty areas are provided: human relations; nutrient…

Food Service Worker. Dietetic Support Personnel Achievement Test.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Vocational and Technical Education, Stillwater.

This guide contains a series of multiple-choice items and guidelines to assist instructors in composing criterion-referenced tests for use in the food service worker component of Oklahoma's Dietetic Support Personnel training program. Test items addressing each of the following occupational duty areas are provided: human relations; personal…

Changing landscapes, changing practice: negotiating access to sleeping sickness services in a post-conflict society.

PubMed

Palmer, Jennifer J; Kelly, Ann H; Surur, Elizeous I; Checchi, Francesco; Jones, Caroline

2014-11-01

For several decades, control programmes for human African trypanosomiasis (HAT, or sleeping sickness) in South Sudan have been delivered almost entirely as humanitarian interventions: large, well-organised, externally-funded but short-term programmes with a strategic focus on active screening. When attempts to hand over these programmes to local partners fail, resident populations must actively seek and negotiate access to tests at hospitals via passive screening. However, little is known about the social impact of such humanitarian interventions or the consequences of withdrawal on access to and utilisation of remaining services by local populations. Based on qualitative and quantitative fieldwork in Nimule, South Sudan (2008-2010), where passive screening necessarily became the predominant strategy, this paper investigates the reasons why, among two ethnic groups (Madi returnees and Dinka displaced populations), service uptake was so much higher among the latter. HAT tests were the only form of clinical care for which displaced Dinka populations could self-refer; access to all other services was negotiated through indigenous area workers. Because of the long history of conflict, these encounters were often morally and politically fraught. An open-door policy to screening supported Dinka people to 'try' HAT tests in the normal course of treatment-seeking, thereby empowering them to use HAT services more actively. This paper argues that in a context like South Sudan, where HAT control increasingly depends upon patient-led approaches to case-detection, it is imperative to understand the cultural values and political histories associated with the practice of testing and how medical humanitarian programmes shape this landscape of care, even after they have been scaled down. Copyright © 2014 Elsevier Ltd. All rights reserved.

‘Making every contact count’: evaluation of the impact of an intervention to train health and social care practitioners in skills to support health behaviour change

PubMed Central

Black, Christina; Tinati, Tannaze; Cradock, Sue; Begum, Rufia; Jarman, Megan; Pease, Anna; Margetts, Barrie; Davies, Jenny; Inskip, Hazel; Cooper, Cyrus; Baird, Janis; Barker, Mary

2015-01-01

A total of 148 health and social care practitioners were trained in skills to support behaviour change: creating opportunities to discuss health behaviours, using open discovery questions, listening, reflecting and goal-setting. At three time points post-training, use of the skills was evaluated and compared with use of skills by untrained practitioners. Trained practitioners demonstrated significantly greater use of these client-centred skills to support behaviour change compared to their untrained peers up to one year post-training. Because it uses existing services to deliver support for behaviour change, this training intervention has the potential to improve public health at relatively low cost. PMID:24713156

Evaluating change in virtual reality adoption for brain injury rehabilitation following knowledge translation.

PubMed

Glegg, Stephanie M N; Holsti, Liisa; Stanton, Sue; Hanna, Steven; Velikonja, Diana; Ansley, Barbara; Sartor, Denise; Brum, Christine

2017-04-01

To evaluate the impact of knowledge translation (KT) on factors influencing virtual reality (VR) adoption and to identify support needs of therapists. Intervention will be associated with improvements in therapists' perceived ease of use and self-efficacy, and an associated increase in intentions to use VR. Single group mixed-methods pre-test-post-test evaluation of convenience sample of physical, occupational and rehabilitation therapists (n=37) from two brain injury rehabilitation centres. ADOPT-VR administered pre/post KT intervention, consisting of interactive education, clinical manual, technical and clinical support. Increases in perceived ease of use (p=0.000) and self-efficacy (p=0.001), but not behavioural intention to use VR (p=0.158) were found following KT, along with decreases in the frequency of perceived barriers. Post-test changes in the frequency and nature of perceived facilitators and barriers were evident, with increased emphasis on peer influence, organisational-level supports and client factors. Additional support needs were related to clinical reasoning, treatment programme development, technology selection and troubleshooting. KT strategies hold potential for targeting therapists' perceptions of low self-efficacy and ease of use of this technology. Changes in perceived barriers, facilitators and support needs at post-test demonstrated support for repeated evaluation and multi-phased training initiatives to address therapists' needs over time. Implications for Rehabilitation Therapists' learning and support needs in integrating virtual reality extend beyond technical proficiency to include clinical decision-making and application competencies spanning the entire rehabilitation process. Phased, multi-faceted strategies may be valuable in addressing therapists' changing needs as they progress from novice to experienced virtual reality users. The ADOPT-VR is a sensitive measure to re-evaluate the personal, social, environmental, technology-specific and system-level factors influencing virtual reality adoption over time.

A durability test of wood posts in Hawaii…second progress report

Treesearch

Roger G. Skolmen

1965-01-01

Exposure of double-diffusion treated and untreated round posts of Hawaii-grown wood showed that (a) untreated 3- to 5-inch posts of 10 species will last from less than a year to 3 years, depending on species, and that (b) except for three species, the treatment did not afford a service life long enough to justify using it.

How Did the Meanings Constructed by Taiwanese Pre-Service Teachers from Educational News Media Affect Their Beliefs?

ERIC Educational Resources Information Center

Liu, Shih-Hsiung; Tsao, Shih-Chieh

2013-01-01

The study investigates how Taiwanese pre-service teachers make meaning after reading positive or negative news coverage of educational events and how they construct meaning impact their pedagogical beliefs. An experiment with a two-group pre-test-post-test design, consisting of a positive and negative news group, is conducted. Multimedia news…

MSFC Three Point Docking Mechanism design review

NASA Technical Reports Server (NTRS)

Schaefer, Otto; Ambrosio, Anthony

1992-01-01

In the next few decades, we will be launching expensive satellites and space platforms that will require recovery for economic reasons, because of initial malfunction, servicing, repairs, or out of a concern for post lifetime debris removal. The planned availability of a Three Point Docking Mechanism (TPDM) is a positive step towards an operational satellite retrieval infrastructure. This study effort supports NASA/MSFC engineering work in developing an automated docking capability. The work was performed by the Grumman Space & Electronics Group as a concept evaluation/test for the Tumbling Satellite Retrieval Kit. Simulation of a TPDM capture was performed in Grumman's Large Amplitude Space Simulator (LASS) using mockups of both parts (the mechanism and payload). Similar TPDM simulation activities and more extensive hardware testing was performed at NASA/MSFC in the Flight Robotics Laboratory and Space Station/Space Operations Mechanism Test Bed (6-DOF Facility).

REAL-TIME TRACER MONITORING OF RESERVOIR STIMULATION PROCEDURES VIA ELECTRONIC WIRELINE AND TELEMETRY DATA TRANSMISSION

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

George L. Scott III

2005-01-01

Finalized Phase 2-3 project work has field-proven two separate real-time reservoir processes that were co-developed via funding by the National Energy Technology Laboratory (NETL). Both technologies are presently patented in the United States and select foreign markets; a downhole-commingled reservoir stimulation procedure and a real-time tracer-logged fracturing diagnostic system. Phase 2 and early Phase 3 project work included the research, development and well testing of a U.S. patented gamma tracer fracturing diagnostic system. This stimulation logging process was successfully field-demonstrated; real-time tracer measurement of fracture height while fracturing was accomplished and proven technically possible. However, after the initial well tests,more » there were several licensing issues that developed between service providers that restricted and minimized Realtimezone's (RTZ) ability to field-test the real-time gamma diagnostic system as was originally outlined for this project. Said restrictions were encountered after when one major provider agreed to license their gamma logging tools to another. Both of these companies previously promised contributory support toward Realtimezone's DE-FC26-99FT40129 project work, however, actual support was less than desired when newly-licensed wireline gamma logging tools from one company were converted by the other from electric wireline into slickline, batter-powered ''memory'' tools for post-stimulation logging purposes. Unfortunately, the converted post-fracture measurement memory tools have no applications in experimentally monitoring real-time movement of tracers in the reservoir concurrent with the fracturing treatment. RTZ subsequently worked with other tracer gamma-logging tool companies for basic gamma logging services, but with lessened results due to lack of multiple-isotope detection capability. In addition to real-time logging system development and well testing, final Phase 2 and Phase 3 project work included the development of a real-time reservoir stimulation procedure, which was successfully field-demonstrated and is presently patented in the U.S. and select foreign countries, including Venezuela, Brazil and Canada. Said patents are co-owned by RTZ and the National Energy Technology Lab (NETL). In 2002, Realtimezone and the NETL licensed said patents to Halliburton Energy Services (HES). Additional licensing agreements (LA) are anticipated with other service industry companies in 2005. Final Phase 3 work has led to commercial applications of the real-time reservoir stimulation procedure. Four successfully downhole-mixed well tests were conducted with commercially expected production results. The most recent, fourth field test was a downhole-mixed stimulated well completed in June, 2004, which currently produces 11 BOPD with 90 barrels of water per day. Conducted Phase 2 and Phase 3 field-test work to date has resulted in the fine-tuning of a real-time enhanced stimulation system that will significantly increase future petroleum well recoveries in the United States and foreign petroleum fields, both onshore and offshore, and in vertical and horizontal wells.« less

3 CFR 13625 - Executive Order 13625 of August 31, 2012. Improving Access to Mental Health Services for Veterans...

Code of Federal Regulations, 2013 CFR

2013-01-01

... health services for veterans, service members, and their families. Our public health approach must..., substance abuse treatment facilities, and rural health clinics, to test the effectiveness of community... full understanding of the underlying mechanisms of Post-Traumatic Stress Disorder (PTSD), other mental...

Situation Awareness of Onboard System Autonomy

NASA Technical Reports Server (NTRS)

Schreckenghost, Debra; Thronesbery, Carroll; Hudson, Mary Beth

2005-01-01

We have developed intelligent agent software for onboard system autonomy. Our approach is to provide control agents that automate crew and vehicle systems, and operations assistants that aid humans in working with these autonomous systems. We use the 3 Tier control architecture to develop the control agent software that automates system reconfiguration and routine fault management. We use the Distributed Collaboration and Interaction (DCI) System to develop the operations assistants that provide human services, including situation summarization, event notification, activity management, and support for manual commanding of autonomous system. In this paper we describe how the operations assistants aid situation awareness of the autonomous control agents. We also describe our evaluation of the DCI System to support control engineers during a ground test at Johnson Space Center (JSC) of the Post Processing System (PPS) for regenerative water recovery.

Parent perceptions of school-based support for students with traumatic brain injuries

PubMed Central

GFROERER, SUSAN DAVIES; WADE, SHARI L.; WU, MICHELLE

2015-01-01

Primary objective To determine whether parents believe schools provided necessary support to their children who sustained traumatic brain injuries. Research design Interview, to determine parent perceptions. Methods and procedure Sixty-six primary caregivers of school-age children who experienced a TBI within the previous 2 years were interviewed regarding what types of special support were needed by and provided for their children during the 3 months immediately following school re-entry. They then rated how difficult it was to obtain support or services from the school and how satisfied they were with the support or services. Main outcomes and results The majority of participants did not perceive the need for school-based services, even when the injury was severe. Almost all students whose parents perceived a need for an adjusted schedule were granted that accommodation, but few students received school-based counselling or behavioural support. Conclusions Results indicated that participants perceived relatively few school-based supports, particularly given the actual academic, behavioural and social challenges experienced by children who have sustained a TBI. Schools and hospitals must take steps to ensure appropriate post-head injury support services. PMID:18608201

Impact of the role of nurse, midwife and health visitor consultant.

PubMed

Coster, Samantha; Redfern, Sally; Wilson-Barnett, Jenifer; Evans, Amanda; Peccei, Riccardo; Guest, David

2006-08-01

This paper describes the findings from one aspect of an evaluation study of the role of the nurse, midwife and health visitor consultant and the consultants' perceived impact of their role on services and patient care. The nurse, midwife and health visitor consultant role was established in 2000 in England to improve patient care, strengthen leadership and provide a clinical career opportunity for nurses, midwives and health visitors. An evaluative study was commissioned to report on the role 4 years after the new consultant posts were first established. A multimethod evaluation was undertaken in 2002-2003 combining focus groups, telephone interviews and a comprehensive questionnaire survey of all the consultants in England. Four hundred and nineteen consultants responded to the questionnaire, 22 volunteered for the focus groups and 32 participated in the interviews. Nearly half (44%) the consultants who responded to the survey reported having a substantial impact on their service and 55% reported having some positive impact. High reported impact increased to 71% for those who had been in post for 2 years or longer. Consultants felt that they had been most successful in providing better support to staff, but only 10% said that they had a major impact on reducing unnecessary expenditure within the service. Factors associated with high levels of reported impact included engagement in a wide range of activities, perceived competence in the role and strong medical support. Those reporting most impact also reported the greatest dissatisfaction with salary. As consultants become more established in their posts, they are able to identify improvements in practice, service reconfiguration and educational advantages for staff. Our findings suggest that the true influence of these posts will become clearer over time as the impact of consultants on long-term organizational change becomes more apparent.

40 CFR 71.24 - Permit applications.

Code of Federal Regulations, 2013 CFR

2013-07-01

... end of the post-reduction year. (4) If a source test will be the supporting basis for establishing post-reduction emissions for one or more emissions units in the early reductions source, the test... to the appropriate State agency; to the EPA Emission Standards Division, Mail Drop 13, Research...

40 CFR 71.24 - Permit applications.

Code of Federal Regulations, 2014 CFR

2014-07-01

... end of the post-reduction year. (4) If a source test will be the supporting basis for establishing post-reduction emissions for one or more emissions units in the early reductions source, the test... to the appropriate State agency; to the EPA Emission Standards Division, Mail Drop 13, Research...

40 CFR 71.24 - Permit applications.

Code of Federal Regulations, 2010 CFR

2010-07-01

... end of the post-reduction year. (4) If a source test will be the supporting basis for establishing post-reduction emissions for one or more emissions units in the early reductions source, the test... to the appropriate State agency; to the EPA Emission Standards Division, Mail Drop 13, Research...

40 CFR 71.24 - Permit applications.

Code of Federal Regulations, 2011 CFR

2011-07-01

... end of the post-reduction year. (4) If a source test will be the supporting basis for establishing post-reduction emissions for one or more emissions units in the early reductions source, the test... to the appropriate State agency; to the EPA Emission Standards Division, Mail Drop 13, Research...

40 CFR 71.24 - Permit applications.

Code of Federal Regulations, 2012 CFR

2012-07-01

... end of the post-reduction year. (4) If a source test will be the supporting basis for establishing post-reduction emissions for one or more emissions units in the early reductions source, the test... to the appropriate State agency; to the EPA Emission Standards Division, Mail Drop 13, Research...

75 FR 13550 - Office of Clinical and Preventive Services: National HIV Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-22

... (CDC) guidelines, and pre- and post-test counseling (when appropriate). Purpose These cooperative... tests with sexually transmitted diseases (STD) screening. II. Award Information Type of Awards... existing public health statutes. Test at least one previously-untested (not tested in the prior five years...

Retrogression and Re-Ageing In-Service Demonstrator Reliability Trials: Stage 3 Component Test Report

DTIC Science & Technology

2012-03-01

6 4.5 Component, Furnace and Quench Bath Thermometry...................................... 6 4.6 Component Heat Treatment...7 4.6.2 Post-Retrogression Quench .................................................................... 9 4.6.3...23 5.5.2 Temperature Profile – Post-Retrogression Quenching .................... 23 5.5.3 Temperature

Support for Offering Sexual Health Services through School-Based Health Clinics

ERIC Educational Resources Information Center

Moore, Michele Johnson; Barr, Elissa; Wilson, Kristina; Griner, Stacey

2016-01-01

Background: Numerous studies document support for sexuality education in the schools. However, there is a dearth of research assessing support for sexual health services offered through school-based health clinics (SBHCs). The purpose of this study was to assess voter support for offering 3 sexual health services (STI/HIV testing, STI/HIV…

Development and evaluation of a home enteral nutrition team.

PubMed

Dinenage, Sarah; Gower, Morwenna; Van Wyk, Joanna; Blamey, Anne; Ashbolt, Karen; Sutcliffe, Michelle; Green, Sue M

2015-03-05

The organisation of services to support the increasing number of people receiving enteral tube feeding (ETF) at home varies across regions. There is evidence that multi-disciplinary primary care teams focussed on home enteral nutrition (HEN) can provide cost-effective care. This paper describes the development and evaluation of a HEN Team in one UK city. A HEN Team comprising dietetians, nurses and a speech and language therapist was developed with the aim of delivering a quality service for people with gastrostomy tubes living at home. Team objectives were set and an underpinning framework of organisation developed including a care pathway and a schedule of training. Impact on patient outcomes was assessed in a pre-post test evaluation design. Patients and carers reported improved support in managing their ETF. Cost savings were realised through: (1) prevention of hospital admission and related transport for ETF related issues; (2) effective management and reduction of waste of feed and thickener; (3) balloon gastrostomy tube replacement by the HEN Team in the patient's home, and optimisation of nutritional status. This service evaluation demonstrated that the establishment of a dedicated multi-professional HEN Team focussed on achievement of key objectives improved patient experience and, although calculation of cost savings were estimates, provided evidence of cost-effectiveness.

Employees' satisfaction as influenced by acoustic and visual privacy in the open office environment

NASA Astrophysics Data System (ADS)

Soules, Maureen Jeanette

The purpose of this study was to examine the relationship between employees' acoustic and visual privacy issues and their perceived satisfaction in their open office work environments while in focus work mode. The study examined the Science Teaching Student Services Building at the University of Minnesota Minneapolis. The building houses instructional classrooms and administrative offices that service UMN students. The Sustainable Post-Occupancy Evaluation Survey was used to collect data on overall privacy conditions, acoustic and visual privacy conditions, and employees' perceived privacy conditions while in their primary workplace. Paired T-tests were used to analyze the relationships between privacy conditions and employees' perceptions of privacy. All hypotheses are supported indicating that the privacy variables are correlated to the employees' perception of satisfaction within the primary workplace. The findings are important because they can be used to inform business leaders, designers, educators and future research in the field of office design.

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.

3 CFR 8864 - Proclamation 8864 of September 14, 2012. National Employer Support of the Guard and Reserve Week...

Code of Federal Regulations, 2013 CFR

2013-01-01

... Reserve Week, 2012By the President of the United States of America A Proclamation During the 236 years.... Today's service members represent the latest in the long line of heroes who have answered their country's call, and their exceptional service in a post-9/11 world has secured their place alongside the...

The Impact of Transition Services in Facilitating College Degree Completion for Students with Visual Impairments: Post-Bachelor's Degree Perspectives

ERIC Educational Resources Information Center

Mask, Paige R.; DePountis, Vicki

2018-01-01

This article portrays the complex nature of the transition process for two students with visual impairments (VI), both functionally blind, who successfully completed a bachelor's degree. Standardized open-ended interviews provided individual perspectives on the transition services, supports, and challenges faced by the participants with VI during…

Improving dementia diagnosis and management in primary care: a cohort study of the impact of a training and support program on physician competency, practice patterns, and community linkages.

PubMed

Lathren, Christine R; Sloane, Philip D; Hoyle, Joseph D; Zimmerman, Sheryl; Kaufer, Daniel I

2013-12-10

Primary care physicians routinely provide dementia care, but may lack the clinical skills and awareness of available resources to provide optimal care. We conducted a community-based pilot dementia training intervention designed to both improve clinical competency and increase utilization of local dementia care services. Physicians (N = 29) and affiliated staff (N = 24) participated in a one-day training program on dementia screening, diagnosis and management that included direct engagement with local support service providers. Questionnaires about their dementia care competency and referral patterns were completed before and 6 months after the training intervention. Physicians reported significantly higher overall confidence in their dementia care competency 6 months post-training compared to pre-training. The largest reported improvements were in their ability to educate patients and caregivers about dementia and making appropriate referrals to community care services. Participants also reported markedly increased use of cognitive screening tools in providing care. Community service providers recorded approximately 160 physician-initiated referrals over a 2 year-period post-training, compared to few beforehand. Combining a targeted physician practice-based educational intervention with community service engagement improves dementia care competency in clinicians and promotes linkages between clinical and community dementia care providers.

The Financial Health and Level of Resilience in Housing Counseling Clientele Post Experience: A Mixed Methods Assessment

ERIC Educational Resources Information Center

Tobe, Erica Anne

2014-01-01

The United States (US) economy experienced the Great Recession from December 2007 through June 2009. During this time, significant job loss and housing instability occurred, creating stress and strain on families. As a support, housing counseling agencies were funded to provide foreclosure counseling and prevention services to support families…

Using Action Plans to Support Communication Programming for Children Who Are Deafblind

ERIC Educational Resources Information Center

Bruce, Susan M.

2008-01-01

The author describes the use of action plans to support 2 teachers' post-in-service implementation of communication strategies with 3 children who are deafblind. In the action plans, the teachers recorded changes in thinking and instructional practices under the 4 aspects of communication: form, function, content, and context. They also recorded…

Challenges of Maintaining Good Clinical Laboratory Practices in Low-Resource Settings:  A Health Program Evaluation Framework Case Study From East Africa.

PubMed

Zhang, Helen L; Omondi, Michael W; Musyoka, Augustine M; Afwamba, Isaac A; Swai, Remigi P; Karia, Francis P; Muiruri, Charles; Reddy, Elizabeth A; Crump, John A; Rubach, Matthew P

2016-08-01

Using a clinical research laboratory as a case study, we sought to characterize barriers to maintaining Good Clinical Laboratory Practice (GCLP) services in a developing world setting. Using a US Centers for Disease Control and Prevention framework for program evaluation in public health, we performed an evaluation of the Kilimanjaro Christian Medical Centre-Duke University Health Collaboration clinical research laboratory sections of the Kilimanjaro Clinical Research Institute in Moshi, Tanzania. Laboratory records from November 2012 through October 2014 were reviewed for this analysis. During the 2-year period of study, seven instrument malfunctions suspended testing required for open clinical trials. A median (range) of 9 (1-55) days elapsed between instrument malfunction and biomedical engineer service. Sixteen (76.1%) of 21 suppliers of reagents, controls, and consumables were based outside Tanzania. Test throughput among laboratory sections used a median (range) of 0.6% (0.2%-2.7%) of instrument capacity. Five (55.6%) of nine laboratory technologists left their posts over 2 years. These findings demonstrate that GCLP laboratory service provision in this setting is hampered by delays in biomedical engineer support, delays and extra costs in commodity procurement, low testing throughput, and high personnel turnover. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Evaluation of the healthcare network for persons with arterial hypertension: study of a health district].

PubMed

Santos, Cleuzieli Moraes Dos; Barbieri, Ana Rita; Gonçalves, Crhistinne Cavalheiro Maymone; Tsuha, Daniel Henrique

2017-06-12

In the context of public health policies, healthcare network is a strategy that aims to promote people's equitable access to services and to reduce fragmentation. The aim of this study was to evaluate the degree of development of components in a healthcare network for hypertension. This was an ex-ante, cross-sectional evaluative study focused on the implementation of a healthcare network for persons with chronic diseases, applying a questionnaire to 17 health administrators from the municipalities (counties) comprising the largest health district in Mato Grosso do Sul State, Brazil. The questionnaire consisted of 65 questions covering the five components: Primary Health Care; Specialized Care; Support Systems; Logistics Systems; and Governance. The study conducted descriptive statistical tests and the classification of services provided in each component using the Friedman test, followed by the Student-Newman-Keuls post hoc test, with significance set at 5%. The results were distributed in quartiles and presented in boxplot graphs. Correlations were established between the dimensions. According to the findings, the components are in an intermediate degree of implementation, with low development of the items needed for establishing networks. Primary Health Care does not coordinate the care, and the Specialized Care and Governance components showed the worst results. The findings indicate predominance of installed services that still fall short of the necessary practices for establishing healthcare networks, which can compromise their implementation.

Effect of Mobile-Assisted Dialect Awareness Training on the Dialect Attitudes of Prospective English Language Teachers

ERIC Educational Resources Information Center

Bozoglan, Hilal; Gok, Duygu

2017-01-01

The purpose of this study was to investigate the impact of a mobile-assisted dialect awareness programme on the dialect attitudes of pre-service English language teachers in Turkey. The study adopted a pre-test and a post-test design including 58 first-grade pre-service English language teachers in two different classes. The experimental group…

Rapid evidence assessment of approaches to community neurological nursing care for people with neurological conditions post-discharge from acute care hospital.

PubMed

Pugh, Judith Dianne; McCoy, Kathleen; Williams, Anne M; Bentley, Brenda; Monterosso, Leanne

2018-04-16

Neurological conditions represent leading causes of non-fatal burden of disease that will consume a large proportion of projected healthcare expenditure. Inconsistent access to integrated healthcare and other services for people with long-term neurological conditions stresses acute care services. The purpose of this rapid evidence assessment, conducted February-June 2016, was to review the evidence supporting community neurological nursing approaches for patients with neurological conditions post-discharge from acute care hospitals. CINAHL Plus with Full Text and MEDLINE were searched for English-language studies published January 2000 to June 2016. Data were extracted using a purpose-designed protocol. Studies describing community neurological nursing care services post-discharge for adults with stroke, dementia, Alzheimer's disease, Parkinson's disease, multiple sclerosis or motor neurone disease were included and their quality was assessed. Two qualitative and three quantitative studies were reviewed. Two themes were identified in the narrative summary of findings: (i) continuity of care and self-management and (ii) variable impact on clinical or impairment outcomes. There was low quality evidence of patient satisfaction, improved patient social activity, depression scores, stroke knowledge and lifestyle modification associated with post-discharge care by neurological nurses as an intervention. There were few studies and weak evidence supporting the use of neurology-generalist nurses to promote continuity of care for people with long-term or progressive, long-term neurological conditions post-discharge from acute care hospital. Further research is needed to provide role clarity to facilitate comparative studies and evaluations of the effectiveness of community neurological nursing models of care. © 2018 John Wiley & Sons Ltd.

Developing a European grid infrastructure for cancer research: vision, architecture and services

PubMed Central

Tsiknakis, M; Rueping, S; Martin, L; Sfakianakis, S; Bucur, A; Sengstag, T; Brochhausen, M; Pucaski, J; Graf, N

2007-01-01

Life sciences are currently at the centre of an information revolution. The nature and amount of information now available opens up areas of research that were once in the realm of science fiction. During this information revolution, the data-gathering capabilities have greatly surpassed the data-analysis techniques. Data integration across heterogeneous data sources and data aggregation across different aspects of the biomedical spectrum, therefore, is at the centre of current biomedical and pharmaceutical R&D. This paper reports on original results from the ACGT integrated project, focusing on the design and development of a European Biomedical Grid infrastructure in support of multi-centric, post-genomic clinical trials (CTs) on cancer. Post-genomic CTs use multi-level clinical and genomic data and advanced computational analysis and visualization tools to test hypotheses in trying to identify the molecular reasons for a disease and the stratification of patients in terms of treatment. The paper provides a presentation of the needs of users involved in post-genomic CTs and presents indicative scenarios, which drive the requirements of the engineering phase of the project. Subsequently, the initial architecture specified by the project is presented, and its services are classified and discussed. A range of such key services, including the Master Ontology on sCancer, which lie at the heart of the integration architecture of the project, is presented. Special efforts have been taken to describe the methodological and technological framework of the project, enabling the creation of a legally compliant and trustworthy infrastructure. Finally, a short discussion of the forthcoming work is included, and the potential involvement of the cancer research community in further development or utilization of the infrastructure is described. PMID:22275955

Application of Athletic Movement Tests that Predict Injury Risk in a Military Population: Development of Normative Data.

PubMed

Teyhen, Deydre S; Shaffer, Scott W; Butler, Robert J; Goffar, Stephen L; Kiesel, Kyle B; Rhon, Daniel I; Boyles, Robert E; McMillian, Daniel J; Williamson, Jared N; Plisky, Phillip J

2016-10-01

Performance on movement tests helps to predict injury risk in a variety of physically active populations. Understanding baseline measures for normal is an important first step. Determine differences in physical performance assessments and describe normative values for these tests based on military unit type. Assessment of power, balance, mobility, motor control, and performance on the Army Physical Fitness Test were assessed in a cohort of 1,466 soldiers. Analysis of variance was performed to compare the results based on military unit type (Rangers, Combat, Combat Service, and Combat Service Support) and analysis of covariance was performed to determine the influence of age and gender. Rangers performed the best on all performance and fitness measures (p < 0.05). Combat soldiers performed better than Combat Service and Service Support soldiers on several physical performance tests and the Army Physical Fitness Test (p < 0.05). Performance in Combat Service and Service Support soldiers was equivalent on most measures (p < 0.05). Functional performance and level of fitness varied significantly by military unit type. Understanding these differences will provide a foundation for future injury prediction and prevention strategies. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Evaluation of Cable Harness Post-Installation Testing. Part B

NASA Technical Reports Server (NTRS)

King, M. S.; Iannello, C. J.

2011-01-01

The Cable Harness Post-Installation Testing Report was written in response to an action issued by the Ares Project Control Board (PCB). The action for the Ares I Avionics & Software Chief Engineer and the Avionics Integration and Vehicle Systems Test Work Breakdown Structure (WBS) Manager in the Vehicle Integration Office was to develop a set of guidelines for electrical cable harnesses. Research showed that post-installation tests have been done since the Apollo era. For Ares I-X, the requirement for post-installation testing was removed to make it consistent with the avionics processes used on the Atlas V expendable launch vehicle. Further research for the report involved surveying government and private sector launch vehicle developers, military and commercial aircraft, spacecraft developers, and harness vendors. Responses indicated crewed launch vehicles and military aircraft perform post-installation tests. Key findings in the report were as follows: Test requirements identify damage, human-rated vehicles should be tested despite the identification of statistically few failures, data does not support the claim that post-installation testing damages the harness insulation system, and proper planning can reduce overhead associated with testing. The primary recommendation of the report is for the Ares projects to retain the practice of post-fabrication and post-installation cable harness testing.

78 FR 45246 - Office of Clinical and Preventive Services National HIV Program: Enhanced HIV/AIDS Screening and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-26

... Prevention (CDC) guidelines, provide pre- and post-test counseling (when indicated), and developing or... by applicable law. Test at least one previously untested (not tested in the prior five years) patient... ensure that clients receive their test results, particularly clients who test positive. ii. Describe how...

77 FR 36550 - Office of Clinical and Preventive Services Funding Opportunity: National HIV Program for Enhanced...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-19

... Disease Control and Prevention (CDC) guidelines, provide pre- and post-test counseling (when indicated... existing public health statutes. Test at least one previously untested (not tested in the prior five years... their test results, particularly clients who test positive. ii. Describe how the program will ensure...

Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India

PubMed Central

Shaikh, Simran; Mburu, Gitau; Arumugam, Viswanathan; Mattipalli, Naveen; Aher, Abhina; Mehta, Sonal; Robertson, James

2016-01-01

Introduction Transgender populations face inequalities in access to HIV, health and social services. In addition, there is limited documentation of models for providing appropriately tailored services and social support for transgender populations in low- and middle-income countries. This paper presents outcomes of the Global Fund-supported Pehchan programme, which aimed to strengthen community systems and provide HIV, health, legal and social services to transgender communities across 18 Indian states through a rights-based empowerment approach. Methods We used a pre- and post-intervention cross-sectional survey design with retrospective analysis of programmatic data. Using stratified sampling, we identified 268 transgender participants in six Indian states from a total of 48,280 transgender people served by Pehchan through 186 community-based organizations. We quantified the impact of interventions by comparing baseline and end line indicators of accessed health social and legal services. We also assessed end line self-efficacy and collective action with regard to social support networks. Results There were significant increases in community-based demand and use of tailored health, legal, social and psychological services over the time of the Pehchan programme. We report significant increases in access to condoms (12.5%, p<0.001) and condom use at last anal sex with both regular (18.1%, p<0.001) and casual (8.1%, p<0.001) male partners. Access to HIV outreach education and testing and counselling services significantly increased (20.10%, p<0.001; 33.7%, p<0.001). In addition, significant increases in access to emergency crisis response (19.7%, p<0.001), legal support (26.8%, p<0.001) and mental health services (33.0%, p<0.001) were identified. Finally, we note that the Pehchan programme successfully provided a platform for the formation, collectivization and visibility of peer support groups. Conclusions The Pehchan programme's community involvement, rights-based collectivization and gender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains. PMID:27431474

Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India.

PubMed

Shaikh, Simran; Mburu, Gitau; Arumugam, Viswanathan; Mattipalli, Naveen; Aher, Abhina; Mehta, Sonal; Robertson, James

2016-01-01

Transgender populations face inequalities in access to HIV, health and social services. In addition, there is limited documentation of models for providing appropriately tailored services and social support for transgender populations in low- and middle-income countries. This paper presents outcomes of the Global Fund-supported Pehchan programme, which aimed to strengthen community systems and provide HIV, health, legal and social services to transgender communities across 18 Indian states through a rights-based empowerment approach. We used a pre- and post-intervention cross-sectional survey design with retrospective analysis of programmatic data. Using stratified sampling, we identified 268 transgender participants in six Indian states from a total of 48,280 transgender people served by Pehchan through 186 community-based organizations. We quantified the impact of interventions by comparing baseline and end line indicators of accessed health social and legal services. We also assessed end line self-efficacy and collective action with regard to social support networks. There were significant increases in community-based demand and use of tailored health, legal, social and psychological services over the time of the Pehchan programme. We report significant increases in access to condoms (12.5%, p<0.001) and condom use at last anal sex with both regular (18.1%, p<0.001) and casual (8.1%, p<0.001) male partners. Access to HIV outreach education and testing and counselling services significantly increased (20.10%, p<0.001; 33.7%, p<0.001). In addition, significant increases in access to emergency crisis response (19.7%, p<0.001), legal support (26.8%, p<0.001) and mental health services (33.0%, p<0.001) were identified. Finally, we note that the Pehchan programme successfully provided a platform for the formation, collectivization and visibility of peer support groups. The Pehchan programme's community involvement, rights-based collectivization and gender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains.

Rehabilitation services after the implementation of the nursing home prospective payment system: differences related to patient and nursing home characteristics.

PubMed

Murray, Patrick K; Love, Thomas E; Dawson, Neal V; Thomas, Charles L; Cebul, Randall D

2005-11-01

The prospective payment system (PPS) for nursing homes was designed to curtail the rapid expansion of Medicare costs for skilled nursing care. This study examines the changes that occurred in nursing home patients and rehabilitation services following the PPS. Free-standing Medicare and/or Medicaid certified nursing homes in Ohio. The percent of new admissions receiving therapy and the amount of rehabilitation therapy provided. A total of 7006 first admissions in 1994-6 (pre-PPS) and 61,569 first admissions in 2000-1 (post-PPS). A logistic model predicting likelihood of rehabilitation was developed and validated in pre-PPS admissions and applied to the post-PPS patients. Rehabilitation services were compared in the pre-PPS and post-PPS cohorts overall, stratified by quintile of predicted score, diagnosis group, and by nursing home profit status. Post-PPS patients had less cognitive impairment, more depression, and more family support. The amount of rehabilitation services declined the most in the higher quintiles of predicted likelihood of rehabilitation and among patients with stroke. The percent of patients receiving rehabilitation services increased the most in the lowest quintile and among patients with medical conditions. These changes were greater in for-profit nursing homes. The implementation of the PPS in nursing homes has been associated with a decrease in the amount of rehabilitation services, targeted at those predicted to receive higher amounts and an increased frequency of providing services targeted at those predicted to be less likely to receive them. The outcomes of the changes deserve further study.

Community perspectives on post-Katrina mental health recovery in New Orleans.

PubMed

Meyers, Diana; Allien, Charles E; Dunn, Donisha; Wennerstrom, Ashley; Springgate, Benjamin F

2011-01-01

Disaster-affected communities may face prolonged challenges to community-wide mental health recovery due to limitations in local resources, infrastructure, and leadership. REACH NOLA, an umbrella non-profit organization comprising academic institutions and community-based agencies, sought to promote community recovery, increase mental health service delivery capacity, and develop local leadership in post-Katrina New Orleans through its Mental Health infrastructure and Training Project (MHIT). The project offered local health service providers training and follow-up support for implementing evidence-based and new approaches to mental health service delivery. This commentary shares the perspectives of three community leaders who co-directed MHIT. They describe the genesis of MHIT, the experience of each agency in adopting leadership roles in addressing post-disaster needs, challenges and growth opportunities, and then overarching lessons learned concerning leadership in a prolonged crisis. These lessons may be relevant to community agencies addressing hurricane recovery in other areas of the Gulf States as well as to inform long-term disaster recovery efforts elsewhere.

The effects of an online basic life support course on undergraduate nursing students’ learning

PubMed Central

Tobase, Lucia; Peres, Heloisa H.C.; Smith, Nicole; Polastri, Thatiane F.; Timerman, Sergio

2017-01-01

Objectives To describe learning outcomes of undergraduate nursing students following an online basic life support course (BLS). Methods An online BLS course was developed and administered to 94 nursing students. Pre- and post-tests were used to assess theoretical learning. Checklist simulations and feedback devices were used to assess the cardiopulmonary resuscitation (CPR) skills of the 62 students who completed the course. Results A paired t-test revealed a significant increase in learning [pre-test (6.4 ± 1.61), post-test (9.3 ± 0.82), p < 0.001]. The increase in the average grade after taking the online course was significant (p<0.001). No learning differences (p=0.475) had been observed between 1st and 2nd year (9.20 ± 1.60), and between 3rd and 4th year (9.67 ± 0.61) students. A CPR simulation was performed after completing the course: students checked for a response (90%), exposed the chest (98%), checked for breathing (97%), called emergency services (76%), requested for a defibrillator (92%), checked for a pulse (77%), positioned their hands properly (87%), performed 30 compressions/cycle (95%), performed compressions of at least 5 cm depth (89%), released the chest (90%), applied two breaths (97%), used the automated external defibrillator (97%), and positioned the pads (100%). Conclusions The online course was an effective method for teaching and learning key BLS skills wherein students were able to accurately apply BLS procedures during the CPR simulation. This short-term online training, which likely improves learning and self-efficacy in BLS providers, can be used for the continuing education of health professionals. PMID:28850944

How Should We Screen for Depression Following a Natural Disaster? An ROC Approach to Post-Disaster Screening in Adolescents and Adults

PubMed Central

Cohen, Joseph R.; Adams, Zachary W.; Menon, Suvarna V.; Youngstrom, Eric A.; Bunnell, Brian E.; Acierno, Ron; Ruggiero, Kenneth J.; Danielson, Carla Kmett

2016-01-01

Background The present study’s aim was to provide the foundation for an efficient, empirically based protocol for depression screening following a natural disaster. Utilizing a Receiver Operating Characteristic (ROC) analytic approach, the study tested a) what specific disaster-related stressors (i.e., property damage, loss of basic services) and individual-related constructs (i.e., PTSD symptoms, trauma history, social support) conveyed the greatest risk for post-natural disaster depression, b) specific cutoff scores across these measures, and c) whether the significance or cutoff scores for each construct varied between adolescents and adults. Methods Structured phone-based clinical interviews were conducted with 2,000 adolescents who lived through a tornado and 1,543 adults who survived a hurricane. Results Findings suggested that in both adolescents and adults, individual-related constructs forecasted greater risk for depressive symptoms following a natural disaster compared to disaster-related stressors. Furthermore, trauma history and PTSD symptoms were particularly strong indicators for adolescent depressive symptoms compared to adult depressive symptoms. Adolescents and adults who reported vulnerable scores for social support, trauma history, and lifetime PTSD symptoms were approximately twice as likely to present as depressed following the natural disaster. Limitations Findings from the present study were limited to post-disaster assessments and based on self-reported functioning 6–12 months following the natural disaster. Conclusions The present study synthesizes the extensive body of research on post-disaster functioning by providing a clear framework for which questions may be most important to ask when screening for depression following a natural disaster. PMID:27259082

How should we screen for depression following a natural disaster? An ROC approach to post-disaster screening in adolescents and adults.

PubMed

Cohen, Joseph R; Adams, Zachary W; Menon, Suvarna V; Youngstrom, Eric A; Bunnell, Brian E; Acierno, Ron; Ruggiero, Kenneth J; Danielson, Carla Kmett

2016-09-15

The present study's aim was to provide the foundation for an efficient, empirically based protocol for depression screening following a natural disaster. Utilizing a Receiver Operating Characteristic (ROC) analytic approach, the study tested a) what specific disaster-related stressors (i.e., property damage, loss of basic services) and individual-related constructs (i.e., PTSD symptoms, trauma history, social support) conveyed the greatest risk for post-natural disaster depression, b) specific cutoff scores across these measures, and c) whether the significance or cutoff scores for each construct varied between adolescents and adults. Structured phone-based clinical interviews were conducted with 2000 adolescents who lived through a tornado and 1543 adults who survived a hurricane. Findings suggested that in both adolescents and adults, individual-related constructs forecasted greater risk for depressive symptoms following a natural disaster compared to disaster-related stressors. Furthermore, trauma history and PTSD symptoms were particularly strong indicators for adolescent depressive symptoms compared to adult depressive symptoms. Adolescents and adults who reported vulnerable scores for social support, trauma history, and lifetime PTSD symptoms were approximately twice as likely to present as depressed following the natural disaster. Findings from the present study were limited to post-disaster assessments and based on self-reported functioning 6-12 months following the natural disaster. The present study synthesizes the extensive body of research on post-disaster functioning by providing a clear framework for which questions may be most important to ask when screening for depression following a natural disaster. Copyright © 2016 Elsevier B.V. All rights reserved.

The disruption management model.

PubMed

McAlister, James

2011-10-01

Within all organisations, business continuity disruptions present a set of dilemmas that managers may not have dealt with before in their normal daily duties. The disruption management model provides a simple but effective management tool to enable crisis management teams to stay focused on recovery in the midst of a business continuity incident. The model has four chronological primary headlines, which steer the team through a quick-time crisis decision-making process. The procedure facilitates timely, systematic, rationalised and justified decisions, which can withstand post-event scrutiny. The disruption management model has been thoroughly tested within an emergency services environment and is proven to significantly support clear and concise decision making in a business continuity context.

Manned Orbital Transfer Vehicle (MOTV). Volume 2: Mission handbook

NASA Technical Reports Server (NTRS)

Boyland, R. E.; Sherman, S. W.; Morfin, H. W.

1979-01-01

The use of the manned orbit transfer vehicle (MOTV) for support of future space missions is defined. Some 20 generic missions are defined each representative of the types of missions expected to be flown in the future. These include the service and update of communications satellites, emergency repair of surveillance satellites, and passenger transport of a six man crew rotation/resupply service to a deep space command post. The propulsive and functional capabilities required of the MOTV to support a particular mission are described and data to enable the user to determine the number of STS flights needed to support the mission, mission peculiar equipment requirements, parametrics on mission phasing and requirements, ground and flight support requirements, recovery considerations, and IVA/EVA trade analysis are presented.

Apollo 13 post-flight Service Module tests to determine reason for explosion

NASA Technical Reports Server (NTRS)

1970-01-01

Sequence photo from 16mm motion picture film of test at Langley Research Center which seeks to determine mechanism by which Apollo 13 panel was separated from Service Module. The test used a 1/2 scale model with a honeycomb sandwich panel and was conducted in a vacuum (41982); Second photograph in sequence of three of panel separation test at Langley Research Center (41983); Full-scale propogation test at the NASA Manned Spacecraft Center of fire inside the Apollo Service Module oxygen tank. The photograph from a motion picture sequence taken from outside the vessel shows failure of tank conduit with abrupt loss of oxygen pressure (41984); Third photograph in sequence of three showing panel separation test at Langley Research Center (41985).

Improving the Quality of Voluntary Medical Male Circumcision through Use of the Continuous Quality Improvement Approach: A Pilot in 30 PEPFAR-Supported Sites in Uganda

PubMed Central

Opio, Alex; Calnan, Jacqueline; Njeuhmeli, Emmanuel

2015-01-01

Background Uganda adopted voluntary medical male circumcision (VMMC) (also called Safe Male Circumcision in Uganda), as part of its HIV prevention strategy in 2010. Since then, the Ministry of Health (MOH) has implemented VMMC mostly with support from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) through its partners. In 2012, two PEPFAR-led external quality assessments evaluated compliance of service delivery sites with minimum quality standards. Quality gaps were identified, including lack of standardized forms or registers, lack of documentation of client consent, poor preparedness for emergencies and use of untrained service providers. In response, PEPFAR, through a USAID-supported technical assistance project, provided support in quality improvement to the MOH and implementing partners to improve quality and safety in VMMC services and build capacity of MOH staff to continuously improve VMMC service quality. Methods and Findings Sites were supported to identify barriers in achieving national standards, identify possible solutions to overcome the barriers and carry out improvement plans to test these changes, while collecting performance data to objectively measure whether they had bridged gaps. A 53-indicator quality assessment tool was used by teams as a management tool to measure progress; teams also measured client-level indicators through self-assessment of client records. At baseline (February-March 2013), less than 20 percent of sites scored in the “good” range (>80%) for supplies and equipment, patient counseling and surgical procedure; by November 2013, the proportion of sites scoring “good” rose to 67 percent, 93 percent and 90 percent, respectively. Significant improvement was noted in post-operative follow-up at 48 hours, sexually transmitted infection assessment, informed consent and use of local anesthesia but not rate of adverse events. Conclusion Public sector providers can be engaged to address the quality of VMMC using a continuous quality improvement approach. PMID:26207986

Telehealth physician oversight over direct to consumer testing: doctors working with patients towards patient empowerment.

PubMed

Chung, Rick

2012-06-01

Patient empowerment has increased the demand for direct to consumer (DTC) laboratory testing. Multiple professional societies and advocacy groups have raised concerns over how DTC laboratory testing is being offered to consumers without proper physician oversight. Physician telehealth services can properly oversee DTC laboratory testing in a safe and medically sound manner. Using telehealth protocols and standards established by professional health organizations and state regulators, physician telehealth oversight in DTC laboratory test ordering can be effective to increase patient access to healthcare services. With proper physician oversight in test interpretation, post-test counseling, and information collaboration, DTC laboratory testing can remain a reliable and convenient option for consumers. Working within the channel of distribution of most DTC laboratory testing, physician telehealth services can properly oversee DTC laboratory testing in a safe and medically sound manner to ensure that proper test interpretation, counseling, and information collaboration are achieved. Physician telehealth services can properly oversee DTC laboratory testing to ensure that proper test interpretation, counseling, and information collaboration are achieved.

Improving rural and remote practitioners' knowledge of the diabetic foot: findings from an educational intervention.

PubMed

Schoen, Deborah E; Gausia, Kaniz; Glance, David G; Thompson, Sandra C

2016-01-01

This study aimed to determine knowledge of national guidelines for diabetic foot assessment and risk stratification by rural and remote healthcare professionals in Western Australia and their implementation in practice. Assessment of diabetic foot knowledge, availability of equipment and delivery of foot care education in a primary healthcare setting at baseline enabled evaluation of the effectiveness of a diabetic foot education and training program for generalist healthcare professionals. This study employed a quasi-experimental pre-test/post-test study design. Healthcare practitioners' knowledge, attitudes and practice of diabetic foot assessment, diabetic foot risks, risk stratification, and use of the 2011 National Health and Medical Research Council Guidelines were investigated with an electronic pre-test survey(.) Healthcare professionals then undertook a 3-h education and training workshop before completing the electronic post-test knowledge, attitudes and practice survey. Comparison of pre-test/post-test survey findings was used to assess the change in knowledge, attitudes and intended practice due to the workshops. Two hundred and forty-six healthcare professionals from two rural and remote health regions of Western Australia participated in training workshops. Monofilaments and diabetes foot care education brochures, particularly brochures for Aboriginal people, were reported as not readily available in rural and remote health services. For most participants (58 %), their post-test knowledge score increased significantly from the pre-test score. Use of the Guidelines in clinical settings was low (19 %). The healthcare professionals' baseline diabetic foot knowledge was adequate to correctly identify the high risk category. However, stratification of the intermediate risk category was poor, even after training. This study reports the first assessment of Western Australia's rural and remote health professionals' knowledge, attitudes and practices regarding the diabetic foot. It shows that without training, generalists' levels of knowledge concerning the diabetic foot was low and they were unlikely to assess foot risk. The findings from this study in a rural and remote setting cast doubt on the ability of generalist healthcare professionals to stratify risk appropriately, especially for those at intermediate risk, without clinical decision support tools.

Implementation of a handheld electronic point-of-care billing system improved efficiency in the critical care unit.

PubMed

Fahy, Brenda G; Ketzler, Jonathan T

2007-01-01

Coding and billing are time consuming and important considerations for critical care practitioners. A 1-year prospective, observational study incorporated the use of a personal digital assistant and MDeverywhere software (Hauppauge, New York) for patient coding and billing. Twelve months of data were examined before electronic implementation (pre-elec) and compared with a 12-month period after implementation (post-elec) by using an unpaired t test or z test with P < .05 considered significant. The total number of charges was 2479 pre-elec and 2243 post-elec. The days from date of service to billing for services significantly decreased from 37.8 pre-elec to 12.4 post-elec (P < .001); days in accounts receivable significantly decreased from 92.0 to 73.0 (P < .001). The net collection rate increased from 44.7% pre-elec to 49.3% post-elec (P < .001). Duplicate charges significantly decreased from 5.0% pre-elec to 1.4% post-elec ( P < .001). The return on investment was 1.97-fold (197%). The initiation of personal digital assistant technology to facilitate billing and coding resulted in significant improvements.

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

Completion of a Veteran-Focused Civic Service Program Improves Health and Psychosocial Outcomes in Iraq and Afghanistan Veterans With a History of Traumatic Brain Injury

PubMed Central

Lawrence, Karen A.; Matthieu, Monica M.; Robertson-Blackmore, Emma

2017-01-01

Introduction Volunteering as a health promotion intervention is positively related to improved health and well-being in civilians and older adults. Yet, the impacts of participating in a community-based volunteering program on returning military veterans have not been studied, nor have the outcomes for veterans who have experienced a traumatic brain injury (TBI). Materials and Methods This observational, pre–post survey examines health, psychological, and social outcomes from a cohort of post-9/11/01 veterans with (N = 67) and without a reported TBI history (N = 273) who completed a 6-month, 20-hour per week veteran-focused civic service program. This study was approved by the Saint Louis University Institutional Review Board. Results Veterans with a TBI history who completed the 6-month civic service program conducted by a veteran-focused national nonprofit organization showed significant pre–post improvement (p < 0.05) in overall health, decreased post-traumatic stress disorder (PTSD) symptoms, increased perceived self-efficacy, decreased feelings of isolation and loneliness, and increased perceived availability of social support. These significant findings were not due to participants seeking external help for emotional problems. Out of four aspects of PTSD symptomatology assessed, “feeling numb or detached from others, activities, or surroundings” most accounted for the decrease in PTSD scores. Given this and taken together with the significant decrease in social isolation and loneliness and the social nature of the program, we posit that decreased social isolation and loneliness is the primary driver of the improved psychological and social outcomes documented here. Finally, pre–post change scores did not differ significantly between veterans with and without a TBI, indicating that TBI history did not hinder the ability to benefit from this program. Conclusion Completion of this civic service program positively impacted veterans with TBI, especially on psychological and social outcomes important to recovery and life satisfaction after TBI. Civic service may provide an innovative approach to promoting wellness in returning veterans with a TBI. Results of this study provide preliminary evidence that civic service decreases social isolation and loneliness in veterans with a reported TBI history. Given our findings, volunteering may prevent against social isolation and be promotional of perceived social support in veterans with TBI. PMID:28810970

Completion of a Veteran-Focused Civic Service Program Improves Health and Psychosocial Outcomes in Iraq and Afghanistan Veterans With a History of Traumatic Brain Injury.

PubMed

Lawrence, Karen A; Matthieu, Monica M; Robertson-Blackmore, Emma

2017-07-01

Volunteering as a health promotion intervention is positively related to improved health and well-being in civilians and older adults. Yet, the impacts of participating in a community-based volunteering program on returning military veterans have not been studied, nor have the outcomes for veterans who have experienced a traumatic brain injury (TBI). This observational, pre-post survey examines health, psychological, and social outcomes from a cohort of post-9/11/01 veterans with (N = 67) and without a reported TBI history (N = 273) who completed a 6-month, 20-hour per week veteran-focused civic service program. This study was approved by the Saint Louis University Institutional Review Board. Veterans with a TBI history who completed the 6-month civic service program conducted by a veteran-focused national nonprofit organization showed significant pre-post improvement (p < 0.05) in overall health, decreased post-traumatic stress disorder (PTSD) symptoms, increased perceived self-efficacy, decreased feelings of isolation and loneliness, and increased perceived availability of social support. These significant findings were not due to participants seeking external help for emotional problems. Out of four aspects of PTSD symptomatology assessed, "feeling numb or detached from others, activities, or surroundings" most accounted for the decrease in PTSD scores. Given this and taken together with the significant decrease in social isolation and loneliness and the social nature of the program, we posit that decreased social isolation and loneliness is the primary driver of the improved psychological and social outcomes documented here. Finally, pre-post change scores did not differ significantly between veterans with and without a TBI, indicating that TBI history did not hinder the ability to benefit from this program. Completion of this civic service program positively impacted veterans with TBI, especially on psychological and social outcomes important to recovery and life satisfaction after TBI. Civic service may provide an innovative approach to promoting wellness in returning veterans with a TBI. Results of this study provide preliminary evidence that civic service decreases social isolation and loneliness in veterans with a reported TBI history. Given our findings, volunteering may prevent against social isolation and be promotional of perceived social support in veterans with TBI. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

5 CFR 213.3102 - Entire executive civil service.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the National Research Council under its post-doctoral research associate program, may not exceed 2..., stores and other businesses in which the servicing examining office can schedule tests and/or reasonably.... (aa) Scientific and professional research associate positions at GS-11 and above when filled on a...

5 CFR 213.3102 - Entire executive civil service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the National Research Council under its post-doctoral research associate program, may not exceed 2..., stores and other businesses in which the servicing examining office can schedule tests and/or reasonably.... (aa) Scientific and professional research associate positions at GS-11 and above when filled on a...

5 CFR 213.3102 - Entire executive civil service.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the National Research Council under its post-doctoral research associate program, may not exceed 2..., stores and other businesses in which the servicing examining office can schedule tests and/or reasonably.... (aa) Scientific and professional research associate positions at GS-11 and above when filled on a...

5 CFR 213.3102 - Entire executive civil service.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the National Research Council under its post-doctoral research associate program, may not exceed 2..., stores and other businesses in which the servicing examining office can schedule tests and/or reasonably.... (aa) Scientific and professional research associate positions at GS-11 and above when filled on a...

Providing web-based mental health services to at-risk women

PubMed Central

2011-01-01

Background We examined the feasibility of providing web-based mental health services, including synchronous internet video conferencing of an evidence-based support/education group, to at-risk women, specifically poor lone mothers. The objectives of this study were to: (i) adapt a face-to-face support/education group intervention to a web-based format for lone mothers, and (ii) evaluate lone mothers' response to web-based services, including an online video conferencing group intervention program. Methods Participating mothers were recruited through advertisements. To adapt the face-to-face intervention to a web-based format, we evaluated participant motivation through focus group/key informant interviews (n = 7), adapted the intervention training manual for a web-based environment and provided a computer training manual. To evaluate response to web-based services, we provided the intervention to two groups of lone mothers (n = 15). Pre-post quantitative evaluation of mood, self-esteem, social support and parenting was done. Post intervention follow up interviews explored responses to the group and to using technology to access a health service. Participants received $20 per occasion of data collection. Interviews were taped, transcribed and content analysis was used to code and interpret the data. Adherence to the intervention protocol was evaluated. Results Mothers participating in this project experienced multiple difficulties, including financial and mood problems. We adapted the intervention training manual for use in a web-based group environment and ensured adherence to the intervention protocol based on viewing videoconferencing group sessions and discussion with the leaders. Participant responses to the group intervention included decreased isolation, and increased knowledge and confidence in themselves and their parenting; the responses closely matched those of mothers who obtained same service in face-to-face groups. Pre-and post-group quantitative evaluations did not show significant improvements on measures, although the study was not powered to detect these. Conclusions We demonstrated that an evidence-based group intervention program for lone mothers developed and evaluated in face-to-face context transferred well to an online video conferencing format both in terms of group process and outcomes. PMID:21854563

Providing web-based mental health services to at-risk women.

PubMed

Lipman, Ellen L; Kenny, Meghan; Marziali, Elsa

2011-08-19

We examined the feasibility of providing web-based mental health services, including synchronous internet video conferencing of an evidence-based support/education group, to at-risk women, specifically poor lone mothers. The objectives of this study were to: (i) adapt a face-to-face support/education group intervention to a web-based format for lone mothers, and (ii) evaluate lone mothers' response to web-based services, including an online video conferencing group intervention program. Participating mothers were recruited through advertisements. To adapt the face-to-face intervention to a web-based format, we evaluated participant motivation through focus group/key informant interviews (n = 7), adapted the intervention training manual for a web-based environment and provided a computer training manual. To evaluate response to web-based services, we provided the intervention to two groups of lone mothers (n = 15). Pre-post quantitative evaluation of mood, self-esteem, social support and parenting was done. Post intervention follow up interviews explored responses to the group and to using technology to access a health service. Participants received $20 per occasion of data collection. Interviews were taped, transcribed and content analysis was used to code and interpret the data. Adherence to the intervention protocol was evaluated. Mothers participating in this project experienced multiple difficulties, including financial and mood problems. We adapted the intervention training manual for use in a web-based group environment and ensured adherence to the intervention protocol based on viewing videoconferencing group sessions and discussion with the leaders. Participant responses to the group intervention included decreased isolation, and increased knowledge and confidence in themselves and their parenting; the responses closely matched those of mothers who obtained same service in face-to-face groups. Pre-and post-group quantitative evaluations did not show significant improvements on measures, although the study was not powered to detect these. We demonstrated that an evidence-based group intervention program for lone mothers developed and evaluated in face-to-face context transferred well to an online video conferencing format both in terms of group process and outcomes.

Evaluating an extended rehabilitation service for stroke patients (EXTRAS): study protocol for a randomised controlled trial.

PubMed

Rodgers, Helen; Shaw, Lisa; Cant, Robin; Drummond, Avril; Ford, Gary A; Forster, Anne; Hills, Katie; Howel, Denise; Laverty, Anne-Marie; McKevitt, Christopher; McMeekin, Peter; Price, Christopher

2015-05-05

Development of longer term stroke rehabilitation services is limited by lack of evidence of effectiveness for specific interventions and service models. We describe the protocol for a multicentre randomised controlled trial which is evaluating an extended stroke rehabilitation service. The extended service commences when routine 'organised stroke care' (stroke unit and early supported discharge (ESD)) ends. This study is a multicentre randomised controlled trial with health economic and process evaluations. It is set within NHS stroke services which provide ESD. Participants are adults who have experienced a new stroke (and carer if appropriate), discharged from hospital under the care of an ESD team. The intervention group receives an extended stroke rehabilitation service provided for 18 months following completion of ESD. The extended rehabilitation service involves regular contact with a senior ESD team member who leads and coordinates further rehabilitation. Contact is usually by telephone. The control group receives usual stroke care post-ESD. Usual care may involve referral of patients to a range of rehabilitation services upon completion of ESD in accordance with local clinical practice. Randomisation is via a central independent web-based service. The primary outcome is extended activities of daily living (Nottingham Extended Activities of Daily Living Scale) at 24 months post-randomisation. Secondary outcomes (at 12 and 24 months post-randomisation) are health status, quality of life, mood and experience of services for patients, and quality of life, experience of services and carer stress for carers. Resource use and adverse events are also collected. Outcomes are undertaken by a blinded assessor. Implementation and delivery of the extended stroke rehabilitation service will also be described. Semi-structured interviews will be conducted with a subsample of participants and staff to gain insight into perceptions and experiences of rehabilitation services delivered or received. Allowing for 25% attrition, 510 participants are needed to provide 90% power to detect a difference in mean Nottingham Extended Activities of Daily Living Scale score of 6 with a 5% significance level. The provision of longer term support for stroke survivors is currently limited. The results from this trial will inform future stroke service planning and configuration. This trial was registered with ISRCTN (identifier: ISRCTN45203373 ) on 9 August 2012.

Cost analysis of a novel interdisciplinary model for advanced illness management.

PubMed

Hopp, Faith P; Trzcinski, Eileen; Roth, Roxanne; Deremo, Dorothy; Fonger, Evan; Chiv, Sokchay; Paletta, Michael

2015-05-01

This research project evaluated cost outcomes for patients in the @HOMe Support program, a novel interdisciplinary home-based program for patients and caregivers facing advanced illness drawing on the Chronic Care Model. Cost analysis involved paired sample t-tests to examine pre-post differences in health care expenditures obtained from Health Maintenance Organization (HMO) claims data for program participants. Average 6-month costs per month significantly declined for patients older than 65 years of age from 1 HMO (US$9300-US$5900, P = .001). Evaluation of the second HMO showed that patients less than 65 years of age with lower preentry costs (<70 000) had a nonsignificant decline in total costs (US$18 787-US$13 781, P = .08). Study findings suggest @HOMe Support is associated with reductions in the use and cost for most health services over time. © The Author(s) 2014.

A University Math Help Centre as a Support Framework for Students, the Instructor, the Course, and the Department

ERIC Educational Resources Information Center

Menz, Petra; Jungic, Veselin

2015-01-01

Among many challenges a math department at a post-secondary institution will most likely be faced with the optimization problem of how best to offer out-of-lecture learning support to several thousand first- and second-year university students enrolled in large math service courses within given spatial, scheduling, financial, technological, and…

A service protocol for post-processing of medical images on the mobile device

NASA Astrophysics Data System (ADS)

He, Longjun; Ming, Xing; Xu, Lang; Liu, Qian

2014-03-01

With computing capability and display size growing, the mobile device has been used as a tool to help clinicians view patient information and medical images anywhere and anytime. It is uneasy and time-consuming for transferring medical images with large data size from picture archiving and communication system to mobile client, since the wireless network is unstable and limited by bandwidth. Besides, limited by computing capability, memory and power endurance, it is hard to provide a satisfactory quality of experience for radiologists to handle some complex post-processing of medical images on the mobile device, such as real-time direct interactive three-dimensional visualization. In this work, remote rendering technology is employed to implement the post-processing of medical images instead of local rendering, and a service protocol is developed to standardize the communication between the render server and mobile client. In order to make mobile devices with different platforms be able to access post-processing of medical images, the Extensible Markup Language is taken to describe this protocol, which contains four main parts: user authentication, medical image query/ retrieval, 2D post-processing (e.g. window leveling, pixel values obtained) and 3D post-processing (e.g. maximum intensity projection, multi-planar reconstruction, curved planar reformation and direct volume rendering). And then an instance is implemented to verify the protocol. This instance can support the mobile device access post-processing of medical image services on the render server via a client application or on the web page.

Pre-Service Teachers' Competencies and Perceptions of Necessity about Practical Tools for Content Development

ERIC Educational Resources Information Center

Eren, Esra; Avci, Zeynep Yurtseven; Kapucu, Munise Seckin

2015-01-01

The purpose of the study is to investigate pre-service teachers' competencies and their perceptions of necessity about using practical tools for content development. The study was designed using pre- and post-test experimental design method. The study group consisted of 170 pre-service teachers at a public university in Turkey. The Practical Tools…

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.

Home-based HIV counseling and testing: Client experiences and perceptions in Eastern Uganda

PubMed Central

2012-01-01

Background Though prevention and treatment depend on individuals knowing their HIV status, the uptake of testing remains low in Sub-Saharan Africa. One initiative to encourage HIV testing involves delivering services at home. However, doubts have been cast about the ability of Home-Based HIV Counseling and Testing (HBHCT) to adhere to ethical practices including consent, confidentiality, and access to HIV care post-test. This study explored client experiences in relation these ethical issues. Methods We conducted 395 individual interviews in Kumi district, Uganda, where teams providing HBHCT had visited 6–12 months prior to the interviews. Semi-structured questionnaires elicited information on clients’ experiences, from initial community mobilization up to receipt of results and access to HIV services post-test. Results We found that 95% of our respondents had ever tested (average for Uganda was 38%). Among those who were approached by HBHCT providers, 98% were informed of their right to decline HIV testing. Most respondents were counseled individually, but 69% of the married/cohabiting were counseled as couples. The majority of respondents (94%) were satisfied with the information given to them and the interaction with the HBHCT providers. Most respondents considered their own homes as more private than health facilities. Twelve respondents reported that they tested positive, 11 were referred for follow-up care, seven actually went for care, and only 5 knew their CD4 counts. All HIV infected individuals who were married or cohabiting had disclosed their status to their partners. Conclusion These findings show a very high uptake of HIV testing and satisfaction with HBHCT, a large proportion of married respondents tested as couples, and high disclosure rates. HBHCT can play a major role in expanding access to testing and overcoming disclosure challenges. However, access to HIV services post-test may require attention. PMID:23146071

32 CFR 245.21 - ESCAT air traffic priority list.

Code of Federal Regulations, 2013 CFR

2013-07-01

... aircraft post-maintenance test flights. (7) Federal aircraft post maintenance check flights in support of... identified as high threat targets. (c) Priority Three. (1) Forces being deployed or performing pre-deployment...

32 CFR 245.21 - ESCAT air traffic priority list.

Code of Federal Regulations, 2010 CFR

2010-07-01

... aircraft post-maintenance test flights. (7) Federal aircraft post maintenance check flights in support of... identified as high threat targets. (c) Priority Three. (1) Forces being deployed or performing pre-deployment...

32 CFR 245.21 - ESCAT air traffic priority list.

Code of Federal Regulations, 2014 CFR

2014-07-01

... aircraft post-maintenance test flights. (7) Federal aircraft post maintenance check flights in support of... identified as high threat targets. (c) Priority Three. (1) Forces being deployed or performing pre-deployment...

32 CFR 245.21 - ESCAT air traffic priority list.

Code of Federal Regulations, 2011 CFR

2011-07-01

... aircraft post-maintenance test flights. (7) Federal aircraft post maintenance check flights in support of... identified as high threat targets. (c) Priority Three. (1) Forces being deployed or performing pre-deployment...

Interpersonal conflict and referrals to counseling among married soldiers following return from deployment.

PubMed

Gibbs, Deborah A; Clinton-Sherrod, A Monique; Johnson, Ruby E

2012-10-01

Deployment represents a significant potential strain on military families. The impact of postdeployment stresses may be increased if family coping resources are diminished by returning service members' physical injuries, mental health issues, or substance abuse. This article examines the health and mental health correlates of self-reported concerns regarding interpersonal conflict among married soldiers following return from deployment and the likelihood that soldiers acknowledging such concerns are referred to counseling services. Among 20,166 married Army soldiers completing Post-Deployment Health Reassessments, 18% reported having experienced serious interpersonal conflict with their spouse, family members, close friends, or coworkers. Results indicate that interpersonal conflict was more common among those who reported health problems, depression, post-traumatic stress disorder, and alcohol abuse. Among soldiers reporting interpersonal conflict and not already receiving services, 11% were referred to service. Findings support the need to communicate with soldiers and their spouses about the availability of services following return from deployment and to continue efforts to reduce stigma associated with seeking treatment.

Pre-Hurricane Perceived Social Support Protects Against Psychological Distress: A Longitudinal Analysis of Low-Income Mothers

PubMed Central

Lowe, Sarah R.; Chan, Christian S.; Rhodes, Jean E.

2013-01-01

Objective In this study, we examined the influence of pre-disaster perceived social support on post-disaster psychological distress among survivors of Hurricane Katrina. Method Participants (N = 386) were low-income mothers between 18 and 34 years of age at baseline (M = 26.4, SD = 4.43). The majority (84.8%) was African American; 10.4% identified as Caucasian, 3.2% identified as Hispanic, and 1.8% identified as other. Participants were enrolled in an educational intervention study in 2004 and 2005. Those who had completed a 1-year follow-up assessment prior to Hurricane Katrina were reassessed approximately 1 year after the hurricane. Measures of perceived social support and psychological distress were included in pre-and post-disaster assessments. Using structural equation modeling and multiple mediator analysis, we tested a model wherein pre-disaster perceived social support predicted post-disaster psychological distress both directly and indirectly through its effects on pre-disaster psychological distress, exposure to hurricane-related stressors, and post-disaster perceived social support. We predicted that higher pre-disaster perceived social support would be predictive of lower pre-disaster psychological distress, lower hurricane-related stressors, and higher post-disaster perceived social support, and that these variables would, in turn, predict lower post-disaster psychologically distress. Results Our analyses provide partial support for the hypothesized model. Although pre-disaster perceived social support did not exert a direct effect on post-disaster psychological distress, the indirect effects of all 3 proposed mediators were significant. Conclusions Pre-disaster social support can decrease both exposure to natural disasters and the negative psychological effects of natural disaster exposure. These findings underscore the importance of bolstering the post-disaster social support networks of low-income mothers. PMID:20658811

Quality of Worklife and Higher Education Support Personnel: Testing the Generalizability of a Proposed Model

ERIC Educational Resources Information Center

Inoshita, Lynn T.

2012-01-01

Higher Education Support Personnel support the faculty in fulfilling the mission of America's colleges and universities. Rarely studied, these personnel include position classifications such as support/service professionals, technical/paraprofessionals, clerical and secretarial, service/maintenance, and skilled crafts. The support/service…

Services used by perinatal substance-users with child welfare involvement: a descriptive study

PubMed Central

2010-01-01

Background Substance use during pregnancy often leads to involvement in the child welfare system, resulting in multiple social service systems and service providers working with families to achieve successful child welfare outcomes. The Vulnerable Infants Program of Rhode Island (VIP-RI) is a care coordination program developed to work with perinatal substance-users to optimize opportunities for reunification and promote permanency for substance-exposed infants. This paper describes services used by VIP-RI participants and child welfare outcomes. Methods Data collected during the first four years of VIP-RI were used to identify characteristics of program participants, services received, and child welfare outcomes: closed child welfare cases, reunification with biological mothers and identified infant permanent placements. Descriptive Results Medical and financial services were associated with positive child welfare outcomes. Medical services included family planning, pre- and post-natal care and HIV test counseling. Financial services included assistance with obtaining entitlement benefits and receiving tangible support such as food and clothing. Conclusions Findings from this study suggest services that address basic family needs were related to positive child welfare outcomes. The provision of basic services, such as health care and financial assistance through entitlement benefits and tangible donations, may help to establish a foundation so mothers can concentrate on recovery and parenting skills. Identification of services for perinatal substance users that are associated with more successful child welfare outcomes has implications for the child welfare system, treatment providers, courts and families. PMID:20807432

Services used by perinatal substance-users with child welfare involvement: a descriptive study.

PubMed

McCann, Kenneth J; Twomey, Jean E; Caldwell, Donna; Soave, Rosemary; Fontaine, Lynne Andreozzi; Lester, Barry M

2010-08-31

Substance use during pregnancy often leads to involvement in the child welfare system, resulting in multiple social service systems and service providers working with families to achieve successful child welfare outcomes. The Vulnerable Infants Program of Rhode Island (VIP-RI) is a care coordination program developed to work with perinatal substance-users to optimize opportunities for reunification and promote permanency for substance-exposed infants. This paper describes services used by VIP-RI participants and child welfare outcomes. Data collected during the first four years of VIP-RI were used to identify characteristics of program participants, services received, and child welfare outcomes: closed child welfare cases, reunification with biological mothers and identified infant permanent placements. DESCRIPTIVE RESULTS: Medical and financial services were associated with positive child welfare outcomes. Medical services included family planning, pre- and post-natal care and HIV test counseling. Financial services included assistance with obtaining entitlement benefits and receiving tangible support such as food and clothing. Findings from this study suggest services that address basic family needs were related to positive child welfare outcomes. The provision of basic services, such as health care and financial assistance through entitlement benefits and tangible donations, may help to establish a foundation so mothers can concentrate on recovery and parenting skills. Identification of services for perinatal substance users that are associated with more successful child welfare outcomes has implications for the child welfare system, treatment providers, courts and families.

Students' perceptions of the interprofessional team in practice through the application of servant leadership principles.

PubMed

Neill, Mark; Hayward, Karen S; Peterson, Teri

2007-08-01

This study examined students' perceptions of interprofessional practice within a framework of servant leadership principles, applied in the care of rural older adults utilizing a service learning model. Mobile wellness services were provided through the Idaho State University Senior Health Mobile project in a collaborative team approach in the community-based setting. Students from varied health professional programs were placed in teams for the provision of wellness care, with communication among team members facilitated by a health professions faculty member serving as field coordinator. The Interdisciplinary Education Perception Scale (IEPS) was used to measure students' perceptions of interprofessional practice using a pretest post-test research design. Multivariate analysis was performed revealing a significant pretest to post-test effect on students' perceptions as measured by factors inherent in the IEPS and deemed essential to effective interprofessional practice. Univariate analysis revealed a significant change in students' perception of professional competence and autonomy, actual cooperation and resource sharing within and across professions, and an understanding of the value and contributions of other professionals from pretest to post-test.

Evaluation of a rural chronic disease self-management program.

PubMed

Stone, Genevieve R; Packer, Tanya L

2010-01-01

Internationally, the prevalence of long-term health conditions is at epidemic proportions. Australia is no exception. The Australian Government's 'Better Health Initiative' has 5 key strategies to build better health care, one of which is the adoption of self-management and self-management support. Self-management allows people to manage their condition and the consequences it brings to their lives in partnership with their health providers. The purpose of this article was to report both the process and patient outcomes following the introduction of the Stanford Chronic Disease Self-Management Program (CDSMP) into an existing service in an Australian rural setting. Implementation processes were evaluated using semi-structured interviews conducted with managers, lay and health professional course leaders and participants about positive and negative aspects of providing the CDSMP. Participant outcomes were evaluated using a modified pre-test, post-test design to evaluate changes in activity participation and self-management knowledge and skills. Both negative and positive aspects of providing the program were represented by two key themes: (1) program content and quality; and (2) logistics of delivery. Throughout the interviews, managers and leaders, and course participants offered recommendations that were thematically grouped into 3 categories: (1) enhancing quality; (2) improving the logistics; and (3) providing resources. Comparison of activity levels with a community sample indicated that participants had significantly decreased participation levels. Scores on the Health Education Impact Questionnaire v2 (heiQ - RETRO) demonstrated statistically better scores at post-test on the domains of 'self monitoring', 'insight' and 'health service navigation' with a trend towards significance on 3 other domains. Future implementation of CDSMPs in rural areas will be encouraged by these patient outcomes, and informed by the qualitative findings from managers, leaders and course participants.

Education and referral criteria: impact on oncology referrals to palliative care.

PubMed

Reville, Barbara; Reifsnyder, JoAnne; McGuire, Deborah B; Kaiser, Karen; Santana, Abbie J

2013-07-01

To describe a quality improvement project involving education and referral criteria to influence oncology provider referrals to a palliative care service. A single group post-test only quasi-experimental design was used to evaluate palliative care service (PCS) referrals following an intervention consisting of a didactic presentation, education outreach visits (EOV) to key providers, and referral criteria. Data on patient demographics, cancer types, consult volume, reasons for referral, pre-consult length of stay, overall hospital stay, and discharge disposition were collected pre-intervention, then post-intervention for 7.5 months and compared. Attending oncologists, nurse practitioner, and house staff from the solid tumor division at a 700-bed urban teaching hospital participated in the project. Two geriatricians, a palliative care nurse practitioner, and rotating geriatric fellows staffed the PCS. The percentage of oncology referrals to PCS increased significantly following the intervention (χ(2) = 6.108, p = .013). 24.9% (390) patients were referred in the 4.6 years pre-intervention and 31.5% (106) patients were referred during 7.5 months post-intervention. The proportion of consults for pain management was significantly greater post-intervention (χ(2) = 5.378, p = .02), compared to pre-intervention, when most referrals were related to end-of-life issues. Lung, pancreatic, and colon were the most common cancer types at both periods, and there were no significant differences in patient demographics, pre-referral length of hospitalization or overall hospital days. There was a trend toward more patients being discharged alive following the intervention. A quality improvement project supported the use of education and referral criteria to influence both the frequency and reasons for palliative care referral by oncology providers.

Food Service Manager Certification: An Evaluation of Its Impact.

ERIC Educational Resources Information Center

Wright, Jerry; Fuen, Lindson

1986-01-01

Discusses a study which sought to determine if food service management training and certification resulted in more sanitary operations. Findings from site inspections, pre/post tests, and attitude surveys indicated that the program did not produce statistically significant differences between control and study groups but that improvements in…

5 CFR 213.3102 - Entire executive civil service.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., stores and other businesses in which the servicing examining office can schedule tests and/or reasonably... temporary basis by persons having a doctoral degree in an appropriate field of study for research activities... the National Research Council under its post-doctoral research associate program, may not exceed 2...

Interactive genetic counseling role-play: a novel educational strategy for family physicians.

PubMed

Blaine, Sean M; Carroll, June C; Rideout, Andrea L; Glendon, Gord; Meschino, Wendy; Shuman, Cheryl; Telner, Deanna; Van Iderstine, Natasha; Permaul, Joanne

2008-04-01

Family physicians (FPs) are increasingly involved in delivering genetic services. Familiarization with aspects of genetic counseling may enable FPs to help patients make informed choices. Exploration of interactive role-play as a means to raise FPs' awareness of the process and content of genetic counseling. FPs attending two large Canadian family medicine conferences in 2005 were eligible -- 93 participated. FPs discussed a case during a one-on-one session with a genetic counselor. Evaluation involved pre and post intervention questionnaires FPs' baseline genetic knowledge was self-rated as uniformly poor. Baseline confidence was highest in eliciting family history and providing psychosocial support and lowest in discussing risks/benefits of genetic testing and counseling process. Post-intervention, 80% of FPs had better appreciation of family history and 97% indicated this was an effective learning experience. Role-play with FPs is effective in raising awareness of the process and content of genetic counseling and may be applied to other health disciplines.

NASA Wrangler: Automated Cloud-Based Data Assembly in the RECOVER Wildfire Decision Support System

NASA Technical Reports Server (NTRS)

Schnase, John; Carroll, Mark; Gill, Roger; Wooten, Margaret; Weber, Keith; Blair, Kindra; May, Jeffrey; Toombs, William

2017-01-01

NASA Wrangler is a loosely-coupled, event driven, highly parallel data aggregation service designed to take advantageof the elastic resource capabilities of cloud computing. Wrangler automatically collects Earth observational data, climate model outputs, derived remote sensing data products, and historic biophysical data for pre-, active-, and post-wildfire decision making. It is a core service of the RECOVER decision support system, which is providing rapid-response GIS analytic capabilities to state and local government agencies. Wrangler reduces to minutes the time needed to assemble and deliver crucial wildfire-related data.

The Effects of Abortion Training on Family Medicine Residents' Clinical Experience.

PubMed

Summit, Aleza K; Gold, Marji

2017-01-01

RHEDI, Reproductive Health Education in Family Medicine, offers technical assistance and funding to family medicine residency programs to support integrated opt-out abortion and reproductive health training for residents. This study assessed the impact of this enhanced training on residents' reproductive health experience. Investigator-developed pre- and post-surveys were administered online to 214 residents at 12 family medicine residency programs before and after their RHEDI training experience. Surveys addressed experience in contraception and abortion, attitudes around abortion provision, and post-residency intentions. Descriptive statistics were generated, and statistical tests were performed to assess changes after training. Surveys had a 90% response rate. After the RHEDI enhanced reproductive health rotation, residents reported increased experience in contraception provision, early pregnancy ultrasound, aspiration and medication abortion, and miscarriage management. After training, residents with experience in IUD insertion increased from 85% to 99%, and contraceptive implant insertion experience rose from 60% to 85%. Residents who had performed any abortions increased from 15% to 79%, and self-rated competency in abortion increased. Finally, almost all residents agreed that early abortion was within the scope of family medicine, and training confirmed residents' intentions to provide reproductive health services after residency. Integrated training in reproductive health, with an emphasis on abortion, increases residents' experience and underscores their understanding of the role of these services in family medicine. Increasing the number of family medicine residency programs that offer this training could help prepare family physicians to meet their patients' needs for reproductive health services.

The GridPP DIRAC project - DIRAC for non-LHC communities

NASA Astrophysics Data System (ADS)

Bauer, D.; Colling, D.; Currie, R.; Fayer, S.; Huffman, A.; Martyniak, J.; Rand, D.; Richards, A.

2015-12-01

The GridPP consortium in the UK is currently testing a multi-VO DIRAC service aimed at non-LHC VOs. These VOs (Virtual Organisations) are typically small and generally do not have a dedicated computing support post. The majority of these represent particle physics experiments (e.g. NA62 and COMET), although the scope of the DIRAC service is not limited to this field. A few VOs have designed bespoke tools around the EMI-WMS & LFC, while others have so far eschewed distributed resources as they perceive the overhead for accessing them to be too high. The aim of the GridPP DIRAC project is to provide an easily adaptable toolkit for such VOs in order to lower the threshold for access to distributed resources such as Grid and cloud computing. As well as hosting a centrally run DIRAC service, we will also publish our changes and additions to the upstream DIRAC codebase under an open-source license. We report on the current status of this project and show increasing adoption of DIRAC within the non-LHC communities.

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

PubMed

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

2009-11-01

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

Online Module for Carrier Screening in Ashkenazi Jewish Individuals Compared with In-Person Genetics Education: A Randomized Controlled Trial.

PubMed

Fan, Chia Wei; Castonguay, Lysanne; Rummell, Sonja; Lévesque, Sébastien; Mitchell, John J; Sillon, Guillaume

2018-04-01

To increase accessibility to genetics services for low-urgency patients seeking Ashkenazi Jewish (AJ) carrier screening, we designed an interactive computer (IC) module that provides pre-test genetics education and allows genetics professionals to order the test without meeting the patients beforehand. We compared this module with in-person genetic counseling (GC) using a randomized trial. AJ individuals were randomized to undergo genetics education via the IC module (n = 26) or GC (n = 28). We compared post-interventional genetics knowledge, perceived genetic risk, and anxiety between the two groups, after accounting for pre-interventional scores, using ANCOVA. Wilcoxon Rank-Sum test was used to compare post-interventional satisfaction. Post-interventional genetics knowledge, risk perception, or anxiety were not significantly different between the two groups after accounting for baseline scores (p = 0.50-0.54), although the data are inconclusive regarding the module's non-inferiority at a 5% margin. Post-intervention satisfaction scores were generally higher in the GC group than the IC module group. Our IC module has the potential to improve access to clinical genetics services for patients and staff, but it is not suitable for all AJ patients and cannot completely replace the benefits of in-person consultations.

[Cancer nursing care education programs: the effectiveness of different teaching methods].

PubMed

Cheng, Yun-Ju; Kao, Yu-Hsiu

2012-10-01

In-service education affects the quality of cancer care directly. Using classroom teaching to deliver in-service education is often ineffective due to participants' large workload and shift requirements. This study evaluated the learning effectiveness of different teaching methods in the dimensions of knowledge, attitude, and learning satisfaction. This study used a quasi-experimental study design. Participants were cancer ward nurses working at one medical center in northern Taiwan. Participants were divided into an experimental group and control group. The experimental group took an e-learning course and the control group took a standard classroom course using the same basic course material. Researchers evaluated the learning efficacy of each group using a questionnaire based on the quality of cancer nursing care learning effectiveness scale. All participants answered the questionnaire once before and once after completing the course. (1) Post-test "knowledge" scores for both groups were significantly higher than pre-test scores for both groups. Post-test "attitude" scores were significantly higher for the control group, while the experimental group reported no significant change. (2) after a covariance analysis of the pre-test scores for both groups, the post-test score for the experimental group was significantly lower than the control group in the knowledge dimension. Post-test scores did not differ significantly from pre-test scores for either group in the attitude dimension. (3) Post-test satisfaction scores between the two groups did not differ significantly with regard to teaching methods. The e-learning method, however, was demonstrated as more flexible than the classroom teaching method. Study results demonstrate the importance of employing a variety of teaching methods to instruct clinical nursing staff. We suggest that both classroom teaching and e-learning instruction methods be used to enhance the quality of cancer nursing care education programs. We also encourage that interactivity between student and instructor be incorporated into e-learning course designs to enhance effectiveness.

Emergency medicine resident attitudes and perceptions of HIV testing before and after a focused training program and testing implementation.

PubMed

Hsieh, Yu-Hsiang; Jung, Julianna J; Shahan, Judy B; Moring-Parris, Daniel; Kelen, Gabor D; Rothman, Richard E

2009-11-01

The objectives were to determine attitudes and perceptions (A&P) of emergency medicine (EM) residents toward emergency department (ED) routine provider-driven rapid HIV testing services and the impact of both a focused training program (FTP) and implementation of HIV testing on A&P. A three-phase, consecutive, anonymous, identity-unlinked survey was conducted pre-FTP, post-FTP, and 6 months postimplementation. The survey was designed to assess residents' A&P using a five-point Likert scale. A preimplementation FTP provided both the rationale for the HIV testing program and the planned operational details of the intervention. The HIV testing program used only indigenous ED staff to deliver HIV testing as part of standard-of-care in an academic ED. The impact of the FTP and implementation on A&P were analyzed by multivariate regression analysis using generalized estimating equations to control for repeated measurements in the same individuals. A "favorable" A&P was operationally defined as a mean score of >3.5, "neutral" as mean score of 2.5 to 3.5, and "unfavorable" as mean score of <2.5. Thirty of 36 residents (83.3%) participated in all three phases. Areas of favorable A&P found in phase I and sustained through phases II and III included "ED serving as a testing venue" (score range = 3.7-4.1) and "emergency medicine physicians offering the test" (score range = 3.9-4.1). Areas of unfavorable and neutral A&P identified in phase I were all operational barriers and included required paperwork (score = 3.2), inadequate staff support (score = 2.2), counseling and referral requirements (score range = 2.2-3.1), and time requirements (score = 2.9). Following the FTP, significant increases in favorable A&P were observed with regard to impact of the intervention on modification of patient risk behaviors, decrease in rates of HIV transmission, availability of support staff, and self-confidence in counseling and referral (p < 0.05). At 6 months postimplementation, all A&P except for time requirements and lack of support staff scored favorably or neutral. During the study period, 388 patients were consented for and received HIV testing; six (1.5%) were newly confirmed HIV positive. Emergency medicine residents conceptually supported HIV testing services. Most A&P were favorably influenced by both the FTP and the implementation. All areas of negative A&P involved operational requirements, which may have influenced the low overall uptake of HIV testing during the study period. (c) 2009 by the Society for Academic Emergency Medicine.

Cold Regions Logistic Supportability Testing of Missiles and Rocket Systems.

DTIC Science & Technology

1984-10-26

006 APPENDIX B - POST-TEST CHECKLIST 1. Have test data been collected, recorded, and presented in accordance with this TOP? YES NO Comment : 2. Have all...data collected been reviewed for correctness and completeness? YES_ NO Comment : 3. Were the facilities, test equipment, instrumentation, and support...YES NO Comment : 5. Were the test results compromised in any way due to test performance procedures? YES_ NO Comment : 6. Were the test results

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 Impact of Inquiry Based Instruction on Science Process Skills and Self-Efficacy Perceptions of Pre-Service Science Teachers at a University Level Biology Laboratory

ERIC Educational Resources Information Center

Sen, Ceylan; Sezen Vekli, Gülsah

2016-01-01

The aim of this study is to determine the influence of inquiry-based teaching approach on pre-service science teachers' laboratory self-efficacy perceptions and scientific process skills. The quasi experimental model with pre-test-post-test control group design was used as an experimental design in this research. The sample of this study included…

Exploring the views and experiences of callers to the PANDA Post and Antenatal Depression Association Australian National Perinatal Depression Helpline: a cross-sectional survey.

PubMed

Biggs, Laura J; Shafiei, Touran; Forster, Della A; Small, Rhonda; McLachlan, Helen L

2015-09-07

Anxiety and depression are common in the perinatal period. Telephone interventions, including telephone peer support and counselling, have been developed to support those experiencing perinatal mental illness. PANDA Post and Antenatal Depression Association provides support to women and men experiencing perinatal mental illness via the Australian National Perinatal Depression Helpline, encompassing both volunteer peer support and professional counselling. This study aimed to explore the experiences of callers to the Helpline. A cross-sectional survey design was used. All new callers from 1(st) May to 30(th) September 2013 were invited to participate. The survey, adapted from a previous survey of PANDA callers, included 23 questions using Likert-type scales, demographic and open-ended questions. Thematic network analysis was undertaken for responses to open-ended questions. 124 responses were received (124/405; 30% response). The majority of callers had called the Helpline regarding themselves (90%), with over one third (33%) of all callers seeking crisis support and help. Ninety-nine per cent of respondents 'agreed' or 'strongly agreed' that staff and/or volunteers understood their concerns, and 97% 'agreed' or 'strongly agreed' that overall PANDA had helped them. Callers described the PANDA service as uniquely tailored to the perinatal period, providing accessible, non-judgemental understanding and support, with a global theme from open-ended comments describing PANDA as 'a safe space to be heard and receive support without judgement'. Recommendations for service changes included increased hours of availability. Callers reported positive experiences of accessing support from the PANDA National Perinatal Depression Helpline. The Helpline was described as an accessible and acceptable telephone support for individuals experiencing perinatal mental illness. Recommendations for changes to the service included an increase in hours of operation to enable greater responsiveness at times of need, reduced waiting times, and access to continuity with the same volunteer and/or telephone counsellor. The findings of the study will be useful in informing future service provision, review, and implementation.

Overcoming barriers to cancer-helpline professionals providing decision support for callers: an implementation study.

PubMed

Stacey, Dawn; Chambers, Suzanne K; Jacobsen, Mary Jane; Dunn, Jeff

2008-11-01

To evaluate the effect of an intervention on healthcare professionals' perceptions of barriers influencing their provision of decision support for callers facing cancer-related decisions. A pre- and post-test study guided by the Ottawa Model of Research Use. Australian statewide cancer call center that provides public access to information and supportive cancer services. 34 nurses, psychologists, and other allied healthcare professionals at the cancer call center. Participants completed baseline measures and, subsequently, were exposed to an intervention that included a decision support tutorial, coaching protocol, and skill-building workshop. Strategies were implemented to address organizational barriers. Perceived barriers and facilitators influencing provision of decision support, decision support knowledge, quality of decision support provided to standardized callers, and call length. Postintervention participants felt more prepared, confident in providing decision support, and aware of decision support resources. They had a stronger belief that providing decision support was within their role. Participants significantly improved their knowledge and provided higher-quality decision support to standardized callers without changing call length. The implementation intervention overcame several identified barriers that influenced call center professionals when providing decision support. Nurses and other helpline professionals have the potential to provide decision support designed to help callers understand cancer information, clarify their values associated with their options, and reduce decisional conflict. However, they require targeted education and organizational interventions to reduce their perceived barriers to providing decision support.

Evaluating the Impact of Hospital Based Drug and Alcohol Consultation Liaison Services.

PubMed

Reeve, Rebecca; Arora, Sheena; Butler, Kerryn; Viney, Rosalie; Burns, Lucinda; Goodall, Stephen; van Gool, Kees

2016-09-01

Consultation liaison (CL) services provide direct access to specialist services for support, treatment advice and assistance with the management of a given condition. Alcohol and other drugs (AOD) CL services aim to improve identification and treatment of patients with AOD morbidity. Our objective was to evaluate the costs and consequences of AOD CL services in hospitals in New South Wales, Australia. Patients were surveyed at eight hospitals and problematic AOD use was identified using the Alcohol, Smoking and Substance Involvement Screening Test (n=1615). For consenting participants, medical record data were obtained from 18 months pre- to 12 months post-survey. We used interrupted time series analyses to compare utilization and costs for patients with and without AOD problems and changes over time between those who received AOD CL and similar patients. Approximately 35% of patients surveyed had AOD problems (excluding tobacco) with 7% requiring intensive treatment. Only 24% of patients requiring intensive treatment were treated by AOD CL. Those treated had relative improvements over time in the cost of presentations to emergency departments, emergency admission performance and increased uptake of appropriate pharmaceuticals. The estimated net benefit of AOD CL services was at least AUD$100,000 savings per hospital per year. Expanding AOD CL services to address current unmet need may lead to even greater cost savings for hospitals. Copyright © 2016 Elsevier Inc. All rights reserved.

Provision of onsite HIV Services in Substance Use Disorder Treatment Programs: A Longitudinal Analysis.

PubMed

Aletraris, Lydia; Roman, Paul M

2015-10-01

The provision of HIV education and testing in substance use disorder (SUD) treatment programs is an important public health strategy for reducing HIV incidence. For many at-risk individuals, SUD treatment represents the primary point of access for testing and receiving HIV-related services. This study uses two waves of nationally representative data of 265 privately-funded SUD treatment programs in the U.S. to examine organizational and patient characteristics associated with offering a dedicated HIV/AIDS treatment track, onsite HIV/AIDS support groups, and onsite HIV testing. Our longitudinal analysis indicated that the majority of treatment programs reported providing education and prevention services, but there was a small, yet significant, decline in the number of programs providing these services. Programs placed more of an emphasis on providing information on the transmission of HIV rather than on acquiring risk-reduction skills. There was a notable and significant increase (from 26.0% to 31.7%) in programs that offered onsite HIV testing, including rapid HIV testing, and an increase in the percentage of patients who received testing in the programs. Larger programs were more likely to offer a dedicated HIV/AIDS treatment track and to offer onsite HIV/AIDS support groups, while accredited programs and programs with a medical infrastructure were more likely to provide HIV testing. The percentage of injection drug users was positively linked to the availability of specialized HIV/AIDS tracks and HIV/AIDS support groups, and the percentage of female clients was associated with the availability of onsite support groups. The odds of offering HIV/AIDS support groups were also greater in programs that had a dedicated LGBT track. The findings suggest that access to hospitals and medical care services is an effective way to facilitate adoption of HIV services and that programs are providing a needed service among a group of patients who have a heightened risk of HIV transmission. Nonetheless, the fact that fewer than one third of programs offered onsite testing, and, of the ones that did, fewer than one third of their patients received testing, raises concern in light of federal guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.

Applying Service-Oriented Architecture on The Development of Groundwater Modeling Support System

NASA Astrophysics Data System (ADS)

Li, C. Y.; WANG, Y.; Chang, L. C.; Tsai, J. P.; Hsiao, C. T.

2016-12-01

Groundwater simulation has become an essential step on the groundwater resources management and assessment. There are many stand-alone pre- and post-processing software packages to alleviate the model simulation loading, but the stand-alone software do not consider centralized management of data and simulation results neither do they provide network sharing functions. Hence, it is difficult to share and reuse the data and knowledge (simulation cases) systematically within or across companies. Therefore, this study develops a centralized and network based groundwater modeling support system to assist model construction. The system is based on service-oriented architecture and allows remote user to develop their modeling cases on internet. The data and cases (knowledge) are thus easy to manage centralized. MODFLOW is the modeling engine of the system, which is the most popular groundwater model in the world. The system provides a data warehouse to restore groundwater observations, MODFLOW Support Service, MODFLOW Input File & Shapefile Convert Service, MODFLOW Service, and Expert System Service to assist researchers to build models. Since the system architecture is service-oriented, it is scalable and flexible. The system can be easily extended to include the scenarios analysis and knowledge management to facilitate the reuse of groundwater modeling knowledge.

Effect of computer-aided instruction versus traditional modes on student PT's learning musculoskeletal special tests

NASA Astrophysics Data System (ADS)

Ford, Gregory Scott

2007-12-01

Title. Effect of computer-aided instruction versus traditional modes on student PT's learning musculoskeletal special tests. Problem. Lack of quantitative evidence to support the use of computer-aided instruction (CAI) in PT education for both the cognitive and psychomotor domains and lack of qualitative support as to an understanding why CAI may or may not be effective. Design. 3 group single-blind pre-test, immediate post-test, final post-test repeated measures with qualitative survey for the CAI group. Methods. Subjects were randomly assigned to CAI, live demonstration or textbook learning groups. Three novel special tests were instructed. Analysis of performance on written and practical examinations was conducted across the 3 repeated measures. A qualitative survey was completed by the CAI group post intervention. Results. CAI is equally as effective as live demonstration and textbook learning of musculoskeletal special tests in the cognitive domain, however, CAI was superior to live demonstration and textbook instruction at final post-testing. Significance. The significance of this research is that a gap in the literature of PT education needs to be bridged as it pertains to the effect of CAI on learning in both the cognitive and psychomotor domains as well as attempt to understand why CAI results in certain student performance. The methods of this study allowed for a wide range of generalizability to any and all PT programs across the country.

Genetics Home Reference: shingles

MedlinePlus

... Aftercare MedlinePlus Encyclopedia: Shingles National Health Service (UK): Post-Herpetic Neuralgia Treatment General Information from MedlinePlus (5 links) Diagnostic Tests Drug Therapy Genetic Counseling Palliative Care Surgery and ...

48 CFR 323.7002 - Actions required.

Code of Federal Regulations, 2014 CFR

2014-10-01

... requirements: (1) Services or products. (2) Research, development, or test projects. (3) Transportation of... contract; (2) Evaluating a prospective contractor's safety and health programs; and (3) Conducting post...

48 CFR 323.7002 - Actions required.

Code of Federal Regulations, 2012 CFR

2012-10-01

... requirements: (1) Services or products. (2) Research, development, or test projects. (3) Transportation of... contract; (2) Evaluating a prospective contractor's safety and health programs; and (3) Conducting post...

48 CFR 323.7002 - Actions required.

Code of Federal Regulations, 2013 CFR

2013-10-01

... requirements: (1) Services or products. (2) Research, development, or test projects. (3) Transportation of... contract; (2) Evaluating a prospective contractor's safety and health programs; and (3) Conducting post...

48 CFR 323.7002 - Actions required.

Code of Federal Regulations, 2011 CFR

2011-10-01

... requirements: (1) Services or products. (2) Research, development, or test projects. (3) Transportation of... contract; (2) Evaluating a prospective contractor's safety and health programs; and (3) Conducting post...

An exploration of how young people and parents use online support in the context of living with cystic fibrosis.

PubMed

Kirk, Susan; Milnes, Linda

2016-04-01

There is increasing recognition of the Internet's potential role in providing information and support for people living with long-term conditions. However, how young people and parents use online forms of self-care support in the context of living with childhood chronic illness has been under-researched. To explore how online peer support is used by young people and parents to support self-care in relation to cystic fibrosis (CF). Online forum for young people and parents based on a CF charity website. A total of 279 individuals participated in the forum during the study. An online ethnographical approach, involving observing, downloading and analysing discussion group postings. All postings made over a random 4-month period were included (151 discussion threads). The online setting enabled a physically disconnected group to connect and create a safe space to collectively share experiences and receive support to manage and live with cystic fibrosis. Participants exchanged experientially derived advice and views on how to manage treatments, emotions, relationships, identity and support from services. While parents sought information and support on managing specific therapies/services and ways of maintaining their child's health, the information and support young people desired appeared to be more directed at how to 'fit' CF into their everyday lives. Online support groups appear to supplement professional support in relation to self-management. They enable young people and parents to share experiences, feelings and strategies for living with long-term conditions with peers and develop the expertise to empower them in interactions with health-care professionals. © 2015 John Wiley & Sons Ltd.

Incidence and prevalence of antibody to hepatitis C virus in FDNY first responders before and after work at the World Trade Center disaster site.

PubMed

Webber, Mayris P; Liu, Yang; Cohen, Hillel W; Schwartz, Theresa; Weiden, Michael D; Kelly, Kerry; Ortiz, Viola; Zeig-Owens, Rachel; Jaber, Nadia; Colbeth, Hilary L; Prezant, David J

2018-06-20

The goals of this study were to assess the impact of work at the World Trade Center (WTC) site in relation to new, post-9/11/2001 (9/11) antibody to hepatitis C Virus (anti-HCV); and, evaluate secular trends in WTC-exposed male Fire Department of New York City (FDNY) Firefighters and Emergency Medical Services (EMS) responders. FDNY monitors responder health through physical exams and routine blood work. We used descriptive statistics to compare trans-9/11 and post-9/11 incidence and to assess trends in prevalence from 2000 to 2012. Trans-9/11 incidence of new anti-HCV was 0.42 per 100 persons compared with post-9/11 incidence of 0.34 (P = 0.68). Overall seroprevalence was 1.3%; rates declined from 1.79 per 100 to 0.49 per 100 over time (P < 0.0001). Work at the WTC was not associated with new infection. Biennial seroprevalence in responders declined over time, supporting the FDNY decision to discontinue routine annual testing in this cohort. © 2018 Wiley Periodicals, Inc.

A Comparison of Two Approaches to Developing In-Service Teachers' Knowledge and Strategies for Teaching Nature of Science

ERIC Educational Resources Information Center

Vhurumuku, Elaosi; Chikochi, Andrew

2017-01-01

This paper reports the results of a study that compared two approaches to developing in-service teachers' subject matter knowledge and strategies for teaching nature of science. A treatment post-test only quasi-experimental research design was used. One group of in-service teachers (n = 15) was taught using what is called a capsular approach. In…

An evaluation of primary care led dementia diagnostic services in Bristol.

PubMed

Dodd, Emily; Cheston, Richard; Fear, Tina; Brown, Ellie; Fox, Chris; Morley, Clare; Jefferies, Rosalyn; Gray, Richard

2014-11-29

Typically people who go to see their GP with a memory problem will be initially assessed and those patients who seem to be at risk will be referred onto a memory clinic. The demographic forces mean that memory services will need to expand to meet demand. An alternative may be to expand the role of primary care in dementia diagnosis and care. The aim of this study was to contrast patient, family member and professional experience of primary and secondary (usual) care led memory services. A qualitative, participatory study. A topic guide was developed by the peer and professional panels. Data were collected through peer led interviews of people with dementia, their family members and health professionals. Eleven (21%) of the 53 GP practices in Bristol offered primary care led dementia services. Three professional panels were held and were attended by 9 professionals; nine carers but no patients were involved in the three peer panels. These panels identified four main themes: GPs rarely make independent dementia diagnosis; GPs and memory nurses work together; patients and carers generally experience a high quality diagnostic service; an absence of post diagnostic support. Evidence relating to these themes was collected through a total of 46 participants took part; 23 (50%) in primary care and 23 (50%) in the memory service. Patients and carers were generally satisfied with either primary or secondary care led approaches to dementia diagnosis. Their major concern, shared with many health care professionals, was a lack of post diagnostic support.

Specialist perioperative allergy clinic services in the UK 2016: Results from the Royal College of Anaesthetists Sixth National Audit Project.

PubMed

Egner, W; Cook, T; Harper, N; Garcez, T; Marinho, S; Kong, K L; Nasser, S; Thomas, M; Warner, A; Hitchman, J; Floss, K

2017-10-01

Guidelines for investigation of perioperative drug allergy exist, but the quality of services is unknown. Specialist perioperative anaphylaxis services were surveyed through the Royal College of Anaesthetists 6 th National Audit Project. We compare self-declared UK practice in specialist perioperative allergy services with national recommendations. A SurveyMonkey™ questionnaire was distributed to providers of allergy services in the UK. Responses were assessed for adherence to the best practice recommendations of the British Society for Allergy and Clinical Immunology (BSACI), the Association of Anaesthetists of Great Britain and Ireland and the National Institute for Health and Care Excellence (NICE) Guidance on Drug Allergy-CG183. Over 1200 patients were evaluated in 44 centres annually. Variation in workload, waiting times, access, staffing and diagnostic approach was noted. Paediatric centres had the longest routine waiting times (most wait >13 weeks) in contrast to adult centres (most wait <12 weeks). Service leads are allergists/immunologists (91%) or anaesthetists (7%). Potentially important differences were seen in: testing repertoire [10/44 (23%) lacked BSACI compliant neuromuscular blocking agent (NMBA) panels and 17/44 (39%) lacked a NAP6-defined extended panel; many failed to screen all cases for chlorhexidine 19/44 (43%) or latex 21/44 (48%)], staffing [only 26/44 (59%) had specialist nurses and 18/44 (41%) an anaesthetist] and provision of information [18/44 (41%) gave immediate information in clinic and 5/44 (11%) sign-posted support groups]. Most centres were able to provide diagnostic challenges to antibiotics [40/44 (91%]) and local anaesthetics [41/44 (93%)]. Diagnostic testing is not harmonized, with marked variability in the NMBA panels used to identify safe alternatives. Chlorhexidine and latex are not part of routine testing in many centres. Poor access to services and patient information provision require attention. Harmonization of diagnostic approach is desirable, particularly with regard to a minimum NMBA panel for identification of safe alternatives. © 2017 John Wiley & Sons Ltd.

Predictors of employment participation following lung transplant.

PubMed

Cumming, Kate; O'Brien, Lisa; Harris, Jane

2016-10-01

Limited information about return to productive activities after lung transplantation has been published. The purpose of our study was to identify issues relating to occupational engagement in employment after surgery. We conducted a cross-sectional study of surviving lung transplant recipients from one transplant service in Australia. We used descriptive statistics, chi-square tests and Cox regression to analyse the data. A total of 100 lung transplant recipients completed the assessment (83.3% of 120 eligible surviving recipients). The mean age of respondents was 50 ± 13 years; 45% of the sample were men. Cystic fibrosis and chronic obstructive pulmonary disease were the most frequent pre-transplant diagnoses. Fifty-five percent of participants identified employment or alternate occupational engagement prior to transplant. Of those respondents who had not retired from work prior to transplant, 44.2% identified engagement in paid employment after transplantation. Participants who obtained paid employment post-transplantation were more likely to have completed high school (P = 0.05) or worked as managers (P < 0.0001). Occupational therapists should be actively involved in pre- and post-transplantation goal setting and intervention to support return to work. Pre-transplant, participation in any amount of voluntary or paid employment or study will maintain networks, skills, and confidence. Post-transplant, while physician encouragement is known as a key predictor of return to work, occupational therapist support can address function and activity components of work participation. © 2016 Occupational Therapy Australia.

Manpower Planning for New Weapon Systems

DTIC Science & Technology

1978-12-01

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

Employing the Army Health System Outside the Main Gate

DTIC Science & Technology

2014-05-22

Publications and Forms , http://armypubs.army.mil/ doctrine/ADRP_1.html (accessed 5 September 2013), 2-10. 9...of the HSS and FHP missions for training, pre-deployment, deployment, and post-deployment operations. The AHS includes all mission support services...performed, provided, or arranged by the AMEDD to support HSS and FHP mission requirements for the Army and as directed, for joint, intergovernmental

Quantitative Procedure for Position Identity Definition.

DTIC Science & Technology

1979-12-01

integrated into an effi- cient and cohesive team, are necessary for the sucessful performance of the mission of the 2-17 Department of the Army. Military...Headquarters (Ft Monroe) ROTC Group (TRADOC-Ft Knox) Large Post Headquarters (Ft Bragg) Recruiting Support Center (Cameron Service School (Engineer) Station...College (Ft Belvoir) (Ft Belvoir) Defense Mapping School (Ft Belvoir) The apparent distinction in Army directives between combat, combat support, and

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42 CFR 414.310 - Determination of reasonable charges for physician services furnished to renal dialysis patients.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Pre-dialysis and post-dialysis examinations, or examinations that could have been furnished on a pre-dialysis or post-dialysis basis. (4) Insertion of catheters for patients who are on peritoneal dialysis and... laboratory test results, nurses' notes and any other medical documentation, as a basis for— (i) Adjustment of...

42 CFR 414.310 - Determination of reasonable charges for physician services furnished to renal dialysis patients.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Pre-dialysis and post-dialysis examinations, or examinations that could have been furnished on a pre-dialysis or post-dialysis basis. (4) Insertion of catheters for patients who are on peritoneal dialysis and... laboratory test results, nurses' notes and any other medical documentation, as a basis for— (i) Adjustment of...

Scientific method by argumentation design: learning process for maintaining student’s retention

NASA Astrophysics Data System (ADS)

Siswanto; Yusiran; Asriyadin; Gumilar, S.; Subali, B.

2018-03-01

The purpose of this research describes the effect of scientific methods designed by argumentation in maintaining retention of pre-service physics teachers (students) in mechanical concept. This learning consists of five stages including the first two stages namely observing and questioning. While the next three stages of reasoning, trying, and communicating are made of argumentation design. To know the effectiveness of treatment, students are given pre-test and post-test in one time. On the other hand, students were given advanced post-test to know the durability of retention as many as four times in four months. The results show that there was mean difference between pre-test and post-test based on the Wilcoxon test (z = -3.4, p=0.001). While the effectiveness of treatment is in the high category based on normalized gain values ( = 0.86). Meanwhile, mean difference of all post-test is significantly different based on Analysis of Varian (F = 365.63, p = 0.00). However, in the fourth month, students retention rates began to stabilize based on Tuckey’s HSD (p=0.074) for comparison of mean difference between fourth and fifth post-test. Overall, learning designed can maintain students retention within 4 months after the learning finish.

Critical care in the surgical global period.

PubMed

Painter, Julie R

2013-03-01

This article explores the rules and regulations from Current Procedural Terminology (CPT) code set and US Medicare and Medicaid Services (Medicare) regarding multiple physicians reporting critical care services during the global period. The article takes into account the critical care definitions, regulations, documentation requirements, and services each provider can report to Medicare. A clinical scenario based on literature supporting the types of complications and care that might typically be included in the post-operative period for a patient who is surgically treated for a type A aortic dissection was analyzed. It was determined that multiple physicians may provide critical care services to a single patient during the global period. The physician who performed the primary procedure cannot report critical care separately unless documentation supporting use of modifier 25 (significant, separately identifiable services) or 24 (unrelated services) supports that critical care is unrelated to the global period. Other physicians may report critical care services separately if specific criteria are met. To report critical care services to Medicare, the patient's condition must meet the Medicare definition of critical care and the physicians should generally represent different specialties providing different aspects of care to the critically ill or injured patient as defined by Medicare. There should be no overlap in time of services provided by each physician. Each physician's documentation should clearly support medical necessity with the diagnosis demonstrating the critical nature of the patients' illness, the total time spent providing critical care, the critical care service provided, and other contributing factors.

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

PubMed

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

2016-08-15

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

Promoting father involvement in early home visiting services for vulnerable families: Findings from a pilot study of "Dads matter".

PubMed

Guterman, Neil B; Bellamy, Jennifer L; Banman, Aaron

2018-02-01

Despite mounting evidence on the importance of fathers in children's development, evidence-based perinatal home visitation programs have largely overlooked fathers in the design and delivery of services. This paper describes the design, development, and pilot testing of the "Dads Matter" enhancement to standard home visiting services. Dads Matter is a manualized intervention package designed to fully incorporate fathers into perinatal home visiting services. Twenty-four families were enrolled in a pilot study to assess the feasibility, acceptability, and preliminary outcomes of the intervention. Using a quasi-experimental time-lagged design, 12 families received standard home visiting services and completed baseline and four-month post-tests. Home visitor staff were then trained and supervised to implement the Dads Matter enhancement in addition to standard services. Twelve additional families were then enrolled and completed baseline and four-month post-tests. Implementation data indicated that Dads Matter was implemented as planned. Cohen's d scores on outcome measures indicate positive trends associated with Dads Matter in the quality of the mother-father relationship, perceived stress reported by both parents, fathers' involvement with the child, maltreatment indicators, and fathers' verbalizations toward the infant. Effect sizes generally ranged from moderate to large in magnitude and were larger than overall effect sizes of home visitation services alone reported in prior meta-analyses. Dads Matter appears to be a feasible, acceptable, and promising approach to improving fathers' engagement in home visiting services and promoting family and child well-being. Copyright © 2017. Published by Elsevier Ltd.

Ares 1 First Stage Design, Development, Test, and Evaluation

NASA Technical Reports Server (NTRS)

Williams, Tom; Cannon, Scott

2006-01-01

The Ares I Crew Launch Vehicle (CLV) is an integral part of NASA s exploration architecture that will provide crew and cargo access to the International Space Station as well as low earth orbit support for lunar missions. Currently in the system definition phase, the CLV is planned to replace the Space Shuttle for crew transport in the post 2010 time frame. It is comprised of a solid rocket booster (SRB) first stage derived from the current Space Shuttle SRB, a liquid oxygen/hydrogen fueled second stage utilizing a derivative of the Apollo upper stage engine for propulsion, and a Crew Exploration Vehicle (CEV) composed of command and service modules. This paper deals with current design, development, test, and evaluation planning for the CLV first stage SRB. Described are the current overall point-of-departure design and booster subsystems, systems engineering approach, and milestone schedule requirements.

Twelve-Step affiliation and 3-year substance use outcomes among adolescents: social support and religious service attendance as potential mediators.

PubMed

Chi, Felicia W; Kaskutas, Lee A; Sterling, Stacy; Campbell, Cynthia I; Weisner, Constance

2009-06-01

Twelve-Step affiliation among adolescents is little understood. We examined 12-Step affiliation and its association with substance use outcomes 3 years post-treatment intake among adolescents seeking chemical dependency (CD) treatment in a private, managed-care health plan. We also examined the effects of social support and religious service attendance on the relationship. We analyzed data for 357 adolescents, aged 13-18, who entered treatment at four Kaiser Permanente Northern California CD programs between March 2000 and May 2002 and completed both baseline and 3-year follow-up interviews. Measures at follow-up included alcohol and drug use, 12-Step affiliation, social support and frequency of religious service attendance. At 3 years, 68 adolescents (19%) reported attending any 12-Step meetings, and 49 (14%) reported involvement in at least one of seven 12-Step activities, in the previous 6 months. Multivariate logistic regression analyses indicated that after controlling individual and treatment factors, 12-Step attendance at 1 year was marginally significant, while 12-Step attendance at 3 years was associated with both alcohol and drug abstinence at 3 years [odds ratio (OR) 2.58, P < 0.05 and OR 2.53, P < 0.05, respectively]. Similarly, 12-Step activity involvement was associated significantly with 30-day alcohol and drug abstinence. There are possible mediating effects of social support and religious service attendance on the relationship between post-treatment 12-Step affiliation and 3-year outcomes. The findings suggest the importance of 12-Step affiliation in maintaining long-term recovery, and help to understand the mechanism through which it works among adolescents.

Improving sexual health for HIV patients by providing a combination of integrated public health and hospital care services; a one-group pre- and post test intervention comparison.

PubMed

Dukers-Muijrers, Nicole Htm; Somers, Carlijn; Hoebe, Christian Jpa; Lowe, Selwyn H; Niekamp, Anne-Marie Ejwm; Oude Lashof, Astrid; Bruggeman, Cathrien Amvh; Vrijhoef, Hubertus Jm

2012-12-27

Hospital HIV care and public sexual health care (a Sexual Health Care Centre) services were integrated to provide sexual health counselling and sexually transmitted infections (STIs) testing and treatment (sexual health care) to larger numbers of HIV patients. Services, need and usage were assessed using a patient perspective, which is a key factor for the success of service integration. The study design was a one-group pre-test and post-test comparison of 447 HIV-infected heterosexual individuals and men who have sex with men (MSM) attending a hospital-based HIV centre serving the southern region of the Netherlands. The intervention offered comprehensive sexual health care using an integrated care approach. The main outcomes were intervention uptake, patients' pre-test care needs (n=254), and quality rating. Pre intervention, 43% of the patients wanted to discuss sexual health (51% MSM; 30% heterosexuals). Of these patients, 12% to 35% reported regular coverage, and up to 25% never discussed sexual health topics at their HIV care visits. Of the patients, 24% used our intervention. Usage was higher among patients who previously expressed a need to discuss sexual health. Most patients who used the integrated services were new users of public health services. STIs were detected in 13% of MSM and in none of the heterosexuals. The quality of care was rated good. The HIV patients in our study generally considered sexual health important, but the regular counselling and testing at the HIV care visit was insufficient. The integration of public health and hospital services benefited both care sectors and their patients by addressing sexual health questions, detecting STIs, and conducting partner notification. Successful sexual health care uptake requires increased awareness among patients about their care options as well as a cultural shift among care providers.

Improving sexual health for HIV patients by providing a combination of integrated public health and hospital care services; a one-group pre- and post test intervention comparison

PubMed Central

2012-01-01

Background Hospital HIV care and public sexual health care (a Sexual Health Care Centre) services were integrated to provide sexual health counselling and sexually transmitted infections (STIs) testing and treatment (sexual health care) to larger numbers of HIV patients. Services, need and usage were assessed using a patient perspective, which is a key factor for the success of service integration. Methods The study design was a one-group pre-test and post-test comparison of 447 HIV-infected heterosexual individuals and men who have sex with men (MSM) attending a hospital-based HIV centre serving the southern region of the Netherlands. The intervention offered comprehensive sexual health care using an integrated care approach. The main outcomes were intervention uptake, patients’ pre-test care needs (n=254), and quality rating. Results Pre intervention, 43% of the patients wanted to discuss sexual health (51% MSM; 30% heterosexuals). Of these patients, 12% to 35% reported regular coverage, and up to 25% never discussed sexual health topics at their HIV care visits. Of the patients, 24% used our intervention. Usage was higher among patients who previously expressed a need to discuss sexual health. Most patients who used the integrated services were new users of public health services. STIs were detected in 13% of MSM and in none of the heterosexuals. The quality of care was rated good. Conclusions The HIV patients in our study generally considered sexual health important, but the regular counselling and testing at the HIV care visit was insufficient. The integration of public health and hospital services benefited both care sectors and their patients by addressing sexual health questions, detecting STIs, and conducting partner notification. Successful sexual health care uptake requires increased awareness among patients about their care options as well as a cultural shift among care providers. PMID:23270463

AGR-1 Compact 1-3-1 Post-Irradiation Examination Results

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

Demkowicz, Paul Andrew

The Advanced Gas Reactor (AGR) Fuel Development and Qualification Program was established to perform the requisite research and development on tristructural isotropic (TRISO) coated particle fuel to support deployment of a high-temperature gas-cooled reactor (HTGR). The work continues as part of the Advanced Reactor Technologies (ART) TRISO Fuel program. The overarching program goal is to provide a baseline fuel qualification data set to support licensing and operation of an HTGR. To achieve these goals, the program includes the elements of fuel fabrication, irradiation, post-irradiation examination (PIE) and safety testing, fuel performance modeling, and fission product transport (INL 2015). A seriesmore » of fuel irradiation experiments is being planned and conducted in the Advanced Test Reactor (ATR) at Idaho National Laboratory (INL). These experiments will provide data on fuel performance under irradiation, support fuel process development, qualify the fuel for normal operating conditions, provide irradiated fuel for safety testing, and support the development of fuel performance and fission product transport models. The first of these irradiation tests, designated AGR-1, began in the ATR in December 2006 and ended in November 2009. This experiment was conducted primarily to act as a shakedown test of the multicapsule test train design and provide early data on fuel performance for use in fuel fabrication process development. It also provided samples for post-irradiation safety testing, where fission product retention of the fuel at high temperatures will be experimentally measured. The capsule design and details of the AGR-1 experiment have been presented previously (Grover, Petti, and Maki 2010, Maki 2009).« less

AGR-1 Compact 5-3-1 Post-Irradiation Examination Results

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

Demkowicz, Paul; Harp, Jason; Winston, Phil

The Advanced Gas Reactor (AGR) Fuel Development and Qualification Program was established to perform the requisite research and development on tristructural isotropic (TRISO) coated particle fuel to support deployment of a high-temperature gas-cooled reactor (HTGR). The work continues as part of the Advanced Reactor Technologies (ART) TRISO Fuel program. The overarching program goal is to provide a baseline fuel qualification data set to support licensing and operation of an HTGR. To achieve these goals, the program includes the elements of fuel fabrication, irradiation, post-irradiation examination (PIE) and safety testing, fuel performance, and fission product transport (INL 2015). A series ofmore » fuel irradiation experiments is being planned and conducted in the Advanced Test Reactor (ATR) at Idaho National Laboratory (INL). These experiments will provide data on fuel performance under irradiation, support fuel process development, qualify the fuel for normal operating conditions, provide irradiated fuel for safety testing, and support the development of fuel performance and fission product transport models. The first of these irradiation tests, designated AGR-1, began in the ATR in December 2006 and ended in November 2009. This experiment was conducted primarily to act as a shakedown test of the multicapsule test train design and provide early data on fuel performance for use in fuel fabrication process development. It also provided samples for post-irradiation safety testing, where fission product retention of the fuel at high temperatures will be experimentally measured. The capsule design and details of the AGR-1 experiment have been presented previously.« less

Health professionals responding to men for safety (HERMES): feasibility of a general practice training intervention to improve the response to male patients who have experienced or perpetrated domestic violence and abuse.

PubMed

Williamson, Emma; Jones, Sue K; Ferrari, Giulia; Debbonaire, Thangam; Feder, Gene; Hester, Marianne

2015-05-01

To evaluate a training intervention for general practice-based doctors and nurses in terms of the identification, documentation, and referral of male patients experiencing or perpetrating domestic violence and abuse (DVA) in four general practices in the south west of England. Research suggests that male victims and perpetrators of DVA present to primary care clinicians to seek support for their experiences. We know that the response of primary care clinicians to women patients experiencing DVA improves from training and the establishment of referral pathways to specialist DVA services. The intervention consisted of a 2-h practice-based training. Outcome measures included: a pre-post, self-reported survey of staff practice; disclosures of DVA as documented in medical records pre-post (six months) intervention; semi-structured interviews with clinicians; and practice-level contact data collected by DVA specialist agencies. Results show a significant increase in clinicians' self-reported preparedness to meet the needs of male patients experiencing or perpetrating DVA. There was a small increase in male patients identified within the medical records (6 pre- to 17 post-intervention) but only five of those patients made contact with a specialist DVA agency identified within the referral pathway. The training increased clinicians' confidence in responding to male patients affected by DVA. The increase in recorded identification of DVA male patients experiencing or perpetrating DVA was small and contact of those patients with a specialist DVA support service was negligible. We need to better understand male help seeking in relation to DVA, further develop interventions to increase identification of male patients experiencing or perpetrating DVA behaviours, and facilitate access to support services.

Studies of thermionic materials for space power applications

NASA Technical Reports Server (NTRS)

1971-01-01

Service life tests of LC-8 and LC-9 carbide-fueled thermionic converters are discussed. Post operational tests of the converters to show emitter diametric change, microstructures of cladding and fuel, and analysis of fuel composition are described. The fabrication and performance of high temperature thermocouples used in the test procedures are included.

75 FR 70557 - Endocrine Disruptor Screening Program; Draft Policies and Procedures for Screening Safe Drinking...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-17

... intends to post the status of the test orders, including recipients' responses, on the EPA Web site so... screening program using appropriate validated test systems and other scientifically relevant information to... chemicals. Scientific research and development services (NAICS code 5417), e.g., persons who conduct testing...

Improving Access to Pediatric Cardiology in Cape Verde via a Collaborative International Telemedicine Service.

PubMed

Lapão, Luís Velez; Correia, Artur

2015-01-01

This paper addresses the role of international telemedicine services in supporting the evacuation procedures from Cape Verde to Portugal, enabling better quality and cost reductions in the management of the global health system. The Cape Verde, as other African countries, health system lacks many medical specialists, like pediatric cardiologists, neurosurgery, etc. In this study, tele-cardiology shows good results as diagnostic support to the evacuation decision. Telemedicine services show benefits while monitoring patients in post-evacuation, helping to address the lack of responsive care in some specialties whose actual use will help save resources both in provision and in management of the evacuation procedures. Additionally, with tele-cardiology collaborative service many evacuations can be avoided whereas many cases will be treated and followed locally in Cape Verde with remote technical support from Portugal. This international telemedicine service enabled more efficient evacuations, by reducing expenses in travel and housing, and therefore contributed to the health system's improvement. This study provides some evidence of how important telemedicine really is to cope with both the geography and the shortage of physicians.

Cold Regions Logistic Supportability Testing of Aviation, Air Delivery Equipment, and Aircraft Weapons Subsystems.

DTIC Science & Technology

1985-05-20

APPENDIX B - POST-TEST CHECKLIST 1. Have test data been collected, recorded, and presented in accordance with this TOP? YES NO . Comment : 2. Have all...data collected been reviewed for correctness and completeness? YES NO . Comment : 3. Were the facilities, test equipment, instrumentation, and support...YES NO . Comment : 5. Were the test results compromised in any way due to test performance procedures? YES_ NO . Comment : 6. Were the test results

Changes in University Students after Joining a Service Leadership Program in China

ERIC Educational Resources Information Center

Shek, Daniel T. L.; Lin, Li

2016-01-01

This study examined the effectiveness of a 4.5-day service leadership program for students from Chinese universities using objective outcome evaluation. The participants were assessed before and after the program, with two post-test measurements (immediate assessment and assessment 12 days after the completion of class learning). At pretest and…

Nutrition Education and Support Program for Community-Dwelling Adults with Intellectual Disabilities

ERIC Educational Resources Information Center

Humphries, Kathleen; Traci, Meg Ann; Seekins, Tom

2008-01-01

To test the efficacy, acceptability, and appropriateness of a nutrition education and support program, 4 community-based group homes for adults with intellectual or developmental disabilities participated in a pilot intervention with extended baseline period and pre--post-test design. Adults (N = 32) with intellectual or developmental…

Low Density Supersonic Decelerator (LDSD) Supersonic Flight Dynamics Test (SFDT) Plume Induced Environment Modelling

NASA Technical Reports Server (NTRS)

Mobley, B. L.; Smith, S. D.; Van Norman, J. W.; Muppidi, S.; Clark, I

2016-01-01

Provide plume induced heating (radiation & convection) predictions in support of the LDSD thermal design (pre-flight SFDT-1) Predict plume induced aerodynamics in support of flight dynamics, to achieve targeted freestream conditions to test supersonic deceleration technologies (post-flight SFDT-1, pre-flight SFDT-2)

Creep-Rupture Behavior of Ni-Based Alloy Tube Bends for A-USC Boilers

NASA Astrophysics Data System (ADS)

Shingledecker, John

Advanced ultrasupercritical (A-USC) boiler designs will require the use of nickel-based alloys for superheaters and reheaters and thus tube bending will be required. The American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel Code Section II PG-19 limits the amount of cold-strain for boiler tube bends for austenitic materials. In this summary and analysis of research conducted to date, a number of candidate nickel-based A-USC alloys were evaluated. These alloys include alloy 230, alloy 617, and Inconel 740/740H. Uniaxial creep and novel structural tests and corresponding post-test analysis, which included physical measurements, simplified analytical analysis, and detailed microscopy, showed that different damage mechanisms may operate based on test conditions, alloy, and cold-strain levels. Overall, creep strength and ductility were reduced in all the alloys, but the degree of degradation varied substantially. The results support the current cold-strain limits now incorporated in ASME for these alloys for long-term A-USC boiler service.

48 CFR 242.202 - Assignment of contract administration.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., charting, and geodesy services; (F) Base, post, camp, and station purchases; (G) Operation or maintenance... installation, test, and checkout of the missiles and associated equipment); (Q) Operation and maintenance of, or installation of equipment at, military test ranges, facilities, and installations; and (R) The...

48 CFR 242.202 - Assignment of contract administration.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., charting, and geodesy services; (F) Base, post, camp, and station purchases; (G) Operation or maintenance... installation, test, and checkout of the missiles and associated equipment); (Q) Operation and maintenance of, or installation of equipment at, military test ranges, facilities, and installations; and (R) The...

48 CFR 242.202 - Assignment of contract administration.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., charting, and geodesy services; (F) Base, post, camp, and station purchases; (G) Operation or maintenance... installation, test, and checkout of the missiles and associated equipment); (Q) Operation and maintenance of, or installation of equipment at, military test ranges, facilities, and installations; and (R) The...

48 CFR 242.202 - Assignment of contract administration.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., charting, and geodesy services; (F) Base, post, camp, and station purchases; (G) Operation or maintenance... installation, test, and checkout of the missiles and associated equipment); (Q) Operation and maintenance of, or installation of equipment at, military test ranges, facilities, and installations; and (R) The...

48 CFR 242.202 - Assignment of contract administration.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., charting, and geodesy services; (F) Base, post, camp, and station purchases; (G) Operation or maintenance... installation, test, and checkout of the missiles and associated equipment); (Q) Operation and maintenance of, or installation of equipment at, military test ranges, facilities, and installations; and (R) The...

Exploring positive pathways to care for members of the UK Armed Forces receiving treatment for PTSD: a qualitative study

PubMed Central

Murphy, Dominic; Hunt, Elizabeth; Luzon, Olga; Greenberg, Neil

2014-01-01

Objective To examine the factors which facilitate UK military personnel with post-traumatic stress disorder (PTSD) to engage in help-seeking behaviours. Methods The study recruited active service personnel who were attending mental health services, employed a qualitative design, used semi-structured interview schedules to collect data, and explored these data using interpretative phenomenological analysis (IPA). Results Five themes emerged about how participants were able to access help; having to reach a crisis point before accepting the need for help, overcoming feelings of shame, the importance of having an internal locus of control, finding a psychological explanation for their symptoms and having strong social support. Conclusions This study reported that for military personnel who accessed mental health services, there were a number of factors that supported them to do so. In particular, factors that combated internal stigma, such as being supported to develop an internal locus of control, appeared to be critical in supporting military personnel to engage in help-seeking behaviour. PMID:24624262

Effectiveness and cost-effectiveness of implementing HIV testing in primary care in East London: protocol for an interrupted time series analysis.

PubMed

Leber, Werner; Beresford, Lee; Nightingale, Claire; Barbosa, Estela Capelas; Morris, Stephen; El-Shogri, Farah; McMullen, Heather; Boomla, Kambiz; Delpech, Valerie; Brown, Alison; Hutchinson, Jane; Apea, Vanessa; Symonds, Merle; Gilliham, Samantha; Creighton, Sarah; Shahmanesh, Maryam; Fulop, Naomi; Estcourt, Claudia; Anderson, Jane; Figueroa, Jose; Griffiths, Chris

2017-12-14

HIV remains underdiagnosed. Guidelines recommend routine HIV testing in primary care, but evidence on implementing testing is lacking. In a previous study, the Rapid HIV Assessment 2 (RHIVA2) cluster randomised controlled trial, we showed that providing training and rapid point-of-care HIV testing at general practice registration (RHIVA2 intervention) in Hackney led to cost-effective, increased and earlier diagnosis of HIV. However, interventions effective in a trial context may be less so when implemented in routine practice. We describe the protocol for an MRC phase IV implementation programme, evaluating the impact of rolling out the RHIVA2 intervention in a post-trial setting. We will use a longitudinal study to examine if the post-trial implementation in Hackney practices is effective and cost-effective, and a cross-sectional study to compare Hackney with two adjacent boroughs providing usual primary care (Newham) and an enhanced service promoting HIV testing in primary care (Tower Hamlets). Service evaluation using interrupted time series and cost-effectiveness analyses. We will include all general practices in three contiguous high HIV prevalence East London boroughs. All adults aged 16 and above registered with the practices will be included. The interventions to be examined are: a post-trial RHIVA2 implementation programme (including practice-based education and training, external quality assurance, incentive payments for rapid HIV testing and incorporation of rapid HIV testing in the sexual health Local Enhanced Service) in Hackney; the general practice sexual health Network Improved Service in Tower Hamlets and usual care in Newham. Coprimary outcomes are rates of HIV testing and new HIV diagnoses. The chair of the Camden and Islington NHS Research Ethics Committee, London, has endorsed this programme as an evaluation of routine care. Study results will be published in peer-reviewed journals and reported to commissioners. © 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.

Exploring assistive technology and post-school outcomes for students with severe disabilities.

PubMed

Bouck, Emily C; Flanagan, Sara M

2016-11-01

This study sought to understand the extent to which students with severe disabilities receive assistive technology in school and out-of-school, and the relationship between receipt of assistive technology in school and post-school outcomes for these students. This study was a secondary analysis of the National Longitudinal Transition Study-2 (NLTS2) from the USA. To analyze the data in this correlational study, researchers conducted frequency distributions, Chi Square Tests of Associations, significance tests and logistic regressions. The main results suggest (a) receipt of assistive technology in school varied greatly by disability identification; (b) receipt of assistive technology post-school also varied by disability identification, but receipt was generally lower; and (c) few statistically significant post-school outcome differences existed between students who received assistive technology and those who did not. An under-utilization of assistive technology exists in practice in the USA for students with severe disabilities. Implications for Rehabilitation An under-utilization of assistive technology for secondary students and adults with severe disabilities likely exists. A need exists for improved collaboration between professionals in rehabilitation and professionals in schools to ensure continuation of needed services or aids, such as assistive technology. Additional research is needed to better understand the adult life (or post-school) outcomes of individuals with severe disabilities, factors from PK-12 schooling or post-school services that positively and negative impact those outcomes.

LDSD POST2 Modeling Enhancements in Support of SFDT-2 Flight Operations

NASA Technical Reports Server (NTRS)

White, Joseph; Bowes, Angela L.; Dutta, Soumyo; Ivanov, Mark C.; Queen, Eric M.

2016-01-01

Program to Optimize Simulated Trajectories II (POST2) was utilized to develop trajectory simulations characterizing all flight phases from drop to splashdown for the Low-Density Supersonic Decelerator (LDSD) project's first and second Supersonic Flight Dynamics Tests (SFDT-1 and SFDT-2) which took place June 28, 2014 and June 8, 2015, respectively. This paper describes the modeling improvements incorporated into the LDSD POST2 simulations since SFDT-1 and presents how these modeling updates affected the predicted SFDT-2 performance and sensitivity to the mission design. The POST2 simulation flight dynamics support during the SFDT-2 launch, operations, and recovery is also provided.

Post-Test Inspection of NASA's Evolutionary Xenon Thruster Long-Duration Test Hardware: Discharge and Neutralizer Cathodes

NASA Technical Reports Server (NTRS)

Shastry, Rohit; Soulas, George C.

2016-01-01

The NEXT Long-Duration Test is part of a comprehensive thruster service life assessment intended to demonstrate overall throughput capability, validate service life models, quantify wear rates as a function of time and operating condition, and identify any unknown life-limiting mechanisms. The test was voluntarily terminated in February 2014 after demonstrating 51,184 hours of high-voltage operation, 918 kg of propellant throughput, and 35.5 MN-s of total impulse. The post-test inspection of the thruster hardware began shortly afterwards with a combination of non-destructive and destructive analysis techniques, and is presently nearing completion. This paper presents relevant results of the post-test inspection for both discharge and neutralizer cathodes. Discharge keeper erosion was found to be significantly reduced from what was observed in the NEXT 2 kh wear test and NSTAR Extended Life Test, providing adequate protection of vital cathode components throughout the test with ample lifetime remaining. The area of the discharge cathode orifice plate that was exposed by the keeper orifice exhibited net erosion, leading to cathode plate material building up in the cathode-keeper gap and causing a thermally-induced electrical short observed during the test. Significant erosion of the neutralizer cathode orifice was also found and is believed to be the root cause of an observed loss in flow margin. Deposition within the neutralizer keeper orifice as well as on the downstream surface was thicker than expected, potentially resulting in a facility-induced impact on the measured flow margin from plume mode. Neutralizer keeper wall erosion on the beam side was found to be significantly lower compared to the NEXT 2 kh wear test, likely due to the reduction in beam extraction diameter of the ion optics that resulted in decreased ion impingement. Results from the post-test inspection have led to some minor thruster design improvements.

"New Skills and Abilities to Enable Me to Support My Pupils in a Forward Thinking Positive Way:" A Self-Discovery Programme for Teachers in Mainstream School

ERIC Educational Resources Information Center

Powell, Lesley; Cheshire, Anna

2008-01-01

The purpose of this study is to adapt, deliver, and pilot test the Self-discovery Programme (SDP) for teachers in mainstream school. The study used a pre-test post-test design. Quantitative data were collected by self-administered questionnaires given to teachers at two points in time: baseline (immediately pre-SDP) and immediately post-SDP.…

Australian smokers' support for plain or standardised packs before and after implementation: findings from the ITC Four Country Survey.

PubMed

Swift, Elena; Borland, Ron; Cummings, K Michael; Fong, Geoffrey T; McNeill, Ann; Hammond, David; Thrasher, James F; Partos, Timea R; Yong, Hua-Hie

2015-11-01

Plain packaging (PP) for tobacco products was fully implemented in Australia on 1 December 2012 along with larger graphic health warnings. Using longitudinal data from the Australian arm of the ITC Four Country Survey, we examined attitudes to the new packs before and after implementation, predictors of attitudinal change, and the relationship between support and quitting activity. A population-based cohort study design, with some cross-sectional analyses. Surveys of Australian smokers assessed attitudes to PP at four time points prior to implementation (from 2007 to 2012) and one post-implementation wave collected (early/mid-2013). Trend analysis showed a slight rise in opposition to PP among smokers in the waves leading up to their implementation, but no change in support. Support for PP increased significantly after implementation (28.2% pre vs 49% post), such that post-PP more smokers were supportive than opposed (49% vs 34.7%). Multivariate analysis showed support either before or after implementation was predicted by belief in greater adverse health impacts of smoking, desire to quit and lower addiction. Among those not supportive before implementation, having no clear opinion about PP (versus being opposed) prior to the changes also predicted support post-implementation. Support for PP was prospectively associated with higher levels of quitting activity. Since implementation of PP along with larger warnings, support among Australian smokers has increased. Support is related to lower addiction, stronger beliefs in the negative health impacts of smoking, and higher levels of quitting activity. 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/

Pre- and post-test genetic counseling for chromosomal and Mendelian disorders.

PubMed

Fonda Allen, Jill; Stoll, Katie; Bernhardt, Barbara A

2016-02-01

Genetic carrier screening, prenatal screening for aneuploidy, and prenatal diagnostic testing have expanded dramatically over the past 2 decades. Driven in part by powerful market forces, new complex testing modalities have become available after limited clinical research. The responsibility for offering these tests lies primarily on the obstetrical care provider and has become more burdensome as the number of testing options expands. Genetic testing in pregnancy is optional, and decisions about undergoing tests, as well as follow-up testing, should be informed and based on individual patients' values and needs. Careful pre- and post-test counseling is central to supporting informed decision-making. This article explores three areas of technical expansion in genetic testing: expanded carrier screening, non-invasive prenatal screening for fetal aneuploidies using cell-free DNA, and diagnostic testing using fetal chromosomal microarray testing, and provides insights aimed at enabling the obstetrical practitioner to better support patients considering these tests. Copyright © 2016 Elsevier Inc. All rights reserved.

Long-Term Outcomes and Needs of Military Service Members After Noncombat-Related Traumatic Brain Injury.

PubMed

Miller, Kelly J; Kennedy, Jan E; Schwab, Karen A

2017-03-01

Assess the prevalence of self-identified unmet service needs in a military sample an average of 5 years following noncombat traumatic brain injury (TBI). Examine relationships between unmet needs and background, injury-related and outcome variables. The study sample consisted of 89 veterans and service members who sustained non-combat TBI between 1999 and 2003, selected from enrollees in the Defense and Veterans Brain Injury Center TBI registry. Semistructured telephone interview was used to collect information about participants' self-reported unmet service needs, symptoms, and functional status. Most participants (65%) reported having at least one unmet service need. The most prevalent needs were "getting information about available post-TBI services" (47%) and "improving memory and attention" (45%). Unmet needs were associated with cognitive difficulties, physical and emotional symptoms, mental health diagnosis/treatment, and poorer functional status. Needs for services following TBI are associated with poor symptomatic and functional outcomes and may persist for years after injury in military service members and veterans. The study suggests service members' needs post TBI for improved cognition, support for emotional issues, and resources for vocational skills. Information about available services should be made accessible to those recovering from TBI to reduce the incidence of long-term unmet needs. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Effectiveness of psychosocial interventions in abused children and their families

PubMed Central

Derakhshanpour, Firoozeh; Hajebi, Ahmad; Panaghi, Leili; Ahmadabadi, Zohre

2017-01-01

Background: Child abuse is a significant public health and social problem worldwide. It can be described as a failure to provide care and protection for children by the parents or other caregivers. This study aimed at evaluating the effectiveness of psychosocial interventions in abused children and their families. Methods: This quasi-experimental study was conducted in the psychosocial support unit of a pediatric hospital in Bandar Abbas, Iran, from 2012 to 2013. The participants consisted of child abuse cases and their parents who referred to the psychosocial support unit to receive services. Services delivered in this unit included parenting skills training, psychiatric treatments, and supportive services. The effectiveness of the interventions was assessed with Child Abuse Questionnaire, General Health Questionnaire (GHQ), and Strengths and Difficulties Questionnaires (SDQ). Participants were assessed at baseline, at 3, and 6 months follow-ups. ANOVA with repeated measures and Friedman test were used to evaluate the effect of the interventions. Results: A total of 68 children and their parents enrolled in this study, of whom 53% were males. Post-intervention follow-ups revealed significant changes in mothers' general health questionnaire (p<0.001), and children's conduct problem (p<0.05), hyperactivity (p<0.001), and peer problems (p<0.05). Physical and emotional abuses significantly decreased (p<0.001). Conclusion: Our findings revealed that psychosocial interventions effectively improved child-parents interaction and mental health of parents. The effectiveness of interventions based on subgroup analysis and implications of the results have been discussed for further development of psychosocial interventions in the health system. PMID:29445678

Effectiveness of psychosocial interventions in abused children and their families.

PubMed

Derakhshanpour, Firoozeh; Hajebi, Ahmad; Panaghi, Leili; Ahmadabadi, Zohre

2017-01-01

Background: Child abuse is a significant public health and social problem worldwide. It can be described as a failure to provide care and protection for children by the parents or other caregivers. This study aimed at evaluating the effectiveness of psychosocial interventions in abused children and their families. Methods: This quasi-experimental study was conducted in the psychosocial support unit of a pediatric hospital in Bandar Abbas, Iran, from 2012 to 2013. The participants consisted of child abuse cases and their parents who referred to the psychosocial support unit to receive services. Services delivered in this unit included parenting skills training, psychiatric treatments, and supportive services. The effectiveness of the interventions was assessed with Child Abuse Questionnaire, General Health Questionnaire (GHQ), and Strengths and Difficulties Questionnaires (SDQ). Participants were assessed at baseline, at 3, and 6 months follow-ups. ANOVA with repeated measures and Friedman test were used to evaluate the effect of the interventions. Results: A total of 68 children and their parents enrolled in this study, of whom 53% were males. Post-intervention follow-ups revealed significant changes in mothers' general health questionnaire (p<0.001), and children's conduct problem (p<0.05), hyperactivity (p<0.001), and peer problems (p<0.05). Physical and emotional abuses significantly decreased (p<0.001). Conclusion: Our findings revealed that psychosocial interventions effectively improved child-parents interaction and mental health of parents. The effectiveness of interventions based on subgroup analysis and implications of the results have been discussed for further development of psychosocial interventions in the health system.

Evaluation of a training program of hypertension for accredited social health activists (ASHA) in rural India.

PubMed

Abdel-All, Marwa; Thrift, Amanda Gay; Riddell, Michaela; Thankappan, Kavumpurathu Raman Thankappan; Mini, Gomathyamma Krishnakurup; Chow, Clara K; Maulik, Pallab Kumar; Mahal, Ajay; Guggilla, Rama; Kalyanram, Kartik; Kartik, Kamakshi; Suresh, Oduru; Evans, Roger George; Oldenburg, Brian; Thomas, Nihal; Joshi, Rohina

2018-05-02

Hypertension is a major risk factor for cardiovascular disease, a leading cause of premature death and disability in India. Since access to health services is poor in rural India and Accredited Social Health Activists (ASHAs) are available throughout India for maternal and child health, a potential solution for improving hypertension control is by utilising this available workforce. We aimed to develop and implement a training package for ASHAs to identify and control hypertension in the community, and evaluate the effectiveness of the training program using the Kirkpatrick Evaluation Model. The training program was part of a cluster randomised feasibility trial of a 3-month intervention to improve hypertension outcomes in South India. Training materials incorporated details on managing hypertension, goal setting, facilitating group meetings, and how to measure blood pressure and weight. The 15 ASHAs attended a five-day training workshop that was delivered using interactive instructional strategies. ASHAs then led community-based education support groups for 3 months. Training was evaluated using Kirkpatrick's evaluation model for measuring reactions, learning, behaviour and results using tests on knowledge at baseline, post-training and post-intervention, observation of performance during meetings and post-intervention interviews. The ASHAs' knowledge of hypertension improved from a mean score of 64% at baseline to 76% post-training and 84% after the 3-month intervention. Research officers, who observed the community meetings, reported that ASHAs delivered the self-management content effectively without additional assistance. The ASHAs reported that the training materials were easy to understand and useful in educating community members. ASHAs can be trained to lead community-based group educational discussions and support individuals for the management of high blood pressure. The feasibility trial is registered with the Clinical Trials Registry - India (CTRI) CTRI/2016/02/006678 (25/02/2016).

Opportunities, challenges and systems requirements for developing post-abortion family planning services: Perceptions of service stakeholders in China

PubMed Central

Richards, Esther; Zhang, Weihong; Hu, Lina; Wu, Shangchun; Tolhurst, Rachel

2017-01-01

Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers’ perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces—Zhejiang, Hubei and Yunnan—were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable the systematic development of high quality PAFP, including actively targeting young and unmarried people in service provision, obtaining policy support and increasing the investment of human and financial resources. PMID:29045434

Opportunities, challenges and systems requirements for developing post-abortion family planning services: Perceptions of service stakeholders in China.

PubMed

Jiang, Hong; Xu, Jieshuang; Richards, Esther; Qian, Xu; Zhang, Weihong; Hu, Lina; Wu, Shangchun; Tolhurst, Rachel

2017-01-01

Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers' perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces-Zhejiang, Hubei and Yunnan-were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable the systematic development of high quality PAFP, including actively targeting young and unmarried people in service provision, obtaining policy support and increasing the investment of human and financial resources.

Extending the Reach of Early Intervention Training for Practitioners: A Preliminary Investigation of an Online Curriculum for Teaching Behavioral Intervention Knowledge in Autism to Families and Service Providers

PubMed Central

Hamad, Charles D.; Serna, Richard W.; Morrison, Leslie; Fleming, Richard

2013-01-01

Early behavioral intervention, based on the methods of applied behavior analysis, has the strongest and most consistent scientific support as a means of teaching skills to young children with Autism Spectrum Disorder and reducing their restricted and maladaptive behavior. Though individual ABA-based treatment plans are usually developed, designed and supervised by a senior-level clinician, they are most often implemented by a practitioner, such as a parent, direct service provider, aide, or an early childhood professional from a related discipline. Unfortunately, few practitioner-orientated training programs are available to geographically disparate persons. Online distance-learning education offers a potential solution to this problem. Fifty-one individuals participated in an initial study of a short, three-module online course. The results showed a highly statistically significant difference between the mean pre-test and post-test score. The outcomes suggest the feasibility and user satisfaction of teaching BI knowledge acquisition online, and thus bolster confidence that future, larger-scale curricula aimed at teaching BI in a distance-learning format is warranted. PMID:23504540

42 CFR 414.509 - Reconsideration of basis for and amount of payment for a new clinical diagnostic laboratory test.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) or § 414.509(a)(3) that the basis for payment for a new test will be gapfilling, CMS posts interim... for a new clinical diagnostic laboratory test. 414.509 Section 414.509 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests...

Development of a web application for water resources based on open source software

NASA Astrophysics Data System (ADS)

Delipetrev, Blagoj; Jonoski, Andreja; Solomatine, Dimitri P.

2014-01-01

This article presents research and development of a prototype web application for water resources using latest advancements in Information and Communication Technologies (ICT), open source software and web GIS. The web application has three web services for: (1) managing, presenting and storing of geospatial data, (2) support of water resources modeling and (3) water resources optimization. The web application is developed using several programming languages (PhP, Ajax, JavaScript, Java), libraries (OpenLayers, JQuery) and open source software components (GeoServer, PostgreSQL, PostGIS). The presented web application has several main advantages: it is available all the time, it is accessible from everywhere, it creates a real time multi-user collaboration platform, the programing languages code and components are interoperable and designed to work in a distributed computer environment, it is flexible for adding additional components and services and, it is scalable depending on the workload. The application was successfully tested on a case study with concurrent multi-users access.

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.

Design and initial results from a supported education initiative: the Kansas Consumer as Provider program.

PubMed

McDiarmid, Diane; Rapp, Charles; Ratzlaff, Sarah

2005-01-01

Despite increased attention to consumer-providers, there remains a lack of models that prepare, support, and sustain consumers in provider roles. This article describes the Consumer as Provider (CAP) Training program at the University of Kansas School of Social Welfare, which creates opportunities for individuals with severe psychiatric disabilities to develop knowledge and skills to be effective as human service providers. CAP fosters a partnership between colleges and community mental health centers where students experience classroom and internship activities. Outcome from a 2-year longitudinal study on CAP graduates indicates increased employability, especially in social services field, and higher post-secondary educational involvement.

AAL service development loom--from the idea to a marketable business model.

PubMed

Kriegel, Johannes; Auinger, Klemens

2015-01-01

The Ambient Assisted Living (AAL) market is still in an early stage of development. Previous approaches of comprehensive AAL services are mostly supply-side driven and focused on hardware and software. Usually this type of AAL solutions does not lead to a sustainable success on the market. Research and development increasingly focuses on demand and customer requirements in addition to the social and legal framework. The question is: How can a systematic performance measurement strategy along a service development process support the market-ready design of a concrete business model for AAL service? Within the EU funded research project DALIA (Assistant for Daily Life Activities at Home) an iterative service development process uses an adapted Osterwalder business model canvas. The application of a performance measurement index (PMI) to support the process has been developed and tested. Development of an iterative service development model using a supporting PMI. The PMI framework is developed throughout the engineering of a virtual assistant (AVATAR) as a modular interface to connect informal carers with necessary and useful services. Future research should seek to ensure that the PMI enables meaningful transparency regarding targeting (e.g. innovative AAL service), design (e.g. functional hybrid AAL service) and implementation (e.g. marketable AAL support services). To this end, a further reference to further testing practices is required. The aim must be to develop a weighted PMI in the context of further research, which supports both the service engineering and the subsequent service management process.

Enhancing preparedness and satisfaction of caregivers of patients discharged from an inpatient rehabilitation facility using an interactive website.

PubMed

Stone, Karon

2014-01-01

Research indicates a need for improved caregiver preparation to provide care following a patient's discharge from inpatient rehabilitation. The aim of this project was to test the use of web-based resources to enhance the preparedness and satisfaction of such caregivers. A website was provided to caregivers with resources and e-mail access to a rehabilitation nurse practitioner. Care recipients had the following diagnoses: stroke, amputation, trauma/orthopedic, brain injury or debility. Preparedness for caregiving was assessed before utilization of the website and after discharge. Satisfaction of the resources was assessed after discharge. Measures included the Preparedness for Caregiver Scale and the Client Satisfaction Questionnaire. Seventy caregivers completed the predischarge preparedness tool. Thirty returned both tools postdischarge. Analysis of pre-post test data indicated increased preparedness to provide care after resource use, no increase meeting the caregiver's personal needs, and satisfaction with the resources provided. The caregivers of brain-injured patients reported less preparation as caregivers than those who cared for patients with other diagnoses. Although high interest was reported in using e-mail with the nurse practitioner, the resource was not utilized. This preliminary study supports the clinical relevance of Internet resources to improve caregiver preparation. With shortened hospital stays, providing applicable and evidence-based websites and other online services for caregivers can complement other healthcare services. More research focused on preparing caregivers and supporting personal caregiver needs is needed to evaluate the impact on overall rehabilitation outcomes. © 2013 Association of Rehabilitation Nurses.

42 CFR 414.40 - Coding and ancillary policies.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Global surgery policy (for example, post- and pre-operative periods and services, and intra-operative..., which typically comprise a technical component (the taking of the test) and a professional component...

42 CFR 414.40 - Coding and ancillary policies.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Global surgery policy (for example, post- and pre-operative periods and services, and intra-operative..., which typically comprise a technical component (the taking of the test) and a professional component...

42 CFR 414.40 - Coding and ancillary policies.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Global surgery policy (for example, post- and pre-operative periods and services, and intra-operative..., which typically comprise a technical component (the taking of the test) and a professional component...

Initial accomplishments of the Environmental Control and Life Support System (ECLSS) atmosphere revitalization (AR) predevelopment operational system test (POST) for the Space Station Freedom (SSF)

NASA Technical Reports Server (NTRS)

Dunn, Kevin H.; Bulgajewski, Peter J.

1992-01-01

Initial results of the integrated AR POST conducted by Boeing at Marshall Space Flight Center in 1992 are presented. The three baselined ECLSS Man Tended Capability AR assemblies were integrated and operated in a closed door chamber in which the internal atmosphere was monitored. The test provides a prerequisite checkout of the AR subsystem in preparation for longer duration tests in which the AR subsystem will be integrated with the Water Recovery Management subsystem. The integrated AR POST will serve as an early test bed to evaluate the integration of the space station ECLSS AR subsystem during design maturation.

Intimate partner violence in the post-war context: Women’s experiences and community leaders’ perceptions in the Eastern Province of Sri Lanka

PubMed Central

Guruge, Sepali; Ford-Gilboe, Marilyn; Varcoe, Colleen; Jayasuriya-Illesinghe, Vathsala; Ganesan, Mahesan; Sivayogan, Sivagurunathan; Kanthasamy, Parvathy; Shanmugalingam, Pushparani; Vithanarachchi, Hemamala

2017-01-01

Background Exposure to armed conflict and/or war have been linked to an increase in intimate partner violence (IPV) against women. A substantial body of work has focused on non-partner rape and sexual violence in war and post-war contexts, but research about IPV is limited, particularly in Asian settings. This paper presents the finding of a study conducted in the Eastern Province of Sri Lanka. The study explored women’s experiences of and responses to IPV as well as how health and social service providers perceive the problem. It also explored the IPV-related services and supports available after the end of a 30-year civil war. Method We conducted in-depth, qualitative interviews with 15 women who had experienced IPV and 15 service providers who were knowledgeable about IPV in the Eastern Province of Sri Lanka. Interviews were translated into English, coded and organized using NVivo8, and analyzed using inductive thematic analysis. Results Participants described IPV as a widespread but hidden problem. Women had experienced various forms of abusive and controlling behaviours, some of which reflect the reality of living in the post-war context. The psychological effects of IPV were common, but were often attributed to war-related trauma. Some men used violence to control women and to reinstate power when their gender roles were reversed or challenged due to war and post-war changes in livelihoods. While some service providers perceived an increase in awareness about IPV and more services to address it, this was discordant with women’s fears, feelings of oppression, and perception of a lack of redress from IPV within a highly militarized and ethnically-polarized society. Most women did not consider leaving an abusive relationship to be an option, due to realistic fears about their vulnerability to community violence, the widespread social norms that would cast them as outsiders, and the limited availability of related services and supports. Implications These findings revealed the need for more research about IPV in post-war contexts. Women’s experiences in such contexts are influenced and may be masked by a complex set of factors that intersect to produce IPV and entrap women in violence. A more nuanced understanding of the context-specific issues that shape women’s experiences of IPV- and community responses to it—is needed to develop more comprehensive solutions that are relevant to the local context. PMID:28362862

Intimate partner violence in the post-war context: Women's experiences and community leaders' perceptions in the Eastern Province of Sri Lanka.

PubMed

Guruge, Sepali; Ford-Gilboe, Marilyn; Varcoe, Colleen; Jayasuriya-Illesinghe, Vathsala; Ganesan, Mahesan; Sivayogan, Sivagurunathan; Kanthasamy, Parvathy; Shanmugalingam, Pushparani; Vithanarachchi, Hemamala

2017-01-01

Exposure to armed conflict and/or war have been linked to an increase in intimate partner violence (IPV) against women. A substantial body of work has focused on non-partner rape and sexual violence in war and post-war contexts, but research about IPV is limited, particularly in Asian settings. This paper presents the finding of a study conducted in the Eastern Province of Sri Lanka. The study explored women's experiences of and responses to IPV as well as how health and social service providers perceive the problem. It also explored the IPV-related services and supports available after the end of a 30-year civil war. We conducted in-depth, qualitative interviews with 15 women who had experienced IPV and 15 service providers who were knowledgeable about IPV in the Eastern Province of Sri Lanka. Interviews were translated into English, coded and organized using NVivo8, and analyzed using inductive thematic analysis. Participants described IPV as a widespread but hidden problem. Women had experienced various forms of abusive and controlling behaviours, some of which reflect the reality of living in the post-war context. The psychological effects of IPV were common, but were often attributed to war-related trauma. Some men used violence to control women and to reinstate power when their gender roles were reversed or challenged due to war and post-war changes in livelihoods. While some service providers perceived an increase in awareness about IPV and more services to address it, this was discordant with women's fears, feelings of oppression, and perception of a lack of redress from IPV within a highly militarized and ethnically-polarized society. Most women did not consider leaving an abusive relationship to be an option, due to realistic fears about their vulnerability to community violence, the widespread social norms that would cast them as outsiders, and the limited availability of related services and supports. These findings revealed the need for more research about IPV in post-war contexts. Women's experiences in such contexts are influenced and may be masked by a complex set of factors that intersect to produce IPV and entrap women in violence. A more nuanced understanding of the context-specific issues that shape women's experiences of IPV- and community responses to it-is needed to develop more comprehensive solutions that are relevant to the local context.

Post-TRANSPO test program: summary report. Volume I

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

Cusick, R.T.; Mooring, E.E.

1973-06-01

The report given encompasses the Post-TRANSPO Test Program (PTTP) operation, organization, and instrumentation. The more significant tests are described and a summary of the analyses performed to data is provided for the construction and testing of four prototype Personal Rapid Transit (PRT) Systems at Dulles International Airport. These systems are the Bendix Dashaveyor, the Ford Motor ACT, the Rohr Monocab and the Transportation Technology TTI. Each prototype featured two vehicles with a minimum of 1000 feet of guideway, off-line stations and fully automatic control. The TTI used air cushions for vertical support and a linear induction motor for propulsion. Themore » other systems used rubber tires, two supported from a roadway and the other, the Monocab, suspended from an overhead guidebeam. Conclusions and recommendations for further work are presented.« less

Improving socio-emotional health for pupils in early secondary education with Pyramid: A school-based, early intervention model.

PubMed

Jayman, Michelle; Ohl, Maddie; Hughes, Bronach; Fox, Pauline

2018-05-01

Policymakers are focusing increased attention on the role of schools to promote and support children's mental health, and evidence-based models of good practice are in demand. Pyramid Club is a school-based, socio-emotional intervention, demonstrably effective with primary-aged pupils. This study extends previous Pyramid Club evaluations by examining effectiveness with pupils in early secondary education; service users' perceptions and experiences were investigated to increase understanding of Pyramid's impact, thus supporting enhanced practice. Participants (n = 126) comprised selected pupils, aged 11-14 (52 males; 74 females), who completed the 10 week programme (Pyramid group) and a non-intervention comparison group. Club leaders (n = 23) were trained, Pyramid volunteers. A mixed-methods design was implemented. The Strengths and Difficulties Questionnaire (SDQ), informant-rated version (Goodman, 1997, J Child Psychol Psychiat, 38, 581) and self-report version (Goodman, Meltzer, & Bailey, 1998, Europ Child Adolesc Psychiatry, 7, 125), was used to measure socio-emotional well-being: pre-club (baseline assessment), post-test (within 2 weeks of programme completion), and at 12-month follow-up (informant-rated version only). Focus groups were conducted separately with Pyramid pupils and Club leaders. Findings from informants and self-reports identified significant improvements for the Pyramid group in total difficulties and on pertinent SDQ subscales (e.g., emotional symptoms and peer relationship problems) at post-test. Improvements were sustained at 12-month follow-up. Comparison pupils demonstrated minimal change over time. Thematic analysis of qualitative data supported the quantitative findings and provided valuable insights into the Pyramid Club experience. Findings contribute to evidence-based, preventative models for the early adolescent population and support the social validity of Pyramid Club. © 2018 The Authors. British Journal of Education Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.

Impact of integration of sexual and reproductive health services on consultation duration times: results from the Integra Initiative.

PubMed

Siapka, Mariana; Obure, Carol Dayo; Mayhew, Susannah H; Sweeney, Sedona; Fenty, Justin; Vassall, Anna

2017-11-01

The lack of human resources is a key challenge in scaling up of HIV services in Africa's health care system. Integrating HIV services could potentially increase their effectiveness and optimize the use of limited resources and clinical staff time. We examined the impact of integration of provider initiated HIV counselling and testing (PITC) and family planning (FP counselling and FP provision) services on duration of consultation to assess the impact of PITC and FP integration on staff workload. This study was conducted in 24 health facilities in Kenya under the Integra Initiative, a non-randomized, pre/post intervention trial to evaluate the impact of integrated HIV and sexual and reproductive health services on health and service outcomes. We compared the time spent providing PITC-only services, FP-only services and integrated PITC/FP services. We used log-linear regression to assess the impact of plausible determinants on the duration of clients' consultation times. Median consultation duration times were highest for PITC-only services (30 min), followed by integrated services (10 min) and FP-only services (8 min). Times for PITC-only and FP-only services were 69.7% higher (95% Confidence Intervals (CIs) 35.8-112.0) and 43.9% lower (95% CIs -55.4 to - 29.6) than times spent on these services when delivered as an integrated service, respectively. The reduction in consultation times with integration suggests a potential reduction in workload. The higher consultation time for PITC-only could be because more pre- and post-counselling is provided at these stand-alone services. In integrated PITC/FP services, the duration of the visit fell below that required by HIV testing guidelines, and service mix between counselling and testing substantially changed. Integration of HIV with FP services may compromise the quality of services delivered and care must be taken to clearly specify and monitor appropriate consultation duration times and procedures during the process of integrating HIV and FP services. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Impact of integration of sexual and reproductive health services on consultation duration times: results from the Integra Initiative

PubMed Central

Siapka, Mariana; Obure, Carol Dayo; Mayhew, Susannah H; Fenty, Justin; Initiative, Integra; Vassall, Anna

2017-01-01

Abstract The lack of human resources is a key challenge in scaling up of HIV services in Africa’s health care system. Integrating HIV services could potentially increase their effectiveness and optimize the use of limited resources and clinical staff time. We examined the impact of integration of provider initiated HIV counselling and testing (PITC) and family planning (FP counselling and FP provision) services on duration of consultation to assess the impact of PITC and FP integration on staff workload. This study was conducted in 24 health facilities in Kenya under the Integra Initiative, a non-randomized, pre/post intervention trial to evaluate the impact of integrated HIV and sexual and reproductive health services on health and service outcomes. We compared the time spent providing PITC-only services, FP-only services and integrated PITC/FP services. We used log-linear regression to assess the impact of plausible determinants on the duration of clients’ consultation times. Median consultation duration times were highest for PITC-only services (30 min), followed by integrated services (10 min) and FP-only services (8 min). Times for PITC-only and FP-only services were 69.7% higher (95% Confidence Intervals (CIs) 35.8–112.0) and 43.9% lower (95% CIs −55.4 to − 29.6) than times spent on these services when delivered as an integrated service, respectively. The reduction in consultation times with integration suggests a potential reduction in workload. The higher consultation time for PITC-only could be because more pre- and post-counselling is provided at these stand-alone services. In integrated PITC/FP services, the duration of the visit fell below that required by HIV testing guidelines, and service mix between counselling and testing substantially changed. Integration of HIV with FP services may compromise the quality of services delivered and care must be taken to clearly specify and monitor appropriate consultation duration times and procedures during the process of integrating HIV and FP services. PMID:29194545

78 FR 31941 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-28

... burden 810 RISE Staff Pre-Test 157 1 .25 39 RISE Staff Post-Test 157 1 .25 39 RISE burden 78 Estimated... addition, evaluation plans were developed to support rigorous site-specific and cross-site studies to... and Lesbian Center's Recognize Intervene Support Empower (RISE) project. A third phase of the study...

NASA's Astronant Family Support Office

NASA Technical Reports Server (NTRS)

Beven, Gary; Curtis, Kelly D.; Holland, Al W.; Sipes, Walter; VanderArk, Steve

2014-01-01

During the NASA-Mir program of the 1990s and due to the challenges inherent in the International Space Station training schedule and operations tempo, it was clear that a special focus on supporting families was a key to overall mission success for the ISS crewmembers pre-, in- and post-flight. To that end, in January 2001 the first Family Services Coordinator was hired by the Behavioral Health and Performance group at NASA JSC and matrixed from Medical Operations into the Astronaut Office's organization. The initial roles and responsibilities were driven by critical needs, including facilitating family communication during training deployments, providing mission-specific and other relevant trainings for spouses, serving as liaison for families with NASA organizations such as Medical Operations, NASA management and the Astronaut Office, and providing assistance to ensure success of an Astronaut Spouses Group. The role of the Family Support Office (FSO) has modified as the ISS Program matured and the needs of families changed. The FSO is currently an integral part of the Astronaut Office's ISS Operations Branch. It still serves the critical function of providing information to families, as well as being the primary contact for US and international partner families with resources at JSC. Since crews launch and return on Russian vehicles, the FSO has the added responsibility for coordinating with Flight Crew Operations, the families, and their guests for Soyuz launches, landings, and Direct Return to Houston post-flight. This presentation will provide a summary of the family support services provided for astronauts, and how they have changed with the Program and families the FSO serves. Considerations for future FSO services will be discussed briefly as NASA proposes one year missions and beyond ISS missions. Learning Objective: 1) Obtain an understanding of the reasons a Family Support Office was important for NASA. 2) Become familiar with the services provided for astronauts and their families and how they changed with the Program and family needs.

Does the utilization of dental services associate with masticatory performance in a Japanese urban population?: the Suita study

PubMed Central

Kikui, Miki; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Yoshimuta, Yoko; Yasui, Sakae; Nokubi, Takashi; Maeda, Yoshinobu; Kokubo, Yoshihiro; Watanabe, Makoto; Miyamoto, Yoshihiro

2015-01-01

Abstract There are numerous reports on the relationship between regular utilization of dental care services and oral health, but most are based on questionnaires and subjective evaluation. Few have objectively evaluated masticatory performance and its relationship to utilization of dental care services. The purpose of this study was to identify the effect of regular utilization of dental services on masticatory performance. The subjects consisted of 1804 general residents of Suita City, Osaka Prefecture (760 men and 1044 women, mean age 66.5 ± 7.9 years). Regular utilization of dental services and oral hygiene habits (frequency of toothbrushing and use of interdental aids) was surveyed, and periodontal status, occlusal support, and masticatory performance were measured. Masticatory performance was evaluated by a chewing test using gummy jelly. The correlation between age, sex, regular dental utilization, oral hygiene habits, periodontal status or occlusal support, and masticatory performance was analyzed using Spearman's correlation test and t‐test. In addition, multiple linear regression analysis was carried out to investigate the relationship of regular dental utilization with masticatory performance after controlling for other factors. Masticatory performance was significantly correlated to age when using Spearman's correlation test, and to regular dental utilization, periodontal status, or occlusal support with t‐test. Multiple linear regression analysis showed that regular utilization of dental services was significantly related to masticatory performance even after adjusting for age, sex, oral hygiene habits, periodontal status, and occlusal support (standardized partial regression coefficient β = 0.055). These findings suggested that the regular utilization of dental care services is an important factor influencing masticatory performance in a Japanese urban population. PMID:29744141

Does the utilization of dental services associate with masticatory performance in a Japanese urban population?: the Suita study.

PubMed

Kikui, Miki; Ono, Takahiro; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Yoshimuta, Yoko; Yasui, Sakae; Nokubi, Takashi; Maeda, Yoshinobu; Kokubo, Yoshihiro; Watanabe, Makoto; Miyamoto, Yoshihiro

2015-12-01

There are numerous reports on the relationship between regular utilization of dental care services and oral health, but most are based on questionnaires and subjective evaluation. Few have objectively evaluated masticatory performance and its relationship to utilization of dental care services. The purpose of this study was to identify the effect of regular utilization of dental services on masticatory performance. The subjects consisted of 1804 general residents of Suita City, Osaka Prefecture (760 men and 1044 women, mean age 66.5 ± 7.9 years). Regular utilization of dental services and oral hygiene habits (frequency of toothbrushing and use of interdental aids) was surveyed, and periodontal status, occlusal support, and masticatory performance were measured. Masticatory performance was evaluated by a chewing test using gummy jelly. The correlation between age, sex, regular dental utilization, oral hygiene habits, periodontal status or occlusal support, and masticatory performance was analyzed using Spearman's correlation test and t -test. In addition, multiple linear regression analysis was carried out to investigate the relationship of regular dental utilization with masticatory performance after controlling for other factors. Masticatory performance was significantly correlated to age when using Spearman's correlation test, and to regular dental utilization, periodontal status, or occlusal support with t -test. Multiple linear regression analysis showed that regular utilization of dental services was significantly related to masticatory performance even after adjusting for age, sex, oral hygiene habits, periodontal status, and occlusal support (standardized partial regression coefficient β  = 0.055). These findings suggested that the regular utilization of dental care services is an important factor influencing masticatory performance in a Japanese urban population.

The Development of TPACK, Technology Integrated Self-Efficacy and Instructional Technology Outcome Expectations of Pre-Service Physical Education Teachers

ERIC Educational Resources Information Center

Cengiz, Cevdet

2015-01-01

The purpose of this intervention has been to improve pre-service physical education teachers' Technological Pedagogical Content Knowledge (TPCK or TPACK), Technology Integrated Self-Efficacy (TISE), and Instructional Technology Outcome Expectations (ITOE). A pre-/post-test design without a control group was used in the study. Participants were…

Curriculum Infusion of the Social Norms Approach: Information Only vs. Service Learning

ERIC Educational Resources Information Center

Flynn, Mark A.; Carter, Elizabeth

2016-01-01

A two-group pretest-post-test quasi-experiment was conducted to analyze the impact of curriculum infusion of the social norms approach on students' alcohol perceptions and behaviors. This study extended previous research by examining two types of curriculum infusion, information only (IO) and service learning (SL). Also, owing to variations in…

Grooming coercion and the post-conflict trading of social services in wild Barbary macaques.

PubMed

McFarland, Richard; Majolo, Bonaventura

2011-01-01

In animal and human societies, social services such as protection from predators are often exchanged between group members. The tactics that individuals display to obtain a service depend on its value and on differences between individuals in their capacity to aggressively obtain it. Here we analysed the exchange of valuable social services (i.e. grooming and relationship repair) in the aftermath of a conflict, in wild Barbary macaques (Macaca sylvanus). The relationship repair function of post-conflict affiliation (i.e. reconciliation) was apparent in the victim but not in the aggressor. Conversely, we found evidence for grooming coercion by the aggressor; when the victim failed to give grooming soon after a conflict they received renewed aggression from the aggressor. We argue that post-conflict affiliation between former opponents can be better described as a trading of social services rather than coercion alone, as both animals obtain some benefits (i.e. grooming for the aggressor and relationship repair for the victim). Our study is the first to test the importance of social coercion in the aftermath of a conflict. Differences in competitive abilities can affect the exchange of services and the occurrence of social coercion in animal societies. This may also help explain the variance between populations and species in their social behaviour and conflict management strategies.

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

PubMed Central

2014-01-01

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

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

PubMed

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

2014-01-08

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

Identification of Commercial Items Risk Factors

DTIC Science & Technology

2003-03-01

performance measures, vendors availability of support, testing and managing organizational change . 1. Process Risk Factor: Commercial Standards Military...support, testing and managing organizational change . C. ASSESSING RESULTS Completing the questions and assessing/compiling the results should help...to performance measures, vendors availability of support, testing and managing organizational change . SECTION I Service

40 CFR 62.14104 - Requirements for municipal waste combustor operating practices.

Code of Federal Regulations, 2013 CFR

2013-07-01

...), proceed in accordance with ASME PTC 4.1-1964 (Reaffirmed 1991), Power Test Codes: Test Code for Steam Generating Units (with 1968 and 1969 Addenda). For design, construction, installation, calibration, and use... Mechanical Engineers, Service Center, 22 Law Drive, Post Office Box 2900, Fairfield, NJ 07007. You may...

40 CFR 62.14104 - Requirements for municipal waste combustor operating practices.

Code of Federal Regulations, 2014 CFR

2014-07-01

...), proceed in accordance with ASME PTC 4.1-1964 (Reaffirmed 1991), Power Test Codes: Test Code for Steam Generating Units (with 1968 and 1969 Addenda). For design, construction, installation, calibration, and use... Mechanical Engineers, Service Center, 22 Law Drive, Post Office Box 2900, Fairfield, NJ 07007. You may...

40 CFR 62.14104 - Requirements for municipal waste combustor operating practices.

Code of Federal Regulations, 2010 CFR

2010-07-01

...), proceed in accordance with ASME PTC 4.1-1964 (Reaffirmed 1991), Power Test Codes: Test Code for Steam Generating Units (with 1968 and 1969 Addenda). For design, construction, installation, calibration, and use... Mechanical Engineers, Service Center, 22 Law Drive, Post Office Box 2900, Fairfield, NJ 07007. You may...

40 CFR 62.14104 - Requirements for municipal waste combustor operating practices.

Code of Federal Regulations, 2012 CFR

2012-07-01

...), proceed in accordance with ASME PTC 4.1-1964 (Reaffirmed 1991), Power Test Codes: Test Code for Steam Generating Units (with 1968 and 1969 Addenda). For design, construction, installation, calibration, and use... Mechanical Engineers, Service Center, 22 Law Drive, Post Office Box 2900, Fairfield, NJ 07007. You may...

40 CFR 62.14104 - Requirements for municipal waste combustor operating practices.

Code of Federal Regulations, 2011 CFR

2011-07-01

...), proceed in accordance with ASME PTC 4.1-1964 (Reaffirmed 1991), Power Test Codes: Test Code for Steam Generating Units (with 1968 and 1969 Addenda). For design, construction, installation, calibration, and use... Mechanical Engineers, Service Center, 22 Law Drive, Post Office Box 2900, Fairfield, NJ 07007. You may...

Evaluation of an Audio Cassette Tape Lecture Course

ERIC Educational Resources Information Center

Blank, Jerome W.

1975-01-01

An audio-cassette continuing education course (Selected Topics in Pharmacology) from Extension Services in Pharmacy at the University of Wisconsin was offered to a selected test market of pharmacists and evaluated using a pre-, post-test design. Results showed significant increase in cognitive knowledge and strong approval of students. (JT)

78 FR 20355 - Notice of Availability of Funds and Solicitation for Grant Applications for Face Forward-Serving...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-04

...The U.S. Department of Labor (we, the Department or DOL) Employment and Training Administration (ETA), announces the availability of approximately $26 million in grant funds authorized by the Workforce Investment Act. Under this solicitation, DOL expects to award 26 grants for up to $1,000,000 each to cover a 39-month period of performance, which includes a planning period of up to six months, program operation period of 24 months, and a minimum of nine months of post program support and follow-up services provided to each participant. Any non- profit organization with IRS 501(c)(3) status, unit of state or local government, or any Indian and Native American entity eligible for grants under WIA Section 166, may apply for these grants to provide services to eligible participants in areas with high-poverty and high- crime rates. These services will include diversion and/or expungement (required for all participants), case management, mentoring, education, training leading to industry-recognized credentials for in demand industries and occupations in the State or local area, service- learning, workforce activities, and post-program support and follow-up services. The complete SGA and any subsequent SGA amendments in connection with this solicitation are described in further detail on ETA's Web site at http://www.doleta.gov/grants/ or on http://www.grants.gov. The Web sites provide application information, eligibility requirements, review and selection procedures, and other program requirements governing this solicitation.

Microgravity effects on standardized cognitive performance measures

NASA Technical Reports Server (NTRS)

Schiflett, Samuel G.

1992-01-01

The purpose of this experiment, selected to fly on the International Microgravity Laboratory (IML-2) Spacelab mission, is to determine the effects of microgravity upon the cognitive skills which are critical to successful performance of many tasks on board the Space Shuttle. Six tests from the Unified Tri-service Cognitive Performance Assessment Battery (UTC-PAB) will be administered to the Mission Specialists to fulfill the goals of this experiment. These tests are based upon current theoretical models of human performance and the hypothesized effects of microgravity. The principle objective is the identification of the effects of microgravity upon specific information processing skills affecting performance from those of fatigue and shifts in work/rest cycles. Multiple measures of both short and long term fatigue will be obtained and used as a major independent variable for the analysis of these performance data. Scientific supporting studies will determine optimum practice and performance testing schedules for the astronauts. The same tests will be used post-flight to collect data on the recovery of any cognitive performance impairment compared with pre-flight, baseline levels.

The NHERI RAPID Facility: Enabling the Next-Generation of Natural Hazards Reconnaissance

NASA Astrophysics Data System (ADS)

Wartman, J.; Berman, J.; Olsen, M. J.; Irish, J. L.; Miles, S.; Gurley, K.; Lowes, L.; Bostrom, A.

2017-12-01

The NHERI post-disaster, rapid response research (or "RAPID") facility, headquartered at the University of Washington (UW), is a collaboration between UW, Oregon State University, Virginia Tech, and the University of Florida. The RAPID facility will enable natural hazard researchers to conduct next-generation quick response research through reliable acquisition and community sharing of high-quality, post-disaster data sets that will enable characterization of civil infrastructure performance under natural hazard loads, evaluation of the effectiveness of current and previous design methodologies, understanding of socio-economic dynamics, calibration of computational models used to predict civil infrastructure component and system response, and development of solutions for resilient communities. The facility will provide investigators with the hardware, software and support services needed to collect, process and assess perishable interdisciplinary data following extreme natural hazard events. Support to the natural hazards research community will be provided through training and educational activities, field deployment services, and by promoting public engagement with science and engineering. Specifically, the RAPID facility is undertaking the following strategic activities: (1) acquiring, maintaining, and operating state-of-the-art data collection equipment; (2) developing and supporting mobile applications to support interdisciplinary field reconnaissance; (3) providing advisory services and basic logistics support for research missions; (4) facilitating the systematic archiving, processing and visualization of acquired data in DesignSafe-CI; (5) training a broad user base through workshops and other activities; and (6) engaging the public through citizen science, as well as through community outreach and education. The facility commenced operations in September 2016 and will begin field deployments beginning in September 2018. This poster will provide an overview of the vision for the RAPID facility, the equipment that will be available for use, the facility's operations, and opportunities for user training and facility use.

COURSE: Computer Retrieval for Local District Planning and Evaluation.

ERIC Educational Resources Information Center

Wolmut, Peter; Thomas, Gregory

The Multnomah County Education Service District (MCESD) provides the following support services to the 12 school districts in its jurisdiction in the metropolitan Portland area: (1) curricular support in terms of developing measurable goals and objectives; (2) support for nationally and locally developed group tests; (3) development and field…

Social support network characteristics of incarcerated women with co-occurring major depressive and substance use disorders.

PubMed

Nargiso, Jessica E; Kuo, Caroline C; Zlotnick, Caron; Johnson, Jennifer E

2014-01-01

The nature of social support available to incarcerated women is not well-understood, particularly among women at high risk of negative outcomes, including women dually diagnosed with Major Depressive Disorder and a Substance Use Disorder (MDD-SUD). Descriptive statistics and paired-tests were conducted on 60 incarcerated MDD-SUD women receiving in-prison substance use and depression treatments to characterize the women's social networks, including the strength of support, network characteristics, and types of support provided as well as to determine what aspects of social support may be amenable to change during incarceration and post-release. Study results showed that, on average, women perceived they had moderately supportive individuals in their lives, although more than a quarter of the sample could not identify any regular supporters in their network at baseline. During incarceration, women's social networks significantly increased in general supportiveness, and decreased in network size and percentage of substance users in their networks. Participants maintained positive social support gains post-release in most areas while also significantly increasing the size of their support network post-release. Findings suggest that there are aspects of incarcerated MDD-SUD women's social networks that are amenable to change during incarceration and post-release and provide insight into treatment targets for this vulnerable population.

Social support network characteristics of incarcerated women with co-occurring major depressive and substance use disorders

PubMed Central

Nargiso, Jessica E.; Kuo, Caroline C.; Zlotnick, Caron; Johnson, Jennifer E.

2014-01-01

The nature of social support available to incarcerated women is not well understood, particularly among women at high risk of negative outcomes, including women dually-diagnosed with Major Depressive Disorder and a Substance Use Disorder (MDD-SUD). Descriptive statistics and paired-tests were conducted on 60 incarcerated MDD-SUD women receiving in-prison substance use and depression treatments to characterize the women’s social networks, including the strength of support, network characteristics, and types of support provided as well as to determine what aspects of social support may be amenable to change during incarceration and post-release. Study results showed that on average women perceived they had moderately supportive individuals in their lives, although more than a quarter of the sample could not identify any regular supporters in their network at baseline. During incarceration, women’s social networks significantly increased in general supportiveness, and decreased in network size and percentage of substance users in their networks. Participants maintained positive social support gains post-release in most areas while also significantly increasing the size of their support network post-release. Findings suggest that there are aspects of incarcerated MDD-SUD women’s social networks that are amenable to change during incarceration and post-release and provide insight into treatment targets for this vulnerable population. PMID:25052785

45 CFR 1388.6 - Program criteria-services and supports.

Code of Federal Regulations, 2011 CFR

2011-10-01

... according to accepted practices of scientific evaluation; (iv) Research methods that are used to test hypotheses, validate procedures, and field test projects; and (v) Direct service and project practices and...

Minimising post-operative risk using a Post-Anaesthetic Care Tool (PACT): protocol for a prospective observational study and cost-effectiveness analysis

PubMed Central

Phillips, Nicole M; Kent, Bridie; Colgan, Stephen; Mohebbi, Mohammadreza

2015-01-01

Introduction While the risk of adverse events following surgery has been identified, the impact of nursing care on early detection of these events is not well established. A systematic review of the evidence and an expert consensus study in post-anaesthetic care identified essential criteria for nursing assessment of patient readiness for discharge from the post-anaesthetic care unit (PACU). These criteria were included in a new nursing assessment tool, the Post-Anaesthetic Care Tool (PACT), and incorporated into the post-anaesthetic documentation at a large health service. The aim of this study is to test the clinical reliability of the PACT and evaluate whether the use of PACT will (1) enhance the recognition and response to patients at risk of deterioration in PACU; (2) improve documentation for handover from PACU nurse to ward nurse; (3) result in improved patient outcomes and (4) reduce healthcare costs. Methods and analysis A prospective, non-randomised, pre-implementation and post-implementation design comparing: (1) patients (n=750) who have surgery prior to the implementation of the PACT and (2) patients (n=750) who have surgery after PACT. The study will examine the use of the tool through the observation of patient care and nursing handover. Patient outcomes and cost-effectiveness will be determined from health service data and medical record audit. Descriptive statistics will be used to describe the sample and compare the two patient groups (pre-intervention and post-intervention). Differences in patient outcomes between the two groups will be compared using the Cochran-Mantel-Haenszel test and regression analyses and reported as ORs with the corresponding 95% CIs. Conclusions This study will test the clinical reliability and cost-effectiveness of the PACT. It is hypothesised that the PACT will enable nurses to recognise and respond to patients at risk of deterioration, improve handover to ward nurses, improve patient outcomes, and reduce healthcare costs. PMID:26033942

Examination of changes in pathology tests ordered by Diagnosis-Related Group (DRGs) following CPOE introduction.

PubMed

Vecellio, Elia; Georgiou, Andrew; Toouli, George; Eigenstetter, Alex; Li, Ling; Wilson, Roger; Westbrook, Johanna I

2013-01-01

Electronic test ordering, via the Electronic Medical Record (EMR), which incorporates computerised provider order entry (CPOE), is widely considered as a useful tool to support appropriate pathology test ordering. Diagnosis-related groups (DRGs) are clinically meaningful categories that allow comparisons in pathology utilisation by patient groups by controlling for many potentially confounding variables. This study used DRG data linked to pathology test data to examine changes in rates of test ordering across four years coinciding with the introduction of an EMR in six hospitals in New South Wales, Australia. This method generated a list of high pathology utilisation DRGs. We investigated patients with a Chest pain DRG to examine whether tests rates changed for specific test groups by hospital emergency department (ED) pre- and post-EMR. There was little change in testing rates between EDs or between time periods pre- and post-EMR. This is a valuable method for monitoring the impact of EMR and clinical decision support on test order rates.

29 CFR 4.130 - Types of covered service contracts illustrated.

Code of Federal Regulations, 2012 CFR

2012-07-01

... services. (8) Chemical testing and analysis. (9) Clothing alteration and repair. (10) Computer services... maintenance and operation and engineering support services. (16) Exploratory drilling (other than part of...

29 CFR 4.130 - Types of covered service contracts illustrated.

Code of Federal Regulations, 2011 CFR

2011-07-01

... services. (8) Chemical testing and analysis. (9) Clothing alteration and repair. (10) Computer services... maintenance and operation and engineering support services. (16) Exploratory drilling (other than part of...

The effect of an occupational therapy mental health day treatment centre on the use of inpatient services in the Western Cape, South Africa.

PubMed

Engelbrecht, Riekie; Plastow, Nicola; Botha, Ulla; Niehaus, Djh; Koen, Liezl

2018-04-27

The aim of this study was to determine whether attendance at an occupational therapy-led day treatment centre for mental health care users affects the use of inpatient services in South Africa. A retrospective pre-test/post-test quasi-experimental study design was used to compare admissions and days spent in hospital during the 24 months before and after attendance at the centre, using the hospital's electronic records. Total population sampling yielded data for 44 mental health care users who made first contact with the service between July 2009 and June 2010. Data were compared using the Kruskal-Wallis test, Wilcoxon Signed Ranks test and Mann-Whitney U test. There was a significant decrease in the number of admissions (z = -4.093, p = 0.00) and the number of days spent in hospital (z = -4.730, p = 0.00). Participants were admitted to psychiatric care 33 times less in the 24 months' post-intervention, indicating a medium effect (r = 0.436). They also spend 2569 days less in hospital, indicating a large effect (r = 0.504). The findings suggest that an occupational therapy-led day treatment centre could be effective in reducing the use of inpatient mental health services in South Africa. Implications for Rehabilitation Attendance at an occupational therapy-led community day treatment centre decreases the number of admissions and number of days spent in hospital and is therefore beneficial to mental health care users and service providers. The study indicates that the successful implementation of a community day treatment centre for mental health care users on the grounds of a tertiary hospital by utilising existing resources is possible.

An educational package that supports laycarers to safely manage breakthrough subcutaneous injections for home-based palliative care patients: development and evaluation of a service quality improvement.

PubMed

Healy, Sue; Israel, Fiona; Charles, Margaret A; Reymond, Liz

2013-06-01

Palliative care services strive to support people to live and die well in their chosen environment, with optimal symptom control and a pattern of care supportive of laycarers. The likelihood of patients remaining at home often depends upon laycarers, who may be required to manage subcutaneous medications. This study reports the development, trial and evaluation of a package that teaches laycarers to manage subcutaneous medications used for symptom control in home-based patients. The package was developed by palliative care stakeholders and comprises an educational session, delivered by nurses, and a range of demonstrative, audiovisual and written resources. The package was trialled across 24 sites and was evaluated by 76 laycarers (pre- and post-use) and 53 nurses (at study completion). Outcomes of primary interest were perceived global usefulness of the package and rated relevance of components. Laycarers and nurses rated the usefulness and relevance of the package highly - all means were above 5 on a 7-point scale. Also, laycarers were invited to comment on the package, and three focus groups for 26 nurses explored post hoc issues following package implementation. In terms of the palliative patient's illness trajectory, consensus was that the time for package introduction depended upon each particular clinical situation and laycarer. Nursing opinion was divided concerning whether it is safe and appropriate for laycarers to manage subcutaneous injections. Nevertheless, this study demonstrates that the package supports laycarers to manage subcutaneous medications. This has important implications for families, services and health-care systems.

Predictors of post-traumatic stress symptoms in Oklahoma City: exposure, social support, peri-traumatic responses.

PubMed

Tucker, P; Pfefferbaum, B; Nixon, S J; Dickson, W

2000-11-01

Eighty-five adults seeking mental health assistance six months after the Oklahoma City bombing were assessed to determine which of three groups of variables (exposure, peri-traumatic responses, and social support) predicted development of post-traumatic stress disorder (PTSD) symptoms. Variables most highly associated with subsequent PTSD symptoms included having been injured (among exposure variables), feeling nervous or afraid (peri-traumatic responses), and responding that counseling helped (support variables). Combining primary predictors in the three areas, PTSD symptoms were more likely to occur in those reporting counseling to help and those feeling nervous or afraid at the time of the bombing. Implications of these findings are discussed for behavioral health administrators and clinicians planning service delivery to groups of victims seeking mental health intervention after terrorist attacks and other disasters.

“When You’re Sitting on the Fence, Hope’s the Hardest Part”: Challenges and Experiences of Heterosexual and Same-Sex Couples Adopting Through the Child Welfare System

PubMed Central

Moyer, April M.; Kinkler, Lori A.; Richardson, Hannah B.

2012-01-01

Foster-to-adopt families can be viewed as systems that are influenced by many other systems (e.g., the legal system, the social service agency, and the birth family). The current qualitative study of 84 foster-to-adopt parents (members of 42 lesbian, gay, and heterosexual couples) examined the types of challenges that parents faced as they navigated multiple systems during the initial post-placement period. Some participants described the legal insecurity associated with their role as foster-to-adopt parents as impacting their personal well-being and their attachment to their children. Lack of support services and disorganization within social service agencies, as well as strained relationships with birth parents, were also identified as stressors for foster-to-adopt parents. Importantly, lesbian and gay participants faced additional concerns regarding the security of their placement, due to the possibility for discrimination within the various systems involved with the foster-to-adopt process. Participants as a whole also identified positive aspects of their experiences within various systems; for example, they appreciated child care subsidies, state-provided health insurance, and supportive social workers. Our findings provide insights into foster-to-adopt parents’ experiences during the initial post-placement period, and have implications for adoption services aimed to improve placement stability and enhance family functioning in foster-to-adopt families. PMID:23226935

Investigating the effect of Alcohol Brief Interventions within accident and emergency departments using a data informatics methodology.

PubMed

Baldacchino, Alex; O'Rourke, Louise; Humphris, Gerry

2018-07-01

Alcohol Brief Interventions (ABI) have been implemented throughout Scotland since 2008 and aim to reduce hazardous drinking through a Scottish Government funded initiative delivered in a range of settings, including Accident and Emergency (A and E) departments. To study the extent to which Alcohol Brief Interventions (ABI) are associated with later health service use. An opportunistic informatics approach was applied. A unique patient identifier was used to link patient data with core datasets spanning two years previous and two years post ABI. Variables included inpatient attendance, outpatient attendance, psychiatric admissions, and A and E attendance and prescribing. Patients (N = 1704) who presented at A and E departments who reported an average alcohol consumption of more than 8 units daily received the ABI. Fast Alcohol Screening Test (FAST) was used to assess patients for hazardous alcohol consumption. Multilevel linear modelling was employed to predict post-intervention utilisation using pre-ABI variables and controlling for person characteristics and venue. Significant decrease in A and E usage was found at one and two years following the ABI intervention. Previous health service use was predictive of later service use. A single question (Item 4) on the FAST was predictive of A and E attendance at one and two years. This investigation and methodology used provide support for the delivery of the ABI. However, it cannot be ascertained whether this is due to the ABI or simply is a result of making contact with a specialist in the addiction field. Copyright © 2018 Elsevier B.V. All rights reserved.

"I Don't See the Point ..."

ERIC Educational Resources Information Center

Hull, Barbara

2005-01-01

Widening participation initiatives have had a noticeable effect on universities: student support services, especially at the post 1992 universities, are at a level undreamed of in the past. This has opened up the benefits of a university education to students previously excluded by social class, disability or ethnic group. One aspect of key…

Factors affecting employment outcomes for people with disabilities who received Disability Employment Services in Taiwan.

PubMed

Jang, Yuh; Wang, Yun-Tung; Lin, Meng-Hsiu

2014-03-01

One of the most important rehabilitation goals is to return people with disabilities to paid employment. The purposes of this study were (1) to explore employment status and (2) to identify factors that may affect the employment outcomes of people with disabilities who received Disability Employment Services (DES). A retrospective study was conducted on clients who commenced and closed DES between January 2008 and December 2010 in a metropolitan city in Taiwan, using the files from the National Vocational Rehabilitation Services Documentary System. Sixty-nine percent (1,684 out of 2,452) of the clients in this study were engaged in paid employment after receiving DES. Logistic regression analyses indicated that clients with no psychiatric disability or mild impairment and with useful vocational qualifications, typical work experience, more post-employment services, and less pre-employment services were associated with a higher rate of successful employment outcomes. This study provides empirical evidence of the association between person- and DES-related factors and the employment outcomes of people with disabilities. Future improvements in health, school-to-work transition services, and vocational rehabilitation for people with disabilities should place more emphasis on providing work-based work experience, professional vocational training, access to college/professional education, career exploration, effective supported employment services, and other post-employment services.

Vocal effectiveness of speech-language pathology students: Before and after voice use during service delivery.

PubMed

Couch, Stephanie; Zieba, Dominique; Van der Linde, Jeannie; Van der Merwe, Anita

2015-03-26

As a professional voice user, it is imperative that a speech-language pathologist's(SLP) vocal effectiveness remain consistent throughout the day. Many factors may contribute to reduced vocal effectiveness, including prolonged voice use, vocally abusive behaviours,poor vocal hygiene and environmental factors. To determine the effect of service delivery on the perceptual and acoustic features of voice. A quasi-experimental., pre-test-post-test research design was used. Participants included third- and final-year speech-language pathology students at the University of Pretoria(South Africa). Voice parameters were evaluated in a pre-test measurement, after which the participants provided two consecutive hours of therapy. A post-test measurement was then completed. Data analysis consisted of an instrumental analysis in which the multidimensional voice programme (MDVP) and the voice range profile (VRP) were used to measure vocal parameters and then calculate the dysphonia severity index (DSI). The GRBASI scale was used to conduct a perceptual analysis of voice quality. Data were processed using descriptive statistics to determine change in each measured parameter after service delivery. A change of clinical significance was observed in the acoustic and perceptual parameters of voice. Guidelines for SLPs in order to maintain optimal vocal effectiveness were suggested.

HOME-BASED BLOOD PRESSURE INTERVENTIONS FOR AFRICAN AMERICANS

PubMed Central

Feldman, Penny H.; McDonald, Margaret V.; Mongoven, Jennifer M.; Peng, Timothy R.; Gerber, Linda M.; Pezzin, Liliana E.

2009-01-01

Background Efforts to increase blood pressure (BP) control rates in African Americans, a traditionally underserved, high risk population must address both provider practice and patient adherence issues. The Home-Based BP Intervention for African Americans study is a three-arm randomized controlled trial designed to test two strategies to improve HTN management and outcomes in a decentralized service setting serving a vulnerable and complex home care population. The primary study outcomes are systolic BP, diastolic BP, and BP control; secondary outcomes are nurse adherence to HTN management recommendations, and patient adherence to medication, healthy diet and other self-management strategies. Methods and Results Nurses (N=312) in a nonprofit Medicare-certified home health agency are randomized along with their eligible hypertensive patients (N=845). The two interventions being tested are: (i) a “basic” intervention delivering key evidence-based reminders to home care nurses and patients while the patient is receiving traditional post-acute home health care; and (ii) an “augmented” intervention that includes that same as the basic intervention, plus transition to an ongoing HTN Home Support Program that extends support for 12 months. Outcomes are measured at 3 and 12 months post baseline interview. The interventions will be assessed relative to usual care and to each other. Conclusions Systems change to improve BP management and outcomes in home health will not easily occur without new intervention models and rigorous evaluation of their impact. Results from this trial will provide important information on potential strategies to improve BP control in a low income, chronically ill patient population. PMID:20031844

Investigating preferences for support with life after stroke: a discrete choice experiment.

PubMed

Burton, Christopher R; Fargher, Emily; Plumpton, Catrin; Roberts, Gwerfyl W; Owen, Heledd; Roberts, Eryl

2014-02-08

There is little evidence of service user preferences to guide the commissioning and improvement of services that support life after stroke. We report the first investigation of patients' and family carers' preferences for community services after stroke using a discrete choice experiment (DCE). Two workshops with patients and family carers (n = 8) explored stroke experiences, identifying attributes important in shaping views about service design, and piloted data collection strategies. Attributes were group versus individual support; service provider; additional support for social and leisure activities; and the total time required to access services. Patients and family carers were recruited six months post stroke-onset (mean 331 days) from four stroke services, and invited to participate in the DCE. Patients' general health (EQ5D) and functional dependence (Barthel Index) were also assessed. Of 474 eligible patients, 144 (30%) expressed an interest in the study, and 80 (56%) of these completed the survey questionnaire. 34 of 74 (46%) family carers recruited through patients completed the DCE. All four attributes were significant in shaping patients preferences for stroke support service delivery (p < 0.05), confirming the interpretation of workshop findings. Patients prefer help and support for emotional needs, communication problems and physical difficulties to be provided on an individual basis; and to be offered additional social and leisure activities that they are able to attend on their own. Patients would appear to prefer that voluntary organisations do not provide these services, although this may be linked to lack of experience of these services. Family carers would prefer help and support in their caring role on a one-to-one basis. Whilst health related quality of life is associated with preference for format of service, results were relatively consistent across sub-groups, with the exception of time since stroke, where social and leisure activities had a greater impact on preferences of established service users. The data provide unique insights into how preferences for community services that support life after stroke are shaped. This information can be used to inform both service re-design, and barriers to implementation that will need to be accounted for in policy shifts towards a more mixed economy of service provision.

20 CFR 404.1323 - Post-World War II service excluded.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Post-World War II service excluded. 404.1323... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services Post-World War II Veterans § 404.1323 Post-World War II service excluded. Your service was not in the active service...

20 CFR 404.1322 - Post-World War II service included.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Post-World War II service included. 404.1322... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services Post-World War II Veterans § 404.1322 Post-World War II service included. Your service was in the active service of...

20 CFR 404.1322 - Post-World War II service included.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Post-World War II service included. 404.1322... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services Post-World War II Veterans § 404.1322 Post-World War II service included. Your service was in the active service of...

20 CFR 404.1323 - Post-World War II service excluded.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Post-World War II service excluded. 404.1323... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services Post-World War II Veterans § 404.1323 Post-World War II service excluded. Your service was not in the active service...

20 CFR 404.1322 - Post-World War II service included.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Post-World War II service included. 404.1322... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services Post-World War II Veterans § 404.1322 Post-World War II service included. Your service was in the active service of...

20 CFR 404.1323 - Post-World War II service excluded.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Post-World War II service excluded. 404.1323... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services Post-World War II Veterans § 404.1323 Post-World War II service excluded. Your service was not in the active service...

20 CFR 404.1322 - Post-World War II service included.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Post-World War II service included. 404.1322... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services Post-World War II Veterans § 404.1322 Post-World War II service included. Your service was in the active service of...

20 CFR 404.1323 - Post-World War II service excluded.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Post-World War II service excluded. 404.1323... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services Post-World War II Veterans § 404.1323 Post-World War II service excluded. Your service was not in the active service...

Service evaluation of an educational intervention to improve sexual health services in primary care implemented using a step-wedge design: analysis of chlamydia testing and diagnosis rate changes.

PubMed

Town, Katy; McNulty, Cliodna A M; Ricketts, Ellie J; Hartney, Thomas; Nardone, Anthony; Folkard, Kate A; Charlett, Andre; Dunbar, J Kevin

2016-08-02

Providing sexual health services in primary care is an essential step towards universal provision. However they are not offered consistently. We conducted a national pilot of an educational intervention to improve staff's skills and confidence to increase chlamydia testing rates and provide condoms with contraceptive information plus HIV testing according to national guidelines, known as 3Cs&HIV. The effectiveness of the pilot on chlamydia testing and diagnosis rates in general practice was evaluated. The pilot was implemented using a step-wedge design over three phases during 2013 and 2014 in England. The intervention combined educational workshops with posters, testing performance feedback and continuous support. Chlamydia testing and diagnosis rates in participating general practices during the control and intervention periods were compared adjusting for seasonal trends in chlamydia testing and differences in practice size. Intervention effect modification was assessed for the following general practice characteristics: chlamydia testing rate compared to national median, number of general practice staff employed, payment for chlamydia screening, practice urban/rurality classification, and proximity to sexual health clinics. The 460 participating practices conducted 26,021 tests in the control period and 18,797 tests during the intervention period. Intention-to-treat analysis showed no change in the unadjusted median tests and diagnoses per month per practice after receiving training: 2.7 vs 2.7; 0.1 vs 0.1. Multivariable negative binomial regression analysis found no significant change in overall testing or diagnoses post-intervention (incidence rate ratio (IRR) 1.01, 95 % confidence interval (CI) 0.96-1.07, P = 0.72; 0.98 CI 0.84-1.15, P = 0.84, respectively). Stratified analysis showed testing increased significantly in practices where payments were in place prior to the intervention (IRR 2.12 CI 1.41-3.18, P < 0.001) and in practices with 6-15 staff (6-10 GPs IRR 1.35 (1.07-1.71), P = 0.012; 11-15 GPs IRR 1.37 (1.09-1.73), P = 0.007). This national pilot of short educational training sessions found no overall effect on chlamydia testing in primary care. However, in certain sub-groups chlamydia testing rates increased due to the intervention. This demonstrates the importance of piloting and evaluating any service improvement intervention to assess the impact before widespread implementation, and the need for detailed understanding of local services in order to select effective interventions.

#Vapelife: An Exploratory Study of Electronic Cigarette Use and Promotion on Instagram.

PubMed

Laestadius, Linnea I; Wahl, Megan M; Cho, Young I

2016-10-14

The growth of social networking services has enabled the sharing of electronic cigarette opinions and experiences via user-generated content. This exploratory study analyzed electronic cigarette content found on the visual social networking service, Instagram, in order to highlight public health challenges created by this content and support understanding of electronic cigarette promotion and usage. A qualitative content analysis was performed on Instagram posts made with the hashtags #ecig or #vape in October 2014. Images, text, and hashtags from 85 posts (43 #ecig, 42 #vape) were analyzed. In addition, the total number of posts made with eight key electronic cigarette hashtags was recorded at four points between March 2014 and October 2015. The total number of #vape posts on Instagram grew by 4,163,274 during the study period, while #ecig posts increased by 741,916. Of the posts examined in-depth, corporate users made up over half of posts. No posts were critical of electronic cigarettes. Few mentioned electronic cigarettes in the context of health benefits. No posts included major brands, and mod style electronic cigarettes were mentioned or depicted in over half of posts. A majority of posts included hashtags expressing vaping identity and community. In addition, users mentioned novel practices such as sub-ohming. Conclusions/Importance: Instagram users in our sample characterized electronic cigarettes primarily as novel devices rather than equivalents to cigarettes. Further, hashtag communities and identities appear to be forming around vaping. Future research should consider the public health implications of these hashtags, as well as novel electronic cigarette practices.

Online social networking by patients with diabetes: a qualitative evaluation of communication with Facebook.

PubMed

Greene, Jeremy A; Choudhry, Niteesh K; Kilabuk, Elaine; Shrank, William H

2011-03-01

Several disease-specific information exchanges now exist on Facebook and other online social networking sites. These new sources of knowledge, support, and engagement have become important for patients living with chronic disease, yet the quality and content of the information provided in these digital arenas are poorly understood. To qualitatively evaluate the content of communication in Facebook communities dedicated to diabetes. We identified the 15 largest Facebook groups focused on diabetes management. For each group, we downloaded the 15 most recent "wall posts" and the 15 most recent discussion topics from the 10 largest groups. Four hundred eighty unique users were identified in a series of 690 comments from wall posts and discussion topics. Posts were abstracted and aggregated into a database. Two investigators evaluated the posts, developed a thematic coding scheme, and applied codes to the data. Patients with diabetes, family members, and their friends use Facebook to share personal clinical information, to request disease-specific guidance and feedback, and to receive emotional support. Approximately two-thirds of posts included unsolicited sharing of diabetes management strategies, over 13% of posts provided specific feedback to information requested by other users, and almost 29% of posts featured an effort by the poster to provide emotional support to others as members of a community. Approximately 27% of posts featured some type of promotional activity, generally presented as testimonials advertising non-FDA approved, "natural" products. Clinically inaccurate recommendations were infrequent, but were usually associated with promotion of a specific product or service. Thirteen percent of posts contained requests for personal information from Facebook participants. Facebook provides a forum for reporting personal experiences, asking questions, and receiving direct feedback for people living with diabetes. However, promotional activity and personal data collection are also common, with no accountability or checks for authenticity.

Lifestyle change in the cancer setting using 'the teachable moment': protocol for a proof-of-concept pilot in a urology service.

PubMed

Lee, Alyssa Sara; Ozakinci, Gozde; Leung, Steve; Humphris, Gerry; Dale, Hannah; Hamlet, Neil

2016-01-01

Previous research has shown diagnosis or screening for cancer may be a 'teachable moment' for prevention through lifestyle change. Previous trials have been successful but have been delivered via national programmes targeting patients being screened for colorectal cancer. This manuscript reports the protocol for a proof-of-concept study to assess the feasibility and acceptability of a lifestyle change service targeting men suspected or diagnosed with cancer of the prostate in a secondary care cancer service within the UK. Lifestyle change will be promoted through integration of a lifestyle change service in a urology department in one NHS Board. The service is delivered by a Health Psychologist and uses motivational interviewing and behavioural change techniques to motivate and support patients to consider and address topics such as increasing physical activity and a healthy diet, smoking cessation, alcohol reduction and weight loss. A service evaluation will assess feasibility and acceptability via a patient experience survey, a survey exploring staff knowledge, attitudes and practice, pre- and post-intervention lifestyle behaviour survey and an audit of routine patient database. This pilot will assess the viability of using cancer testing and diagnosis as a teachable moment for lifestyle change in a unique population (i.e. men with suspected cancer of the prostate). If successful, this approach offers potential for preventative services to enhance routine and person-centred clinical cancer care provided within secondary care settings.

Implementation of the affordable care act: a case study of a service line co-management company.

PubMed

Lanese, Bethany

2016-09-19

Purpose The purpose of this paper is to test and measure the outcome of a community hospital in implementing the Affordable Care Act (ACA) through a co-management arrangement. RQ1: do the benefits of a co-management arrangement outweigh the costs? RQ2: does physician alignment aid in the effective implementation of the ACA directives set for hospitals? Design/methodology/approach A case study of a 350-bed non-profit community hospital co-management company. The quantitative data are eight quarters of quality metrics prior and eight quarters post establishment of the co-management company. The quality metrics are all based on standardized national requirements from the Joint Commission and Centers for Medicare and Medicaid Services guidelines. These measures directly impact the quality initiatives under the ACA that are applicable to all healthcare facilities. Qualitative data include survey results from hospital employees of the perceived effectiveness of the co-management company. A paired samples difference of means t-test was conducted to compare the timeframe before co-management and post co-management. Findings The findings indicate that the benefits of a co-management arrangement do outweigh the costs for both the physicians and the hospital ( RQ1). The physicians benefit through actual dollar payout, but also with improved communication and greater input in running the service line. The hospital benefits from reduced cost - or reduced penalties under the ACA - as well as better communication and greater physician involvement in administration of the service line. RQ2: does physician alignment aid in the effective implementation of the ACA directives set for hospitals? The hospital improved in every quality metric under the co-management company. A paired sample difference of means t-test showed a statistically significant improvement in five of the six quality metrics in the study. Originality/value Previous research indicates the potential effectiveness of co-management companies in improving healthcare delivery and hospital-physician relations (Sowers et al., 2013). The current research takes this a step further to show that the data do in fact support these concepts. The hospital and the physicians carrying out the day-to-day actions have shared goals, better communication, and improved quality metrics under the co-management company. As the number of co-management companies increases across the USA, more research can be directed at determining their overall impact on quality care.

Dynamic and Quasi-Static Grade Crossing Collision Tests

DOT National Transportation Integrated Search

2009-03-02

To support the development of a proposed rule [1], a fullscale : dynamic test and two full-scale quasi-static tests have : been performed on the posts of a state-of-the-art (SOA) end : frame. These tests were designed to evaluate the dynamic and : qu...

Development and process evaluation of a Web-based responsible beverage service training program.

PubMed

Danaher, Brian G; Dresser, Jack; Shaw, Tracy; Severson, Herbert H; Tyler, Milagra S; Maxwell, Elisabeth D; Christiansen, Steve M

2012-09-22

Responsible beverage service (RBS) training designed to improve the appropriate service of alcohol in commercial establishments is typically delivered in workshops. Recently, Web-based RBS training programs have emerged. This report describes the formative development and subsequent design of an innovative Web-delivered RBS program, and evaluation of the impact of the program on servers' knowledge, attitudes, and self-efficacy. Formative procedures using focus groups and usability testing were used to develop a Web-based RBS training program. Professional alcohol servers (N = 112) who worked as servers and/or mangers in alcohol service settings were recruited to participate. A pre-post assessment design was used to assess changes associated with using the program. Participants who used the program showed significant improvements in their RBS knowledge, attitudes, and self-efficacy. Although the current study did not directly observe and determine impact of the intervention on server behaviors, it demonstrated that the development process incorporating input from a multidisciplinary team in conjunction with feedback from end-users resulted in creation of a Web-based RBS program that was well-received by servers and that changed relevant knowledge, attitudes, and self-efficacy. The results also help to establish a needed evidence base in support of the use of online RBS training, which has been afforded little research attention.

The effect of peer support on breast-feeding duration among primiparous women: a randomized controlled trial.

PubMed

Dennis, Cindy-Lee; Hodnett, Ellen; Gallop, Ruth; Chalmers, Beverley

2002-01-08

Most mothers stop breast-feeding before the recommended 6 months post partum. A systematic review showed that breast-feeding support programs by health care professionals did not substantially improve breast-feeding outcomes beyond 2 months post partum. We conducted a randomized controlled trial to evaluate the effect of peer (mother-to-mother) support on breast-feeding duration among first-time breast-feeding mothers. We recruited 256 breast-feeding mothers from 2 semi-urban community hospitals near Toronto and randomly assigned them to a control group (conventional care) or a peer support group (conventional care plus telephone-based support, initiated within 48 hours after hospital discharge, from a woman experienced with breast-feeding who attended a 2.5-hour orientation session). Follow-up of breast-feeding duration, maternal satisfaction with infant feeding method and perceptions of peer support received was conducted at 4, 8 and 12 weeks post partum. Significantly more mothers in the peer support group than in the control group continued to breast-feed at 3 months post partum (81.1% v. 66.9%, p = 0.01) and did so exclusively (56.8% v. 40.3%, p = 0.01). Breast-feeding rates at 4, 8 and 12 weeks post partum were 92.4%, 84.8% and 81.1% respectively among the mothers in the peer support group, as compared with 83.9%, 75.0% and 66.9% among those in the control group (p < or = 0.05 for all time periods). The corresponding relative risks were 1.10 (95% confidence interval [CI] 1.01-2.72) at 4 weeks, 1.13 (95% CI 1.00-1.28) at 8 weeks and 1.21 (95% CI 1.04-1.41) at 12 weeks post partum. In addition, when asked for an overall rating of their feeding experience, significantly fewer mothers in the peer support group than in the control group were dissatisfied (1.5% v. 10.5%) (p = 0.02). Of the 130 mothers who evaluated the peer support intervention, 81.6% were satisfied with their peer volunteer experience and 100% felt that all new breast-feeding mothers should be offered this peer support intervention. The telephone-based peer support intervention was effective in maintaining breast-feeding to 3 months post partum and improving satisfaction with the infant feeding experience. The high satisfaction with and acceptance of the intervention indicates that breast-feeding peer support programs, in conjunction with professional health services, are effective.

The effect of peer support on breast-feeding duration among primiparous women: a randomized controlled trial

PubMed Central

Dennis, Cindy-Lee; Hodnett, Ellen; Gallop, Ruth; Chalmers, Beverley

2002-01-01

Background Most mothers stop breast-feeding before the recommended 6 months post partum. A systematic review showed that breast-feeding support programs by health care professionals did not substantially improve breast-feeding outcomes beyond 2 months post partum. We conducted a randomized controlled trial to evaluate the effect of peer (mother-to-mother) support on breast-feeding duration among first-time breast-feeding mothers. Methods We recruited 256 breast-feeding mothers from 2 semi-urban community hospitals near Toronto and randomly assigned them to a control group (conventional care) or a peer support group (conventional care plus telephone-based support, initiated within 48 hours after hospital discharge, from a woman experienced with breast-feeding who attended a 2.5-hour orientation session). Follow-up of breast-feeding duration, maternal satisfaction with infant feeding method and perceptions of peer support received was conducted at 4, 8 and 12 weeks post partum. Results Significantly more mothers in the peer support group than in the control group continued to breast-feed at 3 months post partum (81.1% v. 66.9%, p = 0.01) and did so exclusively (56.8% v. 40.3%, p = 0.01). Breast-feeding rates at 4, 8 and 12 weeks post partum were 92.4%, 84.8% and 81.1% respectively among the mothers in the peer support group, as compared with 83.9%, 75.0% and 66.9% among those in the control group (p ≤ 0.05 for all time periods). The corresponding relative risks were 1.10 (95% confidence interval [CI] 1.01–2.72) at 4 weeks, 1.13 (95% CI 1.00–1.28) at 8 weeks and 1.21 (95% CI 1.04–1.41) at 12 weeks post partum. In addition, when asked for an overall rating of their feeding experience, significantly fewer mothers in the peer support group than in the control group were dissatisfied (1.5% v. 10.5%) (p = 0.02). Of the 130 mothers who evaluated the peer support intervention, 81.6% were satisfied with their peer volunteer experience and 100% felt that all new breast-feeding mothers should be offered this peer support intervention. Interpretation The telephone-based peer support intervention was effective in maintaining breast-feeding to 3 months post partum and improving satisfaction with the infant feeding experience. The high satisfaction with and acceptance of the intervention indicates that breast-feeding peer support programs, in conjunction with professional health services, are effective. PMID:11800243

How home HIV testing and counselling with follow-up support achieves high testing coverage and linkage to treatment and prevention: a qualitative analysis from Uganda.

PubMed

Ware, Norma C; Wyatt, Monique A; Asiimwe, Stephen; Turyamureeba, Bosco; Tumwesigye, Elioda; van Rooyen, Heidi; Barnabas, Ruanne V; Celum, Connie L

2016-01-01

The successes of HIV treatment scale-up and the availability of new prevention tools have raised hopes that the epidemic can finally be controlled and ended. Reduction in HIV incidence and control of the epidemic requires high testing rates at population levels, followed by linkage to treatment or prevention. As effective linkage strategies are identified, it becomes important to understand how these strategies work. We use qualitative data from The Linkages Study, a recent community intervention trial of community-based testing with linkage interventions in sub-Saharan Africa, to show how lay counsellor home HIV testing and counselling (home HTC) with follow-up support leads to linkage to clinic-based HIV treatment and medical male circumcision services. We conducted 99 semi-structured individual interviews with study participants and three focus groups with 16 lay counsellors in Kabwohe, Sheema District, Uganda. The participant sample included both HIV+ men and women (N=47) and HIV-uncircumcised men (N=52). Interview and focus group audio-recordings were translated and transcribed. Each transcript was summarized. The summaries were analyzed inductively to identify emergent themes. Thematic concepts were grouped to develop general constructs and framing propositional statements. Trial participants expressed interest in linking to clinic-based services at testing, but faced obstacles that eroded their initial enthusiasm. Follow-up support by lay counsellors intervened to restore interest and inspire action. Together, home HTC and follow-up support improved morale, created a desire to reciprocate, and provided reassurance that services were trustworthy. In different ways, these functions built links to the health service system. They worked to strengthen individuals' general sense of capability, while making the idea of accessing services more manageable and familiar, thus reducing linkage barriers. Home HTC with follow-up support leads to linkage by building "social bridges," interpersonal connections established and developed through repeated face-to-face contact between counsellors and prospective users of HIV treatment and male circumcision services. Social bridges link communities to the service system, inspiring individuals to overcome obstacles and access care.

Distance education for tobacco reduction with Inuit frontline health workers.

PubMed

Collins, Rob; Hammond, Merryl; Carry, Catherine L; Kinnon, Dianne; Killulark, Joan; Nevala, Janet

2013-01-01

Tobacco reduction is a major priority in Canadian Inuit communities. However, many Inuit frontline health workers lacked the knowledge, confidence and support to address the tobacco epidemic. Given vast distances, high costs of face-to-face training and previous successful pilots using distance education, this method was chosen for a national tobacco reduction course. To provide distance education about tobacco reduction to at least 25 frontline health workers from all Inuit regions of Canada. Promising practices globally were assessed in a literature survey. The National Inuit Tobacco Task Group guided the project. Participants were selected from across Inuit Nunangat. They chose a focus from a "menu" of 6 course options, completed a pre-test to assess individual learning needs and chose which community project(s) to complete. Course materials were mailed, and trainers provided intensive, individualized support through telephone, fax and e-mail. The course ended with an open-book post-test. Follow-up support continued for several months post-training. Of the 30 participants, 27 (90%) completed the course. The mean pre-test score was 72% (range: 38-98%). As the post-test was done using open books, everyone scored 100%, with a mean improvement of 28% (range: 2-62%). Although it was often challenging to contact participants through phone, a distance education approach was very practical in a northern context. Learning is more concrete when it happens in a real-life context. As long as adequate support is provided, we recommend individualized distance education to others working in circumpolar regions.

Testing and reference model analysis of FTTH system

NASA Astrophysics Data System (ADS)

Feng, Xiancheng; Cui, Wanlong; Chen, Ying

2009-08-01

With rapid development of Internet and broadband access network, the technologies of xDSL, FTTx+LAN , WLAN have more applications, new network service emerges in endless stream, especially the increase of network game, meeting TV, video on demand, etc. FTTH supports all present and future service with enormous bandwidth, including traditional telecommunication service, traditional data service and traditional TV service, and the future digital TV and VOD. With huge bandwidth of FTTH, it wins the final solution of broadband network, becomes the final goal of development of optical access network.. Fiber to the Home (FTTH) will be the goal of telecommunications cable broadband access. In accordance with the development trend of telecommunication services, to enhance the capacity of integrated access network, to achieve triple-play (voice, data, image), based on the existing optical Fiber to the curb (FTTC), Fiber To The Zone (FTTZ), Fiber to the Building (FTTB) user optical cable network, the optical fiber can extend to the FTTH system of end-user by using EPON technology. The article first introduced the basic components of FTTH system; and then explain the reference model and reference point for testing of the FTTH system; Finally, by testing connection diagram, the testing process, expected results, primarily analyze SNI Interface Testing, PON interface testing, Ethernet performance testing, UNI interface testing, Ethernet functional testing, PON functional testing, equipment functional testing, telephone functional testing, operational support capability testing and so on testing of FTTH system. ...

Testing and evaluation of sign support with cluster attachments.

DOT National Transportation Integrated Search

1990-04-01

Two full-scale crash tests were conducted on the Louisiana two-post, inclined, slip-base sign assembly with cluster sign attachment. These two tests were performed and evaluated in accordance with guidelines under NCHRP Report 230 and standards estab...

Training children aged 5-10 years in manual compliance control to improve drawing and handwriting.

PubMed

Bingham, Geoffrey P; Snapp-Childs, Winona

2018-04-12

A large proportion of school-aged children exhibit poor drawing and handwriting. This prevalence limits the availability of therapy. We developed an automated method for training improved manual compliance control and relatedly, prospective control of a stylus. The approach included a difficult training task, while providing parametrically modifiable support that enables the children to perform successfully while developing good compliance control. The task was to use a stylus to push a bead along a 3D wire path. Support was provided by making the wire magnetically attractive to the stylus. Support was progressively reduced as 3D tracing performance improved. We report studies that (1) compared performance of Typically Developing (TD) children and children with Developmental Coordination Disorder (DCD), (2) tested training with active versus passive movement, (3) tested progressively reduced versus constant or no support during training, (4) tested children of different ages, (5) tested the transfer of training to a drawing task, (6) tested the specificity of training in respect to the size, shape and dimensionality of figures, and (7) investigated the relevance of the training task to the Beery VMI, an inventory used to diagnose DCD. The findings were as follows. (1) Pre-training performance of TD and DCD children was the same and good with high support but distinct and poor with low support. Support yielded good self-efficacy that motivated training. Post training performance with no support was improved and the same for TD and DCD children. (2) Actively controlled movements were required for improved performance. (3) Progressively reduced support was required for good performance during and after training. (4) Age differences in performance during pre-training were eliminated post-training. (5) Improvements transferred to drawing. (6) There was no evidence of specificity of training in transfer. (7) Disparate Beery scores were reflected in pre-training but not post-training performance. We conclude that the method improves manual compliance control, and more generally, prospective control of movements used in drawing performance. Copyright © 2018. Published by Elsevier B.V.

Evaluation of a liaison librarian program: client and liaison perspectives.

PubMed

Tennant, Michele R; Cataldo, Tara Tobin; Sherwill-Navarro, Pamela; Jesano, Rae

2006-10-01

This paper describes a survey-based evaluation of the five-year old Liaison Librarian Program at the University of Florida. Liaison librarians, faculty, students, staff, residents, and post-doctoral associates were queried via Web-based surveys. Questions addressed client and liaison perspectives on a variety of issues, including program and service awareness and usage, client-library relations and communication, client support for the program, and liaison workload. Approximately 43% of the 323 client respondents were aware of liaison services; 72% (n = 163) of these clients had had contact with their liaison. Ninety-five percent (n = 101) of faculty and students who reported contact with their liaison supported the continuation of the program. Liaison services were used by a greater percentage of faculty than students, although they had similar patterns of usage and reported the same "traditional" services to be most important. Liaisons indicated that communications with clients had increased, the reputation of the library was enhanced, and their workloads had increased as a result of the Liaison Librarian Program. Survey results suggest that the Liaison Librarian Program has a core set of clients who use and highly value the services provided by liaisons. Recommendations addressing workload, training, marketing, and administrative support are provided.

StreetWise: developing a serious game to support forensic mental health service users' preparation for discharge: a feasibility study.

PubMed

Reynolds, L M; Davies, J P; Mann, B; Tulloch, S; Nidsjo, A; Hodge, P; Maiden, N; Simpson, A

2017-05-01

WHAT IS KNOWN ON THE SUBJECT?: Serious gaming can support learning and development. The use of serious games for skills development and the rehearsal of the management of events that cannot be replicated in real life is well established. Few serious games have been used in mental health services, and none in forensic mental health care. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: How a serious game may be coproduced by forensic mental health service users and game developers The acceptability of the therapeutic use of serious gaming by forensic mental health service users and providers. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Computer games may be used by practitioners in their therapeutic work with forensic mental health service users. Mental health nurses to use serious games to creatively and safely bridge the gap for service users between receiving care in controlled environments and living more independent in the community. Introduction Assessment of users' skills and confidence to safely respond to risky community-based situations underpins discharge planning. Serious games have been used for skills development, and this study trialled their use in forensic mental health services. Aim The aim was to develop and test the acceptability and usability of an innovative serious game to support forensic mental health service users' preparation for discharge. Method A prototype serious game was developed by service users and researchers. Acceptability and usability testing was undertaken and service providers interviewed about the acceptability of serious gaming for forensic mental health services. Result A prototype game was produced and successfully trialled by service users. However, both service users and providers identified that work needed to be done to develop and test a game with greater complexity. Discussion The acceptability and usability of using serious games to support service users to develop skills needed for successful discharge was demonstrated. Implications for practice Mental health practitioners may use gaming to support their practice and work innovatively with other professions such as game developers to create new ways of working in forensic mental health services. © 2016 John Wiley & Sons Ltd.

The Relationship between the Role of the School Psychologist and Post-Secondary School Outcomes for Special Education Students

ERIC Educational Resources Information Center

Sher, Robert

2012-01-01

Since the federal law IDEIA of 2004 allowed for the determination of LD eligibility for Special Education services, it was expected that School Psychologists would have begun spending less time devoted to standardized tests, and more time providing other services such as counseling, consultation, and interventions. Moreover, any benefit that these…

Post-Test Inspection of NASA's Evolutionary Xenon Thruster Long-Duration Test Hardware: Discharge Chamber

NASA Technical Reports Server (NTRS)

Shastry, Rohit; Soulas, George C.

2016-01-01

The NEXT Long-Duration Test is part of a comprehensive thruster service life assessment intended to demonstrate overall throughput capability, validate service life models, quantify wear rates as a function of time and operating condition, and identify any unknown life-limiting mechanisms. The test was voluntarily terminated in February 2014 after demonstrating 51,184 hours of high-voltage operation, 918 kg of propellant throughput, and 35.5 MN-s of total impulse. The post-test inspection of the thruster hardware began shortly afterwards with a combination of non-destructive and destructive analysis techniques, and is presently nearing completion. This paper presents relevant results of the post-test inspection for the discharge chamber as well as other miscellaneous components such as the high-voltage propellant isolators and electrical cabling. Comparison of magnetic field measurements taken during pretest and post-test inspections indicate that the field strength did not degrade, consistent with performance data obtained during the test. Inspection of discharge chamber mesh samples show a deposition coating primarily composed of grid material that is approximately 15 micrometers in thickness. This thickness is well within the retention capability of the mesh and is therefore not expected to present any issues. Approximately 3.1 grams of deposition flakes were found at the bottom of the discharge chamber, composed primarily of grid material and carbon. Calculated size histograms of these flakes indicate that 99% have a maximum dimension of 200 micrometers or smaller, which is significantly less than the ion optics grid gap. Larger flakes that are capable of causing a grid-to-grid short will be analyzed to determine if their formation will occur in flight or is a facility effect. The high-voltage propellant isolators as well as numerous other electrical insulators were inspected and no evidence of arcing or any other issues were found.

The implementation of nucleic acid amplification technology testing for living tissue donors.

PubMed

Westby, J; Lomas, R J; Kearney, J N

2010-05-01

There is a significant requirement within the United Kingdom for tissue grafts from living donors. To ensure safety, blood samples from these donors are tested for pathogens at donation, and at 180 days post donation. Nucleic acid amplification technology (NAT) permits more sensitive detection of pathogens in blood samples than serum antigen testing. NAT testing can be applied to samples from living tissue donors to eliminate the need to re-test these donors 180 days post-donation before grafts can be implanted. This has major financial and operational advantages for a tissue bank, and this manuscript describes how NAT testing was assessed and implemented by NHSBT Tissue Services. When compared to traditional serum antigen testing, NAT testing was more cost effective, more convenient for donors and resulted in a greater proportion of donated grafts being made available for transplant.

[Loyalty to professional and military duty].

PubMed

Chizh, I M

1995-01-01

The author of this article--Chief of the Russian Armed Forces Medical Service--analyses the trends of optimization of medical support of the Army and Navy, taking into account the experience of combat casualty care during Chechen crisis. In order to enhance the efficiency of medical support during combat activities all the personnel is supplied with first-aid kits. Each company is reinforced with a medical assistant or army physician; battalion medical posts--with physicians, medical assistants, aidmen, mobile dressing room and ambulances; regiment medical posts--with two surgeons, an anaesthesiologist, an instrument nurse and nurse-anaesthetist. The primary medical care is provided at the battalion medical post; qualified (secondary) surgical care--at regiment medical posts, and specialized (tertiary) medical care--at special medical detachments (SMD) and military hospitals. The wounded are evacuated from the zone of combat actions by APC or MICV, and then by helicopters. The further evacuation of wounded is realized by transport or medical aircraft, including "Skalpel" flight surgery plane. The experience of army physicians has proved the necessity of multilateral development of Mobile Forces Medical Service and the formation of aeromobile hospitals. An airborne infantry battalion must have a medical company in its organic structure, and respectively a separate medical battalion must have an aeromobile medical company. The SMD which are assigned to act in the emergency situations of peaceful time also can be effective in providing medical care (including specialized care) during local military conflicts. Thinking over the further development of medical support in the Armed Forces the author assigns a number of tasks throughout all the chain of medical command, including medical establishments, medical examination boards, the Corps of Senior medical specialists (in surgery, internal medicine, pathologicoanatomy, sanitary supervision, etc). A special attention is paid to the formation of an efficient system of sanitary-epidemiological supervision in the Armed Forces; the improvement of medical assistance for servicewomen, retired officers and their dependents; the enforcement of military and labour discipline in the units and establishments of medical service; training and education of medical personnel; the strict adherence to the principles of medical ethics, deontology, and oath of physician.

20 CFR 404.1321 - Ninety-day active service requirement for post-World War II veterans.

Code of Federal Regulations, 2012 CFR

2012-04-01

... post-World War II veterans. 404.1321 Section 404.1321 Employees' Benefits SOCIAL SECURITY... of the Uniformed Services Post-World War II Veterans § 404.1321 Ninety-day active service requirement for post-World War II veterans. (a) The 90 days of active service required for post-World War II...

20 CFR 404.1321 - Ninety-day active service requirement for post-World War II veterans.

Code of Federal Regulations, 2013 CFR

2013-04-01

... post-World War II veterans. 404.1321 Section 404.1321 Employees' Benefits SOCIAL SECURITY... of the Uniformed Services Post-World War II Veterans § 404.1321 Ninety-day active service requirement for post-World War II veterans. (a) The 90 days of active service required for post-World War II...

20 CFR 404.1321 - Ninety-day active service requirement for post-World War II veterans.

Code of Federal Regulations, 2014 CFR

2014-04-01

... post-World War II veterans. 404.1321 Section 404.1321 Employees' Benefits SOCIAL SECURITY... of the Uniformed Services Post-World War II Veterans § 404.1321 Ninety-day active service requirement for post-World War II veterans. (a) The 90 days of active service required for post-World War II...

20 CFR 404.1321 - Ninety-day active service requirement for post-World War II veterans.

Code of Federal Regulations, 2011 CFR

2011-04-01

... post-World War II veterans. 404.1321 Section 404.1321 Employees' Benefits SOCIAL SECURITY... of the Uniformed Services Post-World War II Veterans § 404.1321 Ninety-day active service requirement for post-World War II veterans. (a) The 90 days of active service required for post-World War II...

Effects of an employer-based intervention on employment outcomes for youth with significant support needs due to autism.

PubMed

Wehman, Paul; Schall, Carol M; McDonough, Jennifer; Graham, Carolyn; Brooke, Valerie; Riehle, J Erin; Brooke, Alissa; Ham, Whitney; Lau, Stephanie; Allen, Jaclyn; Avellone, Lauren

2017-04-01

The purpose of this study was to develop and investigate an employer-based 9-month intervention for high school youth with autism spectrum disorder to learn job skills and acquire employment. The intervention modified a program titled Project SEARCH and incorporated the use of applied behavior analysis to develop Project SEARCH plus Autism Spectrum Disorder Supports. A randomized clinical trial compared the implementation of Project SEARCH plus Autism Spectrum Disorder Supports with high school special education services as usual. Participants were 49 high-school-aged individuals between the ages of 18 and 21 years diagnosed with an autism spectrum disorder and eligible for supported employment. Students also had to demonstrate independent self-care. At 3 months post-graduation, 90% of the treatment group acquired competitive, part-time employment earning US$9.53-US$10.66 per hour. Furthermore, 87% of those individuals maintained employment at 12 months post-graduation. The control group's employment outcomes were 6% acquiring employment by 3 months post-graduation and 12% acquiring employment by 12 months post-graduation. The positive employment outcomes generated by the treatment group provide evidence that youth with autism spectrum disorder can gain and maintain competitive employment. Additionally, there is evidence that they are able to advance within that time toward more weekly hours worked, while they also displayed increasing independence in the work setting.

22 CFR 11.2 - Written examination for appointment to class 7 or 8.

Code of Federal Regulations, 2012 CFR

2012-04-01

... written examination is designed to permit the Board to test the candidate's intelligence, breadth and quality of knowledge, and understanding. It will consist of three parts: (1) A general ability test, (2... designated cities in the United States and at Foreign Service posts on dates established by the Board of...

22 CFR 11.2 - Written examination for appointment to class 7 or 8.

Code of Federal Regulations, 2013 CFR

2013-04-01

... written examination is designed to permit the Board to test the candidate's intelligence, breadth and quality of knowledge, and understanding. It will consist of three parts: (1) A general ability test, (2... designated cities in the United States and at Foreign Service posts on dates established by the Board of...

22 CFR 11.2 - Written examination for appointment to class 7 or 8.

Code of Federal Regulations, 2010 CFR

2010-04-01

... written examination is designed to permit the Board to test the candidate's intelligence, breadth and quality of knowledge, and understanding. It will consist of three parts: (1) A general ability test, (2... designated cities in the United States and at Foreign Service posts on dates established by the Board of...

22 CFR 11.2 - Written examination for appointment to class 7 or 8.

Code of Federal Regulations, 2011 CFR

2011-04-01

... written examination is designed to permit the Board to test the candidate's intelligence, breadth and quality of knowledge, and understanding. It will consist of three parts: (1) A general ability test, (2... designated cities in the United States and at Foreign Service posts on dates established by the Board of...

22 CFR 11.2 - Written examination for appointment to class 7 or 8.

Code of Federal Regulations, 2014 CFR

2014-04-01

... written examination is designed to permit the Board to test the candidate's intelligence, breadth and quality of knowledge, and understanding. It will consist of three parts: (1) A general ability test, (2... designated cities in the United States and at Foreign Service posts on dates established by the Board of...

National Centers for Environmental Prediction

Science.gov Websites

Modeling Mesoscale Modeling Marine Modeling and Analysis Teams Climate Data Assimilation Ensembles and Post streamline the interaction of analysis, forecast, and post-processing systems within NCEP. The NEMS Force, and will eventually provide support to the community through the Developmental Test Center (DTC

Crash testing of Louisiana's 3 1/2" diameter multi-directional, single steel post, small sign support : final report.

DOT National Transportation Integrated Search

1993-03-01

The Louisiana Department of Transportation and Development (LDOTD) contracted with the Texas Transportation Institute (TTI) to evaluate the impact characteristics of Louisiana's multi-directional, 8.9 cm (3-1/2 in) diameter steel post, small sigh sup...

Lessons Learned from Optical Payload for Lasercomm Science (OPALS) Mission Operations

NASA Technical Reports Server (NTRS)

Sindiy, Oleg V.; Abrahamson, Matthew J.; Biswas, Abhijit; Wright, Malcolm W.; Padams, Jordan H.; Konyha, Alexander L.

2015-01-01

This paper provides an overview of Optical Payload for Lasercomm Science (OPALS) activities and lessons learned during mission operations. Activities described cover the periods of commissioning, prime, and extended mission operations, during which primary and secondary mission objectives were achieved for demonstrating space-to-ground optical communications. Lessons learned cover Mission Operations System topics in areas of: architecture verification and validation, staffing, mission support area, workstations, workstation tools, interfaces with support services, supporting ground stations, team training, procedures, flight software upgrades, post-processing tools, and public outreach.

Exploring the feasibility and acceptability of couple-based psychosexual support following prostate cancer surgery: study protocol for a pilot randomised controlled trial

PubMed Central

2014-01-01

Background Men who undergo surgery for prostate cancer frequently experience significant side-effects including urinary and sexual dysfunction. These difficulties can lead to anxiety, depression and reduced quality of life. Many partners also experience psychological distress. An additional impact can be on the couple relationship, with changes to intimacy, and unmet psychosexual supportive needs in relation to sexual recovery and rehabilitation. The aim of this exploratory randomised controlled trial pilot study is to determine the feasibility and acceptability of a novel family-relational-psychosexual intervention to support intimacy and reduce distress among couples following prostate cancer surgery and to estimate the efficacy of this intervention. Methods/Design The intervention will comprise six sessions of psychosexual and relationship support delivered by experienced couple-support practitioners. Specialist training in delivering the intervention will be provided to practitioners and they will be guided by a detailed treatment manual based on systemic principles. Sixty-eight couples will be randomised to receive either the intervention or standard care (comprising usual follow-up hospital appointments). A pre-test, post-test design will be used to test the feasibility of the intervention (baseline, end of intervention and six-month follow-up) and its acceptability to couples and healthcare professionals (qualitative interviews). Both individual and relational outcome measures will assess sexual functioning, anxiety and depression, couple relationship, use of health services and erectile dysfunction medication/technologies. An economic analysis will estimate population costs of the intervention, compared to usual care, using simple modelling to evaluate the affordability of the intervention. Discussion Given the increasing incidence and survival of post-operative men with prostate cancer, it is timely and appropriate to determine the feasibility of a definitive trial through a pilot randomised controlled trial of a family-relational-psychosexual intervention for couples. The study will provide evidence about the components of a couple-based intervention, its acceptability to patients and healthcare professionals, and its influence on sexual and relational functioning. Data from this study will be used to calculate sample sizes required for any definitive trial. Trial registration ClinicalTrials.gov Identifier: NCT01842438. Registration date: 24 April 2013; Randomisation of first patient: 13 May 2013 PMID:24886676

Web-based training on weapons of mass destruction response for emergency medical services personnel.

PubMed

Gershon, Robyn R M; Canton, Allison N; Magda, Lori A; DiMaggio, Charles; Gonzalez, Dario; Dul, Mitchell W

2009-01-01

To develop, implement, and assess a web-based simulation training program for emergency medical services (EMS) personnel on recognition and treatment of ocular injuries resulting from weapons of mass destruction (WMD) attacks. The training program consisted of six modules: WMD knowledge and event detection, ocular anatomy, ocular first aid (ie, flushing, cupping, and patching), and three WMD simulations (ie, sarin gas release, anthrax release, and radioactive dispersal device). Pretest, post-test, and 1-month follow-up test and a program evaluation were used to measure knowledge gain and retention and to assess the effectiveness of the program. New York State EMS. Four hundred and sixty-four individuals participated in the training program and all waves of the testing (86 percent retention rate). The effectiveness of the training intervention was measured using pretest and post-test questionnaires and analyzed using dependent t-tests. Assessment scores for overall knowledge increased from the pretest (mean = 15.7, standard deviation [SD] = 2.1) to the post-test (mean = 17.8, SD = 1.3), p < 0.001, and from pretest (mean = 15.7, SD = 2.1) to 1-month follow-up test (mean = 16.6, SD = 2.0), p < 0.001. Ninety-two percent of respondents indicated that the program reinforced understanding of WMDs. This training method provides an effective and low-cost approach to educate and evaluate EMS personnel on emergency treatment of eye trauma associated with the use of WMD. Online training should also be supplemented with hands-on practice and refresher trainings.